PLATELETS
• Also called Thrombocytes
• Main role in the arrest of bleeding
• Normal Value-2-5 lakhs/[Link] of blood
• Life span-8-11 days
STRUCTURE OF PLATELETS
Plasma membrane:-
• Contains phospholipids, cholesterol, glycolipids and glycoprotein coat.
• Glycoprotein coat are meant to combine with specific substances like collagen,
fibrinogen and von- Willebrand factor (factor that plays an important role in
platelet adhesion).
• Glycoprotein coat helps in the adhesion of platelets
• Shows extensive invagination with complicated canalicular system- serves as a
pathway for the uptake of cellular calcium and release of intracellular
substances to ECF
Platelet cytoplasm:-
• Non-nucleated (nucleus is absent but other cell organelles are present in
platelets).
• Endoplasmic reticulum and Golgi apparatus for synthesis of enzymes and
calcium storage.
• Mitochondria and enzyme system for the synthesis of ATP and ADP.
• Microtubules to maintain the oval shape.
• Contractile proteins- actin and myosin that enable activated platelets to change
shape.
Properties
• Adhesion- attachment to a rough surface.
• Aggregation- grouping of platelets.
• Agglutination- clumping of platelets.
• Blood vessels are of three layers:
• Outer layer – Epithelium
• Middle layer –layer of collagen fibers (smooth muscle with collagen fibers )
• Inner layer – endothelium
• Under normal conditions, the endothelium is smooth, so platelets do not stick to it.
• When the endothelium is damaged, the collagen fibers of the middle layer get exposed.
• As blood flows through the damaged area, platelets come in contact with the exposed
collagen.
• Since collagen is a rough surface, platelets attach to it.
• This attachment of platelets to collagen is called platelet adhesion (first property).
• After adhesion, the platelets get activated and their shape changes from oval to irregular
with pseudopodia.
• Activated platelets release chemical substances like ADP and thromboxane A₂, which attract
more platelets to the site of injury.
• This grouping of platelets is called platelet aggregation (second property).
• Finally, the aggregated platelets stick firmly to each other, forming a platelet plug. This
clumping of platelets is called platelet agglutination (third property).
Hemostasis
• Hemo- blood stasis- stable
• It is the arrest or stoppage of bleeding by physiological process.
• It include 3 steps:
I. Vasoconstriction
II. Platelets plug formation
III. Blood coagulation/ Blood clotting
Vasoconstriction
• Constriction of blood vessels just before the area of injury/damage.
• At the point of injury, platelets adhere on the exposed collagen fibers (rough
surface).
• Activated platelets release vasoconstrictors like serotonin (5-HT) and nor-
epinephrine that leads to vasoconstriction (narrowing of blood vessels).
• This helps in temporary prevention of blood loss.
II. Platelet plug formation
• Temporary hemostatic plug.
• Activated platelets adhere, aggregate and agglutinate at the point of injury to
form platelet plug.
• Temporarily seals the injured area thereby decreasing blood loss.
• Helps in the activation of clotting factors leading to blood coagulation
BLOOD COAGULATION
• Also called Permanent hemostatic plug.
• Process by which blood loses its fluid form and gets converted into a jelly- like
substance at the point of injury to prevent further blood loss.
• Occurs by the activation of clotting factors in blood.
CLOTTING FACTORS
• Factor I- Fibrinogen
• Factor II- Prothrombin
• Factor III- Tissue Thromboplastin
• Factor IV- Calcium
• Factor V- Labile factor
• Factor VI- Absent
• Factor VII- Stable factor
• Factor VIII- Anti- hemophilic factor
• Factor IX- Christmas factor
• Factor X- Stuart Prower factor
• Factor XI-Plasma thromboplastin
• Factor XII- Hegman factor
• Factor XIII- Fibrin stabilizing factor
Disorders of clotting factors:
• Hemophilia A is caused by deficiency of Factor VIII.
• Hemophilia B (Christmas disease) is caused by deficiency of Factor [Link]
patients show prolonged bleeding, especially into joints.
• Von Willebrand disease, caused by deficiency of von Willebrand factor, which is
required for platelet adhesion and for carrying Factor VIII.
• Vitamin K deficiency also causes clotting factor disorders because vitamin K is
essential for synthesis of Factors II, VII, IX, and X.
Stages of Blood coagulation
1. Formation of prothrombin activator in 2 pathways- Extrinsic pathway (from
injured tissues) and Intrinsic pathway (within the blood itself/damage to
blood vessel).
2. Conversion of prothrombin to thrombin
3. Conversion of fibrinogen to fibrin
Intrinsic pathway
Endothelial damage + collagen exposure
HMW Kinogen, Kallikrein
XII XIIa Platelets
XI XIa
IX IXa Phospholipids
VIII VIIIa
X Xa Va, Ca2+ Prothrombin activator