Quiz 4 Flashcards
____ is the process of stopping blood loss
Hemostasis
_____ is the principle mechanism of hemostasis
Blood coagulation
_____ is mesh of protein filaments that traps blood’s formed elements to form a red, gelatinous mass
Blood clot
_____ are threads that holds the blood cells together and they seal the
wound to prevent loosing of blood
Fibrin threads
Clotting factors are present in the blood at all times in their _____ form
inactive
Clotting factors become activated upon injury through the _____ and _____ pathways
extrinsic, intrinsic
Clotting factors are produced by the _____
liver
_____ is required to produce clotting factors
Vitamin K
_____ results from fibrin and fibrin is the result of _____
Coagulation, fibrinogen
Fibrinogen is normally inactive and gets activated by _____ and which result from prothrombin from clotting
factor _____
thrombi, X(stuart-power factor)
Clotting factors have 2 factors:
Intrinsic pathway
Extrinsic pathway
The extrinsic pathway is defined as damage to ____ within ____ and outside of the _____
cells, blood vessels, blood vessels
Intrinsic Pathway is defined as exposure of _____ of subendothelial cells of blood vessels to blood flow
activates _____
collagen fibers, clotting factors
_____ ONLY occurs inside injured blood vessels
Intrinsic Pathway
In the extrinsic pathway, _____ is released by injured cells, both injured blood vessel cells and injured tissue cells, activates _____.
Tissue factor (aka Tissue Thromboplastin), clotting factors
Tissue factor is aka _____
Tissue Thromboplastin
In the extrinsic pathway, tissue factor activates _____ which activates _____
Proconvertin (CF 7), Stuart-Prower factor (CF 10)
In the intrinsic pathway, Collagen fibers exposed activate ______ which activates _____ which activates _____ which activates _____
Hageman factor (CF 12), Plasma thromboplastin antecedent (CF 11), Christmas factor (CF 9), Stuart-Prower factor (CF 10)
Both cascades result in CF 10 to _____ to thrombin to _____ to fibrin
Prothromin (CF 2), fibrinogen (CF 1)
____ forms a net and traps the formed elements in blood which leads to COAGULATION(blood clot)
Fibrin
_____ is a necessary component of coagulation
Ca2+
Patients with severe blood loss are given ____ injections to help withblood clotting
calcium chloride
Platelet Activation and the Platelet Plug only occurs ____ injured blood vessels
inside
Platelet Activation:
1) exposure of _____ of subendothelial cells of blood vessels to blood flow
2) _____ becomes activated and attaches to the exposed collagen fibers, stopping ____ of platelets.
3) The platelets form a _____ on top of the
exposed collagen
4) _____become activated and then attach a second layer of platelets, etc
collagen fibers
von Willebrand factor (circulating in blood in inactive form), movement, single layer
Platelets
Platelet activation results in the formation of a _____
platelet plug
The platelet plug ____ blocks the damaged blood vessel
physically (mechanically)
Stasis results from _____ and _____ through 2 independent and simultaneous processes
platelet activation (platelet plug), coagulation (blood clotting via CF cascade)
_____ can be formed inside and outside vessels while
_____ can only be formed inside a blood vessel
Blood clots, Platelet plugs
Platelets activated via von Willebrand factor also undergo _____
degranulation
Activated platelets release:
- _____ – promotes platelet activation
- Thromboxane A2 (TxA2) promotes _____
- Growth factors promote (2)
ADP
vasoconstriction
wound healing, fibroblast chemotaxis
_____ prevents excess or uncontrolled blood clotting
Anticoagulation System
Anticoagulation System has 3 components
Hemodynamics
Endothelial mediation
Fibrinolitic system
Slow blood flow is important for coagulation, otherwise activated CFs get washed out and a clot cannot be formed, this is the definition of _____
Hemodynamics
With endothelial mediation the platelet plug is formed, surrounding uninjured endothelial cells release _____ which prevents extra or excess platelet aggregation
prostacyclin (PGI2)
With the Fibrinolitic system, ____ also activates tissue plasminogen activator, which converts plasminogen into ____, resulting in degradation of activated CFs
