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The division of coagulation in two pathways is arbitrary, originating from laboratory tests in which clotting times were measured either after the clotting was initiated by glass, the intrinsic pathway; or clotting was initiated by thromboplastin (a mix of tissue factor and phospholipids), the extrinsic pathway. [31]
Therefore, although the coagulation cascade can be triggered in vitro through the intrinsic pathway only, in vivo coagulation is triggered by the extrinsic pathway. However, the model better describing how coagulation works is the so-called cell-based model, a more integrated picture of the whole process, in which phospholipid surfaces, such as ...
[4] [5] [6] The ability of FXII to bind to negatively charged surfaces and activate coagulation forms the basis of the aPTT test, in which artificial materials act as a surface for contact activation. This test is used to measure the contact activation pathway (intrinsic pathway) and the common pathway of clotting. [7]
Its role in the blood clotting is the initiation of thrombin formation from the zymogen prothrombin. Thromboplastin defines the cascade that leads to the activation of factor X—the tissue factor pathway. In doing so, it has replaced the previously named extrinsic pathway in order to eliminate ambiguity.
Blood coagulation pathways in vivo showing the central role played by thrombin. Factor Xa is the activated form of the coagulation factor X, also known as thrombokinase. Factor X is an enzyme, a serine endopeptidase, which plays a key role at several stages of the coagulation system. Factor X is synthesized in the liver.
Blood is drawn into a test tube containing liquid sodium citrate, which acts as an anticoagulant by binding the calcium in a sample. The blood is mixed, then centrifuged to separate blood cells from plasma (as prothrombin time is most commonly measured using blood plasma). In newborns, a capillary whole blood specimen is used. [2]
Characteristics of the velocity of passage of the intrinsic coagulation pathway; Poor plasma (the most convenient to work with, but no realization of the thrombocyte clotting mechanism) Contact activation pathway; Prothrombin time test (or prothrombin test, INR, PT) – velocity of passage of the extrinsic blood coagulation pathway Poor plasma
Factor XI (FXI) is produced by the liver and circulates as a homo-dimer in its inactive form. [9] The plasma half-life of FXI is approximately 52 hours. The zymogen factor is activated into factor XIa by factor XIIa (FXIIa), thrombin, and FXIa itself; due to its activation by FXIIa, FXI is a member of the "contact pathway" (which includes HMWK, prekallikrein, factor XII, factor XI, and factor IX).