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ME2019 PART 2 > Thombosis > Flashcards

Thombosis Flashcards

1
Q

What is the lining of an artery composed of?

A

Several endothelial cell, making a basal lamina to ‘sit on’

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2
Q

What is found around the basal lamina of an artery?

A

Smooth muscle cells

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3
Q

What is found around the smooth muscle cells around an artery?

A

Interstitial collagen fibres

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4
Q

What is the middle of an artery called?

A

Lumen

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5
Q

What does the lumen of an artery contain?

A

Red blood cells

White blood cells

Platelets

Plasma

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6
Q

What is the colour of platelets and what size are they?

A

White and small

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7
Q

What are platelets not normally exposed to which is important in terms of thrombosis?

A

Interstitial collagen fibres

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8
Q

What does the plasma consist of?

A

Water

Numerous proteins

Clotting factors

Other molecules

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9
Q

What is serum?

A

Plasma without clotting factors

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10
Q

Where are clotting factors produced?

A

Liver or by epithelial cells

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11
Q

How are clotting factors named?

A

With a roman number, such as Factor VII

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12
Q

What kind of system are clotting factors?

A

Amplification system resulting in thrombin production

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13
Q

What do clotting factors result in the formation of?

A

Thrombin

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14
Q

What does thrombin do?

A

Converts soluble fibrinogen into insoluble fibrin

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15
Q

What is the process of damage to the formation off fibrin known as?

A

Clotting cascade which is an amplification system

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16
Q

What does TP stand for in terms of clotting?

A

Tissue factor

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17
Q

What is the basic process of the formation of fibrin?

A

1) Damage to vessel
2) Tissue factor is exposed
3) Tissue factor combines with clotting factor to convert prothrombin into thrombin
4) Thrombin converts fibrinogen into fibrin

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18
Q

What could the initial damage of the vessel be due to?

A

Trauma

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19
Q

What does trauma causing vessel damage lead to?

A

1) Exposure of interstitial collagen
2) Exposure of molecule called a tissue factor
3) Blood leaks out and the serum comes into contact with the interstitial collagen fibres, where plasma clotting factors are activated

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20
Q

What is interstitial collagen?

A

Collagen in connective tissues between structures

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21
Q
A
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22
Q

Where are tissue factors released from?

A

Smooth muscle cells

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23
Q

What exposes and releases tissue factors from smooth muscle cells?

A

Trauma

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24
Q

What does the tissue factor do?

A

Binds to the clotting factor and initiates the clotting cascade

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25
Q

What are many clotting factors?

A

Serine proteases, which have serine amino acids in them and they cleave other clotting factors to form the active molecules

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26
Q

What do many clotting factors do?

A

Cleave other clotting factors to form the active molecule

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27
Q

What is the difference between fibrin and fibrinogen?

A

Fibrinogen is a small soluble molecule, whereas fibrin is a large aggregate of insoluble strands

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28
Q

What is the end point of the clotting cascade?

A

The formation of fibrin from fibrinogen

29
Q

Where are platelets produced?

A

In bone marrow

30
Q

What cells are platelets formed from?

A

Megakaryocyte

31
Q

Why do megakaryocytes get so big?

A

They undergo nuclear division but not cell division so have many nuclei

32
Q

How do platelets leave megakaryocytes?

A

Bud off as fragements from cytoplasmic extension, they are very small

33
Q

What is the process of platelets working?

A

1) Trauma to vessel exposes platelets to interstitial collagen
2) Platelets try to form a bridge to closs the gap

34
Q

What is coagulation?

A

Solidification of blood

35
Q

What are the 2 types of coagulation?

A

Thrombus formation

Clot formation

36
Q

Where does thrombus formation occur?

A

In flowing blood

37
Q

What colour is a pure thrombus?

A

Pale cream

38
Q

What does a thrombus consist of?

A

Platelets and a mesh like network of fibrin strands

39
Q

What is thrombosis?

A

The process of thrombus formation which occurs in flowing blood

40
Q

How to platelets adhere to interstitial collagen?

