Coagulate, form plug, prevent blood loss

Formed by fragmentation from megakaryoctyes

Figure 16-10c: Megakaryocytes and platelets

Figure 16-11: Overview of hemostasis and tissue repair

Vasoconstriction
Platelet activation
Multiple factors
Positive feedback

Aggregation
Loose plug

Figure 16-12: Platelet plug formation

1. Vascular spasm
Vessel damage
Vasospasm / vasoconstriction

presses the opposed endothelial surfaces of the vessel together

Local myogenic spasm

pain

Neural reflex

Local humoral factor

Vascular wall damage

Thromboxan A2
TXA2
thrombocyte

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2. Platelet plug
Vessel damage
Platelets are able to stick to exposed collagen proteins that have become coated
with a protein (von Willebrand factor) secreted by endothelial cells

Thrombocyte activation
swelling
Unwell shape
Sticky
Contraction of the contractile protein
ADP secretion >>
Thromboxan A2 (prostaglandin)
Thrombocyte activation
a stickiness that capable of keeping them glued together

Formation of platelet plug

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Stages
Prothrombinase
activation
Converting prothrombin
to thrombin
Converting fibrinogen to
fibrin

Pathway
Extrinsic
Intrinsic
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Widmaier EP, Raff H and Strang KT, 2004. Vander, Sherman and Lucianos Human Physiology : The Mechanism of Body
Function. 9th ed. McGraw-Hill Publishing
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Prothrombin
Ca++
Fibrinogen
Fibrin
Polymerization

Figure 16-13: The coagulation cascade

Roles of
the liver
in
clotting
Widmaier EP, Raff H and Strang KT, 2004.
Vander, Sherman and Lucianos Human
Physiology : The Mechanism of Body Function.
9th ed. McGraw-Hill Publishing
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Begin >=30 seconds after damage occurs

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Figure 1912a14

Bleeding stopped
Vessel repair
Plasmin
Fibrinolysis
Clot dissolved

Figure 16-14: Coagulation and fibrinolysis

Hemophilia
Cardiovascular Diseases

Key problem clots block undamaged blood

vessels
Anticoagulants prevent coagulation
Keep platelets from adhering
Prevent fibrin coagulation

"Clot Busters": Prevent further clotting

Speed fibrinolysis
Limit tissue damage (heart, brain)

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Unnecessary clotting is prevented by

endothelial lining the blood vessels
Platelet adhesion is prevented by:

The smooth endothelial lining of blood vessels

Heparin and PGI2 secreted by endothelial cells
Vitamin E quinone, a potent anticoagulant

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Platelet activation initiates clot formation

Clotting prevents blood loss but is a problem
in cardiovascular disease

Guyton AC and Hall JE, 2006. Textbook of Medical

Physiology. 11th ed. Philadelphia: WB. Saunders Co
Ganong WF, 2005. Review of Medical Physiology. 22nd
ed. New York: Lange Medical Books / McGraw-Hill
Medical Publishing Division
Silverthorn DU, 2004. Human Physiology, An
integrated Approach. 3rd ed. Pearson education Inc.
publishing as Benjamin Cummings
Silbernagl S and Lang F. 2000. Color Atlas of
Patophysiology. 2nd ed. GeorgThiemeVerlag,
Stuttgart,Germany.
Widmaier EP, Raff H and Strang KT, 2004. Vander,
Sherman and Lucianos Human Physiology : The
Mechanism of Body Function. 9th ed. McGraw-Hill
Publishing
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