HAEMOSTASIS and

THROMBOSIS

Wahyu Djatmiko
Blood
The fluid that circulates in the blood vessels of
the body

Homeostasis
Constant conditions within organisms in
interaction with external environment.

Haemostasis
Stoppage of bleeding from the blood vessels

stoppage of bleeding from the blood

 Three Haemostatic Components

Extra-vascular

The tissues surrounding blood vessels involved in

hemostasis when local vessel is injured.

It plays a part in Hemostasis by providing back-

pressure on the injured vessel through swelling and
trapping of escaped blood
 Vascular
The blood vessels through which blood flow, it depends
on the size, amount, of smooth muscle within their walls
and integrity of the endothelial cell lining.

Intra Vascular
The platelets and plasma proteins that circulate within
the blood vessels.
These components are involved in Coagulation (clot or
thrombus formation) or Fibrinolysis (clot or thrombus
dissolution).
This over all process consists of 4 parts
Vascular constriction

Platelet activation by thrombin

The clot formed

Fibrinolysis by Plasmin
HAEMOSTASIS PROCESS
HAEMOSTASIS PROCESS Cont...
Role of Blood Vessels
Blood flows through the vascular system to and from all
parts of the body. The vascular system consists of
capillaries, arteries, and veins.
Blood normally carried within vessels whose physical
capabilities include Contraction (narrowing) and
dilation, which are controlled by the smooth muscle of
the vessel media.
Vasoconstriction and Vasodilatation provide the means
for control blood flow rate and blood pressure.
Substances released from the endothelial cells and sub-
endothelial smooth muscles also contribute to normal
blood flow and prevent abnormal formation of clot.
 The Role of Platelets
Anucleate cellular fragments; multiple granules,
multiple organelles.
Synthesis controlled by IL-6, IL-3, IL-11, & thrombopoietin
Circulate as inactive, non-binding concave discs
On stimulation, undergo major shape change
Activation of platelets alters the permeability of the
membrane and allows entry of calcium and release of
chemotactic substances that attract coagulation factors
to the surface.
Develop receptors for clotting factors.
Develop ability to bind to each other & subendothelium
Disorders of platelets : - functional disorders
- disorders in the number of platelets
The Role of Coagulation
The process of forming clots/semisolid lumps in a
Liquid.

Mechanism

Two pathways lead to the formation of a fibrin clot: the

intrinsic and extrinsic pathway. Although they are
initiated by distinct mechanisms.
Both pathways are complex and involve numerous
different proteins termed clotting factors.
Extrinsic Pathway
Fibrin clot formation in response to tissue injury is the
most clinically relevant event of homeostasis under
normal physiological conditions. This process is the result
of the activation of the extrinsic pathway.

Intrinsic Pathway
The formation of a red thrombus or a clot in response to an
abnormal vessel wall in the absence of tissue injury
is the result of the intrinsic pathway.
Coagulation Cascade

Siemens.com/coagulation
New Coagulation Cascade

www.sigmaaldrich.com
Haemostasis

Without this balance, the individual may experience either

excessive bleeding (poor clot formation or excessive Fibrinolysis)

Vaso-occlusion (uncontrolled formation of thrombin in vascular

system, occluding vessels and depriving organs of blood).
 Bleeding
Purpura is purple-colored spots and patches that occur on the
skin, and in mucus membranes, including the lining of the
mouth.
Purpura occurs when small blood vessels leak blood under the
skin.
When purpura spots are less than 3 millimeters in diameter,
they are called peteciae
Purpura spots larger than 1 centimeter are called ecchymoses.
Rudolf Virchow
1821-1902

VIRCHOWS TRIAD
Arterial Thrombosis
Venous Thrombosis
TAKE HOME MESSAGE
Thank You