Hematology | Hemostasis: Coagulation Cascade

Official Ninja Nerd Website: ninjanerd.org
Ninja Nerds!
During this lecture Professor Zach Murphy will be teaching you about Hemostasis. We will be discussing the coagulation cascade including the intrinsic and extrinsic clotting mechanisms.
This video will cover the following topics:
1. Vascular Spasm
2. Platelet Plug Formation
3. Coagulation
4. Clot Retraction and Repair
5. Fibrinolysis
References:
● Le T, Bhushan V, Sochat M, Chavda Y, Zureick A. First Aid for the USMLE Step 1 2018. New York, NY: McGraw-Hill Medical; 2017
● Marieb EN, Hoehn K. Anatomy & Physiology. Hoboken, NJ: Pearson; 2020.
● Boron WF, Boulpaep EL. Medical Physiology.; 2017.
● Urry LA, Cain ML, Wasserman SA, Minorsky PV, Orr RB, Campbell NA. Campbell Biology. New York, NY: Pearson; 2020.
● Jameson JL, Fauci AS, Kasper DL, Hauser SL, Longo DL, Loscalzo J. Harrison's Principles of Internal Medicine. New York etc.: McGraw-Hill Education; 2018.
● Sabatine MS. Pocket Medicine: the Massachusetts General Hospital Handbook of Internal Medicine. Philadelphia: Wolters Kluwer; 2020
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#ninjanerd #Hemostasis #Hematology

[@xclvrfip]

I just want you to know that 7 years later and this video is still helping medical students throughout the world. I love you! Thank you for sharing your knowledge and love of teaching free of charge for us to consume. Thank you a million times!

[@valentinaandreea7484]

I never in my life had a professor as good as you, they "tried" to explain this in weeks what you clearly did in 40 min. Amazing content for all the medical students out there!!!!

[@lachyt5247]

What kind of medical school is spending weeks on coagulation cascade

[@omerkhan9865]

@@lachyt5247 mine has repeated this topic 4 times and each time it went over my head. Ninja nerd literally is an angel

[@daniedeklerk1914]

@@lachyt5247 For us it was literally one day before they posted new learning material.😂😭

[@lachyt5247]

@@daniedeklerk1914 Same for me, "Any part of coag factors will be on the exam" was about the extent of depth for our lectures.

[@TheMascara89]

Not in med school...have to learn this and I'm do grateful this guy posted this.

[@heidypreston5914]

Thank you for doing more in 20 min than my professor in an entire semester

[@chellestan]

Ninja Nerd is saving my education during this pandemic!

[@farizaevloeva-n8k]

sooo truuuee!!!!

[@benonicarvalho]

I 100% agree

[@liasbozkurt467]

broo you should have your own university

[@alphonseahortensis683]

Anyway we all consider him as our university dont we😀😀

[@siobhanquinn4635]

Right ?

[@nandannayaka]

Yes broo new ninja med schools

[@nuran5537]

I would enroll in a heart beat

[@sanskrutijambhulkar9667]

I would obviously definitely take admission there ASAP

[@techdesigner9741]

1- Vascular Spasm 7:10 2- Plug Formation 10:55 3- Coagulation Cascade 17:55 (Coagulation Cascade recap 30:00) 4- Clot Retraction & Repair 33:18 5- Fibrinolysis 36:15 Summary 39:30 Drugs: Heparin 40:00 Clopidogrel (Plavix) 40:58 Abciximab 41:34 Prodaxa 42:02 Warfarin 42:17

[@Snaps444]

Bless you

[@tota9868]

Thank you so much

[@rorschach.7366]

Thank you

[@RUYINAETENGsMEDICDIARY]

Thanks so much!!!❤

[@susiefoxy8130]

Been watching this guy over the last week due to having severe anemia and being diagnosed with a dvt…easier to understand and I’m a qualified nurse!

[@bakhchaaso6035]

my teacher with a PhD degree in hematology couldn't get any close to teaching like you, THANK YOU

[@prasunanand6893]

Very true

[@prasunanand6893]

I'm in a med school still...never got these concepts

[@ahmedmuhammed1028]

Are you from Kurdistan?

