DETERMINATION OF BLEEDING TIME

Date:
Definition

"It is the time interval between commencement and arrest of bleeding"

Apparatus required:
Sterile needle/Lancet, spirit, filter/ blotting paper, stop watch.
Duke's method:

The fingertip issterilized with spirit and allowed to dry.

A deep puncture is made with a lancet.
Blood will start flowing and the time is noted as 0 second. Blood collected on the fingertip is
blotted by touching it with a filter paper every 15 seconds in sequence.
Each time fresh part of filter paper is used.
The blood spots on the filter paper gets smaller each time and finally no trace of blood is left
on the filter paper, i.e. the bleeding has completely stopped.
The number of bloodspots on the paper is counted and bleeding time is calculated and
expressed in minutes.

Normal bleeding time is 1 -3 minutes

Observation:The bleeding time ofthe subject is: @mìnutes
QUESTIONS:
30 Seconds.
1. Define bleeding time?
2. What is the role of platelets in arrest of
bleeding?
3. What are the contents of platelet
4. List the functions of
granules?
platelets?
5. What is purpura?

Date: Signature

55
 efine bleeding time ?
3leeding time is defined as time ite val
between puncture to the vessel to the
Stoppage f bleeding
2 What 1s the role ct platelets in
Of biecding ? arrest
>Bleeding time dep ends on the
of
vasoconstriction and effectivenes
platelct plug
formation
The response ot platelets in
nclu de Change in Shape, hemast as is
Surface increase in
adhesiventss
aggregrate with other and the tencdency to
pug plateleta to fom a
’plateiets Cidhere to the injured vessel wal.
’Adhesion is followed by aggregation of
Dlatelcts, which are activated to releaue
a number of chemicals that case
Vasoconstriction and temporany hemostatic
plug formation.
3. TWhat are the cont ents ot
platelet granule ?
’Dene granules mainly contain
6iogctive amins or example, Sero tomin
and histamlne), adenine
Mucleotidesas
poly phosphata and Pyrophasphatea
wel as high concentralions of
particulanly Caleiun Catiane

56
 4. dst the funtions f platelets ?
’Regulation of hemostasis in the vesrel.
Amportant role in innate immunity
’ Regulation o tumor giowth and
ertra vas ations in the Vessel
’Thein primary function is to prevent
and Stop 6leeding
6. What upurpura ?
Purpura is a condition of ed o purple
discofored spots on the Skin that do not
blanch on applying pressuIe.
Yhe Spots ar Caused by bleedig undern eath
disorders,
the skin secondary to platelet disordes, or
Vascula7 disordeS, Coagul ation
Other Causes .

57
 DETERMINATION OFCLOTTING TIME
Definition
*It is time taken by the
blood to form a fibrin strand it
after has been shed."
Method (capillary tube method):
The Fingertip is
Blood is drawn sterilized using spirit and a deep
the drop of blood.immediately into a capillary tube puncture
is made with a
by placing one lancet.
The capillary tube is end of the capil
The tube is held in tilted downwards so that it fills
between
After two minutes small the two immediately
palms for two minutes and the tËme is tM
observing for lengths of capillary tube are to maintain optimum t
When the threadformation
of clot isof-fibrin threads between the snapped off every 30 set
The time from the seen the
start of blood flowtimeto noted.
is snapped ends.
the
Normal value is 3-8 minutes.
formation of clot gives the clotting timk
Observation:The normal clotting time of thesubject is.
mìnutes
30 seconds
QUESTIONS:

1. Define clotting time?

. What are the 3 major steps in mechanism of clotting?
. What are the indications for determining bleeding time and clotting time?
. Name vitamin K dependent clotting factors?
5. Name the clotting disorders?
. Whatis the mode of inheritance in hemophilia?
7. Why blood does not clot inside the body?
8. What are anticoagulants,classify and mention the mode of action of each?

1. Jefine clotting time?

’ is time taken by the blood to form a
St rand after it has becn shea.
major
. What are the 3 stes nmechanism of
Clotting ?
Blood coagulations occurs in three St ages.
1.Activatlon of Stuart- Powr factor.
2-formation of th1ombin trom prothiombin.
3. fho1mation ot fibiin from fibrinogen.
3. What are the in dications for determining
Dlecding time and Clottin¢ time ?
The bleeding time mormal Tange u
ppToximatchy a-9 minutes, and
the Clotting time normal Tange u
S-15 mìnute.

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 A6nomad blcedina teut vesutls could indicate
Plated -lated disorders , Such as
t61ombocytoopcnia, genctic bleeding disorder,
7nreased isk of haemorrhages and
(pis taas.
4. Name the
vitamin kdependent Clottimg
actors ?
’Vitamin K-dependent Clotting factors are
Commonly divided
factor - ||; ffatoxfnto
-VIlprofhenonhagic
; factor-lx ;
and antithyom6otic fiactor -x
Protein C
Protein s
5.
Name the clotting
’ Throm 60cytopenia
’ Thiom basthenia isordets ?

Adiopathica thrombocytopenic purpuTa

’Hemophili
’
Christm sdisease
6. What is the
mode of inheritance in
ofHemophilia
factor ym. ocCUTS ue to the hemophilia?
deficiency
’N iSis an X-(inked
disorder. recessive 6leeding
’The abnormality
X ch70mosome. is located on the
-> Women are Caries nd
uually- do not
Sutr 70m the cdisease becase
are prot ccled By the Second X- they
which is wially normal. 60
ChromoSoMe,
7.Why blood does not clot igide the body?
Yhe 6lpod dosnot clot inside the body
6ecawe ot the pesence of heparin in
the blo od
. What are anti
Coaqula nts Clasity and mentton
the mode of a ction of each ?
Anticoaqulant are a qroup of medications that
decrecse the blo od's abjlity to clot .
Anticoagula nta
Used in Viva Used in Vitro

Parenterad Orat |Heparin Calciunn

’ Some act directhy by en2yme Comp

inhibiti0n, while othrs
61nding to antithrombin 6 by
indinecthy, by tom the ltver
prerentin their SyHthes iu
Parentera Direct
Indtrect
Dinect
Oral Indirect
’Hepain MchyAntithrombin forms aa
Complex with
Activated Serine proteas
Co agulaton factors
JTnactivales
Da, Xa,Xo,XIa