Coagulation Cascade

Intrinsic Pathway Extrinsic Pathway

Contact System Cellular Injury

High MW Kininogen
Kallikrein Prekallikrein Subendothelium
AT III

Factor XII Factor XII

Tissue Factor
Factor X Ca++
Factor XI Factor XI a Factor VIIa Factor VII

Soluble Kininogen
Soluble Factor XIa
Ca++
Ca++ AT III
Activated Platelet Platelet Phospholipids
Factor IX Factor IX a
Tissue Factor
AT III . Surface
Factor VIIIa Factor VIIIa Factor IX a-Factor VIIIa Prothrombin Factor Xa

Platelet Phospholipids Ca++ Ca++

Factors Xa- Va Factors Xa- Va
Factor X Factor Xa Complex Complex Factor Va Factor V
AT III Ca++

Factor V Factor Va

AT III Factor XIII

Activated
Protein C Thrombin
Protein S
Complex
AT III Factor XIIIa

Fibrinogen Fibrin Fibrin

Protein C Activated Protein S Cross linked
Ca++
Protein C

Thrombin Plasminogen Plasmin

Thrombomodulin TPA, Urokinase,
Thrombomodulin Streptokinase AT III
Complex
Fibrin
Endothelium Common Pathway Degradation

Action of an enzyme Protein binding/interaction

Inhibition
Enzymatic conversion of Thrombin feedback activity
substrate to product