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By the end of this section, you will be able to:
  • Describe the three mechanisms involved in hemostasis
  • Explain how the extrinsic and intrinsic coagulation pathways lead to the common pathway, and the coagulation factors involved in each
  • Discuss disorders affecting hemostasis

Platelets are key players in hemostasis    , the process by which the body seals a ruptured blood vessel and prevents further loss of blood. Although rupture of larger vessels usually requires medical intervention, hemostasis is quite effective in dealing with small, simple wounds. There are three steps to the process: vascular spasm, the formation of a platelet plug, and coagulation (blood clotting). Failure of any of these steps will result in hemorrhage    —excessive bleeding.

Vascular spasm

When a vessel is severed or punctured, or when the wall of a vessel is damaged, vascular spasm occurs. In vascular spasm    , the smooth muscle in the walls of the vessel contracts dramatically. This smooth muscle has both circular layers; larger vessels also have longitudinal layers. The circular layers tend to constrict the flow of blood, whereas the longitudinal layers, when present, draw the vessel back into the surrounding tissue, often making it more difficult for a surgeon to locate, clamp, and tie off a severed vessel. The vascular spasm response is believed to be triggered by several chemicals called endothelins that are released by vessel-lining cells and by pain receptors in response to vessel injury. This phenomenon typically lasts for up to 30 minutes, although it can last for hours.

Formation of the platelet plug

In the second step, platelets, which normally float free in the plasma, encounter the area of vessel rupture with the exposed underlying connective tissue and collagenous fibers. The platelets begin to clump together, become spiked and sticky, and bind to the exposed collagen and endothelial lining. This process is assisted by a glycoprotein in the blood plasma called von Willebrand factor, which helps stabilize the growing platelet plug    . As platelets collect, they simultaneously release chemicals from their granules into the plasma that further contribute to hemostasis. Among the substances released by the platelets are:

  • adenosine diphosphate (ADP), which helps additional platelets to adhere to the injury site, reinforcing and expanding the platelet plug
  • serotonin, which maintains vasoconstriction
  • prostaglandins and phospholipids, which also maintain vasoconstriction and help to activate further clotting chemicals, as discussed next

A platelet plug can temporarily seal a small opening in a blood vessel. Plug formation, in essence, buys the body time while more sophisticated and durable repairs are being made. In a similar manner, even modern naval warships still carry an assortment of wooden plugs to temporarily repair small breaches in their hulls until permanent repairs can be made.

Coagulation

Those more sophisticated and more durable repairs are collectively called coagulation    , the formation of a blood clot. The process is sometimes characterized as a cascade, because one event prompts the next as in a multi-level waterfall. The result is the production of a gelatinous but robust clot made up of a mesh of fibrin    —an insoluble filamentous protein derived from fibrinogen, the plasma protein introduced earlier—in which platelets and blood cells are trapped. [link] summarizes the three steps of hemostasis.

