Hemostasis

Question 1

What is coagulation?

Answer 1

Physiological process by which blood changes from liquid to gel

Question 2

What is hemostasis?

Answer 2

Cessation of blood loss from damaged vessel

Question 3

When does coagulation begin?

Answer 3

Instantly after injury

Question 4

What are the stages of hemostasis?

Answer 4

Primary + Secondary

Question 5

Cell type: primary hemostasis

Answer 5

Platelets

Question 6

Cell type: Secondary hemostasis

Answer 6

Clotting factors

Question 7

What starts both primary and secondary hemostasis?

Answer 7

Exposure of blood to sub-endothelial collagen

Question 8

Where do platelets come from?

Answer 8

Derived + released from bone marrow

Question 9

How do platelets travel?

Answer 9

Circuate as anucleate cells

Question 10

What are platelets a source of?

Answer 10

Preformed chemokines in intracellular storage granules

Question 11

What happens once platelets are activated?

Answer 11

Synthesize thromboxane A2 from arachidonic acid

Question 12

What occurs during primary hemostasis?

Answer 12

Platelets adhere to subendo collagen
Adherence –> cytosolic reactions = platelet activation
Release of granules + AA metabolism

Question 13

What do the granules released by platelets in primary hemostasis do?

Answer 13

Recruit + activate additional platelets

= Platelet aggregation

Question 14

What coagulation factor is NOT produced by the liver?

Answer 14

Factor 8

Question 15

What is Factor 8?

Answer 15

megakaryocytes

Question 16

What happens when coagulation factors are activated?

Answer 16

Fibrin formation

Question 17

What three pathways occur during secondary hemostasis?

Answer 17

Intrinsic + Extrinsic + Common

Question 18

Initiated by: Intrinsic

Answer 18

Contact activation of F7

Question 19

Initiated by: Extrinsic

Answer 19

Tissue factor

Question 20

Initiated by: Common

Answer 20

Fibrin formation

Question 21

What is fibrinoolysis?

Answer 21

Regulates coagulation

Enzymatic dissolution of fibrin

Question 22

What enzyme is functional in fibrinolysis?

Answer 22

plasminogen activators (tPA)

Question 23

What happens is fibrinolysis?

Answer 23

Plasmin degrades fibrin into soluble degradation products

Question 24

What are the three methods of surgical hemostasis?

Answer 24

Mechanical + Thermal + Chemical

Question 25

Methods: Mechanical hemostasis

Answer 25

Direct pressure Sutures Tourniqet Gel foam

Question 26

Methods: Thermal hemostasis

Answer 26

Electrocautery Laser US device Cryosurgery

Question 27

Methods: Chemical

Answer 27

``` Epi Phenylephrine Formalin Vitamin K Protamine ```

Question 28

How does thermal hemostasis work?

Answer 28

Engery focally transmitted onto tissue Depends on water content = vaporization of cells along energy application

Question 29

Thermal tissue damage: Coagulation

Answer 29

lower power | produces thermal coagulum

Question 30

Thermal tissue damage: Desiccation

Answer 30

heat lower than what is needed for cutting | Used for treating nodules under skin

Question 31

Thermal tissue damage: Fulguration

Answer 31

Electrode held away from tissue Air gap between electrode and tissue ionized Burning and charring more superficial Used on skin tags

Question 32

What does electrocautery do to the inside of the cell?

Answer 32

Protein denaturation

Question 33

What hertz does tissue damage occur?

Answer 33

3000 to 4000

Question 34

What are the two types of electrocautery?

Answer 34

Monopolar -- and -- Bipolar

Question 35

What is monopolar electrocuatery?

Answer 35

Pointed electrode makes contact with tissue | Patient is attached to electrode

Question 36

What is a bipolar electrocautery?

Answer 36

Voltage applied via pair of electrodes | Use forceps to pass the current

Question 37

What three things are involved in clotting?

Answer 37

Fibrinogen - thrombin - fibrin

Question 38

What three things are involved in clot lysis?

Answer 38

Plasminogen - tPA - Plasmin