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APA - 2 > Hemostasis > Flashcards

Hemostasis Flashcards

1
Q

What is hemostasis

A

Process by which the body maintains a delicate balance between bleeding and clotting.

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2
Q

What is the Tunica Intima?

A

Lining separating flowing blood from the vessel, made of endothelial cells.

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3
Q

Tunica media: Endothelial cells synthesize and secrete procoagulants, anticoagulants, and fibrinolytics. What are they?

A 
von Willebrand factor (vWF)
Tissue factor
Nitric Oxide
Prostacyclin
Thromboxane A2
ADP
Tissue Factor Pathway Inhibitor
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4
Q

T/F: the tunica media

A

Forms a barrier separating fluid contents within the blood vessel from the highly thrombogenic material that lies in the Tunica Media

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5
Q

What are the endothelial cell procoagulants?

A

Von Willebrand factor & tissue factor

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6
Q

What is Von Willebrand factor necessary for?

A

Necessary cofactor for adherence of platelets to the subendothelial layer

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7
Q

What is tissue factor necessary for

A

Activates the clotting cascade pathway when injury to the vessel occurs

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8
Q

What are the endothelial cells: vasoconstriction

A

Thromboxane A2

Adenosine diphosphate (ADP)

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9
Q

What are the endothelial cells: vasodilation

A

Nitric oxide

Prostacyclin

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10
Q

What are the endothelial cells: coagulation inhobitors

A

Tissue Factor Pathway Inhibitor

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11
Q

Where is the tunica media located?

A

sub endothelial

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12
Q

What are the characteristics of the tunica media

A

Extremely thrombogenic & Very active

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13
Q

Parts of the tunica media subendothelial layer

A

Collagen & Fibronectin

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14
Q

What is the tunica adventitia?

A

Third layer (outermost)

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15
Q

What does the tunica adventitia do?

A

Control of blood flow by influencing the vessel’s degree of contraction.

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16
Q

What 2 substances help control the blood flow by influencing the vessel’s degree of contraction.

A

Nitric oxide & prostacyclin

17
Q

Where are platelets formed?

A

bone marrow

18
Q

Platelet cell characteristics

A 
Contain mitochondria ~
Glycogen stores ~
Contractile proteins, calcium, enzymes ~
Alpha (α) granules ~
vWF
Fibrinogen
Fibronectin
Platelet factor 4
Platelet growth factor
Dense granules
Serotonin
ADP
ATP
Histamine
Epinephrine
19
Q

Produce ________.
Activate coagulation factors
Influence recruitment of platelets

There is no ____, _____, _____

Inactive unless activated as a result of ________

Adequate hemostasis is not possible in the absence of ________

A

thrombin

nucleus, RNA, DNA

tissue trauma

activated platelets

20
Q

Produce ________.
Activate coagulation factors
Influence recruitment of platelets

There is no ____, _____, _____

Inactive unless activated as a result of ________

Adequate hemostasis is not possible in the absence of ________

A

thrombin

nucleus, RNA, DNA

tissue trauma

activated platelets

21
Q

What is the goal in clot formation with platelets

A

Goal: Adherence of the platelet to the injured vessel wall and the subsequent response of the clotting cascade to form a stable clot and halt the progress of the bleeding.

22
Q

Vessel injury and clot formation

A

slide 20

23
Q

adhesion - primary plug

A

slide 21/23/26

24
Q

What factor is responsible for the adhesion of platelets?

A

vWF

25
Q

What are zymogens?

A

activation of cofactors

26
Q

Cofactors are enzymes with the exception of factor ____ & ___

A

V and VIII

27
Q

Coagulation cofactors (zymogens) circulate in an _____ state until they are activated to assist in the process of _______

A

inactive

coagulation

28
Q

What are the 2 clotting pathways?

A

Extrinsic Pathway
Intrinsic Pathway

Two separate and distinct pathways
Function independent of each other but in conjunction with platelet activity and the common coagulation pathway

29
Q

What is the Extrinsic Pathway / Tissue Factor Pathway

A

Activated by injury “outside” the vessel wall

Organ trauma or crushing injury

Factor III - tissue factor

Factor VII - proconvertin

30
Q

What is Intrinsic Pathway / Contact Activation Pathway

A

Initiated when damage occurs to blood vessel itself

Initiated by prekallikrein and high molecular weight kininogen

Factor XII
Factor XI
Factor IX
Factor VIII

31
Q

What is the common pathway of intrinsic and extrinsic pathways

A

Formation of XV - Prothrombinase complex
Factor X - Stuart-Prowers
Factor V - Proaccelerin

Activation of Factor II - Prothrombin
Factor IIa - Thrombin

Activation of Factor I - Fibrinogen
Factor Ia - Fibrin

Activation of Factor XIII - Fibrin Stabilizing

~~ Stable Clot ~~

32
Q

The common pathway is the _____ pathways of the coagulation cascade

A

terminal

33
Q

T/F: Fibrin (Factor Ia) together with Fibrin stabilizing factor (Factor XIII) secure the initial clot as a stable secondary plug and bleeding stops.

A

True

34
Q

Thrombin activates factors

A

V, VIII, I, XIII

35
Q

Thrombin recruits platelets to

A

the injured area

36
Q

Adequate _____ must be present to activate sufficient fibrin to form a “stable” or “secondary” clot.

A

Thrombin

37
Q 
Thrombin (the anticoagulant) 
1. Prevents runaway clot formation
Release tPA - which
2. Stimulates protein C and S
Inhibits clot formation - which
3. Works with antithrombin III - which
A
  1. releases tPA
  2. inhibits clot formation
  3. Interferes with coagulation
38
Q

which electrolyte is highly involved in many parts of the common pathway

A

Ca

39
Q

What are sources of coag factors

A

Most formed by liver

Calcium from Diet

vWF formed in endothelial cells

II, VII, IX, X are vitamin K dependent

APA - 2 (2 decks)

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