A

Molecules on their surface, this is how they can do so in flowing blood

41
Q

What enhances the surface molecules of platelets that allow it to adhere to interstitial collagen in flowing blood?

A

Factor VIII

42
Q

What is the process of clot formation?

A

1) Blood leaks out off a vessel and becomes stationary
2) Clotting cascade is activated next to the stationary blood sitting next to the interstitial collagen
3) Clot consists of network of fibrin strands and red blood cells

43
Q

What is haemostasis?

A

Stopping bleeding

44
Q

What is the process of haemostasis in normal skin with a wound?

A

1) Vessel in skin is surrounded by collagen
2) Blood flows through vessel in the skin
3) Trauma disrupts one side of the vessel
4) Blood leaks out
5) Clotting system is activated by collagen and by the stationary blood, forming a clot

If this does not work correctly the process goes on:

6) Vessel continues to bleed
7) Vasocontricts to decrease blood loss
8) Platelets and fibrin form thrombus to bridge the gap between the ends of the vessel adjacent to flowing blood
9) Skin stops bleeding so haemostasis has been achieved

45
Q

What happens if the formation of a clot does not stop bleeding in the skin?

A

1) Vessel vasoconstricts to decrease blood loss
2) Platelets and fibrin form thrombus to bridge the gap between the end ends of the vessel adjacent to flowing blood
3) Skin stops bleeding so haemostasis has been achieved

46
Q

What occurs in any wound due to trauma where there may be bleeding?

A

Vasoconstriction helps reduce bleeding

Clot formation occur in space around vessel and may fill void of wounded tissue

Thrombus forms in flowing blood and stops bleeding from gaps in vessels

47
Q

What is granulation tissue?

A

After healing new vessels can grow into area of wound

48
Q

What do the capillaries that grow in granulation tissue do?

A

Oxygenate the area of the wound and keep it alive

49
Q

What does stagnant mean?

A

Stationary

50
Q

When is thrombosis good?

A

If it allows blood to flow along the vessel

51
Q

When is thrombosis bad?

A

If it blocks the vessel

It causes stationary blood behind it which results in clotting

52
Q

What does thrombosis blocking a vessel lead to?

A

Ischaemiae (lack of blood flow to tissues)

Hypoxia (lack of oxygen in tissues)

53
Q

What is ischaemia?

A

Lack of blood flow to tissues

54
Q

What is hypoxia?

A

Lack of oxygen in tissues

55
Q

What eventually happens after thrombosis?

A

The vessel wall repairs itself and the thrombus is removed

56
Q

What is the thombus removed by?

A

Fibrinolytic system which removes fibrin and stops thombi from propogating

57
Q

What does the fibrinolytic system do?

A

Removes fibrin and stops thombi from propogating

58
Q

What does the fibrinolytic system depend on?

A

Plasma protein called plasminogen being converted to plasmin

Plasmin cutes up fibrin into fibrin degradation products

59
Q

What is the precurser of plasmin?

A

Plasminogen

60
Q

What does plasmin do?

A

Cuts up fibrin into fibrin degradation products

61
Q

What is the fibrinolytic system normally in balance with?

A

The clotting system

62
Q

What is important at the site of injury to limit the extent of the evolving thrombus?

A

Plasmin generation

63
Q

What is thrombosis and clotting normal in?

A

Wound healing

Stopping bleeding during menstruation

Some embryonic processes

64
Q

When is thrombosis and clotting abnormal?

A

Vessels which have abnormal walls (such as affected by atheromas)

Blood which has abnormal constituents (the clotting system or platelets are abnormal)

Abnormal flow in vessel

65
Q

What are the 3 things associated with abnormal thrombosis and clotting called?

A

Virchow’s triad

66
Q

What are the 3 things of virchow’s triad?

A

Abnormalities of vessel wall

Abnormalities of constituents of the blood

Abnormalities of vessel flow

67
Q

What are thrombi composed of?

A

Platelets mixed with fibrin, forming in flowing blood

68
Q

What does a clot consist of?

A

Fibrin admixes with red blood cells, forming in stationary blood

ME2019 PART 2 (45 decks)

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