Gerinnung

Sēo gerinnung mennisces blōdes is a manigfeald ƿeorc under þǣm blōd ƿierþ fæst clott. Hēo is hefig dǣl blōdfæstunge on þǣre þe derod ǣdre ƿāg is geþeaht mid blōdclottspēnclotte tō forsettenne blēdunge and tō helpenne tō bētenne deroda ǣdran. Cōða on gerinnunge cunnon ƿyrcan mā blēdunge oþþe blōdinfæstunge and ǣdrforsettunge.

Sceortlīce

In geƿunelīcum hāde gerinnunge is ongunnen bearhtmhƿīlum æfter sēo derung gelimpþ þǣre ǣdrinrinde; þǣr līmblōd macaþ blōdfæstendne clamm be þǣre derunge stōƿe. Mann hāteþ þis forme blōdfæstung. Æfterre blōdfæstung þǣræfter gelimpþ þǣr blōdƿǣtdǣlas, þā hātaþ clottimbras, andsƿariaþ (on manigfealdre endebyrdnesse) tō scieppenne blōdclottspēna þā hyrdaþ þone līmblōdclamm.

Frome blōdfæstung

Forme blōdfæstung is begunnen þǣr līmblōd ætfielhþ flǣsclīmtimberspēninclum on þǣre ǣdrinrinde þurh ānlīce afōndas for Ia oþþe IIa sƿēteltimberæglīmtimbere synderlīce on þǣm anƿlitan flǣsclīmtimbres. Þēos ætfeolung gelimpþ þurh þone ǣdrblēdungādltimber, þe ƿyrceþ bindunga betƿeox þǣm līmblōdclēofan Ib oþþe IX oþþe X sƿēteltimberæglīmtimbere and flǣsclīmtimberspēninclum.

Þā līmblōdclēofan sind þonne ongunnene and hīe bedǣlaþ þā innunge heora cyrnela tō þǣm blōdƿǣtan, þe þonne onginþ ōðre līmblōdclēofan and hƿīte blōdclēofan. Hīe drēogaþ ƿrixle on heora gesceape þe nacaþ lēohttimbereletimbrenne andƿlitan þǣm gerinnungtimberum þā þurfon his. Spēnæglīmtimber bint nēa līmblōdclēofan þurh þā scieppunga hlenca þurh þone IIb oþþe IIIa sƿēteltimberæglīmtimber. Ēac beginþ gerinnunginƿyrcend līmblōdclēofan.

Æfterre blōdfæstung

Sēo endebyrdness gerinnunge

Sēo gerinnungendebyrdness. Rǣdunge endebyrdness: HWMK = Gemotlīce hefig fōrelirƿeccendmoltentimber, PK = Fōrelirƿeccendlȳsendmoltentimber, TFPI = Flǣscmasctimberpæþhremming. Sƿeart areƿe = aƿendung oþþe onginn gerinnungtimbres. Rēada areƿan = ƿeorc hremminga. Hǣƿna areƿan = andsƿara þā sind afȳsda fram ƿyrcendum timbre. Grǣg areƿe = missenlīca brūcunga gerinnunginƿyrcendes.

Sēo endebyrdness gerinnunge æfterran blōdfastunge hafaþ tƿegen paðas, se hrīnungonginnpæþ and se flǣscmasctimberpæþ þā ƿyrcaþ blōdclottspēna. Mann ǣr ƿēnde þætte sēo endebyrdness gerinnunge stōde on tƿǣm paðum þā ƿǣron efen hefige þā ƿǣron geþēode ƿiþ gemǣnne pæð. Mann ƿāt nū þæt se forma pæþ for þǣm onginne blōdes gerinnunge is se flǣscmasctimberpæþ. Þā paðas sind endebyrdness andsƿara, on þǣm þe fōreinƿyrcend seolcscearplyftegednes inæglīmtimberinƿyrcendes and þæs fōreinƿyrcendes sƿēteltimberæglīmtimbren efentimber sind ongunnen tō ƿeorðenne ƿyrcende dǣlas þā þonne gefȳsaþ þā nīehstan andsƿare on þǣre endebyrdnesse. Gerinnunga timberas sind geƿunelīce geƿriten mid Rēmiscum rīmum, mid lytelum "a" stafan on þǣm ende tō tācnienne ƿyrcende sceap, þe endemest ƿyrceþ betƿeohbundena blōdclottspēna.

