To stop blood flow after damage, the body uses three methods to maintain hemostasis: vascular spasms, platelet plug formation, and clotting. Clotting is an important process to prevent blood loss when blood vessels are cut or damaged. The blood clot is a plug of platelets reinforced by a fibrin mesh. However, in a person with disseminated intravascular coagulation, DIC, blood clots have formed in the blood vessels when this is not necessary. This leads to organ damage due to blocked blood vessels; furthermore, it leads to life-threatening bleeding due to wasting clotting factors and platelets when they are needed. According to Marieb and Hoehn, to cause a blood clot, the enzyme, thrombin and clotting factors are necessary. Clotting factors are represented by Roman numerals. There are thirteen different types of clotting factors. There are two ways to initiate the blood clot; the extrinsic pathway and the intrinsic pathway. With the extrinsic route, coagulation is faster in external tissues. With cutting, cells are damaged and more tissue factors, TFs, are produced on the protein surface. This TF then binds to factor VII, forms the TF/VIIa complex, and converts to factor IX and factor X. With the intrinsic pathway, slower but broader coagulation occurred in damaged vessels. Factor XII circulates regularly in the blood, but when the blood vessel is cut, blood flows into the tissue space. Collagens present in tissues activate factor XII. This activated factor XIIa triggers factor XI which then activates factor IX and factor X. Factor ... ... middle of paper ......dal, MD. “What are cytokines?” NewMedical. December 2, 2013. medical.net/health/What-are-Cytokines.aspx> Ballard, Jeffrey L. and John J. Bergan. Chronic venous insufficiency: diagnosis and treatment. London: Springer, 2000. 158-59. Print.Schlesinger, Kimberly, MD, and Margaret Ragni, MD “DIC, Sepsis, Inflammation, and ActivatedProtein C (APC).” DIC, Sepsis, Inflammation and Activated Protein C (APC). The Institute for Transfusion Medicine, 2002. .Yuksel M, Okajima K, Uchiba M, Horiuchi S, Okabe H: Activated protein C inhibits lipopolysaccharide-induced tumor necrosis factor alpha production by inhibiting nuclear factor kappa activation B and activator protein. 1 in human monocytes. Hemostasis Thromb 2002, 88:267-273.