LECTURE NO (4 )

Blood Physiology
Dr: Ibrahim Ali

Hemostasis (1)

Dept.Of Physiology
HEMOSTASIS
 Definition :
 Prevention of blood
loss by arrest of
bleeding and
maintenance of blood
in fluid state.
Mechanisms of hemostasis:

Following an injury to a vessel the following

events take place:
1- Vasospasm( vasoconstriction) - Vascular
Phase
2- Formation of platelet plug - Platelet Phase
3- Formation of blood clot - Coagulation
Phase.
4- Fibrinolysis or fibrous tissues formation and
resolution.
Haemostasis:
BV Injury

Tissue
Neural Factor

Blood Vessel Platelet Coagulation

Constriction Activation Activation
Primary hemostatic plug

Reduced
Plt-Fusion Thromibn,
Blood flow
Fibrin

Stable Hemostatic Plug

 1- Vasoconstriction
Vasoconstriction in injury vessel wall immediately
occurs due to contraction of the smooth muscle as
result to :-
1. Local myogenic spasm
2. Neural factors (Pain nerve, sympathetics )
3. Humoral factors :Vasoconstrictor substance e.g.
Thromboxan A2, serotonin and catecholamines

Purpose:- to minimize the flow of blood from the

wound site.
 2- Platelets plug
 Aggregation of platelets to close a hole
(small) in blood vessels (large holes need
the third step – blood coagulation)
 The formation of a platelets plug occurs by
the following steps:-
1. Platelets adhesion
2. Platelets secretion
3. Platelets aggregation
Platelet function: hemostasis
(formation of platelet plug)

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Platelets
 Small cells (2-4 micrometer in diameter).
 Count : 150.ooo-400.ooo/mm3.
 Life span : about 5-10 days.
 They circulate in the blood in an inactive
state
 60-70% found in the circulation and the
remaining in the spleen (Explain
splenectomy for ttt of thrombocytopenia)
 The formation of platelet thrombocyte is
under effect of thrombopoietien
 Their production is regulated by specific
CSF this secreted from fibroblast,
endothelial cells and leukocyte.
 The platelets membranes contains receptors
for collagen and von Willebrand factor
(vWF), both are important for attachment of
platelets to collagen at sites of blood vessel
injury.
 Also they have a receptors for ADP and
fibrinogen
 Platelets
(Thrombocytes)
The cytoplasm contains:

A-actin and myosin (which allow contraction of

platelets)

B- granules:
1. Dense granules – non protein substance:
serotonin, ADP ,calcium
2. Alpha granules – protein substance : number of
clotting factors e.g V, VIII, PDGF wound healing
stimulator , F 13, fibrinogen and Von
Willebrand factor
3. Glycogen granules provide the energy source
for platelet
 Functions of platelets

 Participates in hemostasis by :
1- Vasospasm: release a vasoconstrictor
(serotonin).
2- Platelet plug formation (aggregation of
platelets to close a hole in a blood vessels).
3- Blood coagulation (release some clotting
factor, F 13, F 3 phospholipids).
4- Release of PDGF for repair of damaged blood
vessels
Formation of platelet plug:

 3 stages lead to formation of the plug

1) Platelets adhesion
 Injury of the vessel wall exposes the
collagen normally covered by the
endothelium
 A factor produced by the platelets and
endothelium is important for the adhesion(
vonWillbrand Factor (vWF)
 The binding of platelets to collagen results
in activation of the platelets
2)Platelets activation:
 this results in:
a) the release of the contents of the
cytoplasmic granules
b)formation and secretion of
ThromboxaneA2, serotonin and ADP
 Thromboxane A2 promotes platelets
aggregation and vasoconstriction
3)Platelets aggregation:
The active platelets aggregate together at the
side of the injury
Serotonin cause vasospasm
TXA2 and ADP activate platelets to swell and
stick to previous ones and release the same
contents , then again TXA2 and ADP activate
other platelets and the cycle repeated (+ve
feedback mechanism)

Platelets plug
 con

 The platelet plug is formed within one min

 Firstly it formed primary haemostatic plug

 Platelet aggregation successfully stops

hundreds of small hemorrhages every day
Note

 Platelets deficiency – thrombocytopenia –

when the count is less than 50.000 . Associated
with spontaneous bleeding under the skin,
bleeding tendency and Petechial hemorrhage
after minor trauma , eeg. Thrombtic
Thrombocytopenic purpura

 Thrombocytosis - its high count platelets –

associated with thrombotic problems
BLOOD COAGULATION