[@princessjazz5767]

they do it purposely... srsly.. i have realized this... a lot of PHD's do not want to teach but they have to teach for money ofcourse and because they had shit dng the phd they purposely make stuff look confusing and hard for students because their very intent is not to teach... I know what i said is v harsh but this is what i noticed in most of the PHD Professors... they some how miraculously want you to just know everything ALREADY. Then why do we even need the degree or why do we even need to be in school if we knew stuff already ...

[@buzzaldrin4814]

@@ahmedmuhammed1028there is no place called kurdistan lmao

[@Jason-vn5xj]

Holy crap I cannot thank you enough for 32:00-32:45! That is SUCH an easy way to remember the pathways! That outline really helped me scaffold the whole thing. That's wonderful.

[@livebungusreaction]

ANyone reading this please find a way to make up a way to memorize everything. Maybe I am just lucky that I am creative but idk how anyone survives without making up weird memorization tricks for everything, apparently it's a talent or you haven't tried yet. no matter what it will all be goofy sounding if you make it up but it just has to work for you

[@josefinehje5429]

my professors can't handle zoom meanwhile: this guy educates people all over the world in less than a 1h video.

[@seba-nl6tq]

I am not a native English speaker, and study this process from books is really tiring. You make it so simple and easy to understand. Thank you Ninja Nerd!

[@worsethannicotine4474]

Hi.... I don't usually comment on youtube videos but this time I did to just tell you how amazing you are. You're the type of teacher that actually shows the why and the how instead of projecting information without reasoning!

[@Deejavu_life]

You are the best physiology teacher you know I watched this video in class because my lecturer is explaining and I couldn’t understand 😭🥺then I remembered I have NINJA 🥷 NERD and I watched...God bless you

[@azaandas573]

People at my school literally go to your channel before watching the lectures here or even looking at the ppt slides, and I think I'm going to follow their footsteps. You made something so complicated so easily understandable. Quit making med school look like a piece of cake man!!

[@sharonchristina5828]

I honestly cried after watching this. I loved it and i think i will never forget this ever. You are literally the best teacher ever and yo should be recognised even more !

[@Tself02]

This guy is so awesome! I learn more and retain more from these videos than I do from attending my actual class. Thank you, Good Sir!!

[@NinjaNerdOfficial]

+Tiffany Selrick LOL!!! I'm so glad these videos are helping!! Thank you for your super kind words!!

[@miyamiyukotorres1386]

Your youtube channel is such a gem! You explained everything concisely. This really helped me in understanding hemostasis in just one sitting. Currently studying for my midterm exam on Hematology, and this video became my supplemental notes. Please keep on educating the community, you are making a difference. Thank you thank you!

[@samamso2155]

I am MD, and I watched many videos about hemostasis , really this one is the best. good job.

[@AlexaMoss-eg9lw]

I know this video was created 7 years ago… but this man deserves his flowers! Absolutely amazing job, and right off the dome! You are my hero!

[@devarshipatel725]

I never post comments but I have a coagulation exam coming up and you explained almost two entire PowerPoint lectures!! You explained it in such simple terms that even I was amazed at how simple coagulation can be if it is explained properly! idk your background since this is the first video of yours ive watched but damn youre good Thank you!!!!

[@wendyfranco8613]

These videos have helped me so much in med school, especially during coved and online classes. They brings these concepts that can seems so overwhelming and make them clear and actually 100X more fun and engaging.

[@annagalbraith4102]

My professor taught us a great trick to remember the intrinsic pathway coagulation factors. Work 8 to 12 and take a break at ten to go to the common. Great video! It was very helpful to review the whole process step by step. Definitely following and checking out more of your videos!

[@zeljanaradonjic9942]

Im speechless. This is by far the best video I have ever seen in my life. Such light headed explanation of smth that is written on 100smth pages in Guyto. If I pass my physio exam in 4 days, its going to be all you man. Thank you so much and just keep up with this

[@SnuggleSnatcher]

Dude I’m in a pathophysiology class and we’re reviewing this for an exam and you saved my life!

