Hemostasis
19
                                               DEFINITION
                                               STAGES OF HEMOSTASIs
                                                   VASOCONSTRICTION
                                                     PLATELET PLUG FORMATION
                                                   cOAGULATION OF BLOOD
     DEFINITION                                                    platelets to the collagen is accelerated by von Willebrand
Hemostasis is defined as arrest or stoppage of bleeding            actor. nis tactor acts as a bridge between a specific
                                                                   glycoprotein present on the surface of platelet and
                                                                   collagen fibrils.
   STAGES OF HEMOSTASIS
When a blood vessel is injured, the injury initiates a                   PLATELET PLUGFORMATION
series of reactions, resulting in hemostasis. It occurs in         Platelets get adhered to the collagen of ruptured blood
three stages (Fig. 19.1):                                          vessel and secrete adenosine diphosphate (ADP) and
1. Vasoconstriction
2. Platelet plug formation                                         thromboxane A These two substances attract more and
    Coagulation of blood.                                          more platelets and activate them. All these platelets aggre
                                                                   gate together and forma loose temporary platelet plug or
    VASOcONSTRICTION                                               temporary hemostatic plug, which closes the ruptured
                                                                   vessel and prevents further blood loss. Platelet aggrega
Immediately after injury. the blood vessel constricts tion is accelerated by platelet-activating factor (PAF).
and decreases the loss of blood from damaged
portion. Usually, arterioles and small arteries constrictCOAGULATION OF BLOOD
Vasoconstriction is purely alocal phenomenon. vwie    Durion this process. the fibrinogen is converted into
Diood vesseis are cut, ne enoonelum is damaged and fibrin. Fibrin threads get attached to the loose platelet
Oen and ge activated. The activated platelets secrete plug. which blocks the ruptured part of blood vessels
serotonin and other vasoconstrictor substances which and prevents further blood loss completely. Mechanism
cause constriction of the blood vessels. Adherence of of blood coagulation is explained in the next chapter.
     128   Section 2     Blood and Body Fluids
                                       Injury to the biood vessel and damage of endothelium
                                                         Exposure of collagen
                                     von Willebrand factor
                                                  Adherence of platelets to collagen
                                                         Activation of platelets
               Secretion of serotonin                    Secretion of ADP and                    Formation of
                                                             thromb0xane A                   prothrombin activator
                                                                              PAI
                                                             Aggregatb
                  Vasoconstriction                            Platelet plug                     Blood clotting
                                                               formation
                       Stage                                      Stage 2                          Stage 3