Chapter 12

Question 1

When a blood vessel is sealed to prevent blood loss or hemorrhage.

Answer 1

Hemostasis (asis- stop bleeding)

Question 2

when inappropriate blood clotting occurs or when clotting is insufficient to stop the flow of blood from the vascular compartment.

Answer 2

Abnormal hemostasis

Question 3

Is needed to activate factors II, VII, IX, X

Answer 3

Vitamin K

Question 4

what happens during normal hemostasis?

Answer 4

sealing of broken blood vessel

Question 5

what happens during abnormal hemostasis?

Answer 5

inappropriate clotting- thrombosis insufficient clotting

Question 6

platelets live up to:

Answer 6

8-9 days in circulation

Question 7

platelets are also called

Answer 7

thrombocytes

Question 8

platelets are large fragments of _____ that come from ___

Answer 8

megakaryocytes, bone marrow

Question 9

What triggers platelet production

Answer 9

thrombopoietin (hormone) that triggers new megkaryocyte formation

Question 10

platelets are made in the :

Answer 10

liver, kidney, smooth muscle, and bone marrow

Question 11

platelets are stored in the:

Answer 11

spleen

Question 12

healthy people have what # of platelets

Answer 12

150,000-400,000 circulating at any given time

Question 13

platelet structure is:

Answer 13

* a hybrid between RBC and WBC * have glycoproteins that stick out from cell to help them connect to other platelets (clot formation) * inside: glycogen, enzymes, mitochondria *A granules, and B granules

Question 14

a granules are made of what and do what?

Answer 14

fibrinogen, coagulation factors, plasminogen * they facilitate platelet aggregation, blood clotting, and vessel repair * Return things to normal

Question 15

B granules are made of what and do what?

Answer 15

ADP, ATP, calcium, histamine, serotonin. * they vasoconstrict and perform platelet adhesion to injured site

Question 16

Coagualtion Factors: (2)

Answer 16

Plasma Proteins & Calcium (Favor IV)

Question 17

Plasma proteins:

Answer 17

circulate as inactive pro-coagulation factors synthesized by liver EX: vWF made my megakaryocytes and endothelium

Question 18

Examples of anticoagulants:

Answer 18

Antithrombin III Protein C&S Plasmnogen __> Plasmin

Question 19

Damaged Endothelial ___ clotting while healthy endothelium ___ clotting

Answer 19

encourages prevents

Question 20

Clot Formation and Dissolution Steps (5)

Answer 20

1. Vessel Spasm 2. Platelet plug formation 3. blood coagulation 4. clot retraction 5. clot dissolution and lysis

Question 21

1.) Vessel spasm

Answer 21

1st thing in clot formation * TXA2- released by Nervous System to spasm vessel

Question 22

2.) Platelet plug formation

Answer 22

2nd step in clot formation *vWF is needed to bind to collagen and create adhesion Adhesion–> granule release–>platelet aggregation

Question 23

3. Blood coagulation

Answer 23

3rd step in clot formation * coagulation cascade of factors

Question 24

4. Clot Retraction

Answer 24

4th step in clot formation- 1st in dissolution * actin and myosin pull damaged vessel closed *exudate is squeezed out of cells in the process

Question 25

5. Clot dissolution and lysis

Answer 25

5th step in clot formation- 2nd in dissolution \*plasminogen--\> plasmin: fiber breakdown

Question 26

Plasminogen is activated by?

Answer 26

Tissue plasminogen factor (TPa)

Question 27

1st thing to happen when tissue gets damaged \* is the spark that starts the coagulation cascade\*

Answer 27

Tissue Factor gets released from the extrinsic pathway

Question 28

prothrombin turns into thrombin with what activator?

Answer 28

calcium Ca++

Question 29

Factor XIII 13 helps do what?

Answer 29

turn fibrin strands into the platelet plug by creating the meshwork that holds the clot together

Question 30

What converts fibrinogen into fibrin?

Answer 30

thrombin

Question 31

Extrinsic meets the intrinsic pathway in the coagulation cascade where?

Answer 31

Factor X and Factor V

Question 32

the important last 3 factors in the intrinsic pathway are?

