Coag cascade

Nitrioxide and PGI₂

inactivates platelets

Heparin sulfate

natural anticoagulant, binds to Antithrombin II

Antithrombin II

degrades or inactivates Factors II, IV, and X

Thrombomodulin

Binds to thrombin II

Thrombin II

activates protein C (APC)

Protein C

Degrades factor V and VIII; proteins S and Ca²⁺ are cofactors in this process

Endothelin

secreted by epithelial cells in vascular spasm, causes smooth muscle to contract to cause vasoconstriction

vWF

secreted by damage epithelial cells once nitric oxide and PGI₂ are inhibited

GP1b

how vWF and platelets are bound together

GPIIbIIIa

how platelets bind to other platelets

ADP and Thromboxane A₂ (TxA₂)

secreted from platelets to activate even more platelets to bring them to the site of injury to cause plt aggregation

Thromboxane A₂ (TxA₂) and Serotonin

released from platelets to bind to smooth muscle and cause more constriction to add to vascular spams and vasoconstriction

Factor XII (Hagman’s Factor)

Comes into contact with negatively charged platelets first, start of intrinsic pathway

Factor XIIa

with the help of HMWK (Fitzgerald factor) and Fletcher Factor, activates Factor XI to XIa

Factor XIa

activates Factor IX to IXa

Factor IXa

interacts with Factor VIII to make a complex, but requires PF₃ and Ca²⁺ as cofactors

IXa, VIII, PF₃, Ca²⁺ complex

Group of intrinsic molecules that actives Factor X to Xa wich kick starts the common pathway

Xa, PF₃, Ca²⁺

group on common pathway molecules that activate the Prothrombin activator

Prothrombin activator

converts prothrombin (factor II) to thrombin (IIa)

Thrombin (IIa)

links fibrinogen and changes it to fibrin which is a soluble and jelly-like consistency

reacts with factor XIII in order to activate it, need Ca²⁺ as a cofactor in this step

Factor XIIIa

takes fibrin strands and cross links them to make a fibrin mesh which keeps the platelet plug in place

Tissue Factor (Factor III)

Start of extrinsic pathway, secreted by damaged cells, activates factor VII to VIIa

Factor VIIa

can activate Factor X to Xa (start of common pathway), or activate factor IX to IXa (end of intrinsic pathway)

Actin and myosin

start of the clot retraction and repair, pull edges of endothelial cells together

PDGF

secreted from platelets, goes to site of injury on smooth muscle and trigger mitosis

if there is damage to collagen it makes connective tissue patterns

Vascular endothelial growth factor (VEGF)

secreted by platelets, helps regenerate endothelial cells

Tissue Plasminogen Activator (TPA)

rests on epithelial cells and activates plasminogen to plasmin

Plasmin

degrades fibrin down to Fibrin degeneration products such as D-dimers