Þā gerinnungtimberas sind seolcscearplyftegedne inæglīmtimberinƿyrcendas būton FVIII and FV þā sind sƿēteltimberæglīmtimbras. Þā seolcscearplyftēgednan inæglīmtimberinƿyrcendas ƿyrcaþ þurh þā ætfeolunge ōðrum æglīmtimberum be ānlīcum stōƿum. Se XIII timber is betƿeohscearplyftegedscearplyftinƿyrcend. C æglīmtimber is ēac seolcscearplyftegeden inæglīmtimberinƿyrcend.

Sēo gerinnungendebyrdness cann mann sceortlīce amearcian þus: -

1. Flǣscmasctimberpæþ: þæt hēafodƿeorc þisses pæðes is tō forþberenne gemet gerinnunginƿyrcendes. Gerinnunginƿyrcend is se ānlīca hefigosta dǣl þǣre gerinnungendebyrdnesse gif mann smēage his andsƿara onginnes ƿeorc. FVIIa begǣþ on mārum gemete þonne ǣnig ōðer ongunnen gerinnungtimber, and æfter gederunge on þǣre ǣdrinrinde is flǣscmasctimber (TF) forþsend, and þis þǣr ƿierþ æglīmtimbermanigfealdness mid FVIIa (þēos manigfealdness hāteþ TF-FVIIa) and þis onginþ FIX and FX. FVII self is ongunnen fram gerinnunginƿyrcende, FXIa, blōdclottspēntōlȳsunginƿyrcend, FXII, and XFa. Þæt onginn FXa fram TF-FVIIa is nēan sōna forseted fram flǣscmasctimberhremminge (TFPI). FXa and his efentimber FVa ƿyrcaþ þā fōregerinnunginƿyrcendtimbermanigfealdnesse þe aƿendeþ fōregerinnunginƿyrcend tō gerinnunginƿyrcende. Gerinnunginƿyrcend þonne onginþ ōðre dǣlas þǣre gerinnungendebyrdnesse, ēac FV and FVII (þe ƿierþ FXI and þā þā FIX), and onginþ and lȳseþ FVIII fram bindunge tō vWF. FVIIIa is se efenƿyrcend FXIa and ætgædere hīe ƿyrcaþ þā tēoþtimberclēofendmanigfealdnesse þe onginþ FX and sƿā gǣþ se hring forþ.
2. Hrīnungonginnpæþ: sēo forme æglīmtimbermanigfealdness on flǣsclīmtimbre is geƿorht fram gemotlīce hefigum fōrelirƿeccendmoltentimbre (HMWK), fōrelirƿeccendlȳsendmoltentimbe, and FXII; fōrelirƿeccendlȳsendmoltentimber is is aƿend tō lirƿeccendlȳsendmoltentimbre, and FXII ƿierþ FXIIa. FXIIa aƿendeþ FXI tō FXIa. FXI is ēac ongunnen fram FVIIa. FIX is þonne ongunnen fram FXIa þe mid his efentimbre FVIIIa ƿierþ sēo tēoþtimberclēofendmanigfealdness þe aƿendeþ FX tō FXa. Þæt lytele ƿeorc þe se hrīnungonginnpæþ dēþ on þǣm onginne clottmacunge cann mann sēon for þȳ þe þroƿeras mid grēatum ƿanum FXII, HMWK and fōrelirƿeccendlȳsendmoltentimbres nabbaþ blēdungādle.
3. Gerinnunginwyrcend ƿyrceþ hefiglīce on gerinnunge. His hefigoste ƿeorc is sēo aƿendung spēnæglīmtimbres tō blōdclottspēnum, se hēafodtimber þæt blōdfæstungclammes. Ēac onginþ hē FVIII and FV and heora hremmminge C æglīmtimber (þǣr blōdclottgefadungæglīmtimber sīe andƿeard), and hē onginþ FXIII, þe ƿyrceþ efenƿeorþe bendas þā cnyttaþ betƿeox þǣm blōdclottspēnmanigdǣltimbrum þā sind geƿorhte fram ƿyrcendum āndǣltimbrum.

