Haemostasis Flashcards
1- Describe the haemostatic pathway and explain why cells and their surfaces are crucial to the pathway 2) Explain how clots participate in wound healing 3) Describe a mechanism by which the vascular endothelial cell regulates haemostasis and how It may be altered by physical damage or infection 4) Describe the difference between haemophilia and thrombophilia 5) Describe the role of the clotting system in defence
What triggers primary haemostasis?
- Damage to endothelium causing collagen to become exposed.
What happens following vascular injury?
Exposes collagen to come into contact with blood components to activate clotting
What are the 3 stages of primary haemostasis?
- Adhere
- Activate
- Aggregate (via fibrinogen)
What happens during platelet adherence?
- Endothelium continuously releases small amounts of von Willebrand Factor, circulates in blood.
- Endothelial cell also store von Willebrand factor in Weibel- Palade boxes
- When collagen exposed, von Willebrand factor binds to collagen receptors.
- Platelets express receptors for collagen and von Willebrand Factor and become activated when these proteins bind to them.
- Activated platelets express functional fibrinogen receptors, required for aggregation
What are Weibel- Palade bodes?
Small storage granules located in endothelial cells, store von Willebrand factor
What happens during platelet activation?
- Platelets begin to aggregate by binding to fibrinogen which links them together.
- This is because the fibrinogen receptors on platelets bind together, binding the platelets together.
- Platelets release multiple pro-activation/aggregation signalling molecules.
What molecules do platelets release during platelet activation?
ADP
Thromboxane A2 (TXA2)
When platelets become activated, what can they become?
Degranulated, releasing some of their storage granules (including alpha granules, dense granules, lysosomes)
These also include cytokines that can further activate platelets
What do alpha granules release?
Fibrinogen and von Willebrand factor
What do dense granules release?
Serotonin, which recruits other platelets
What do lysosomes do in haemostasis?
Mobilises energy stores
What happens during platelet aggregation?
- Platelets bind and collect together with other platelets, creating a mesh.
- Bind with fibrinogen through fibrinogen receptors
What happens in secondary haemostasis?
- Deposition of insoluble fibrin generated by coagulation cascade:
Thrombin(protease) - cleaves circulating soluble fibrinogen into an insoluble fibrin mesh
What is tissue factor?
- Sub-endothelial trigger for coagulation cascade, mechanism for which fibrinogen is converted to fibrin.
- Initiator of clotting
When does tissue factor become exposed?
When the endothelial layer is damaged, so tissue factor is released by damaged tissue