Define Physiology and Anatomy of Hemostasis Terms Flashcards

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Hemostatis 
The process by which blood vessels are repaired after an injury. It starts from vascular contraction as an initial reaction to injury, then to clot formation, and finally removal of the clot when the repair to injury is done. 
Four stages of Hemostatis
1. Vascular phase2. Platelet phase3. Coagulation phase4. Fibrinolysis
Stage one of hemostatis
Injury to a blood vessel causes it to constrict, slowing the flow of blood
Stage two of hemostatis
Injury to the endothelial lining causes platelets to adhere to it.Additional platelets stick to the site, forming a temporary platelet plug in a process called 'aggregation.'Vascular phase and platelet phase comprise the primary hemostatis. Bleeding time test is used to evaluate primary hemostatis.
Stage three - coagulation phase
Involves a cascade of interactions of coagulation factors that converts the temporary platelet plug to a stable fibrin clot. The coagulation cascade involves an intrinsic system and extrinsic system, which ultimately come together in a common pathway.
Activated partial thromboplastin time (APTT) - test used to evaluate the intrinsic pathway. This is also used to monitor heparin therapy.
Prothrombin time (PT) - test used to evaluate the extrinsic pathway. This is also used to monitor coumadin therapy.
Stage four - Fibrinolysis
This is the breakdown and removal of the clot. As tissue repair starts, plasmin (an enzyme) starts breaking down the fibrin in clot. Fibrin degradation products (FDPs) measurement is used to monitor the rate fibrinolysis. 
SPECIAL SPECIMEN HANDLING
SPECIAL SPECIMEN HANDLING
Warmed Specimen
Some tests require that the specimen collected be kept warm until the serum is separated from the cells. 
Blood is collected in tubes pre-warmed in the incubator (or Chemical hand warmer) for 30 minutes.
Chilled Specimens
Some test require that the specimen collected be chilled immediately after collection in an ice and water mixture. The specimen then must be immediately transported to the lab for processing.
Light-sensitive specimens
Wrap in aluminum foild immediately after they are drawn.
Exposure to light coudl alter the test results for: Bilrubin, beta-carotene, Vitamins A and B6, and porphyrins.
Cold Agglutinins
C.A. are antibodies produced in response to Mycoplasma pneumoniae infection (atypical pneumonia). The antibodies formed may attach to red blood cells at temperatures below body temperature, and as such, the specimen must be kept warm until the serum is separated from the cells. Blood is collected in red-topped tubes pre-warmed in the incubator at 37 degrees Celsius for 30 minutes.
Chilled specimens
Some tests require that the specimen collected be chilled immediately after collection in crushed ice or ice and water mixture. Likewise, the specimen must be immediately transported to the laboratory for processing. Some of the tests that require chilled specimen are: arterial gases, ammonia, lactic acid, pyruvate, ACTH
Specimens that require Chilling
- ammonia- Arterial Blood Gases (also determine PH)- Gastrin - Glucagon- Lactic Acid- Parathyroid Hormone- Partial Thromboplastin Time- Prothrombin Time
Specimens that require protection from Light
- Bilirubin-Carotene-Red Cell Folate- Serum Folate- Urine Porphyrins- Vitamin B12
Specimens requiring 37 degree Celsius Collection and transportation
- Cold agglutinin- Cryofibrinogen- Cryoglobulin (Cryoprotein)