Platelets
• INTRODUCTION
• STRUCTURE AND COMPOSITION
• NORMAL COUNT AND VARIATIONS
• PROPERTIES
• FUNCTIONS
• DEVELOPMENT
• LIFESPAN AND FATE
• APPLIED PHYSIOLOGY – PLATELET
DISORDERS
INTRODUCTION
• Platelets or thrombocytes are the formed
elements of blood.
• Platelets are small colorless, non-nucleated
and moderately refractive bodies.
• Size of Platelets
Diameter : 2.5 μ (2 to 4 μ)
Volume : 7.5 cu μ (7 to 8 cu μ).
• Shape of Platelets: Normally, platelets are of
several shapes, viz. spherical or rod-shaped
and become oval or disk-shaped when
inactivated, dumbbell shape.
STRUCTURE AND COMPOSITION
• Platelet is constituted by:
1. Cell membrane or surface membrane
2. Microtubules
3. Cytoplasm.
1. CELL MEMBRANE:
• 6 nm thick.
• Cell membrane of platelet contains of -
Glycoproteins, Phospholipids .
[Link]: Microtubules form a ring
around cytoplasm below the cell membrane.
• These tubules provide structural support for
the inactivated platelets to maintain the disk
like shape.
3. CYTOPLASM: Cytoplasm of platelets contains
the cellular organelles, Golgi apparatus,
endoplasmic reticulum, mitochondria,
microtubule, micro vessels, filaments and
granules.
NORMAL COUNT AND VARIATIONS
• Normal platelet count is 2,50,000/cu mm of
blood. It ranges between 2,00,000 and
4,00,000/cu mm of blood.
PHYSIOLOGICAL VARIATIONS
• 1. Age: Platelets are less in infants (1,50,000
to 2,00,000/cu mm) and reaches normal level
at 3rd month after birth.
• 2. Sex: There is no difference in the platelet
count between males and females. In females,
it is reduced during menstruation.
• 3. High altitude: Platelet count increases.
• 4. After meals: After taking food, the platelet
count increases.
PROPERTIES OF PLATELETS
Platelets have three important properties :
1. Adhesiveness 2. Aggregation
3. Agglutination.
• 1. ADHESIVENESS: Adhesiveness is the
property of sticking to a rough surface.
• 2. AGGREGATION (GROUPING OF PLATELETS)
• 3. AGGLUTINATION: Agglutination is the
clumping together of platelets.
FUNCTIONS OF PLATELETS
1. ROLE IN BLOOD CLOTTING: Platelets are
responsible for the formation of intrinsic
prothrombin activator. This substance is
responsible for the onset of blood clotting.
• 2. ROLE IN CLOT RETRACTION: Cytoplasm of
platelets contains the contractile proteins,
namely actin, myosin and thrombosthenin,
which are responsible for clot retraction
• 3. ROLE IN PREVENTION OF BLOOD LOSS
(HEMOSTASIS): Platelets secrete 5-HT, which
causes the constriction of blood vessels.
• 4. ROLE IN REPAIR OF RUPTURED BLOOD
VESSEL : Platelet-derived growth factor
(PDGF) formed in cytoplasm of platelets is
useful for the repair of the endothelium and
other structures of the ruptured blood vessels.
• 5. ROLE IN DEFENSE MECHANISM: By the
property of agglutination, platelets encircle
the foreign bodies and destroy them.
• DEVELOPMENT OF PLATELETS:
• Platelets are formed from bone marrow.
• Pluripotent stem cell gives rise to the colony
forming unit-megakaryocyte (CFU-M).
• This develops into megakaryocyte.
• Cytoplasm of megakaryocyte form
pseudopodium.
• A portion of pseudopodium is detached to
form platelet, which enters the circulation
LIFESPAN AND FATE OF PLATELETS
• Average lifespan of platelets is 10 days.
• It varies between 8 and 11 days. Platelets are
destroyed by tissue macrophage system in
spleen.
• So, splenomegaly (enlargement of spleen)
decreases platelet count and
• splenectomy (removal of spleen) increases
platelet count.
APPLIED PHYSIOLOGY -PLATELET DISORDERS
Platelet disorders are:
• Thrombocytopenia
• Thrombocytosis
• Thrombocythemia
• Glanzmann’s thrombasthenia.
Thrombocytopenia: Decrease in platelet count is
called thrombocytopenia.
• Acute infections, Typhoid, Tuberculosis
Thrombocytosis:Increase in platelet count is called
thrombocytosis.
• Allergic conditions, Asphyxia, Hemorrhage, Bone
Thrombocythemia: Thrombocythemia is the
condition with persistent and abnormal
increase in platelet count.
• Carcinoma, Chronic leukemia.
Glanzmann’s Thrombasthenia: Glanzmann’s
thrombasthenia is an inherited hemorrhagic
disorder, caused by structural or functional
abnormality of platelets. It leads to
thrombasthenic purpura.
