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PCS > Unit 2 - blood vessels/ haemostasis > Flashcards

Unit 2 - blood vessels/ haemostasis Flashcards

1
Q

what are the three layers of blood vessel wall

A

tunica intima
tunica media
tunica adventitia

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2
Q

what consists the tunica intima?

A 
endothelium
subendothelium (collagen)
internal elastic lamina
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3
Q

what is the function of the tunica media?

A

provides structural support (smooth muscle fibres - arranged in lamellae) and vasoreactivity (vasoconstriction/dilation)

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4
Q

what is the difference in the thickness of tunica media in arteries and veins?

A

thicker in arteries

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5
Q

what components are found in the tunica adventitia?

A

fibroblasts
vaso vasorum - nutrients/ remove waste from wall
nervi vasorum - regulate vasoreactivity

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6
Q

where does atherosclerosis have its effect?

A

plaque between tunica intima and media

- contains foam cells and smooth muscle cells

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7
Q

how does scurvy affect blood vessels?

A

production of structural faulty collagen - loss of vessel integrity

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8
Q

what proteins are found in blood?

A

haemostatic proteins = coagulation factors/ fibrinolytic system/ regulatory
transport: specific/ non-specific

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9
Q

give example of specific transport proteins

A

lipoproteins
VLDL/ LDL - atherogenic
HDL - anti-atherogenic

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10
Q

give example of non-specific transport protein

A

albumin

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11
Q

what clinical tests are used to analyse liquid component of blood?

A

coagulation screen/ BMP (basic metabolic panel)/ cholesterol test

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12
Q

what is the first step of haemostasis?

A

vessel constriction - damaged endothelium - localised contractile response of smooth muscle causes narrowing of blood vessels:
decreased blood flow/ increased shear force/ decreased blood volume

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13
Q

what is the first stage of clot formation?

A

primary haemostasis

  • loss of endothelial cells exposes collagen in subendothelium so von Willebrand factor binds directly
  • conformational change in VWF allows it to bind to platelets to begin formation of soft clot
  • platelets also bind to the collagen directly using platelet glycoprotein receptors
  • platelet activation: change of shape/ release of molecules/ surface negatively charged
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14
Q

explain the intrinsic pathway

A

XIIa →XIa →IXa.VIIIa→X→Xa.Va→IIa (→fibrinogen to fibrin)

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15
Q

explain the extrinsic pathway

A

TFVIIa→X→Xa.Va→IIa (→fibrinogen to fibrin)

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16
Q

what is the common pathway?

A

Xa.Va→IIa (→fibrinogen to fibrin)

17
Q

what is coagulator factor II and IIa known as?

A

prothrombin and thrombin

18
Q

fibrin polymers are cross connected to the clot by?

A

FXIIIa

19
Q

what is the classical model of fibrin formation?

A

intrinsic/ extrinsic pathway

20
Q

what are three components to the cell-based model?

A

initiation
amplification
propagation

21
Q

describe initiation

A

small amounts of coagulation factors diffuse from vasculature into surrounding tissues and become non-specifically activated
= similar to extrinsic pathway (apart from Va)
TFVIIa→Xa→IIa

22
Q

describe amplification

A

coagulation factors from blood come into contact with thrombin produced which is a potent activator leading to activation of platelets and substrate coagulation factors (Va/ VIIIa/ XIa)

23
Q

describe propagation

A

formation of IXa.VIIIa complex which has high affinity for negatively charged platelets
- similar to intrinsic pathway to produce more thrombin -thrombin burst(IXa.VIIIa→X→Xa.Va→IIa (→fibrinogen to fibrin)
complexes bind to phospholipid surface are adjacent to each other - efficient process

24
Q

what is the three types of haemophilia?

A

A - factor XIII deficiency
B - factor IX deficiency
C -factor XI deficiency
(activity of IXa.VIIIa complex compromised - inefficient fibrin formation)

25
Q

give 3 tests of haemostasis

A

APTT - activated partial thromboplastin time (time of intrinsic pathway)
PT - prothrombin time (time of extrinsic pathway)
fibrinogen/ claus assay - how much fibrinogen present

26
Q

what is INR?

A

international normalised ratio - monitors anticoagulant therapy for patients with thrombosis treated with warfarin

27
Q

what is the clinical presentation of a patient with haemophilia A?

A

subcutaneous haematoma

28
Q

what is the clinical presentation of a patient with haemophilia B?

A

joint bleed in knee (ankles)

29
Q

what is the effect of DVT?

A

deep vein thrombosis - thrombus impairs blood flow - oedema/ phlebitis

PCS (29 decks)

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