Æfter onginne fram þǣm hnīgungonginnpæðe oþþe flǣscmasctimberpæðe is sēo gerinnungendebyrdness freoðod on blōdfæstungfȳsendre byrdnesse fram þǣm ƿuniendan onginne FVIII and FIX tō ƿyrcenne þā tēoþtimberclēofendmanigfealdnesse, oþþæt hēo sīe gesleaht fram þǣm ƿiþgerinnungpaðum.

Efentimbras and hremminga

Missenlīc andƿeorc sind nȳdþearf for þǣm rihtan ƿeorce þǣre gerinnungendebyrdnesse:

• Cealctimber and lēohttimbereletimber (andtimber þǣre clēofanfilmne) sind nȳdþearfe on þǣm tēoþtimberclēofendes and fōregerinnunginƿyrcendtimbres manigfealdnessum. Cealctimber is andƿeorc þǣre bindunge þāra manigfealdnessa þurh þā endesittendan gamma cōlæðmlyftegedlīmscearplyftegedlāfa on FXa and FIXa ƿiþ þā lēohttimbereletimbrene andƿlitan þā sind areahte fram blōdlīme. Cealctimber is ēac nȳdþearf be ōðrum stedum on þǣre gerinnungendebyrdnesse.
• K līffōda is full hefig timber on liferlīcum līmscearplyftæðmlyftinƿyrcendum þe ēacnaþ līmscearplyftegedlāfa on þǣm timbrum II, IX, and X, ēac S æglīmtimbre, C æglīmtimbre, and Z æglīmtimbre. Ƿana K līffōdan (tō bȳsne, on undrincunge, nytte gerinnungforsettenda, oþþe ādle) forseteþ þæs inƿyrcendes ƿeorc and ƿyrceþ þā gescapennesse K līffōdlēasæglīmtimbra; þis ƿyrceþ dǣllīc oþþe nā gamma cōlæðmlfytegedinsettunge and geƿǣceþ þāra gerinnungtimbra cræft tō þēodenne ƿiþ areahtne lēohttimbereletimber.

Þrēo ƿeorc ƿiþbregedaþ þā gerinnungendebyrdnesse. Ungeƿunelīcnessa cunnon ēacnian þā ƿēne þæt blōdinfæstung gelimpe:

• C æglīmtimber is hefig efentimbra hremming, þe geƿanaþ þā FVa and FVIIIa efentimbras. Hit is ongunnen fram gerinnunginƿyrcende mid blōdclottgefadungæglīmtimbre and þearþ þæt his efeninƿyrcend S æglīmtimber ƿyrce. Asprungenness ǣghƿæðeres S æglīmtimbres oþþe C æglīmtimbres on rīme oþþe gebyrde cann ƿyrcan oferblōdinfæstunge. Geƿanod ƿeorc C æglīmtimbres ( þurh ƿiðercirr ongunnen C æglīmtimbres ), tō bȳsne þurh oferblōdinfæstunge V timber oþþe ofermmicelne VIII gerinnungtimber, ēac cann ƿyrcan blōdinfæstunge ƿēne.
• Ƿiþgerinnunginƿyrcend is seolcscearplyftegedenra inæglīmtimberinƿyrenda hremming þe geƿanaþ þā seolcscearplyftegedne inæglīmtimberinƿyrcendas; gerinnunginƿyrcend and Xa timber, ēac XIIa timbre and XIa timbre. Hē is ā dōnlīc, ac his ætfelgung þissum timbrum is ēacnod manigfealdlīce þurh þǣre andƿeardnesse lifersƿefelegedsealt (sƿētscearplyfttimber) oþþe þā tōþegnunge lifertimbera (missenlīc lifertimberlīc ēacniaþ gesibbnesse tō FXa, FIIa, oþþe tō bǣm). Ƿana on micelnesse oþþe byrdnesse ƿitgerinnunginƿyrcendes (fram gebyrde oþþe fram æfter gebyrde) ƿyrceþ oferblōdinfæstunge
• Flǣscmasctimberpæþhremming dƿeleþ onginne of FIX and FX fram FVIIa æfter hire ǣrstan onginne.

Wikimedia Commons hæfþ māran gemyndþrǣdas sibb mid: Coagulation