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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

ഫസ്റ്റ് ചാപ്റ്റർ ഇംപോർട്ടൻസ് പോസ്റ്റ്
Reshma Reply
Yes....
Loving
nhi samjh aya
Anshika
Nhi wt is this
Loving
I don't know
Anshika
Okk wre frm u r
Loving
what is mean of? reshma
Asad
D bone in d ankle joint re what ?
Ifunanya Reply
can one define a cell as a basic unit of a living organism
Michael Reply
Which of the following hormones are responsible for the adolescent growth spurt? estrogen and testosterone, even in women?
Kepa Reply
estrogen
Farhana
Estrogen!
Jazil
estrogen hormone
Michael
yes estrogen hormone
Anshika
yes
Sale
What is sling give d characteristics of sling uses of sling
adamu Reply
a sling a rope used in hunting ie throwing of rocks
Michael
I went to learn anatomy of joints
Arman Reply
me 2
adamu
joint have 3 cartilaginous joint fibrous joint synovial joint U can reserch in Google can explain U well
sopheaktra
define sling
adamu
To throw with a circular or arcing motion
real
what is respiration
Osele Reply
what is respiration
Paul
Respiration is the process by which oxygen is taken in and carbon dioxide is given out.
Md
Respiration is the combination of inhalation and exhalation.
Khim
inhalation is the taking in air from environment to lung and exhalation is taking out sir from the lung to environment ..
Khim
is the process by wich gases(oxygen and carbon(IV)oxide go through the nose, trachea and the lungs to the blood stream
Michael
what is holistic
Kibrom Reply
Holistic means encompassing the whole of a thing, and not just the part. Holistic medicine looks at the whole person for answers, not just at physical symptoms. You might have heard of holistic medicine, which tries to treat someone as mind and body, instead of treating only the part of the patient
I want to learn one by one system like skeleton system... muscular system
Mary Reply
i want to learn this
Kibrom
what is the difference between regional anatomy and system anatomy
David
system anatomy is when we study the system like digestive, circulatory, reproductive, but regional anatomy is studying the anatomy by regions of body like anatomy of neck, thorax, head etc. Regional anatomy may include system anatomy...
Biplav
yes
Anshika
explain in details factors that affects bone development
Precious Reply
describe the process of bone healing
Precious
out line factors that delays bone healing
Precious
actually,for the bone formation they must be sufficient level of calcium,phosphorus and vitamin D in the body for it to happen smoothly.
lucky
the above mentioned substances are the ones able for the formation and repairing of bones.
lucky
explain in details factors that affects bone development
Precious
what are tissue
muki Reply
a lots of cells make tissue and a cell body is tissue
Rabab
cells come together to form a tissue and tissues come together to form an organ
Adoma
what is appendicular skeleton
OSE Reply
appendicular skeleton is upper limbs and lower limbs
sopheaktra
what is decompression sickness?
Japhar Reply
It occurs in Scuba divers when they rise too quicky to the sea surface , their oxygen tanks have oxygen mixed with N2 gas which has a high solubility at sea level , when the diver rises the N2 gas bubbles out of plasma and this causes Air Ebolism
Siphiwesihle
if a single part if Nervous system doesn't function like synapse? what will occur
Lilian Reply
no transmission of impulses no respond cause mechanical damage
Komolika
what happens when calcium ion channel is blocked
Jachike
a MORAH /MORAH
Kechi
meaning?
Jachike
transmission of impure
sopheaktra
when calcium ion channels block . lightheadedness Low blood pressure. Slower heart rate. Drowsiness. Constipation. Swelling of feet ankles and legs. Increased appetite. Gastroesophageal reflux disease (GERD
sopheaktra
I'm not sure about it
sopheaktra
low blood pressure
Anshika
what is this substance
Peng Reply
In the human body, there are no atoms as separate entities. Instead, they constantly interact with other atoms to form and break down more complex materials. To fully understand anatomy and physiology, you must understand how atoms are involved in such interactions. The key is to understand the beha
Warid
what are functions of muscle cell
Veronicah
please can someone help with ten functions of the following hormones 1.Gastrin 2. Adrenal sex hormone 3. Secretin 4. Follicle Stimulating Hormone 5. Glucagon 6. Progesterone
Har
4.produces the oetrogen and bursts open to release egg cells.
Komolika
5.regulates the level of glucose in the blood and it is secreted when glucose low in the blood.
Komolika

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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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