Task 1. Bleeding duration determining (by Duke).
To prick the finger on the depth of scarificator point. To absorb flowing blood in every 30 sec in filter paper. Under norma bleeding duration is 2-4 minutes.
Task 2. Aggregatogram analysis principle.
Diagnostic value: it can give information about thrombocytes qualitative defects and platelets dysfunctions, platelets quantitative changes at different pathologic processes. This platelets’ function disturbance will be accompanied by hemorrhages from gums, oral mucosa.
Main aggregatogram indexes:
1. Aggregation angle (α – L on the figure) – index which reflects aggregation coming velocity; it is determined by aggregatogram curve ascent steepness after aggregation inductor addition.
2. Aggregation time (t1) – it is measured from aggregation initiating (beginning) till point on aggregatogram curve corresponding to maximal aggregation; it characterizes aggregation degree.
3. Aggregation latent period duration (t) – index which reflects processes not-registrated on photoelectrocalorymeter (PEC).
4. Desaggregation angle (в) – index which reflects desaggregation process velocity.
5. Aggregation height (h) – index reflecting aggregation degree; it corresponds to thrombocytic plasma optical density decreasing descent in course of aggregation.
FIGURE 12.Aggregatogram.
5. Literature recommended:
1. Lecture course.
2. Mistchenko V.P., Tkachenko E.V. Methodical instructions for dental students (short lecture course).-Poltava, 2005.-P.41-42.
3. Mistchenko V.P., Tkachenko E.V. Methodical instructions for medical students (short lecture course).-Poltava, 2005.-P. 71-73.
4. Mistchenko V.P., Tkachenko E.V. Blood system Physiology //Methodical recommendations to practical classes for students of medical and dental departments.-Poltava, 2005.-20p.
5. Kapit W., Macey R.I., Meisami E. The Physiology Colouring Book: Harpers Collins Publishers, 1987.-P. 138.
6.Guyton – Ganong – Chatterjee. Concise Physiology /Ed. By Dr Raja Shahzad Gull: M.B.B.S., F.C.P.S., King Edward Medical College.-Lahore, 1998 (1st Edition).-P.197-198.
7. Stuart Ira Fox. Human Physiology.-8th Ed.-McGrawHill, 2004.-P.369-370, 374.
8. Seeley R.R., Stephens T.D., Tate P. Essentials of Anatomy and Physiology.-The 3rd Ed.-McGraw Hill, 1999.-P.293-294, 300.
6. Materials for self-control:
Control questions
1. Thrombocytes, amount, structure.
2. Platelets functions.
3. Vascular-platelet hemostasis mechanism.
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4. Microcirculative hemostasis and its significance in dentistry.
5. Thrombocytopoiesis and its regulation.
LESSON 36
BLOOD COAGULATION INVESTIGATION
1. The topic studied actuality.
According to World Health Organization, hemostasiopathies place the first position among the death reasons in adult population.
Salivary glands secret as well as oral cavity different tissues (parodont, salivary glands, mucosa) possess expressed thromboplastin features. These features are the mostly expressed in aged people and in the old. Such an activity is a sign of all saliva types – submandibular, sublingual and parotid one.
Besides thromboplastin, saliva has also other procoagulants. They are analogues of V, VII, VIII, IX, X, XIII plasmic factors part of which is probably filtrated from blood. Saliva can not coagulate because of I and II factors absence.
Anticoagulants (antithromboplastins and antithrombins) were also found in saliva. Their level is less comparatively to the one of procoagulants. They have no such an importance in physiological and pathological processes in oral cavity.
Physiological bases of measurements at prolonged bleeding after tooth extraction
They include:
1) careful local haemostasis by means of making tampons with thrombin, haemostatic spongea and epsilone-aminocapronic acid;
2) in parallel to this – replacement therapy taking into account blood coagulation factors deficiency.
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