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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

Card 5 / 12: For whom would an appreciation of the structural characteristics of the human heart come more easily: an alien who lands on Earth, abducts a human, and dissects his heart, or an anatomy and physiology student performing a dissection of the heart on her very first day of class? Why?
Gelowe Reply
what are regular shaped cells with granules in the cytoplasam
Kabita Reply
PMNL
Dinu
I need sylubuss of clinical officers book
Omary Reply
cholesterol normal value is
BISWANATH Reply
less than 200mg/dl
Ashis
100 to159mg/dL
Dinu
Early this wk. I had some "A & P" questions & answers unfortunately didn't save them, Is there any way I can have them back ,so as 2 save them?. Thnx.
Kechi
what are the functions of the female reproductive system
Lister Reply
it produces the female egg necessary for reproduction, called the Ova or Oocytes. The system is designed to transport the Ova to the site of fertilization.
Kechi
Female reproductive system was mainly functioned to produce ova(ovum) (female eggs) Into which will be fertilized by male gamete to produce zygote
Omary
absolutely right
nimco
wa qalad nimco rage iska hubi
Khaliil
waxwalba ka fikirbay ubaahantahay
Ahmed
ha wayo jawabtoda wa qabyo nimco wey ku raacdat
Khaliil
ha wayo jawabtoda wa qabyo nimco wey ku raacday
Khaliil
wxayaabaha qaarkood waaa in aan u feejignaano
Ahmed
asc if I try female reproductive system has two function the first is to produce egg cell and the second is to protact and nourish the offspring until birth
Muriidi
what is stercobilinogen
Hancerich Reply
fecal urobilinogen. Created by bacteria in the gut. a chemical that gives feces brown color.
Blayne
next question pls.
Kechi
The rate of diffusion increases if the
stella
What's the answer?
Kechi
it's a breaking down of haemoglobin and it's a chemical made by bacteria
Dev
Thnx Dev Raj.
Kechi
yup so any more
Dev
yes I sure do need more "Questions" & "Answers". I'm learning whole lot. Thnx.
Kechi
what is the greatest muscle of the body
Lungu Reply
gluteus maximus
ABDULLAH
pls!!! more "A&P" questions & answers. Thnx.
Kechi
Gluteus maximus
THE
Describe anatomy of cardiovascular system?
cardiovascular system is a group of organs coming together to perform the circulation of blood. The organs invoked are the heart and the blood vessels with blood being the tissue. The heart is a pump and it pumps oxygenated blood through the systemic circuit and deoxygenated blood through the pulmon
bernard
pulmonary circuit.
bernard
more A&P questions pls. Thnx.
Kechi
If an ANOVA yields a significant F value, you could rely on ________ to test significant differences between group means.
Dane Reply
what's ANOVA
Cassandra
analysis of variance
Blayne
plz what you mean with "ANOVA" first
Fatima
anova means analysis of variance, a statistical method in which the variation in a set of observations is divided into distinct components.
Blayne
M value ot test
ABDULLAH
What does it mean by M value ot test?
Orpha
formation of red blood cells
Biketi Reply
explain why... lower back pain in ovarian cancer
Srijoni Reply
we says that protoplasm is the living part of us How?
Muzamil Reply
is the leaving part of our cellular structure.
Eric
it is the leaving part of our blood cellular structure also
ABDULLAH
what is receptor?
Preity Reply
an organ or cell able to respond to light, heat, or other external stimulus and transmit a signal to a sensory nerve.
Jessi
Has anyone taken the first exam?
Sandra
yes
yahye
yes
Allan
hey what is the process after your food is swallowed? how long does it take to get to the stomache until it is released as waste?
Fednise Reply
that is such a broad question. as you begin to swallow its various doses down the alimentary canal that brings the food into your stomach.then depending on whether it's a protein carbohydrate fat that dictates what function takes place in your stomach. these are all steps of digestion.
Joseph
typo sorry it's peristalsis , wave-like projections that push food down your alimentary canal etc. digestion starts in your mouth ends in your large intestines (colon anus)
Joseph
some of the many processes of digestion include hydrolysis dehydration synthesis denaturation of proteins etc. you have to be more specific.
Joseph
there's many different contributing factors the how long it takes food to convert into waste. remember fats, triglycerides proteins and carbohydrates all breakdown two different monomers and structures. you should be looking up metabolic processes.
Joseph
depending how much fiber you have in your diet dictates how much water is brought to your intestines that has to do with excretion whether fiber is insoluble or soluble. this is an anatomy and physiology app. to simply say the stomach will empty its contents in 2 to 3 hours would do you a disservice
Joseph
can the study of anatomy relate to medical technologies
Lean Reply
yes
Khh
absolutely
Jessi
yes...
Sherif
how can I understand micro biology and anatomy better.
Cassandra
yes
Kevin
someone to help me understand glycogeneogenesis
abel
what are the major branches of the aorta?
Kevin
look youtube video
Jessi

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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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