Principle of Coagulation

Question 1

o _______ – in which this is part of hemostasis, happens when there is vessel injury

o Tisue factor also known as _______ or ____

Answer 1

• Vascular intima
• Thromboplastin
• FIII

Question 2

• Involves the interaction of ____,___, , enzymes
  o Vasoconstriction is also known as _____
  o Vessel injury = _________
• Hemo means “_” and stasis means “________”
  o Hemostasis is the stoppage of the blood.
  o Platelet adhesion, platelet aggregation, and
  coagulation factors are part of the hemostasis
  because if these are absent, the bleeding continues.
• A complex process that:
  o Produces a ____ to stop the bleeding
  o Keeps the ______
  o Dissolves the clot as the ______

Answer 2

• HEMOTASIS
• vasoconstriction, platelet adhesion and aggregation and coagulation
• vessel spasm
• Vessel constriction or vessel spasm
• blood
• the stoppage
• clot
• clot confined
• wound heal

Question 3

• Hemo means “______” and stasis means “________”
• ________ will start on the site of the vessel injury

Answer 3

• blood
• stoppage of blood flow
• Hemostasis

Question 4

_________ – ECs secrete von
Willebrand factor (vWF) from storage sites called _______ when activated by vasoactive agents such as thrombin.

Answer 4

• Primary Hemostasis
• Weibel-Palade bodies

Question 5

• Reduction in blood vessel diameter due to smooth muscle constriction.

Answer 5

VASOCONSTRICTION

Question 6

What happens during vessel injury?

Answer 6

There would be constriction (narrowing of blood vessels)

Question 7

_______ – it is wider.

Answer 7

Vasodilation

Question 8

In order for adhesion, we need the _ and _. On the other hand, in aggregation, with the help of the , and _. The platelet one and two will be merging together.
* Once there’s adhesion and aggregation, the bleeding will be prevented. _ is a complex process that produce a clot to stop the bleeding.
* Platelets stop the bleeding in the vessel injury ______. We need _ to make sure that the
hemostatic plug is stable. Once fibrin is present, the ________ comes into the picture, they will be the one to support the clot.
o _______ will be activated by thrombin to Fibrin
* Hemostasis also dissolved the clot by the process called _ which will lyse the fibrin that is form to become normal.

• It also involves the ______, ______, ______ during vessel injury

Answer 8

• PLATELET ADHESION AND AGGREGATION
• vWF and the GPIb
  -fibrinogen, vWF and GPIIb/IIIa
  -Hemostasis
• TEMPORARILY
  -fibrin
• secondary hemostasis
• Fibrinogen
• Fibrinolysis
• capillaries
• arteries
• veins

Question 9

• _______ have the thickest wall of the vascular system.
  -blood vessels that carry oxygen-rich blood away from the heart.

Answer 9

• Arteries

Question 10

known as the inner lining and thinnest
layer composed of single layer of endothelial cells and
sub-endothelial layer of connective tissue.

Answer 10

• Tunica Intima

Question 11

• When the wound is small – _________
• When the wound is big and deep – ________

Answer 11

• Primary hemostasis (platelets)
• Secondary
  hemostasis (coagulation factors)

Question 12

The Key Cellular Elements of Hemostasis

Answer 12

• Vascular Intima
• Extravascular Tissue Factor (TF)
• Platelets
• Blood Coagulation Factors
• Fibrinolytic proteins

Question 13

• The ________ provides the interface between circulating blood and the body tissues.
• The innermost lining of blood vessels is a monolayer of metabolically active ________

Answer 13

• Vascular intima
• endothelial cells

Question 14

• Essential component of functional immune system. This serves as the barrier that prevents the transmigration of immune cells.

Answer 14

Immune Response

Question 15

• Characterizes the capacity of the vessel wall that allows the flow of the blood.

Answer 15

Vascular Permeability

Question 16

• Can promote hematopoietic stem cells & differentiation
• _______ – maintain the survival and selfrenewal of hematopo

Answer 16

• Proliferation
• Endothelial cells

Question 17

In Hemostasis _ are essential

Answer 17

Endothelial cells

Question 18

• The _______ (tissues surrounding blood vessels)
involved in hemostasis when local vessel is injured, through ______ and _______.
• It plays a part in hemostasis by providing back-pressure on the injured vessel through _____ and ______ of escaped blood.
• The platelets and plasma proteins that circulate within the
blood vessels.
o These components are involved in Coagulation (clot or thrombus formation) or _______ (clot or thrombus dissolution).
➢ _______ – destruction or lysis of the fibrin
during wound healing
▪ We need to control the activate by the
help of inhibitors to prevent too much
activation

Answer 18

• EXTRAVASCULAR COMPONENT
• extra-vascular
• swelling
• inflammation
• swelling
• trapping
• Fibrinolysis

Question 19

• The platelets and plasma proteins that - circulate within the blood vessels
• The Vascular Intima, Extravascular Tissue Factor, and Platelets are the components are involved in _______ (clot or thrombus formation) or ______ (clot or thrombus dissolution)

Answer 19

• Platelets
• Coagulation
• Fibrinolysis

Question 20

• Responsible for micro circulation that links between arterial and venous circulation.
• Thinnest walled and most numerous of blood vessels compose of basement membrane that is tightly anchored with collagen that offers support for microvascular unit.
• Most abundant

Answer 20

CAPILLARIES

Question 21

• Smaller blood vessels
• ______: Microscopic continuation of arteries giving off _______ joining capillaries
• ______: microscopic size of veins connecting to capillaries

