Hemostasis


HEMORRHAGE:


non-specific bleeding


EPISTAXIS:


nose bleed


MELENA:


digested blood in stool


HEMOPTYSIS:


coughed up blood


HEMATEMESIS:


blood in vomit


HEMATURIA:


blood in urine


HEMATOMA:


focal pool of blood ´┐Żballoon´┐Ż


PETECHIAE:


multiple tiny hemorrhages


ECCHYMOSES:


like above but larger


PURPURA:


bruising


THROMBUS:


blood clot in vessel


EMBOLUS:


thrombus in motion, or any abnormal object floating in circulation


EMBOLISM:


emboli too large for circulation


INFARCT:


Necrosis due to emboli obstructing blood flow to or from and organ or tissue


SHOCK:


Hypovolemic or normovolemic; ultimate result is hypotension, lock of O2 delivery; septic hypovolemic, anaphylactic, cardiogenic etc,


HYEREMIA:


Increase blood flow into arterioles; normal or pathologic


CONGESTION:


blood stasis in the venules; due to


HEMOSTASIS


Basic ability of the body to maintain vessels and blood flow in the vessels


Coagulation:


Interaction between blood vessel wall, platelets and coagulation factors.


4 Steps to Hemostsis:


1: Vasoconstriction2: Platelets gather at site3: Coagulation Factor4: Return to Normal


What are the 2 Phases of coagualtion?


Mechanical and Chemical


Mechanical Phase


Primary Hemostasis: Damage attacts platelets, attach to each other and endothelium to prevent more damage


Chemical Phase:


Secondary and Tertiary Hemostasis: Platelets Initiate, Coagulation Cascade


What are the 3 Pathways of the Coagulation Cascade?


Intrinsic, Extrinsic, and Common


Intrinsic Pathway is AKA?


Contact Activation Pathway


Extrinsic Pathway is AKA?


Tissue Factor Pathway


Intrinsic Pathway:


-Stimulation by exposed collagen and/ or damage to vessel for platelets to adhere-Factors 5,7,9,10, and11


Extrinsic Pathway:


-Stimulated by non-vascular damage (releases fluids and chemicals)-Factors 7 and 10


Common Pathway:


-Goal: lots of Fibrinogen to fibrin-Intrinsic and Extrinsic Pathway come together at Foactor 10-Now activated Thrombin is a major coagulantFactor 5 and 8 together converts prothrombin to Thrombin


Factor I:


Fibrinogen


Factor II:


Prothrombin


Facotr III:


Tissue Thromboplastin


Factor IV:


Calcium


Factor V:


Proaccelerin


Factor VIII:


Antihemolytic Factor-


Intrinsic Factors:


-XII activates XI-XI activates IX w/ help of calcium-IX (and VIII) activates X-X (and V) convert Prothrombin to Thrombin


Extrinsic Factors:


-Tissue Factor released binds with and activates VII-Activated VII-TF catalyzed by C+++ activates X-X (and V) convert Prothrombin to Thrombin


PLATELETS


-PPSC->Myeloid Stem Cell-> Megakaryoblast-> Promegakaryocyte-> Megakaryocyte-> Platelets -2-4 umInactive is smooth/ Active is irregular