Flashcards in Hemostasis: Blood coagulation and fibrinolysis - Part 1 Deck (20):
What are the four phases of hemostasis?
1) Vascular spasm/ vasoconstriction
2) Platelet plug formation/ primary hemostasis
3) Blood coagulation/ secondary hemostasis
4) Dissolution of the fibrin clot/ tertiary hemostasis
What occurs, in general, in primary hemostasis phase?
Platelet plug formation
What occurs, in general, in secondary hemostasis?
What occurs, in general, in tertiary hemostasis?
Dissolution of the fibrin clot
What is the role of endothelin in the vascular spasm phase of hemostasis?
Stimulates nervous reflexes upon trauma which lead to smooth muscle contraction
What occurs, specifically, during the vascular spasm phase of hemostasis?
-Vessel wall trauma results in smooth muscle contraction
What two factors are released from the injured vessel wall which leads to local myogenic spasm in the blood vessel during the Vascular spasm phase of hemostasis?
What are the stages of platelet plug formation during primary hemostasis?
- Platelet adhesion to the damaged surface and activation
Under normal cicumstances, what prevents platelet adherence and activation?
Negative charges on both the platelets and endothelial cells
During platelet adhesion, which glycoprotein on the platelet surface binds to collagen? What change does this promote?
- Development of pseudopods to promote platelet-platelet interactions
Once GpIa binds to collagen in the beginning of Platelet adhesion, what happens next?
Von Willebrand fator (located on the subendothelial collagen) binds to platelet receptor, Glycoprotein Ib (GpIb) resulting in changes in the platelet membrane
The binding of GpIa to collagen and GpIb to Von Willebrand factor exposes what?
GPIIb/IIIa (located on platelet membrane) for binding of fibrinogen.
What is the role of Von Willebrand factor in platelet adhesion?
-vWf acts as a bridge between specific glycoproteins (GPIb) on the surface of platelets and collagen fibres - facilitates platelet adhesion to the vessel wall and platelet aggregation.
-Complexes with factor VIII; carries it, stabilizes it and prevents its degrdation
Von Willebrand deficiency is associated with what?
A defect in the formation of the platelet plug (primary hemostasis)
Once initial platelet adhesion occurs, the activation of platelets leads to a shape change which results in what?
-Release of granule contents (ADP, CA2+), that activates other platelets, promoting aggregation.
- Increased levels of calcium stimulate the synthesis and release of thromboxane A2.
Aggregation of platelets cannot take place without what?
Increased intracellular calcium levels stimulate platelets to synthesize Thromboxane A2 (TXA2) by activating what?
-Action: cleaves membrane phospholipids to release Arachidonic acid
Cyclo-oxygenase (COX) catalyzes what reaction?
Arachidonic acid -> Prostaglandin G2 (PGG2)
Platelet aggregation (part of primary hemostasis) is mainly mediated by ________, which binds to _____ on adjacent platelets.