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0. Foundations of Medicine > Circulation : Thrombosis > Flashcards

Circulation : Thrombosis Flashcards

1
Q

<p>What is the lining of an artery composed of?</p>

A

<p>Several endothelial cell, making a basal lamina to 'sit on'</p>

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2
Q

<p>What is found around the basal lamina of an artery?</p>

A

<p>Smooth muscle cells</p>

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3
Q

<p>What is found around the smooth muscle cells around an artery?</p>

A

<p>Interstitial collagen fibres</p>

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4
Q

<p>What is the middle of an artery called?</p>

A

<p>Lumen</p>

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5
Q

<p>What does the lumen of an artery contain?</p>

A

<p>Red blood cells</p>

<p>White blood cells</p>

<p>Platelets</p>

<p>Plasma</p>

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6
Q

<p>What is the colour of platelets and what size are they?</p>

A

<p>White and small</p>

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7
Q

<p>What are platelets not normally exposed to which is important in terms of thrombosis?</p>

A

<p>Interstitial collagen fibres</p>

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8
Q

<p>What does the plasma consist of?</p>

A

<p>Water</p>

<p>Numerous proteins</p>

<p>Clotting factors</p>

<p>Other molecules</p>

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9
Q

<p>What is serum?</p>

A

<p>Plasma without clotting factors</p>

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10
Q

<p>Where are clotting factors produced?</p>

A

<p>Liver or by epithelial cells</p>

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11
Q

<p>How are clotting factors named?</p>

A

<p>With a roman number, such as Factor VII</p>

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12
Q

<p>What kind of system are clotting factors?</p>

A

<p>Amplification system resulting in thrombin production</p>

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13
Q

<p>What do clotting factors result in the formation of?</p>

A

<p>Thrombin</p>

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14
Q

<p>What does thrombin do?</p>

A

<p>Converts soluble fibrinogen into insoluble fibrin</p>

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15
Q

<p>What is the process of damage to the formation off fibrin known as?</p>

A

<p>Clotting cascade which is an amplification system</p>

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16
Q

<p>What does TP stand for in terms of clotting?</p>

A

<p>Tissue factor</p>

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17
Q

<p>What is the basic process of the formation of fibrin?</p>

A

<p>1) Damage to vessel</p>

<p>2) Tissue factor is exposed</p>

<p>3) Tissue factor combines with clotting factor to convert prothrombin into thrombin</p>

<p>4) Thrombin converts fibrinogen into fibrin</p>

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18
Q

<p>What could the initial damage of the vessel be due to?</p>

A

<p>Trauma</p>

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19
Q

<p>What does trauma causing vessel damage lead to?</p>

A

<p>1) Exposure of interstitial collagen</p>

<p>2) Exposure of molecule called a tissue factor</p>

<p>3) Blood leaks out and the serum comes into contact with the interstitial collagen fibres, where plasma clotting factors are activated</p>

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20
Q

<p>What is interstitial collagen?</p>

A

<p>Collagen in connective tissues between structures</p>

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21
Q

<p>Where are tissue factors released from?</p>

A

<p>Smooth muscle cells</p>

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22
Q

<p>What exposes and releases tissue factors from smooth muscle cells?</p>

A

<p>Trauma</p>

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23
Q

<p>What does the tissue factor do?</p>

A

<p>Binds to the clotting factor and initiates the clotting cascade</p>

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24
Q

<p>What are many clotting factors?</p>

A

<p>Serine proteases, which have serine amino acids in them and they cleave other clotting factors to form the active molecules</p>

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25
Q

<p>What do many clotting factors do?</p>

A

<p>Cleave other clotting factors to form the active molecule</p>

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26
Q

<p>What is the difference between fibrin and fibrinogen?</p>

A

<p>Fibrinogen is a small soluble molecule, whereas fibrin is a large aggregate of insoluble strands</p>

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27
Q

<p>What is the end point of the clotting cascade?</p>

A

<p>The formation of fibrin from fibrinogen</p>

28
Q

<p>Where are platelets produced?</p>

A

<p>In bone marrow</p>

29
Q

<p>What cells are platelets formed from?</p>

A

<p>Megakaryocyte</p>

30
Q

<p>Why do megakaryocytes get so big?</p>

A

<p>They undergo nuclear division but not cell division so have many nuclei</p>

31
Q

<p>How do platelets leave megakaryocytes?</p>

A

<p>Bud off as fragements from cytoplasmic extension, they are very small</p>

32
Q

<p>What is the process of platelets working?</p>

A

<p>1) Trauma to vessel exposes platelets to interstitial collagen</p>

<p>2) Platelets try to form a bridge to closs the gap</p>

33
Q

<p>What is coagulation?</p>

A

<p>Solidification of blood</p>

34
Q

<p>What are the 2 types of coagulation?</p>

A

<p>Thrombus formation</p>

<p>Clot formation</p>

35
Q

<p>Where does thrombus formation occur?</p>

A

<p>In flowing blood</p>

36
Q

<p>What colour is a pure thrombus?</p>

A

<p>Pale cream</p>

37
Q

<p>What does a thrombus consist of?</p>

A

<p>Platelets and a mesh like network of fibrin strands</p>

38
Q

<p>What is thrombosis?</p>

A

<p>The process of thrombus formation which occurs in flowing blood</p>

39
Q

<p>How to platelets adhere to interstitial collagen?</p>

A

<p>Molecules on their surface, this is how they can do so in flowing blood</p>

40
Q

<p>What enhances the surface molecules of platelets that allow it to adhere to interstitial collagen in flowing blood?</p>

