Bài giảng Quá trình Cầm máu

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Nội dung text: Bài giảng Quá trình Cầm máu

  1. QUÁ TRÌNH CẦM MÁU
  2. Primary Hemostasis
  3. Diagrammatic Representation of the Platelet
  4. Megakaryocyte
  5. Platelets forming from cytoplasm
  6. Normal platelets and one giant platelet
  7. 1. Tiãøu cáöu 1.1. Âàûc tênh cå baín
  8. Cyclo oxygenase
  9. Platelet Phospholipase A2 Phospholipid Arachadonic acid Cyclooxygenase Endoperoxidases Thromboxane synthase Thromboxane A2 Phosphodiesterase Calcium flux
  10. Platelet Function and Aspirin Endothelial cell Platelet Aspirin
  11. BLOOD CLOTTING/COAGULATION: Participants WABeresford BLOOD PLATELETS ENDOTHELIAL CELLS COLLAGEN, CELLS, ETC, OF VESSEL WALL
  12. BLOOD CLOTTING/COAGULATION: Problem Torn wall, Gaps in endothelium, Exposed collagen, Oozing/gushing blood PLATELETS ENDOTHELIAL CELL BLOOD EXPOSED COLLAGEN
  13. BLOOD CLOTTING/COAGULATION: Solutions PLATELETS ENDOTHELIAL CELL EXPOSED COLLAGEN BLOOD Elements to stick to the damaged wall Elements that stick to each other to make a plug Blood material to build a scaffold reinforcing the plug Controls (+ & -) to direct & restrain the processes Ways to consolidate, then later dissolve the plug
  14. BLOOD CLOTTING/COAGULATION: Solutions Elements to stick to the damaged wall Platelets Endothelium Elements that stick to each other to make a plug Platelets Blood material to build a scaffold reinforcing the plug Fibrinogen Controls (+ & -) to direct & restrain the processes Clotting factors Ways to consolidate, then later dissolve the plug Transglutaminase; Plasmin
  15. BLOOD CLOTTING/COAGULATION: Clot BLOOD ENDOTHELIAL CELL EXPOSED COLLAGEN PLATELETS, FIBRIN NETWORK AGGREGATED/AGGLUTINATED
  16. How to get platelets to stick & the clot to form Released factors vWF Thrombin Activation mechanisms Activated receptors Binding intermediaries vWF BLOOD PLATELETS vWF ENDOTHELIAL CELL vWF vWF EXPOSED COLLAGEN
  17. PLATELETS & ENDOTHELIUM Platelet membrane Platelet granules Platelet granules Platelet cytoskeleton Endothelial membrane Weibel-Palade granules
  18. STICKINESS & PLATELET ACTIVATION I Thrombin a a a a vWF Factor XIII Fibrinogen vWF vWF a a a GP IIb/IIIa vWF vWF a exposed collagen in sub-endothelium GP IIa GP Ia GP Ib-IX-V GPs - platelet glycoprotein adhesion molecules
  19. STICKINESS & PLATELET ACTIVATION II vWF GP Ib-IX-V Receptor complex activates GP IIb/IIIa Receptor complex vWF release Irreversible adhesion Platelet recruitment by vWF & ADP signaling a a a a Platelet spreading a a a a 2+ a a + Ca a a
  20. 1.2. Chæïc nàng TC
  21. Spaan J. A. E. et al., 2003
  22. Wall Structures of Veins, Arteries, Arterioles and Capillaries
  23. Wall Structures of Veins, Arteries, Arterioles and Capillaries Vein Muscular Arteriole Capillary artery
  24. 2.3. Vai troì cuía täø chæïc dæåïi näüi maûc
  25. CAÏC GIAI ÂOAÛN CÁÖM MAÏU 1. Thåìi kyì âáöu tiãn 1.1. Hiãûn tæåüng co maûch
  26. 1.2. Dênh tiãøu cáöu vaìo låïp dæåïi näüi maûc 1.3. Hoaût hoaï quaï trçnh âäng maïu
  27. 2. Thåìi kyì måí räüng 2.1. Voìng xoàõn hoaût hoaï tiãøu cáöu 2.2. Caïc cháút gáy ngæng táûp tiãøu cáöu
  28. 3. Thåìi kyì hoaìn thiãûn 3.1. Hoaìn chènh nuït cáöm maïu 3.2. Caïc YT tham gia h/tæåüng co cuûc maïu
  29. ÂIÃÖU HOAÌ QUAÏ TRÇNH CÁÖM MAÏU 1. Vai troì cuía huyãút tæång 2. Vai troì cuía thaình maûch 3. Vai troì cuía caïc tãú baìo maïu 4. Vai troì cuía quaï trçnh tiãu fibrin
  30. This scanning electron micrograph shows the fine structure of a blood clot. Platelets released from the circulation and exposed to the air use fibrinogen from the blood plasma to spin a mesh of fibrin.