CF 12, plasmin
____ is pinpoint hemorrhages
Petechiae
“petechial rash” seen in kids not getting enough ____
vitamin C
____ is larger than a pinpoint, but < 2 cm
Purpura
____ are bruises > 2 cm
Ecchymoses
Ecchymoses examples (3)
Raccoon sign
Battle sign
Cushing’s Syndrom
____ is the overproduction of corticosteroids from adrenal cortex
Cushing’s Syndrome
Cushing’s Syndrome leads to (5)
brittle blood vessels severe osteoporosis obesity diabetes high BP
Prolonged _____ use can have symptoms similar to Cushing’s, easy bruising
steroid medication
____ is leaking of blood into cavities or into tissue
Hematoma
Rupture of middle meningeal artery is ____
epidural hematoma
Normal amount of platelets in blood: is _____
250,000 – 300,000
____ is a disease characterized by < 140,000 = prone to hemorrhage
Thrombocytopenia
In Thrombocytopenia, ____ or ____ rashes are typical and they need to be less than 2 cm
petechial, purpural
In ____ Disease, periodic leakage of blood from mucosa of the stomach and duodenum is common, which results in _____
Von Willebrand’s, hemorrhagic gastroduodenitis— black stool
____ is the increased amount of blood lost during menstruation
menorrhagia
____ disease is genetic, and autosomal. Children with this disease have parents with this disease
Von Willebrand’s
____ is a serious disorder manifested usually from uterus cancer, which results in loss of blood between menstruation periods
metrorrhagia
_____ is the non-production of certain protein clotting factors
Hemophilia
____ is a Genetic disorder, children with this disease have parents that DO NOT have it, it skips a generation. Non production of clotting factor cause of spoiling of the _____.
Hemophilia, genes
Hemophilia is ____ chromosome linked
X (passed on from mother)
2 major types of hemophilia
Hemophilia A – nonproduction of _____
Hemophilia B (aka Christmas Disease) – nonproduction of ____ aka Christmas disease
CF 8 viii
CF 9 ix
____ is a common problem of hemophilia
Hemoarthritis
With hemoarthritis, trauma leads to blood in joint spaces, esp. ____
Knee joint
Iron released from heme into blood destroys the joint cartilage , causes _____ degeneration of the joint
degeneration of the joint
_____ disorders are disorders that arise from interruptions in normal blood flow
Hemodynamic
_____ is platelet activation and platelet aggregation without threat of blood loss or vascular damage
Thrombosis (thrombus formation)
_____ is platelet plug without blood clot
Thrombosis (thrombus formation)
____ can be formed inside and/or outside of a vessel
Blood clot
_____ always originates from a vascular wall and always maintains point of contact with the vascular wall through _____ platelet activation and platelet aggregation
Thrombus, von Willebrand factor
Thrombus in the ____ system: Dense and strong , firm and small (fast)
Thrombus in the _____ system: Loose and weak , loose and large (slow)
arterial
venous
_____ represent a special type of thrombi characterized by visible and microscopic laminations produced by alternating layers:
Lines of Zahn
Lines of Zahn: pale layer composed of ____ mixed with ____ and dark layer composed of _____
platelets, fibrin, RBC’s
2 areas where thrombi with lines of Zahn can be found
Heart
Aorta(usually the arch area)
Example of lines of Zahn
Mitral heart stenosis
____ is hemodynamic stress ( normal wear and tear)
Endothelial damage
Endothelial damage: stretching of endothelial cells from the inner surface of blood vessel, then ____ are exposed, the ____ formed
collagen fibers, thrombus
____ is increased resistance of the vascular wall to the fluid.
Hypertension
2 types of hypertension
Arterial
Venous (ex, renal)
With arterial hypertension, hemodynamic stress is normal wear and tear resulting in ____, accelerated and strengthen by hypertension
arteriosclerosis
Specific changes, such as formation of plaque,
in arterial walls leads to endothelial damage in the arteries…this is called _____
artherosclerosis
Ex: Artherosclerotic plugs
IV lines and injections into veins damage the endothelia resulting in ____
Iatrogenic thrombosis