[@alitaheral-daheri]

you did what my professor couldn't do for months in 50 minutes , you're the best physiologist PROF .that I've ever seen in my life . thanks million ninja much respect for you from me and from all medical students in Yemen . { Sana'a University Faculty of medicine

[@alexnv6416]

Bro we all think you're even able to teach those university professors how they must get the attention to the students! Great work, just keep killing it

[@ifeanyichukwuadibemma9428]

I don't think I've ever commented on youtube in my life, but you GOATED on this one. well done

[@drolagunjuolajide2786]

WHAO! this dude is in a class of his own... saying this is fantastic will just be a gross understatement

[@jimmychan4917]

This man saved atleast 3 of my semesters. Truly one of the best educational channel out there. Keep up the good work

[@skjalgottesen3095]

I feel like a new man after watching this, thank you so much.

[@gurpreetpuri83]

This video made my day. I am preparing for SH(ASCP). I am studying 6 different hematology books and you have just covered everything about hemostasis which I have been reading for the last 3 weeks. Thank you very much

[@TututuTah]

Your videos are amazing, you deserve sooo much more recognition! Please never stop making them they're so great! I plan on watchin' them all over summer ahah. Keep up the good work!

[@NinjaNerdOfficial]

+Nina Kal thank you so much for your kind words. I am so glad that you like them and I hope that they helped.

[@aizireknurlanova9951]

Perhaps scientists and professors receive awards for describing the entire process, but Zach and the NN team receive as a reward the gratitude and love of all the hearts of medical students❤

[@kristie2103]

I don't know if it was the visual way you used to explain this, but I got more from you than listening to my lectures from school over 15 times. This is what people need sometimes, and you do an amazing job. Thank you so much I your knowledge is outstanding!!

[@luhaibalomari6910]

Finally, I found someone who was able to make me understand the coagulation cascade...... Many thanks.....really loved and enjoyed your lecture

[@joshmintoe3973]

Informative at the deepest level, with the use of the simplest language and imagery - perfect! Thank you.

[@architasaha8917]

You have covered the basic so nicely, everything explained in a easiest way. I just loved it. Great job.

[@karessaoneal5874]

After all the lectures I have attended on coagulation and the clotting cascade you finally helped it click! I love your teaching method of saying then drawing and repeating the information with review at the end. Never stop! We need the Ninja Nerd like the smallville needed Superman!

[@seayn6765]

thank you for saving me from another mental breakdown! hands down better than my professor's recorded lecture video! very very very comprehensive!

[@JN-kk4nk]

Honestly, thanks to the whole NINJA NERD TEAM !! i honestly dont think you guys know the impact you have. Thanks to you guys, there will be a lot of more Dr , or ' better' Drs out there in the world. If you look at the big picture, how many people you guys help indirectly its HUGE !!!! You guys have so my respect ! for real

[@annjansen1965]

You are saving my life!!! Biochemistry and now blood clotting finally makes sense to me! Thank you, and keep up the good work!

[@me..7885]

I am really really admiring the way you simplify things i can't get over how grateful I am that we have you prof...

[@daniaizzah8804]

Thank u so much, Mr. Ninjaaa! Im literally shedding tears of happiness...

[@stardustinmydna9272]

I have been pulling my hair out whilst trying to write a college paper on warfarin as an anticoagulant. Thank you so so much for this invaluable piece of brilliance!!! After weeks of reading peer reviewed science papers and still being none the wiser on the coagulation cascade, I stumbled across your video. Your way of teaching deserves a Nobel prize! Repetition, recapping, brilliant illustrations and a phenomenal knowledge/understanding of the subject. Thank you so much, you've gained an admirer and subscriber. :)

[@genevievesimon]

I feel like I comment this a lot but from the bottom of my heart 1) You are the main reason I'm passing vet school 2) Your enthusiasm is one of the most important things that keeps me excited about learning about medicine. I truly, TRULY cannot thank you enough!

[@lewisnunn8072]

Wow, your videoed lecture is a comprehensive masterpiece. By making this subject more understandable you will personally help save many lives because there will be more people to apply this knowledge in helping patients and in advancing this field. Respect.

