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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

name the 5 layers of skin
Monika Reply
stratum basale, stratum spinosum, stratum granulosum, stratum lucidum, stratum corneum
airiz
those are the layers of epidermis,, then we have the dermis which has got two layers that is papillary dermis and reticular dermis.. beneath the dermis we have the hypodermis( subcutaneous layer) which is not considered as a layer of skin
airiz
what's a feedback
ivhil Reply
is the information or comment about something that one have done
Gaston
may be you mean negative or positive feedback mechanism... in general, they mean body response its changes by hormones
Quran
what is endocrin?
Asim Reply
why should there be an inhibition to the process of gastric production in the intestinal phase
Gloria
endocrine is a system through which the secretions of cell directly poured into blood.
Tanveer
why should there be an inhibition to the process of gastric production in the intestinal
Gloria Reply
what is a stimuli
Emily Reply
environment factor that cause a cell to respond
Quran
name the two types of melanin
Laila Reply
deference between RNA and DNA
Ali
.DNA stands for Deoxyribonucleic Acid. The sugar portion of DNA is 2-Deoxyribose.RNA stands for Ribonucleic Acid.  The sugar portion of RNA is Ribose.2.The helix geometry of DNA is of B-Form (A or Z also present).The helix geometry of RNA is of A-Form.3.DNA is a double-stranded molecule consisting o
ryaisha
DNA consists of nucleotide but RNA consists of nucleoside DNA is double standard but RNA is single standard.In DNA at the nitrogen bases adinine,guanine,cytocin and thymine is present but in case of RNA instead of thymine uracil is present.
Tanveer
what are rdna
Budumari
what is a heart
walker Reply
A heart is an organ in the circulatory system that pumps blood throughout the systemic regions
bernard
what is anatomy
Aisha
Anatomy is the study of internal and external structures and the relationship among body parts. (the study of structure).
Tomi
what is the physiology of the heart
nadine
guys help me with a pathophysiology of asthma
Luyando
asthma is a lungs related disorder in which there is difficulty in breathing due to some allergic factors, their is inflamation of alveoli of respiratory part of lungs.also decreases the surface area.
Tanveer
what is meaning of brain strock and its types?
Tanveer
the pathophysiology of asthma is complex and involves airway inflammation and bronchial hyperresponsiveness pathogenesis of asthma
Omkar
skin infection please explain
Hamza Reply
what is malignant melanoma
Akon Reply
cancerous cells 🙄
Sohan
yes benign is non-cancerous malignant is cancerous.
Joseph
that's a simple way of explaining it however you're different processes like mitosis etc a person can be at risk for developing cancer etc
Joseph
you can tell by an unusual growth of a mole, or change in size coloration with melanoma. which is abnormal growth of your squamous cells.
Joseph
Types of wandering connective tissues
Hassan Reply
what are the meaning of skin
PASHALINA Reply
study of external structure of human body is known as anatomy
VINAY Reply
what is Tau?
Vicki Reply
what is sliva
Saqlain Reply
what is gross
Kiran Reply

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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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