Answer 21

• ARTERIOLES AND VENULES
• Arterioles
• meta-arterioles
• Venules

Question 22

• Blood flows through the vascular system to and from all parts of the body. The vascular system consists of ______, ______, and _____.
• Blood normally carried within vessels whose physical capabilities include _______ or
  __________ and ______ or ________ which are controlled by the - smooth muscle of the vessel media

Answer 22

• ROLES OF BLOOD VESSEL IN HEMOSTASIS
• capillaries
• arteries
• veins
• Contraction
• VASOCONSTRICTION (narrowing)
• Dilation
• VASODILATION

Question 23

• ______: Is the process whereby on vessel injury,
  Plasma protein, Tissue factors and Calcium interact on the surface of the platelets to form a Fibrin clot
  o _______ – very important in the activation of
  coagulation factors, without it there is no
  activation of coagulation factors or no clot formation.
• Platelets provide a surface for the coagulation reaction, and interact with fibrin to form _______________

Answer 23

• ROLE OF COAGULATION IN HEMOSTASIS
• Coagulation
• Calcium
• interact with fibrin
• a stable platelet fibrin (FXIII) clot.
• bleeding
• Clotting

Question 24

• Plasma transports at least 16 procoagulants, also called _________.
• Nearly all are glycoproteins synthesized in the _.
• _ is the ultimate substrate of the coagulation pathway.

Answer 24

• coagulation factors
• liver
• Fibrinogen

Question 25

* ________ – inhibits or slow down the process of platelet activation and aggregation

Answer 25

- Prostacyclin

Question 26

• ________ – formation of clot or thrombus formation • _______ are part of coagulation. • Without _______, there would no bleeding/hemorrhage • Without _______, there will be no thrombosis. • If this is balance, there would _____________

Answer 26

- CONCEPT OF NORMAL COAGULATION - Coagulation - Platelets - fibrinolysis - coagulation - no clot formation/thrombosis

Question 27

* Poor clot formation * ___________ – will lead to bleeding * __________ – no ability to form clot * _______________ o Acquired conditions such as ___, ____ and ___________. ➢ Liver is involved because most of coagulation factors are synthesize in the liver.

Answer 27

- CONCEPT OF HYPOCOAGULATION - Excessive fibrinolysis - Hypocoagulation/ - Hypocoaguble disease - Hypo-coagulable states. - DIC - Liver - Kidney diseases

Question 28

* Uncontrolled * Hypercoagulable disease * Other conditions are related to uncontrolled thrombosis are called ______________. * This is related to an appropriate formation of _______ in the vascular vessels that occlude normal blood flow. * Elevated platelets and it is above the reference value * Will lead to ______ * Thrombus is composed of _,_,_,_ There is also a tendency that the RBC will have a hard time to flow and will lead to _________, _______, and _____. * Uncontrolled thrombosis – seen in cases of _ (high risk of having this)

Answer 28

- CONCEPT OF HYPERCOAGULATION - Hyper-coagulable state - thrombi - thrombosis -platelets, WBC, RBCs, cholesterol. - Myocardial infarction - mild stroke - death Polycythemia vera

Question 29

o _________ – where platelet factors enter

Answer 29

secondary Hemostasis

Question 30

o _________ – clot will be dissolved

Answer 30

fibrinolysis (thrombus dissolution)

Question 31

* ___ is a large multimeric glycoprotein that participates in platelet adhesion and transports the procoagulant factor VIII.

Answer 31

VWF

Question 32

* ______ – platelets roll and cling to nonplatelet surfaces. Reversible; seals endothelial gaps, some secretion of growth factors, in arterioles VWF is necessary for it.

Answer 32

Adhesion

Question 33

* _______ – platelets adhere to each other. Irreversible; platelet plugs form, platelet contents are secreted, requires fibrinogen.

Answer 33

Aggregation

Question 34

* _______ – platelets discharge the contents of their granules. Irreversible; occurs during aggregation, platelet contents are secreted, essential to coagulation.

Answer 34

Secretion

Question 35

* _______, _______, and ________ also participate in hemostasis.

Answer 35

erythrocytes, monocytes, and lymphocytes

Question 36

– dissolution of the fibrin.

Answer 36

Fibrinolysis

Question 37

* _______ are larger and have more irregular lumen than arteries. - blood vessels that carry blood back to the heart for reoxygenation.

Answer 37

Veins

Question 38

middle layer, also short, composed of _ and _

Answer 38

tunica media - smooth muscles and elastic tissues/fibers.

Question 39

outer most layer of blood vessels. This is composed of _ annd _ o This is the strongest layer and serves as the barrier

Answer 39

tunica adventitia – - elastic fiber and collagen.

Question 40

* The major role of the ______ is to maintain a complete balance of the body’s tendency toward clotting and bleeding.

Answer 40

hemostatic system

Question 41

o ______ – there’s a thrombus formation that will occlude

Answer 41

Clotting

Question 42

enhances the activity of anti-thrombin III or ATIII

Answer 42

Heparin sulfate-

Question 43

will inactivate the thrombin

Answer 43

o ATIII-

Question 44

*___________ – anticoagulant in which are produce by the endothelial cell

Answer 44

tissue factor pathway inhibitor

Question 45

control the activation of the tissue factor pathway. Essential in hemostasis to maintain or balance it.

Answer 45

o Endothelial cells-

Question 46

* ________ – induces smooth muscle relaxation, vasodilation and inhibits the platelet activation.

Answer 46

Nitric oxide

Question 47

– also present in endothelial cells, act as normal anticoagulant

Answer 47

thrombomodulin