Hemostasis
• DEFINITION: Hemostasis is defined as arrest
or stoppage of bleeding.
• STAGES OF HEMOSTASIS: It occurs in three
stages,
• 1. Vasoconstriction
• 2. Platelet plug formation
• 3. Coagulation of blood.
Coagulation of Blood/Enzyme Cascade Theory
• DEFINITION: Coagulation or clotting is defined as the
process in which blood loses its fluidity and becomes
a jelly-like mass few minutes after it is shed out or
collected in a container.
• FACTORS INVOLVED IN BLOOD CLOTTING:
Thirteen clotting factors are identified:
• Factor I Fibrinogen
• Factor II Prothrombin
• Factor III Thromboplastin (Tissue factor)
• Factor IV Calcium
• Factor V Labile factor (Proaccelerin or accelerator
globulin)
• Factor VI Presence has not been proved
• Factor VII Stable factor
• Factor VIII Antihemophilic factor
(Antihemophilic globulin)
• Factor IX Christmas factor
• Factor X Stuart-Prower factor
• Factor XI Plasma thromboplastin antecedent
• Factor XII Hageman factor (Contact factor)
• Factor XIII Fibrin-stabilizing factor (Fibrinase).
SEQUENCE OF CLOTTING MECHANISM
• ENZYME CASCADE THEORY: Enzyme cascade
theory explains how various reactions, involved
in the conversion of proenzymes to active
enzymes take place in the form of a cascade.
• Stages of Blood Clotting
In general, blood clotting occurs in three stages:
• 1. Formation of prothrombin activator
• 2. Conversion of prothrombin into thrombin
• 3. Conversion of fibrinogen into fibrin.
• BLOOD CLOT: Blood clot is defined as the
mass of coagulated blood which contains
RBCs, WBCs and platelets entrapped in fibrin
meshwork.
• CLOT RETRACTION: After the formation, the
blood clot starts contracting. And after about
30 to 45 minutes, the straw-colored serum
oozes out of the clot. The process involving
the contraction of blood clot and oozing of
serum is called clot retraction.
• FIBRINOLYSIS: Lysis of blood clot inside the
blood vessel is called fibrinolysis.
ANTICLOTTING MECHANISM IN THE BODY:
Physical Factors
• Continuous circulation of blood.
• Smooth endothelial lining of the blood vessels.
Chemical Factors – Natural Anticoagulants:
• All the clotting factors are in inactive state.
ANTICOAGULANTS
• Substances which prevent or postpone coagulation
of blood are called anticoagulants.
Anticoagulants are of three types:
• 1. Anticoagulants used to prevent blood clotting
inside the body, i.e. in vivo.
• 2. Anticoagulants used to prevent clotting of
blood that is collected from the body, i.e. in
vitro.
• 3. Anticoagulants used to prevent blood clotting
both in vivo and in vitro.
HEPARIN
COUMARIN DERIVATIVES: Warfarin.
EDTA
OXALATE COMPOUNDS
CITRATES
• PROCOAGULANTS: accelerate the process of
blood coagulation. Procoagulants are:
THROMBIN, SNAKE VENOM, EXTRACTS OF
LUNGS AND THYMUS.
TESTS FOR BLOOD CLOTTING:
• 1. Bleeding time
• 2. Clotting time
• 3. Prothrombin time
• 4. Partial prothrombin time
• 5. International normalized ratio
• 6. Thrombin time.
APPLIED PHYSIOLOGY
BLEEDING DISORDERS: Bleeding disorders are of
three types:
• 1. Hemophilia.
• 2. Purpura.
• 3. von Willebrand disease.
• Hemophilia : Hemophilia is a group of sex-linked
inherited blood disorders, characterized by
prolonged clotting time.
Causes of hemophilia: lack of formation of
prothrombin activator.
• The formation of prothrombin activator is affected
due to the deficiency of factor VIII, IX or XI.
Types of hemophilia:
• Hemophilia A or classic hemophilia:
deficiency of factor VIII.
• Hemophilia B :deficiency of factor IX.
• Hemophilia C or factor XI deficiency:
• Symptoms of hemophilia: Spontaneous
bleeding, Appearance of blood in urine.
• Purpura: Purpura is a disorder characterized
by prolonged bleeding time.
• Symptoms : hemorrhagic spots, purpuric
spots, ecchymoses.
• Types and causes of purpura:
• Thrombocytopenic purpura
• Idiopathic thrombocytopenic purpura
• Thrombasthenic purpura
• von Willebrand Disease: It is due to deficiency
of von Willebrand factor.
• THROMBOSIS : Thrombosis or intravascular
blood clotting refers to coagulation of blood
inside the blood vessels.
• Complications of Thrombosis: Thrombus,
Embolism and embolus, Ischemia, Necrosis and
infarction.