Ch. 23 Key Terms

Balance between clotting and bleeding

Bleeding

• Clotting
• Too much=fatal

Blood vessels

Aggregation and adhesion form small clumps at injured site, limiting blood loss

• Largest cell in the bone marrow, rarely seen in peripheral blood.
• Platelets are released from the megakaryocyte cytoplasm and enter the peripheral blood.

Cell division without cytoplasmic division (nucleus divides, but the cytoplasm does not)

Plasmin dissolves fibrin

• Blood vessel's diameter decreases.
• First responder to injury

Clot main component is protein (fibrin, glue that fills in the hole of blood vessels)

Liquid portion of a blood specimen after allowed to clot.

Liquid portion of a blood specimen after being centrifuged.

• Arteries: vessels transporting oxygen blood away from the heart.
• Vessels: transporting de-oxygenated blood back to the heart. Thinner and weaker than arteries.

Artery--Arteriole--Capillary--Venule--vein

Middle ground between arteries and veins, where oxygen is delivered to the cells. Very thin, only a single cell layer thick.

Innermost, single endothelial cell layer in contact with blood. Underneath lies collagen. Non-reactive with blood.

• Outer layer
• Connective tissue, nerve endings and the vas vasorm (layers of tissue on outside)

• Intact
• Inert with blood components.
• Traumatized, then physiologically active synthesizes and stores active chemicals

Binds to platelet membrane GP Ib/IIa

starts fibrinolysis clot dissolution

Inhibit platelet aggregation and adhesion

• Fluffy outer coat
• Regulates shape
• Platelet adhesion and aggregation

• vWF
• Thrombospondin
• Fibronectin
• Platelet fibrinogen
• Platelet factor IV
• Platelet adhesion
• Platelet aggregation

• ADP
• Serotonin (Vasoconstriction)

enzymes

• Normal count doesn't necessary mean normal function.
• Manual counts are usually performed to confirm questionable automated platelet counts.

• Performed on all CBCs
• Average # platelets per oil immersion field x 15,000

Platelets "stick" to the surfaces of damaged blood vessels

Platelets sticking to each other at the damaged vessel

attaches to other platelets with Fibrinogen

• Impairs synthesis of platelet's Thromboxane (TXA2).
• TXA2 stimulates platelet granule release.
• Platelet aggregation is impaired for the entire life span of the platelet.
• Inhibit Platelet function (aggregation) and clotting is inhibited.

• Inhibits platelet GP IIb/IIIa
• Inhibits function

Promotes vasoconstriciton

• Plasma hormone
• Promotes vasoconstriction

• Plasma protein precursor to fibrin
• Fibrinogen---Fibrin clot (insoluble)

• Stable precursor of thrombin
• Prothrombin--Thrombin (active)

• Very liable (1/2 life=16 hours)
• Consumed during clotting

• 2 complex components
• High molecular: vWF, VIII RCo (plt. aggregation), VIII Ag (Antigenic site)
• Low molecular: VIII C (procoagulant), VIII Ag (Antigenic site)

Plasma Thromboplastin component

Stuart

Plasma thromboplastin antecedent

Hangeman

Fibrin Stabilizing Factor

• 1,5,8,13
• Consumed during clotting
• 5 and 8 extremely liable
• Increased in inflammation, pregnancy, oral contraceptives.

• 2,7,9, 10
• NEEDS Vitamin K for synthesis
• Not consumed during clotting (except for 2)

• 11, 12, PK (Fletcher), HMWK (Fitzgerald)
• Stable storage/not consumed during clotting.

Activated by contact with negatively charged solid surfaces  (collagen, glass)

Activated by contact with tissue phospholipids (thromboplastin) following endothelial damage

Represents the merging of the Extrinsic and Intrinsic pathways.

• Oral anticoagulants
• Effective for long term, self-medication
• Blood thinner
• Vitamin K antagonists (inhibit Vitamin K)
• Group II (2,7,9,10)
• Synthesis in liver
• Slow acting (8-12 hours)
• Long duration (72 hours)

• Given in a hospital setting-not @ home.
• Inhibits thrombin by enhancing ATIII
• Fast acting (effective within mins after IV dosage)
• 1/2 life=1 hour

• Makes the body system avoid excessive blood flow.
• People without Vitamin K prone to bruising and bleeding.

Proteins begin the process of limiting the formation and eventual remove the clot.

• Starts fibrinolysis
• Activates plasminogen--Plasmin breaks up fibrin

Inactive

• Fragments X, Y, D, E
• Pieces of fibrin
• Inhibit platelet aggregation, fibrin polymerization, thrombin.

• Inhibits Factor 5 and 8
• Synthesized in liver
• Vitamin K dependent

• Natural anticoagulants
• Major system involved in the regulation of blood coagulation and in the protection against thrombotic diseases

• Most active natural anti-coagulant
• Inhibits thrombin (Factors 9, 10, 11, 12)
• Synthesized in liver, platelets, endothelium

Give to people with heart attack symptoms or go through one

• Any tissue (non-plasma) phospholipid substance.
• Cell membrane guts