[@girsavior]

I'm in CRNA school and we are covering this in Pathophys II. Super helpful and very well done. I am so impressed!

[@marwasahnoun1922]

you'are amazing I understand you more than in my class although in my country I learned in Frensh it's so easy in English I love it and you deserve millions of likes 👏👏

[@kw8902]

thank you so much for this video. You explained it so well and took your time to actually draw examples which helped me so much more. You taught me more information in 43 minutes then my teachers taught me in a whole year. THANKS AGAIN!!

[@ifrayousuf4621]

Sir..can u plzz focus the whole board at last in ur videos for a screen shot...or is the picture available anywhere?...that vl b of grt help..

[@ZeyadAlweher]

i have no doubt that you are the best medical speaker i have ever watched in my entire carrier since 33 years... Thanks alot

[@muskaanmemon8475]

39:39- Quick Recap.

[@ridah4419]

Came back to this video for a quick revision, looked for the time stamp comment and found this. Thankyou.

[@Yaanu123]

No words to express that feeling of satisfaction after viewing your lectures....

[@naritastudy6739]

I confused about the people who dislike this video, how can they dislike this amazing video??, Thank You for the video, it really helps me study

[@friedahpanu]

thank you Zach. what can i say,you speak with passion and I pray for more mini yous in this world.

[@LoiLe-wd3vg]

In addition to your great lessons, you even surprised me to another level that you enjoyed the cupping therapy. Just saw the cupping marks on your back neck in this video.

[@TaekwonDana]

This is incredible! Your video was recommended in my hematology class by my Medical Lab Science program director, and I was so pleased to have already found it the night before while I was studying! You're helping my entire cohort remember coagulation and I can't say thank you enough!

[@j-em5762]

Thank you! Would be better if you have subtitles for the hearing-impaired. :)

[@bisterkding9249]

youtube has auto-generated subtitles, they're like 90% accurate probably less so with the medical terminology though lol

[@think2023]

Im a layperson. Mind is BLOWN! By...how well designed the body is....and equally by your powerful combo of raw knowledge, clear explanation, and superb presentation skills!

[@krismacavinta4236]

I was hoping you could capture the whole lecture in the end to look at the whole white board for some of us to draw it too and be able to explain it ourselves in the future💓

[@mishachowdhary2920]

I cannot stress how much this picture is ingrained into my head. I constantly find myself mentalling referencing this diagram during exams because it just makes sense and makes everything seem logical. Ive watched this video at least 40 times. Thank you so much.

[@zeded6935]

17:53 coagulation 25:56 intrinsic 29:58 trick 33:24 clot retraction 36:22 fibrinolysis

[@jeffhecky9861]

Thank you so much Ninja Nerd. You saved my medical education.

[@marymessam2435]

Clapping hands for the professor👌👏👏👏❤️♥️

[@sowhowwelike]

After all these years I discovered that I'm a visual learner. I'm in love with your videos. Also, you are explaining the informations that you gave several times with different words. So I'm feeling so sure about the terms and their meaning and I can focus on the video. Thank you so much.

[@Skepticalstudent45]

University faculty are the only ones that could possibly dislike this lol

[@nillocsavage6646]

I have just summarised a three weeks content on 1page , thank you ninja nerd , you just saved this semester😎

[@mariaamgad7353]

Bro this is amazing.saved me as usual thanks❤️❤️

[@SarahChicharro]

I LOVE HOW YOU EXPLAIN THINGS! This is amazing. I come out of your videos knowing so much more than before. Thank you so much!

[@asterdaniel882]

God bless you !!

[@NinjaNerdOfficial]

+Thomas Eyob thank you so much!!!

[@sarakhan6319]

Best professor ever..!!! I didn't understand what my professor said for 10 days but I got in 40min can't believe 🙏

[@sahalismacilomar8568]

Thank you zuck. I can't imagine how my medical studies will be without your lectures! Every lecture that I watch from you is a like a part of my brain!

