Primarily endothelial cells - allows for easy diffusion of ions, separates the blood from thrombotic material underneath, composed of smooth muscle and some connective tissue.
Intima/interna
collagen and thrombonectin found here; coagulation cascade will be triggered if exposed.
media/subendothelial
two substances important in the anchoring of platelets
collagen and thrombonectin
layer under the influence of vasoactive mediators; primarily produced by endothelial cells but also influenced by NE, and epi from SNS
adventitia/externa
endothelial cells synthesize and secrete what
procoagulants
anticoagulants
fibrinolytics
this initiates the clotting cascade
tissue factor
this adheres platelets to subendothelial layer
vWF
aids in the suppression of coagulation
tissue factor pathway inhibitor
pathway of nitric oxide to relaxation
endothelial cell L-arginine cNOS (+Ca) NO ----> smooth muscle cell NO guanylyl cyclase guanosine triphosphate cGMP relaxation
substances released from endothelial cells that result in vasodilation (inhibit coagulation)
nitric oxide and prostacyclin (mostly in the tunica adventitia and externa)
substances released from platelets resulting in vasoconstriction and aids in coagulation
thromboxane A2 and ADP (mostly in the tunica adventitia and externa)
platelets are formed here
megakaryocytes in the bone marrow
life cycle of typical platelet
8-12 days
normal platelet value
150,000-300,000
platelets produce this which activates other platelets
thrombin
number of platelets used daily to patch micro injuries
7000
platelets contain alpha granules that store
vWF fibrinogen fibronectin platelet factor 4 platelet growth factor
plalets contain dense granules that store these nonproteins
serotonin ADP ATP histamine epi
first step of primary/basic clot formation
vessel wall contraction
vessel wall contraction mediated by which two substances in addition to autonomic reflexes
thromboxane A2
ADP
stage characterized by vWF emerging from endothelial cell and attaching to gpIb receptors on the platelet surface
adhesion
platelets can attach straight to collagen through glycoprotein 1A2A receptors
low shear states
these states require vWF to attach platelet to collagen
high shear states (arterial flow)
binding to vWF initiates this signaling during activation (conformational change to activated form)
“outside in” that activates phospholipase C
these substances activate GPCR to activate phospholipase C
tissue factor
thrombin
ADP
thromboxane A2
these substances are responsible for change of platelet shape
phospholipase C and calcium
phospholipase C stimulates the release of these
alpha and dense granules
thrombin
thromboxane A2
other coags
fibrinogen/fibrin receptors
GpIIb and GpIIIa
GpIIb and GpIIIa receptors on platelet surface change shape and link platelets together with fibrinogen/fibrin to form initial plug
aggegration
activated phospholipase C nitiates this signaling that stimulates the change in GpIIb and GpIIIa receotrs
inside out
factor I
fibrinogen
factor II
prothrombin
factor III
tissue thromboplastin
factor IV
calcium
factor V
proaccelerin
factor VII
proconvertin
factor VIII
antihemophilic factor
factor IX
plasma thromboplastin component; Christmas factor
factor X
stuart-prower factor
factor XI
plasma thromboplastin antecedent
factor XII
Hageman factor
factor XIII
fibrin stabilizing factor
this factor circulates in the plasma attaced to vWF
antihemophilic (VIII)
created in the liver and endothelial cells
tissue factor (factor III) is created here
vascular wall
factor IV is obtained here
diet
these factors are all vitamin K dependent
2, 7, 9, 10
deficiencies may lead to increased prothrombin time and paritial thromboplastin time
extrensic pathway
3, 7
intrinsic pathway
12, 11, 9, 8
common pathway
10, 5, 2, 1, 13
extrensic pathway triggered by this
damage outside the vessel
this limits the release of factor III immediately
tissue factor pathway inhibitor
the intrinsic pathway is triggered by this
damage within the vessel
intrinsic pathway initiated by these substances
prekallikrein
HMWK
activation of Hageman (XII)
___ creates a domino effect of factors activating one another
calcium
both pathways merge here
X
common pathway begins with activation of this factor
X or stuart prower
X forms complex with which factor
V
calcium aids in the activation of __ to ___
II into IIa
IIa activates ___ to ___
I to Ia
stable clot is formed with a cross-linking of mesh with the help of this factor
XIII
thrombin is responsible for which events in the cascade
1. activation of factors V VIII I XIII
thrombin is responsible for which events in the cascade
- recruits more platelets to site of injury
thrombin is responsible for which events in the cascade
- serves as anticoagulant
- releases tissue plasminogen activator from endothelial cells
- stimulate protein C and S production
- signals antithrombin III to interfere with coagulation