A

<p>Factor VIII</p>

41
Q

<p>What is the process of clot formation?</p>

A

<p>1) Blood leaks out off a vessel and becomes stationary</p>

<p>2) Clotting cascade is activated next to the stationary blood sitting next to the interstitial collagen</p>

<p>3) Clot consists of network of fibrin strands and red blood cells</p>

42
Q

<p>What is haemostasis?</p>

A

<p>Stopping bleeding</p>

43
Q

<p>What is the process of haemostasis in normal skin with a wound?</p>

A

<p>1) Vessel in skin is surrounded by collagen</p>

<p>2) Blood flows through vessel in the skin</p>

<p>3) Trauma disrupts one side of the vessel</p>

<p>4) Blood leaks out</p>

<p>5) Clotting system is activated by collagen and by the stationary blood, forming a clot</p>

<p></p>

<p>If this does not work correctly the process goes on:</p>

<p>6) Vessel continues to bleed</p>

<p>7) Vasocontricts to decrease blood loss</p>

<p>8) Platelets and fibrin form thrombus to bridge the gap between the ends of the vessel adjacent to flowing blood</p>

<p>9) Skin stops bleeding so haemostasis has been achieved</p>

44
Q

<p>What happens if the formation of a clot does not stop bleeding in the skin?</p>

A

<p>1) Vessel vasoconstricts to decrease blood loss</p>

<p>2) Platelets and fibrin form thrombus to bridge the gap between the end ends of the vessel adjacent to flowing blood</p>

<p>3) Skin stops bleeding so haemostasis has been achieved</p>

45
Q

<p>What occurs in any wound due to trauma where there may be bleeding?</p>

A

<p>Vasoconstriction helps reduce bleeding</p>

<p>Clot formation occur in space around vessel and may fill void of wounded tissue</p>

<p>Thrombus forms in flowing blood and stops bleeding from gaps in vessels</p>

46
Q

<p>What is granulation tissue?</p>

A

<p>After healing new vessels can grow into area of wound</p>

47
Q

<p>What do the capillaries that grow in granulation tissue do?</p>

A

<p>Oxygenate the area of the wound and keep it alive</p>

48
Q

<p>What does stagnant mean?</p>

A

<p>Stationary</p>

49
Q

<p>When is thrombosis good?</p>

A

<p>If it allows blood to flow along the vessel</p>

50
Q

<p>When is thrombosis bad?</p>

A

<p>If it blocks the vessel</p>

<p>It causes stationary blood behind it which results in clotting</p>

51
Q

<p>What does thrombosis blocking a vessel lead to?</p>

A

<p>Ischaemiae (lack of blood flow to tissues)</p>

<p>Hypoxia (lack of oxygen in tissues)</p>

52
Q

<p>What is ischaemia?</p>

A

<p>Lack of blood flow to tissues</p>

53
Q

<p>What is hypoxia?</p>

A

<p>Lack of oxygen in tissues</p>

54
Q

<p>What eventually happens after thrombosis?</p>

A

<p>The vessel wall repairs itself and the thrombus is removed</p>

55
Q

<p>What is the thombus removed by?</p>

A

<p>Fibrinolytic system which removes fibrin and stops thombi from propogating</p>

56
Q

<p>What does the fibrinolytic system do?</p>

A

<p>Removes fibrin and stops thombi from propogating</p>

57
Q

<p>What does the fibrinolytic system depend on?</p>

A

<p>Plasma protein called plasminogen being converted to plasmin</p>

<p>Plasmin cutes up fibrin into fibrin degradation products</p>

58
Q

<p>What is the precurser of plasmin?</p>

A

<p>Plasminogen</p>

59
Q

<p>What does plasmin do?</p>

A

<p>Cuts up fibrin into fibrin degradation products</p>

60
Q

<p>What is the fibrinolytic system normally in balance with?</p>

A

<p>The clotting system</p>

61
Q

<p>What is important at the site of injury to limit the extent of the evolving thrombus?</p>

A

<p>Plasmin generation</p>

62
Q

<p>What is thrombosis and clotting normal in?</p>

A

<p>Wound healing</p>

<p>Stopping bleeding during menstruation</p>

<p>Some embryonic processes</p>

63
Q

<p>When is thrombosis and clotting abnormal?</p>

A

<p>Vessels which have abnormal walls (such as affected by atheromas)</p>

<p>Blood which has abnormal constituents (the clotting system or platelets are abnormal)</p>

<p>Abnormal flow in vessel</p>

64
Q

<p>What are the 3 things associated with abnormal thrombosis and clotting called?</p>

A

<p>Virchow's triad</p>

65
Q

<p>What are the 3 things of virchow's triad?</p>

A

<p>Abnormalities of vessel wall</p>

<p>Abnormalities of constituents of the blood</p>

<p>Abnormalities of vessel flow</p>

66
Q

<p>What are thrombi composed of?</p>

A

<p>Platelets mixed with fibrin, forming in flowing blood</p>

67
Q

<p>What does a clot consist of?</p>

A

<p>Fibrin admixes with red blood cells, forming in stationary blood</p>

0. Foundations of Medicine (167 decks)

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