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Sudden and severe loss of blood can lead to shock and death. When
blood vessels are damaged, Hemostasis (clot formation) will arrest
bleeding. This process is divided into three phases.
II. Platelet phase - Damaged endothelial cells lining the blood vessel
release von Willebrand's Factor. This substance makes the surfaces of
the endothelial cells "sticky". This condition may, by itself, be enough
to close small blood vessels. In larger blood vessels, platelets begin to
stick to the surfaces of endothelial cells. This effect is called Platelet
Adhesion.
The platelets that adhere to the vessel walls now begin to secrete
Adenosine diphosphate (ADP) which is released from "stuck" platelets.
This material causes the aggregation of nearby free platelets which
attach to the fixed platelets and each other. This
aggregation of platelets leads to the formation of a platelet plug.
This clumping of platelets serves a number of functions:
1. It can plug the break in a small blood vessel.
2. Aggregated platelets release Platelet Thromboplastin (Factor III)
which activates the clotting
process.
3. Clumped platelets provide a surface essential for the clotting
process.Along with ADP, the
clumped platelets secrete thromboxane, a powerful vasoconstrictor.
NAME
SOURCE
PATHWAY
Fibrinogen
Liver
Common
II
Prothrombin (enzyme)
Liver *
Common
III
Thromboplastin
Released by damaged
Extrinsic
cells
III
Thromboplastin
Released by platelets
Intrinsic
IV
Calcium ions
Entire process
Proaccererin
(heat labile cofactor)
VII
Proconvertin (enzyme)
Liver *
Extrinsic
VIII
Anti-hemolytic
factor(cofactor)
Platelets and
endothelium
Intrinsic
IX
Christmas factor(plasma
thromboplastin component) Liver *
Intrinsic
Liver *
XI
Plasma thromboplastin
antecedent (enzyme)
Liver
Intrinsic
Liver
Intrinsic; also
activates plasmin
Liver
Retards fibrinolysis
XII
XIII
Hageman factor
Fibrin stabilizing factor
*vitamin K dependent
males.
2. Hemophilia B (Christmas disease) - leads to the production of a
defective Factor IX. Hemophilia B is due to a defective gene linked to
the X chromosome and is most commonly found in males.
3. Von Willebrand's Disease - the result of a lack of effective von
Willebrand's Factor. It is due to an autosomal dominant gene and
occurs equally in males and females.