The clotting process begins when blood vessels are damaged. Platelets are released from the bloodstream and stick to the damaged tissue, where they release enzymes that trigger a chain reaction. This leads to the conversion of fibrinogen into fibrin threads, which weave together to form a blood clot that seals the break in the blood vessel. For patients with hemophilia, this clotting process does not work properly due to a genetic defect, so their blood does not clot normally and they are at risk of excessive bleeding from minor injuries. The document then describes the steps of clotting in more detail and discusses some blood clotting disorders.

1. THE CLOTTING PROCESS OF BLOOD
BY: PRANAJA ABEL AND ADIMAS HERSETIAWAN/ AKSEL 11
This time we will learn about the process of
blood clotting. We can learn how blood can
clotting if we hurt.
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Let’s go !!

2. CLOTTING BLOOD
 The clotting process of blode is done by blood
platelets/ Trobosit. In a normal state each one milliliter
of blood of adults contain 200.000 – 400.000 blood
platelets.
 When we hurt, we will release blood and a few time
later the blood will freeze. But not in patients with
hemophilia, their blood will difficult to freeze.
Hemophilia coused by a genetic from their parents.
How blood clotting?

3. TAHAP-TAHAP PEMBEKUAN DARAH
 Kulit terluka menyebabkan darah keluar dari pembuluh.
Trombosit ikut keluar juga bersama darah kemudian
menyentuh permukaan-permukaan kasar dan menyebabkan
trombosit pecah. Trombosit akan mengeluarkan zat (enzim)
yang disebut trombokinase.
 Trombokinase akan masuk ke dalam plasma darah dan akan
mengubah protrombin menjadi enzim aktif yang disebut
trombin. Perubahan tersebut dipengaruhi ion kalsium (Ca²+)
di dalam plasma darah. Protrombin adalah senyawa protein
yang larut dalam darah yang mengandung globulin. Zat ini
merupakan enzim yang belum aktif yang dibentuk oleh hati.
Pembentukannya dibantu oleh vitamin K.
 Trombin yang terbentuk akan mengubah firbrinogen menjadi
benangbenang fibrin. Terbentuknya benang-benang fibrin
menyebabkan luka akan tertutup sehingga darah tidak
mengalir keluar lagi. Fibrinogen adalah sejenis protein yang
larut dalam darah

5. PRIMARY AND SECONDARY HEMOSTASIS
 Primary Hemostasis
When a blood vessel is injured, sub-endothelium proteins,
notably the von Willebrand factor (vWF) is exposed. These
factors recruit collagen (main protein of the connective tissue of
animals) and other clotting factors. As a result, the platelets
circulating in blood adhere to the collagen and set off a series of
reactions which result in release of other substances that cause
further adhesion of platelets with collagen. The bound platelets
release more substances that enhance their clumping and aid
the formation of plug of platelets.
 Secondary Hemostasis
Secondary hemostasis involves a cascade of reactions, the aim
of which is to form fibrin. The initial part of this step can be
achieved either by:
 The Tissue Factor Pathway (or the extrinsic pathway)
 The Contact Activation Pathway (or the intrinsic pathway)

6. BLOOD CLOTTING DISORDERS
 Of the various blood disorders, there are many that
are caused due to improper blood clotting. If blood
clots very easily or faster than the normal rate, then
it leads to a condition called thrombosis.
Conversely if it takes long for blood to clot, then one
may suffer from hemorrhage. Hemophilia is another
blood clotting disorder in which blood does not clot
on its own without the help of medical intervention.
Some common blood clot disorders are blood clot
in lungs, deep vein thrombosis and blood clot in the
brain. One needs to be aware of blood clot
symptoms in order to recognize unwanted blood
clots in the body.

7. PENYAKIT HEMOFILIA
 Hemophilia is an inherited bleeding disorder. The blood of someone with
hemophilia will not clot normally. Bleeding may occur spontaneously or
following injury.
 Hemophiliaoccurs in 2 forms, hemophilia A and B. In both forms,
a gene is defective. The defective gene interferes with the ability of the
body to produce the clotting factors that allow for normal clotting. The
result is a tendency for abnormal, excessive bleeding.
 Hemophilia A occurs in 1 in 10,000 people. Hemophilia B occurs in 1 in
40,000.
 With either disorder, you may show a mild form in which bleeding occurs
only under severe stress, such as major injury.
 Moderate cases rarely will have spontaneous bleeding but will bleed
aftersurgery or trauma.
 Severe cases will exhibit spontaneous bleeding-that is, bleeding without any
recognizable trauma. Spontaneous bleeding can occur in any part of your
body, but it is usually in the joints of the fingers, wrists, feet, andspine.

9. THE END
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