[@wonnienyang]

whenever i want to freshen up my knowledge, i always come back to this channel

[@hosseinabedinifard539]

Whenever I have to study a hard lecture in med school ,I search ninjanerd videos and if you have covered that topic I become sure that I could understand that topic with every single detail… thanks for making our life better prof.. maybe you can’t imagine how much you are magically wonderful for me and many medical students

[@Zeus_xoxo89927]

You're literally one of the best teachers out there ,wayyyyy better than my college professors who just likes to use some stupid slides which only helps us to get confused even more ,lots of thanks sir !

[@elormobregimae]

Hi, Ninja, i think you should open a publishing press to revise most medical books in a much simpler way. You are a great teacher. i love all your videos.

[@norajimenarosalesdominguez1398]

this is the best thing ive come across while studying

[@yachiapatel]

Being a medical student had a lot of stress for the topics to get to be throughly understood. However, professors like Ninja Nerd 🤓 just comes to our rescue and make not only our study easy to grab but also interesting. Blessed to have you sir.😇 Kindly keep uploading such videos for us.👍 A big shout out to you and your team.🏆🎖 Amazing efforts ❤ You really are like a NINJA for us who just easies our life smartly 🥳

[@nathanphillips8031]

I really need to show my Son these videos, he is a Sever factor 9 hemophiliac even though hes knows about his condition etc the more you learn about the way the body works the better especially with Bleeding Disorders. dude this has been sooo interesting to watch

[@mustafaadel8140]

It really feels wasting of time when watching medical videos on other channels when you have ninja nerd... SIR you just built different ❤️

[@kenglor2597]

Ninja Nerd content is the real deal. Top notch and deserve all the recognitions.

[@dres4801c]

I love you. I am an M1 and you taught me this 100000x better than our lecture. I'm forever in your debt lmaooo

[@PacoPacabell]

This guy is crazy brilliant at teaching. Genius on so many levels.

[@chenylfleming9977]

I've been following you for the last few months now and studying your studies. Its absolutely mind blowing how well & eloquently you explain the body in such detail. Really really grateful 🙏for such an intelligent soul as yourself. Thank you for the great work & taking into all the valuable intricate details of the functioning of our great physical bodies. Much gratitude xxxx.🙏

[@Sun2s]

I appreciate your understanding of the subject which gave me 360 degrees of hemostasis. I was always struggling to bring all the events together. Your video helped me to understand the subject so well, Now I can link all the information flowing in my mind in bits and pieces.

[@lovelytime2]

Thank God for you and this video. This is a GREAT way to teach these concepts! I just had these lectures in Pharmacy school and I was really concerned because it was so much info but I am feeling better already.

[@SyedSamarAbbas-p5z]

I have a mechanical engineering background and currently pursuing a Ph.D. in modeling the coagulation kinetics. I must say the information disseminated here is sth you'd only get after going through hundreds of book and scientific papers. Great job guys!

[@irenembugua3106]

this is great ninja my 1 time true medical explainer. am a nurse and you make it easy every time, all the time

[@ibilapeterside39]

Give this guy an award!!

[@uliceacosta2551]

I really like your videos and the graphic way you explain the whole process of hemostasis. I have understood the process watching you in more than 40 minutes, what I wasn’t able reading the hematology book and lectures. Thank you very much for your time and for posting your lectures.

[@jazzybelleramas6383]

I love the lightbulb effect this video gave me. Thank you so much !

[@juliamilke150]

You are a life savior!! I was trying to read a chapter in a physiology book for hours and I couldn’t understand it. You made everything so clear! Thank you thank you thank you!!!

[@ASTTEER]

Hello! I am currently studying for my boards examination of the European College of Veterinary Pathologists (ECVP) and I just wanted to thank you for your amazing videos!!! :)

[@GGlui18]

thank you for saving life with your lectures!

