Bone hemostasis

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Bone Hemostasis is a physiological process that prevents bleeding in the bone. It involves the coagulation of blood to form a clot, which is then broken down once the injury has healed. This process is crucial for maintaining the integrity of the bone and preventing excessive blood loss during injury.

Overview[edit | edit source]

Bone hemostasis is a complex process that involves several steps. First, when a blood vessel in the bone is damaged, the body responds by constricting the vessel to reduce blood flow. This is followed by the activation of platelets, which adhere to the site of injury and form a plug. The coagulation cascade is then activated, leading to the formation of a fibrin clot. Finally, the clot is broken down by the process of fibrinolysis once the injury has healed.

Platelet Activation and Aggregation[edit | edit source]

Platelets play a crucial role in bone hemostasis. When a blood vessel is damaged, platelets are activated and adhere to the site of injury. This is facilitated by the protein von Willebrand factor, which binds to the platelets and the damaged vessel wall. The activated platelets then release substances that promote further platelet activation and aggregation, leading to the formation of a platelet plug.

Coagulation Cascade[edit | edit source]

The coagulation cascade is a series of reactions that lead to the formation of a fibrin clot. It involves two pathways: the intrinsic pathway, which is activated by contact with the damaged vessel wall, and the extrinsic pathway, which is activated by tissue factor released from the damaged tissue. These pathways converge to form the common pathway, which leads to the formation of a fibrin clot.

Fibrinolysis[edit | edit source]

Fibrinolysis is the process by which the fibrin clot is broken down. This is facilitated by the enzyme plasmin, which is activated by tissue plasminogen activator. Fibrinolysis is crucial for restoring normal blood flow once the injury has healed.

Disorders of Bone Hemostasis[edit | edit source]

Disorders of bone hemostasis can lead to excessive bleeding or clotting. These include hemophilia, von Willebrand disease, and thrombophilia. Treatment depends on the specific disorder and may involve medication, lifestyle changes, or surgery.

Bone hemostasis Resources
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Contributors: Prab R. Tumpati, MD