第四节 血栓与 及止血检测 .ppt

;;;Intrinsic XII,XI,IX,VIII (APTT);XIIIa;NORMAL HEMOSTASIS GENERAL COMPONENTS;Hemostasis:;Adhesion;Platelet Activation Pathways (2);I - Fibrinogen II - Prothrombin III - Thromboplastin IV - Calcium V - Labile f. VI - Suture deficiency VII - Stable f. ;Intrinsic XII,XI,IX,VIII (APTT);XIIIa;Normal Hemostasis;Antithrombin III and Heparin Proteins C and S TFPI;Fibrinolysis;;;;;;;;;;;;; ;;;;;;;Tests of Hemostasis;APTT;Prothrombin Time (PT);Thrombin Time (TT);Hemostasis and Thrombosis;Normal Hemostasis;Thrombosis;Normal sequence of Hemostasis (4 steps);2. Exposure of subendothelial ECM when there is endothelial injury ECM, especially collagen, is highly thrombogenic Platelets adhere and become activated Change in shape Release of secretory products Aggregation of platelets forms hemostatic plug This is primary hemostasis ;First two steps of normal hemostasis;Normal hemostasis continued;Normal hemostasis continued;Steps 3 and 4;The Main Players in Hemostasis;Endothelial Cells;Endothelial Cells have Prothrombotic Effect;For wound healing;Endothelial cells have Anti-thrombotic properties, too;Factors that favor or inhibit thrombosis;SOooo…..;Platelets;Platelets;Platelets continued;Platelets continued;Thrombocytopenia;Coagulation Cascade;Two pathways of coagulation cascade;Coagulation cascade;Control of cascade to prevent clotting elsewhere;Conditions Causing Bleeding;Hereditary deficiencies;Von Willebrand’s Disease;Platelet Disorders;Platelet Disorders;Thrombi;Thrombotic cycle and influences;Endothelial injury is dominant influence;Alterations in normal blood flow;Stasis and Turbulence;Hypercoagulability;Hypercoagulability;Hypercoagulability;Hypercoagulability;Hypercoagulability;Hematologic Drugs;Hematologic Drugs;Hematologic Drugs;Fate of thrombus;Fate of thrombus, continued;Fates continued;Hemostasis and Thrombosis;Principle of Hemostasis;Process of hemostasis at site of injury;Vascular structure consist of 3 tunics;Blood Vasculature;Vascular role in Vasoconstriction