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Cheatography

(UNFINISHED) Hemostasis and Coagulation Cheat Sheet (DRAFT) by

- Platelets (functions & structure) - Hemostasis - Coagulation (factors & pathways) - Laboratory Evaluation

This is a draft cheat sheet. It is a work in progress and is not finished yet.

BLOOD VESSEL

CONNECTIVE TISSUE:
Fibrob­lasts
 
Smooth Muscle Cells
 
These cells secrete COLLAGEN - a negatively charged substance; platelet agonist
BASEMENT MEMBRANE:
Collag­en-rich (from CT)
 
Serves as support of endoth­elial lining
ENDOTH­ELIAL LINING:
Secretes Heparan Sulfate
 
- an natural antico­agulant to keep blood flowing without turbulence in intact subend­oth­elium
 
- heparan sulfate is inacti­vated by B-thro­mbo­glo­bulin and Platelet Factor 4 for hemostasis to proceed
 
- Zeta potential is also respon­sible for keeping platelets from touching the subend­oth­elium
Zeta Potential:
Platelets: Phosph­olipids (phosp­hot­idy­let­han­ola­mine)
 
Endoth­elial Lining: Collagen (from CT)
- A platelet is a negatively charged cell (from phosph­oli­pids) that can be activated by negati­vel­y-c­harged substances called PLATELET AGONISTS

PLATELET FUNCTIONS

1. ADHESION:
Adhered Platelets: single­-layer of platelets
 
Collag­en-­sti­mulated adhesion
 
Platelet > GP Ib/IX > vWF > Collagen
 
(Platelets have a GP Ib/IX binding site on their membrane that von Willebrand Factor attaches to, to form a bridge between platelets and collagen — found on the subend­oth­elium)
2. SECRETION:
Adhered platelets secrete DENSE GRANULES
 
ADP (from dense granules) recruit & activate surrou­nding inert platelets
 
(Adhered platelets are REacti­vated by thromb­oxane A2 to secrete granules thru OCS)
3. AGGREG­ATION:
ADP-st­imu­lated Platelets expose GP IIb/IIIa
 
Fibrinogen attaches to GP IIb/IIIa
 
Primary Platelet Plug is formed (loose clot)
 
(Fibri­nogen bridges the GP IIb/IIIa binding sites of each platelet to create long spiny projec­tions that indicate activa­tion, and lead to aggreg­ation)
- Platelet functions always have to be enumerated in order
- The 3 functions comprise the events of PRIMARY HEMOSTASIS, meaning its output is a primary platelet plug
 

PLATELET AGONISTS

ARACHI­DONIC ACID
- strongest platelet agonist
 
without this, secretion cannot happen = no ADP-st­imu­lated platelets, and no primary platelet plug formation
THROMB­OXANE A2
- stimulates secretion
 
it reacti­vates the adhered platelets to secrete granules
ADENOSINE DIPHOS­PHATE
- stimulates aggreg­ation
 
from dense granules; causes the aggreg­ation of platelets to form a primary platelet plug = ADP-st­imu­lated Platelets
THROMBIN (agonist & Factor IIa)
- most important protease enzyme
COLLAGEN
- electr­one­gat­ivity in connective tissue
 
*source of negative charge in connective tissue -> epithelial lining
EPINEP­HERINE

THROMB­OXANE A2 AND ARACHI­DONIC ACID PATHWAY

This pathway shows what happens upon injury to blood vessel