[@svgs14]

respect bro, simply amazed. Feeling enlightened now after years of ignoring this difficult topic

[@lowtzechien5308]

(Text wall ahead, very long comment, don't press read more if you don't want to read this) This is my way of remembering the coagulation cascade: I treat them like a family. Before starting, remember that factor four and six are forsake (pun intended, four six--> forsake), they are forsaken, they are left out from this cascade. I start with intrinsic pathway first. The regulation of clotting factors are mentioned at the start of the video. The clotting factors regulated are 2, 9 and 10 by anti-thrombin 3, 5 and 8 by thrombin. If you notice, if we exclude extrinsic pathway, every clotting factor mentioned(2 ,5 8 ,9 ,10) are included in the intrinsic pathway till the end of cascade, while those not mentioned are not present, other than that larger than 10, and factor 1, because he is the head of the family, and nothing gets past the head of the family. This might be more complex than the one mentioned in this video, but I use this method because find this effective for me to remember which clotting factor are the ones being regulated along with the cascade together in one go by relating them together. It also helps me remember which part of the pathway requires PG3 and Ca2+. We start from factor 12. Factor 12 calls and activates the one member older, factor 11. But when factor 11 calls out factor 10, factor 10 is the lazy one, and says nah, you're not convincing me just by yourself.(X marks the spot also helps you remember which factor is the common pathway). So factor 11 calls and activates the one member older of factor 10, factor 9. But even the older factor 9 can't activate factor 10 by himself because that's how lazy factor 10 is. Instead, factor 9 calls one member older, factor 8. Factor 9 together with factor 8(with PG3 and Ca2+), they are finally able to get factor 10 into work. Remember factor 10 is the lazy one? He says, I don't wanna do all the work myself. So he seeks help. Which factor would factor 10 find? Ask yourself, which clotting factors are the ones regulated? 10, 9, 8, 5 and 2. 10, 9 and 8 already appeared in this cascade, so which one is next? Clotting factor 5. Factor 10 and 5 activates the next regulated factor, factor 2(prothrombin). But due to the lazy nature of factor 10, even after seeking help from factor 5, factor 10 is like, meh, let somebody else do the job. So instead factor 10 activates prothrombin activator, not factor 2 itself. And the laziness of factor 10 doesn't stop here, he will get all the help he needs, so he will also take in PG3 and Ca2+ to activate prothrombin activator. Finally, factor 2 is activated(thrombin), he is factor 2, factor TWO, he will do two things. One is to call and activate the head of the family, factor 1(fibrinnogen) into factor 1a(fibrin). The other one is to call factor 13. Factor 13 is like Goku in Dragon Ball Z. He doesn't show up until the very last moment. Factor 2 activates factor 13, with the help of Ca2+ (Goku eats a lot, he needed that energy. But hey, at least PG3 is not involved, unlike the lazy factor 10). As the Goku of the family, factor 13 gives a powerful effect. He creates cross bridges between factor 1a(fibrin) and stabilizes the mesh. Intrinsic factor cascade is finished, now we go onto extrinsic factor. Just remember, which member are not yet mentioned beside the forsaken factor 4 and 6? Factor 3 and 7. The older factor 3 calls and activates the younger factor 7 to help 9 and 10 out. Which part of this cascade requires PG3 and Ca2+? It circles around the factor I gave names to, the lazy factor 10, and Goku, factor 13. Factor 10 is so lazy that activating him requires PG3 and Ca2+, and him activating something else also requires both chemicals. Goku, factor 13, needs Ca2+ because he eats a lot, but he don't need PG3 cuz he's not as lazy as factor 10. And which are the factors regulated by endothelial cells? Intrinsic pathway factors of the cascade, those less than 11, not forsaken and not the head of the family, who are 10, 9, 8, 5 and 2.

[@theharrypotterrulz]

Your videos have genuinely been life-saving. A part of my first paycheck will surely go to your Patreon for how much you've contributed to my understanding of medical concepts!! Thank you heaps for taking the time to help us students so much.

[@danielrebora1350]

BROOOOO I JUST HAD AN EXAM ON THIS IT WOULD HAVE HELPED SO MUCH!! it's nice to finally understand it

[@tmfredrick]

I have a huge Hematology Exam on Monday. This has helped me more than anything I have studied so far! Thank you!!!

[@figsworld12]

I am attending a pathology course. I have learnt so much from you. The teachers tried to teach in 2and half months Thank you so much. This is advanced for pathology however I do now know heraprin, coagulation properly.

[@kayareii9446]

pharmacy student here struggling with pathology.... just wanted to say u are a SAVER!!!!