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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

explain respiratory centers
Tharshana Reply
which enzyme help in excretion of bile
Sakshi Reply
how conversion of Beta-carotiene into vitamin-A takes place
Sakshi
best reference books for anatomy pls suggest that
Sakshi
what is gross anatomy
Saroj Reply
The study of large structure of the body
Mablean
what is scrotum
Dakshit Reply
a bag of skin near the penis which contains the testicles
Mablean
hi
Sardar
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Sardar
Why are you on my digits
Mablean
hi
Kryme
how does it work?
Uriah Reply
I want to know the fertilization process in human
Nana Reply
Which plane divides the body into right and left parts
Kaeze
sagittal plane
Irvin
Thank you
Kaeze
Homestatic regulations usually involves a (n) _ that detects a particular stimulus, and a(n) _that respond to the stimulus by communicating with a (n) _whose activity has an effect on the same stimulus.
Kaeze
A cell is producing proteins to be transported out of that cell. They will be processed on ribosomes that are
Kaeze
what are diseases in the bood
Azoyenime Reply
Haemophilia
Aliyu
right hypochondriac rision how meain word
Ganesh Reply
Diabetes insipidus or diabetes mellitus would most likely be indicated by ________.
Ganesh
oral cavity how miean
Ganesh Reply
oral cavity how mean what
Suresh
seems to me every one is here a doctor and worse part is that even they donot know what to ask.
Muhammad
they know what to ask the problem is how to ask it.too much broken english.
George
dear George ongeche I think if they ask these kind questions and telling themselves as HCPs or medical student's .these are the basic ones go ask something more interesting .
Muhammad
what is blood red
Ahmad Reply
what is human anatomy?
Arpita Reply
tell me what is human anatomy?
Arpita
what is Openstax?
Arpita
arpita jana I think it's not the forum to ask such basic question...
Muhammad
study of structure of an object in this case human body.
Suresh
what are deferent between trasemicacid and vitamin k
Ubah Reply
This medication is used to treat heavy bleeding during your menstrual period. Tranexamic acid works by slowing the breakdown of blood clots, which helps to prevent prolonged bleeding. It belongs to a class of drugs known as antifibrinolytics
Muhammad
jj
John
In the body, vitamin K plays a major role in blood clotting. So it is used to reverse the effects of “blood thinning” medications when too much is given; to prevent clotting problems in newborns who don’t have enough vitamin K; and to treat bleeding caused by medications including salicylates, sulfo
Muhammad
Vitamin K plays a key role in helping the blood clot, preventing excessive bleeding. Unlike many other vitamins, vitamin K is not typically used as a dietary supplement. Vitamin K is actually a group of compounds. The most important of these compounds appears to be vitamin K1 and vitamin K2. Vitami
Muhammad
how much tha total vertebrea bone
Muhammad
26 vertebrea bone
Bhumi
wathe is blood function
dhena Reply
Blood, fluid that transports oxygen and nutrients to the cells and carries away carbon dioxide and other waste products. ... It is a tissue because it is a collection of similar specialized cells that serve particular functions. These cells are suspended in a liquid matrix (plasma), which makes the 
Ashiish
how tissue carries waste matrial
Nadeem
how many bone in human body?
Islam Reply
what is endocrin? plese help many people.
Islam
206
Nadeem
heart layers
Suresh
endoceime is the inner layer of heart
pandit
What is buffer?
Peer Reply
a buffer is a solution that resists a chemical change.
George
Yup it also balances the solutions
Peer

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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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