Questions & Answers

Rheumatoid arthritis affects
Jessica Reply
what is oedema
Nantumbwe Reply
i want abook about physiology including the vitamins
Belal
fluid retention in the body. (also spelt as edema) e.g. fluid retention in the lungs is called Pulmonary Edema). It can also happen as a result of Injury manifested as swelling.
Arif
can you give me an example of a tissue composed of few related types of cells
Theresa Reply
What is LMx1600
Mae Reply
the skeletal system includes all of the bones
All Reply
what is the bone not contain red bone marrow in medulla
Duha Reply
To know the part of human body
Sarah Reply
Anatomy refers to as structure of human body
Sarah
so is the macroscopic and microscopic the types of anatomy
Gloria Reply
is microscopic and macroscopic a type of anatomy
Gloria
yes
Maxine
yes
Yabsra
yes
Sarah
Please can someone explain three glands in endocrine system?
josh
.
Robin
can someone explain disease and the category
gege
type 2 is controled by diet
Chloe Reply
Diet and life style
Paias
Diet how? maybe eating food containing less sugar?
BTS
we must eat protein food to check our diet
Sarah
type 2 diabetes cannot be controlled by insulin so therefore your diet should be well balanced especially you shouldn't eat foods with high sugar level or stopping sugar at all so that the sugar content needed by your body will be provided by the balanced diet taken
Enada
what is hypotension
regina Reply
hypotension is when the blood pressure is less than 60/50
Mursal
hypo means low so it implies low blood pressure
Isaac
ok
Mursal
what is mild DKA
Mursal
mild diabetic ketoacidosis is when there is high level of sugar in the blood and the ketone bodies build up in the body ,is a type 1 which can lead to type 2
Isaac
what is the normal range for blood pressure?
BTS
120 over 80
Danielle
low blood pressure; opposite of high blood pressure which is hypertension
Regina
what if your a type 2 diabetic and you have no way to get meds due to no insurance what is some good over the counter medications to take?
Ashley
type 2 diabets is controlled by diet not meds.type 1 is contolled by insulin.
Chloe
type 1 diabets cant be controlled type 2 can be controlled.type 1 is worse than type 2 diabets.
Chloe
type 2 is purely a lifestyle disease, eat healthy, fresh, natural unprocessed real foods.
Danielle
sometime , we already eat diabetic diet than the results of blood sugar level not turn good , what is the reason ?
Muhammad
What is a "diabetic diet" though? Be specific. Juvenile diabetes and/or Type 1 diabetes is something that one can be born with, this needs medical diagnosis and intervention.
Danielle
what i mean by diabetic diet is we take fiber-rich food like vegetables,nut and also fish.
Muhammad
ok, no cause a doctor told me I needed metformin and my suger won't go under 300
Ashley
what is the difference between plasma and serum
Gloria Reply
Plasma contains fibrinogen while serum doesn't
Kateregga
plasma ----- fibrinogen = serum
Sneha
serum is blood plasma without fibrinogen or other clotting factors While blood plasma contains dissolved protein like fibrinogen,globulin, and albumin), glucose, clotting factors,mineral ions like Na2+,Cl-1,hormones and carbon dioxide
Prince
In what time stomach empty it's content in to doudemun? what is chyme?
Sneha Reply
write the chemical and mechanical digestion which occurs in stomach?
Sneha
Does absorption take place in stomach? what are absorption in the stomach by which cell?
Sneha
Chemical digestion---Mixtures of the food with the gastric acid Mechanical digestion--- churning of the food in the stomach making it become more involved into chyme
Mercy
absorption takes place in the small intestine because of the presence of the villi
Enada
name the muscles supplied redina nerve
Appu Reply
mechanism of hormone releasing by gland
said Reply
why is muscle tissue not considered to be a type of connective tissue?
Ezel Reply
A Skeletal muscles consist of numerous muscles cells called Muscle Fibers . Three layers of connective tissues surrounded these fibers to make the muscles tissues
Manisha
that's wny connective tissues is not considered as muscles fibers
Manisha
there are 4 types of tissues : epithelial, connective tissue, nervous tissue and muscle tissue, each one has its own properties. The main function of connective tissue is nutrition, it supplies nutrientes to epithelial tissues that are responsible for protection.
Ariete
Muscle tissue has properties that allow movement, the function here is movement and not nutrition like connective tissue.
Ariete
In what time stomach empty it's content in to doudemun?
Sneha
write the chemical and mechanical digestion which occurs in stomach?
Sneha
Does absorption take place in stomach? what are absorption in the stomach by which cell?
Sneha
Does absorption take place in stomach? what are the absorption in the stomach by which cell?
Sneha
mechanism of hormone controlling releasing by gland
said
please can someone explain renin angiotensin aldosteron system for me
okolie

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Source:  OpenStax, Anatomy & Physiology. OpenStax CNX. Feb 04, 2016 Download for free at http://legacy.cnx.org/content/col11496/1.8
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