These
are membranes bound cell fragments, having no nucleus they are between 1-2um in
diameter and are about 1/10th to 1/20th abundant to white
blood cells. The production of platelets results from the fragmentation of
large cells called megakaryocytes which are cells derived from stem cells in
the bone marrow. They are produced ata rate of 200billon/day. The production is
regulated by a hormone known as thrombopoiesis. The circulating life is 8-10
days.
The stick surface of the cells allows them to accumulate at the site of
broken blood vessels to form a clot. The normal of this cell is between 150-450
x 10/L Blood clotting is the chief function of platelets and this can be
achieved in 3 states are:
1.
Vascular
spasm or vasoconstrictor.
2.
Formation
of platelet plug.
3.
Blood
clot formation.
Vascular spasm or Vasoconstriction:
In
a normal individual, immediately after a blood vessel has been cut open and
endothelial tissues are damaged, vasoconstriction occur thus slowing blood flow
to the area. The vascular spasm usually lasts for about 30 minutes, long enough
for the next stage of homeostasis to take place.
Formation of a plan platelet plug:
within
20seconds of an injury, coaglation is initiated. Contray to the popular belief
that clotting of a cut on the skin is not initiated by air or drying out, but
by platelet adhering to and activated by collagen in the blood vessels
endothelium. The activated platelet then release the content of hteir granules,
which contain a variety of substances that stimulate futher platelet activation
and enhace the homoeostatic process. This process involves lining up of thre
broken blood vessels and endothelial cells, revealing proteins in the vessel
wasll, platelets swell, grow spiky extensions and starts clumping together.
This results in a platelet plug that seals the injured area. if the injury is
small, a platelet plug may be able to form and close within seconds. Platelets
contain secretory granules and when they sick to the proteins in the vessel
walls they degranulate thus releasing their products which include ADP
(adenosine diphosphate), serotonin and thromboxane A2.
Blood clot formation:
here
the blood changes from a liquid to a gel, at least twelve substances called
clotting factors takes place in a series of chemical reactions that eventually
creates a mesh of protein fibers within the blood. This can be achieved by the
sole function of the clotting factors; these are produced and deposited in the
blood by the liver.
Normal
range:
Adult:
150-450 x 109/L (Cheesbrough, 2006).
200-400
x 103/ul (Ezeilo, 2002)
2.7
erythrocyte sedimentation rate (ESR)
this
test measure how quickly erythrocytes settles in at the bottom of a test tube
for an hour, when there is occurrence of inflammation in the body, certain
proteins cause red blood cells to stick together and fall more quickly than
normal to the bottom of the tube. This is a non-specific test which is raised
in a wide range of infectious, inflammatory, degenerative and malignant
conditions associated with changes in plasma proteins, particularly increase in
immunoglobulins, C-reactive proteins and fibrinogen. Moderately raised
sedimenation rates can sometimes be seen in healthy people (Cheesbrough, 2006).
The test is done using the Westergreen method which is gotten in millimeters
per hour. ESR can be increased by any cause or focus of inflammation such as in
pregnancy or rheumatoid arthritis, it can be decreased in sickle cell anaemia,
polythaemia. ESR values are higher in women as do the elderly (Brigden; 1998).
Normal
value for male: 10mm/hour (Cheesbrough, 2006).
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