Answer 32

Factor X and V: activates prothrombin--\> Factor II: thrombin --\> which activates --\> Factor I: Fibrinogen --\> Fibrin

Question 33

Tissue plasminogen activator (tPA) does what?

Answer 33

fast acting clot breakdown (stroke patients)

Question 34

examples of anticoagulants made by Endothelial cells:

Answer 34

prostacyclin and Nitric Oxide Adenosine Diphosphate- breaks down ADP Histamine Thrombomodulin- breakdown clots/inhibit formation TPa- breaks down clots already formed, fast acting.

Question 35

hypercoagulability

Answer 35

increased ability of the body to clot (abnormal)

Question 36

hypercoagulability can be grouped into two categories:

Answer 36

increased platelet function Accelerated coagulation system activity

Question 37

Increased platelet formation in Hypercoagulability:

Answer 37

- increased platelet # - blood flow disturbances - endothelial damage - platelet aggregation

Question 38

Accelerated coagulation system activity in Hypercoagulability:

Answer 38

- Increased procoagulation factors - decreased anticoagulation factors

Question 39

with accelerated coagulation systems activity in hypercoagulability, what are pt's most at risk for?

Answer 39

deep vein thrombosis

Question 40

accelerated coagulation system activity can be a result of what?

Answer 40

mutation of Factor V (5) it mutates so that Protein C can't recognize it and break it down.

Question 41

thrombocytopenia

Answer 41

decreased platelet levels below 100,000/uL

Question 42

Thrombocytopenia is characterized by:

Answer 42

-spontaneous bleeding in intercellular junctions of postcapillary venules - PETECHIA & PURPURA

Question 43

Petechia and Purpura

Answer 43

petechia- pinpoint hemorhages purpura- dark purple brusing of skin

Question 44

Calcium, Vitamin K, and prothrombin-

Answer 44

all needed to activate certain Factors -Without calcium, blood can't clot.

Question 45

chelating

Answer 45

ionizing calcium so stored blood can't clot

Question 46

cling to walls of blood vessels and bone marrow. Have appendiges that stick out into the blood vessesl so the blood rushing past sheers off pieces of it.

Answer 46

Megakaryocytes

Question 47

thrombopoetin is regulated by

Answer 47

of platelet cells circulating in blood stream

Question 48

the celll membrane has an important role in what?

Answer 48

platelet adhesion and coagulation process

Question 49

the phospholipids in the cell membrane are important for:

Answer 49

binding of calcium and coagulation factors

Question 50

where are coagulation factors synthesized and how do they work?

Answer 50

liver they activate one another so there needs to be a stimulus (injury) in order for them to create a clot.

Question 51

promotes blood flow by blocking platlet adhesion and activation, the coagulation process, and losing blood clots.

Answer 51

normal endothelium (uninjured)

Question 52

if platelets are activated in healthy endothelium, they can't activate why?

Answer 52

because of circulating ADP, Nitric Oxide and Prostacylcins in blood

Question 53

what two natural anticoagulants inactive thrombin (factor IIa)

Answer 53

Heparin & Thrombomodulin

Question 54

adhesion of platelets to the vessel wall occurs when?

Answer 54

when vWF binds to platelet membrane- this links platlets to exposed collagen fibers

Question 55

a granules contain ___ which is required for ____ component of hemostasis

Answer 55

calcium; coagulation

Question 56

during platlet plug formation, a granules binds with _____ allowing them to bind with ____ to form aggregates

Answer 56

ADP; Firbinogen

Question 57

\_\_\_ and ___ combine and create the primary hemostatic platlet plug (expands the platelet aggregation)

Answer 57

ADP & TXa2

Question 58

Aspirin does what? while Plavix and Ticlid does what?

Answer 58

- inhibits prostaglandin synthesis including TXa2 - inhibit ADP pathways in platlet to creat antiplatlet effects

Question 59

the intrinsic pathway of the coagulation cascade begins what what factor?

Answer 59

Factor XII (12)- Hageman Factor

Question 60

decreases prothrombin and procoagulation factors. alters vitamin K so it can't reproduce itself in teh liver, is readily absorbed, and takes effets in 36-72 hours after taken

Answer 60

Warfarin

Question 61

the process of dissolving the fribrin strands in a clot

Answer 61

fibrinolysis

Question 62

^ platlet #

Answer 62

thrombocytosis