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function of the cardio and resp systems - year 1 > coagulation and the clotting cascade > Flashcards

coagulation and the clotting cascade Flashcards

1
Q

physiological response to cut

A
  • activating factors release from tissue and platelets
  • clotting factors activated in plasma
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2
Q

what are clotting factors

A

plasma proteins

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3
Q

where are clotting factors mostly produced

A

in the liver

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4
Q

what does lack of clotting factor mean

A

haemophilia A
(VII deficiency)

haemophilia B
(IX deficiency)

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5
Q

characteristics of platelets

A

very small

essential for clotting of damaged vasculature

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6
Q

what regulates platelet production

A

thrombopoietin

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7
Q

life span of platelets

A

approx 7-10 days

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8
Q

do platelets stick to tissues

A

yes, not to be confused with clotting

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9
Q

formation of plateletss

A

haemocytoblast to
myeloid stem cell to
megakaryoblast to
promegakaryocyte to
megakaryocyte to
platelets

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10
Q

what is haemostasis

A

stoppage of blood flow after damage

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11
Q

steps of haemostasis

A
  • vascular spasms (vasoconstriction at injury)
  • platelet plug formation (plugging the hole)
  • coagulation (blood clotting)
  • fibrin clot formation
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12
Q

what does vascular endothelium do

A

inhibit blood clotting

makes prostacyclin and NO both inhibit platelet aggregation

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13
Q

is the vascular endothelium conductive to clot formation

A

no

it displays membrane proteins that inhibit clotting (heparin like molecules )

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14
Q

what does the vascular endothelium store

A

von willebrand factor granules

constitutively expressed and secreted into circulation or sub-endothelium

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15
Q

first response to vascular injury

A

vasoconstriction is stimulated

  • compression of vessel by escaping blood
  • injury chemicals released by injured cells
  • reflexes from adjacent pain receptors
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16
Q

formation of a platelet plug step 1

A

platelets attach to damaged vessel wall to plug it

17
Q

formation of a platelet plug step 2

A

platelets produce thromboxane A2

18
Q

formation of a platelet plug step 3

A

serotonin/histamine release enhances vascular contraction

19
Q

formation of a platelet plug step 4

A

ADP - attracts and stimulates platelets at site

20
Q

formation of a platelet plug step 5

A

prostacyclin - inhibits aggregation at other sites

21
Q

does a sharply cut vessel bleed longer or shorter than a tore vessel

A

a sharply cut vessel undergoes less spasm
so bleeds longer, than a tore vessel

22
Q

what are the coagulation clotting pathways

A
  1. intrinsic - all components are in the blood
  2. extrinsic - at least one component from tissue, injury response
23
Q

what is needed for activation of VIIa

A

tissue factor

24
Q

when do TF and VIIa contact

A

only after injury

25
Q

what does TF-factor VIIa complex activate

A

factor XIa

26
Q

coagulation clotting step 1

A

platelet cells activated by damage

27
Q

coagulation clotting step 2

A

PF3 and/or tissue factor produced by platelet cells

28
Q

coagulation clotting step 3

A

factor X activated

29
Q

coagulation clotting step 4

A

prothrombin activator (enzyme) produced

30
Q

coagulation clotting step 5

A

prothrombin activator (enzyme) produced

31
Q

coagulation clotting step 6

A

prothrombin conversion to thrombin

32
Q

coagulation clotting step 7

A

thrombin stimulates fibrinogen to fibrin mesh

33
Q

what are the two roles of thrombin

A

conversion of fibrinogen to fibrin

platelet adhesion (activation)

34
Q

factors limiting normal clot growth

A
  • blood moves too fast to allow pro-coagulants
  • factors interfere with normal clotting
  • antithrombin III deactivates thrombin
  • protein C, protein S- inhibits clotting factors
  • heparin - inhibits thrombin, prevents adherence of platelets to injury
35
Q

what is the clotting screen

A

a bundled group of tests used pre-operatively to asses bleeding conditions and some therapies

36
Q

what do routing clotting tests comprise of

A

the prothrombin time (PT)
fibrinogen
activated partial thromboplastin time
thrombin time
D-dimer (broke down clot)

37
Q

how to work out iNR

A

patient PT / Control PT

38
Q

what does prothrombin time measure

A

activation of factor X by extrinsic pathway

function of the cardio and resp systems - year 1 (20 decks)

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