DEPT.

OF PHYSIOLOGY
Chettinad Academy of
Research & Education.
HEMOSTASIS.
STRUCTURE & PROPERTIES OF PLATELETS.
MECHANISM OF PRIMARY HEMOSTASIS.
APPLIED PHYSIOLOGY.
Dr. Sanjay Andrew,
Professor of Physiology.
 HEMOSTASIS.
 Refers to prevention of blood loss
following blood vessel injury.
 Includes the following events in
response to blood vessel trauma:
Vasoconstriction.
PRIMARY
Formation of the
HEMOSTASIS
platelet plug.
Blood coagulation.
SECONDARY
Retraction and
HEMOSTASIS
fibrosis of the clot.
STEPS OF HEMOSTASIS
Hemostasis
 PRIMARY HEMOSTASIS.
 Mediated by platelets.
 Vasoconstriction following blood
vessel injury is due to:
a) Local myogenic spasm.
b) Factors derived from traumatized
tissue as well as platelets which
secrete thromboxane A2 that
causes vasoconstriction.
c) Reflexes mediated by the ANS.
 Bleeding from a blood vessel is
more severe in cut injuries than in
blunt injuries.
 The reason for this is that the
degree of vasoconstriction is
more following a blunt injury than
a cut injury.
 Thus Hemostasis is more efficient
in blunt injuries.
 PHYSICAL AND CHEMICAL
PROPERTIES OF
PLATELETS.
 Are small cells 1-4 micrometers in
diameter.
 Are derived from megakaryocytes
which are large cells that fragment
into platelets either in the bone
marrow or in the systemic circulation.
 Lack a nucleus.
 The normal platelet count = 1.5-3
lakhs/microliter of blood.
Formed Elements on a
Peripheral Blood Smear
Megakaryocyte to Platelets
Platelets on a Peripheral
Blood Smear
Platelets
 PHYSICAL AND CHEMICAL
PROPERTIES OF
PLATELETS.
 The cytoplasm of platelets contains
dense granules and α granules that
consist of:
a) Actin and myosin – which is
responsible for their contraction.
b) Thrombasthenin – another contractile
protein.
c) Endoplasmic reticulum & Golgi
apparatus – which synthesize various
enzymes and store large amounts of
calcium.
d) Mitochondria – are well differentiated
to provide sufficient chemical energy
for platelets to contract.
 PHYSICAL AND CHEMICAL
PROPERTIES OF
PLATELETS.
e) Prostaglandins – which are local
hormones that mediate local
vascular & tissue reactions.
f) Fibrin stabilizing factor-factor
XIII – that has a role in blood
coagulation.
g) Platelet derived growth factor
which promotes the growth of
vascular endothelium and
smooth muscle following injury.
 PHYSICAL AND CHEMICAL
PROPERTIES OF
PLATELETS.
 The cell membrane of platelets
contains a layer of glycoprotein
that repels normal endothelium
yet adheres to damaged
endothelium.
 Platelet cell membrane also
contains phospholipids that
activate steps in blood
coagulation.
 Half life of platelets = 7-10 days.
 MECHANISM OF THE
PLATELET PLUG.
 When platelets contact damaged
vessel wall they undergo the
following changes:
a) They swell and assume irregular
forms that project pseudopods.
b) They contract and release
granules that contain multiple
active factors.
c) They become sticky and adhere
to the damaged tissue.
 MECHANISM OF THE
PLATELET PLUG.
d) They adhere to a protein known
as Von Willebrand factor.
e) They secrete large amounts of
ADP and their enzymes form
thromboxane A2. This is
responsible for activation of
adjacent platelets completing
the formation of the platelet
plug.
 SIGNIFICANCE OF THE
PLATELET PLUG.
 The platelet plug seals off
microtrauma to the blood vessels
that occur thousands of times in a
normal person within a 24 hour
period.
 Thrombocytopenia is thus
associated with hemorrhage
within the body.
Platelet Plug
The Platelet Plug
 Functions of platelets.
 Helps in vasoconstriction following blood vessel
injury. Thromboxane A2 is a potent
vasoconstrictor.
 Forms the platelet plug in response to blood
vessel injury.
 Helps in clot formation by providing
phospholipids & fibrin stabilizing factor.
 Due to its contractile ability platelets help in clot
retraction.
 Platelet derived growth factor is a smooth
muscle cell mitogen that promotes healing after
blood vessel injury.
 Platelets are weak phagocytes.
 THROMBOPOIESIS.
 Occurs in the bone marrow.
 Megakaryocytes are the
precursors of platelets.
 Is stimulated by thrombopoietin
which is produced in the liver &
kidneys.
THROMBOPOIESIS
 TESTS FOR PLATELET
FUNCTION.
 Bleeding time.
 Clot retraction time.
 APPLIED PHYSIOLOGY.
 Thrombocytopenia purpura.
 Thrombocytosis.
 Thrombasthenia purpura.
 Petechial Hemorrhages in a
Patient With Thrombocytopenia
 REFERENCE
LITERATURE.
 TEXTBOOK OF MEDICAL
PHYSIOLOGY – GUYTON.
 REVIEW OF MEDICAL
PHYSIOLOGY – GANONG.