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Monday, February 10, 2014

Hemostatic system and its step and mechanism


Hemostatic system
 Hemostasis is the dynamic process of coagulation .It stop bleeding in the areas of vascular injury .This process involves the interaction of
    -cellular component:
        - Platelets
        - Vascular wall
 -  Protein component :
        - Procoagulants( Coagulation  factors )
        -Fibrinolytics ( for lysis)
        -Anticoagulants (regulation)
     Blood vessel injury →vasoconstriction & exposed endothelium & sub endothelial collagen →stimulation of von Willebrond factor→ platelets activation & adhesion →activated platelets induce platelets aggregation .At the same time tissue factor + collagen &other proteins in the tissue activate the coagulation cascade →formation of thrombin which has multiple effects on coagulation mechanism :
 
-feedback activation of factors 5&8
 -conversion of fibrinogen to fibrin
 -activation of factor 2thus a platelet plug is formed &bleeding stop .If failed then thrombin activate
-factor 13 which links fibrin to form a stable thrombus. Then contractile elements within platelets cause clot retraction
          Thrombin also activate the anticoagulant system leading to limitation of clot size .Thrombin activate
          the fibrinolytic system to cause lyses of the thrombus resulting in recanalysation of the blood vessel.
          Normal hemostasis
Components
                               First limb:
          Coagulation factors
                second limb:
                 Cell component (platelets and endothelial cells)
          Rgulation
        Coagulation system
        Fibrinolysis system
        Anticoagulation system
Platelet structure:

Platelets are non-nucleated cellular fragments produced by megakaryocytes of bone marrow. Their life span is 7-10 days.

 
Normal platelet count is 150 - 400 x 109/ L. (150.000-400.000/mm3).


Functions of platelets
a- They stimulate vasoconstriction of the injured vessels.
b- They form a primary hemostatic plug to seal small vascular tears. This plug is formed by platelet adhesion (sticking of the platelets to the subendothelial structures) followed by aggregation (sticking of the platelets to each other).
c- They play an essential role in fibrin clot formation by the production of platelet factor 3 needed in  blood clot formation.






d- They induce fibrin clot retraction.

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