Podcast
Questions and Answers
What is the role of thrombin in the stabilization of the fibrin clot?
What is the role of thrombin in the stabilization of the fibrin clot?
Which of the following is NOT a mechanism by which natural anticoagulants prevent clot extension?
Which of the following is NOT a mechanism by which natural anticoagulants prevent clot extension?
What is the role of calcium ions (Ca$^{2+}$) in the coagulation cascade?
What is the role of calcium ions (Ca$^{2+}$) in the coagulation cascade?
How do endothelial cells and platelets prevent clot extension?
How do endothelial cells and platelets prevent clot extension?
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What is the role of protein S in the regulation of the coagulation cascade?
What is the role of protein S in the regulation of the coagulation cascade?
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Why does blood not clot in healthy blood vessels?
Why does blood not clot in healthy blood vessels?
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What is the primary function of the Fibrinolytic Phase in haemostasis?
What is the primary function of the Fibrinolytic Phase in haemostasis?
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Which enzyme catalyzes the decarboxylation of factor II, VII, IX, and X in the Coagulation Cascade?
Which enzyme catalyzes the decarboxylation of factor II, VII, IX, and X in the Coagulation Cascade?
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During the BLOOD COAGULATION PHASE, what do Coagulation Factors primarily circulate as?
During the BLOOD COAGULATION PHASE, what do Coagulation Factors primarily circulate as?
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What is the main role of Thrombin in the Coagulation Cascade?
What is the main role of Thrombin in the Coagulation Cascade?
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Which cells are responsible for synthesizing Factor XIII in the Coagulation Cascade?
Which cells are responsible for synthesizing Factor XIII in the Coagulation Cascade?
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What is the purpose of the IMMEDIATE CONSTRICTION PHASE in haemostasis?
What is the purpose of the IMMEDIATE CONSTRICTION PHASE in haemostasis?
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Which of the following is NOT one of the factors that help keep blood in a fluid, un-clotted state in healthy blood vessels?
Which of the following is NOT one of the factors that help keep blood in a fluid, un-clotted state in healthy blood vessels?
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Which of the following is the primary mechanism by which the liver removes activated clotting factors from circulation?
Which of the following is the primary mechanism by which the liver removes activated clotting factors from circulation?
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Which of the following is the primary way that the speed of blood flow helps prevent unnecessary clot formation?
Which of the following is the primary way that the speed of blood flow helps prevent unnecessary clot formation?
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Which of the following is the primary mechanism by which the glycoprotein coat on circulating platelets helps prevent unnecessary clot formation?
Which of the following is the primary mechanism by which the glycoprotein coat on circulating platelets helps prevent unnecessary clot formation?
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What is the primary role of the fibrinolytic system in preventing the propagation of blood clots?
What is the primary role of the fibrinolytic system in preventing the propagation of blood clots?
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Which of the following is the primary way that antithrombin III, a natural anticoagulant in plasma, helps prevent unnecessary clot formation?
Which of the following is the primary way that antithrombin III, a natural anticoagulant in plasma, helps prevent unnecessary clot formation?
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Study Notes
Blood Coagulation and Fibrin Clot Formation
- Thrombin, in the presence of Ca, activates factor XIII, which cross-links fibrin into polymers, stabilizing the fibrin clot.
- Platelets retract within the fibrin clot.
- Ca ions play a crucial role in the activation of most coagulation phases, except for the first two steps in the intrinsic pathway.
Factors Preventing Clot Extension
- Natural anticoagulants:
- Antithrombin III, a non-Vit K dependent plasma protein that inhibits factors IIa, Xa, and other coagulation factors.
- Heparin, a natural anticoagulant that enhances antithrombin III activity.
- Protein C, a natural anticoagulant that inhibits factors V and VIII activity.
- Protein S, a cofactor that activates protein C and increases plasmin formation.
- Autocrine-paracrine mediators:
- Prostacyclin, which promotes vasodilation and inhibits platelet activation.
- Nitric oxide, which inhibits platelet adhesion and aggregation in response to thrombin.
- Tissue-Factor Pathway Inhibitor (TFPI), an anticoagulant that inhibits the extrinsic Tenase complex.
Why Blood Doesn't Clot in Healthy Vessels
- Clotting factors circulate in an inactive form and are activated only upon injury.
- The liver removes activated factors regularly.
- The speed of blood flow prevents activation of clotting factors and contact with tissue factor (TF).
- The healthy endothelial lining of blood vessels is smooth and negatively charged, repelling negatively charged surfaces that can activate the intrinsic pathway.
- Endothelial cells secrete mediators with anticoagulant action, such as NO and PGI2.
- Circulating platelets have a glycoprotein coat that creates repulsion forces, preventing them from sticking to healthy endothelium.
- Plasma contains natural anticoagulants, such as anti-thrombin III and heparin, that antagonize coagulation.
- Plasma contains a tightly regulated fibrinolytic system that prevents uncontrolled extension of thrombus.
Fate of a Blood Clot
- The fibrinolytic phase breaks down the fibrin clot once it becomes unnecessary, preventing uncontrolled extension of thrombus or embolization.
- The process is meant to regain patency of blood vessels during repair.
Haemostasis Process
- Immediate constriction phase:
- Brief reflexive contraction regulated by local myogenic spasm, nervous reflex, and released vasoconstrictors from platelets and endothelium.
- Blood coagulation phase:
- Involves sequential activation reactions of coagulation factors to convert soluble fibrinogen into an insoluble fibrin fiber.
- Most coagulation factors belong to plasma proteins and circulate as inactive proteolytic enzyme precursors.
- Coagulation factors are synthesized mainly by the liver, with the exception of factor XIII, which is synthesized by endothelial cells.
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Description
Test your knowledge on the factors involved in keeping blood in a fluid, un-clotted state within healthy blood vessels. Learn about how these factors prevent unnecessary clot formation and thrombosis.