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 ===
[[Biliþ:Coagulation cascade.png|right|framed|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: -
# ''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.
# ''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. 
# ''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.
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=== Gecostnung gerinnunge ===
Se hrīnungonginnpæþ is ongunnen fram onginne hrīnungtimbra blōdwǣtan, and mann cann bemetan hine mid þǣre contact factor pathway is initiated by activation of contact factors of plasma, and can be measured by the [[partial thromboplastin time|activated partial thromboplastin]] time (aPTT) test.

The Tissue factor pathway is initiated by exposure of blood to "tissue factor" (a specific cellular lipoprotein), and can be measured by the [[prothrombin time]] (PT) test. This is   reported as an [[International normalized ratio|INR]] value when used for the dosing of oral anticoagulants such as [[warfarin]].

The quantatative and qualitative screening of fibrinogen is measured by the [[thrombin time]] (TCT). 
Measurement of the exact amount of fibrinogen present in the blood is generally done using the [[Clauss]] method for fibrinogen testing.

If a coagulation factor is part of the contact or tissue factor pathway, a deficiency of that factor will affect only one of the tests: thus [[hemophilia A]], a deficiency of factor VIII, which is part of the contact factor pathway, results in an abnormally prolonged aPTT test but a normal PT test. The exceptions are prothrombin, fibrinogen and some variants of FX which can only be detected by either aPTT or PT.
Deficiencies of fibrinogen (quantitative or qualitative) will affect all screening tests.

== Disorders of hemostasis ==
* disorders of the platelet and vessel wall
** [[immune thrombocytopenic purpura]] (ITP)
** [[thrombotic thrombocytopenic purpura]] (TTP)
** [[hemolytic-uremic syndrome]] (HUS) 
** [[Glanzmann's thrombasthenia]]
** [[Bernard-Soulier syndrome]] (abnormal glycoprotein Ib-IX-V complex)
** [[storage pool disorder]]s
** [[paroxysmal nocturnal hemoglobinuria]]
** gray platelet syndrome: deficient alpha granules.
** delta storage pool deficiency: deficient dense granules.
* disorders of coagulation and thrombosis
** [[disseminated intravascular coagulation]]
** factor deficiencies
*** [[hemophilia A]]
*** [[hemophilia B]] ("Christmas disease")
*** [[hemophilia C]] (Factor XI deficiency, mild bleeding tendency)
*** [[Von Willebrand disease]] (the commonest bleeding disorder)
** factor inhibitors
* disorders predisposing to thrombosis
** [[heparin-induced thrombocytopenia]] and thrombosis("white clot syndrome")
** [[antiphospholipid syndrome]]
*** Lupus anticoagulant
*** anticardiolipin antibody
** [[factor V Leiden]]
** [[prothrombin mutation]]
** [[protein C deficiency]]
** [[protein S deficiency]]
** [[antithrombin]] deficiency

== Coagulation factors ==
{| border="1" cellpadding="5" cellspacing="0" align="center"
! style="background:#ffdead;" colspan=2 | '''Coagulation factors and related substances'''
|-
| '''Number and/or name''' || '''Function'''
|-
| I ([[fibrinogen]]) ||  forms clot (fibrin)
|-
| II ([[prothrombin]]) || activates I, V, VII, XIII, protein C, platelets
|-
| III || ''unassigned''
|-
| IV || [[calcium in biology|calcium]]
|-
| [[Factor V|V]] (proaccelerin, labile factor) || co-factor of X
|-
| VI || ''unassigned'' - old name of Factor Va
|-
| [[Factor VII|VII]] (stable factor) || activates IX, X
|-
| [[Factor VIII|VIII]] (antihemophilic factor) || co-factor of IX
|-
| [[Factor IX|IX]] (Christmas factor) || activates X
|-
| [[Factor X|X]] (Stuart-Prower factor) || activates II
|-
| [[Factor XI|XI]] (plasma thromboplastin antecedent) || activates XII, IX and prekallikrein
|-
| [[Hageman factor|XII]] (Hageman factor) || activates prekallikrein and [[fibrinolysis]]
|-
| [[factor XIII|XIII]] (fibrin-stabilizing factor) || crosslinks fibrin
|-
| [[von Willebrand factor]] || binds VIII, mediates platelet adhesion
|-
| [[prekallikrein]] || activates XII and prekallikrein; cleaves HMWK
|-
| [[high molecular weight kininogen]] (HMWK) || supports reciprocal activation of XII, XI, and prekallikrein
|-
| [[fibronectin]] || mediates cell adhesion
|-
| [[antithrombin]] III || inhibits IIa, Xa, and other proteases; 
|-
| heparin cofactor II || inhibits IIa, cofactor for heparin and [[dermatan sulfate]] ("minor antithrombin")
|-
| [[protein C]] || inactivates Va and VIIIa
|-
| [[protein S]] || cofactor for activated protein C (APC, binds C4b-binding protein)
|-
| [[plasminogen]] || converts to plasmin, lyses fibrin and other proteins
|-
| [[alpha 2-antiplasmin]] || inhibits plasmin
|-
| [[prourokinase]] || activates plasminogen
|-
| [[tissue plasminogen activator]] (tPA) || activates plasminogen
|-
| [[plasminogen activator inhibitor I]] (PAI1) || inactivates tPA
|-
| [[plasminogen activator inhibitor II]] (PAI2) || inactivates urokinase
|}

== Laboratory tests of coagulation ==
Common: [[APTT]], [[International normalized ratio|INR]] ([[prothrombin time|PT]]), [[TCT]]<br />
Other: factor assays, [[mixing test]], [[antiphospholipid antibody|antiphosholipid antibodies]], genetic tests, 
dilute [[Russell viper]] venom test ([[dRVVT]]), [[bleeding time]]

== Stǣr ==
The exact process of coagulation was largely elucidated in the [[20th century]]. At the end of the 19th century, it was presumed that the coagulation system consisted of four factors (Giangrande 2003): ''thrombokinase/thromboplastin'' (III, released by damaged tissues) - this reacted with ''prothrombin'' (II), which, together with [[calcium in biology|calcium]] (IV), formed ''thrombin'', which converted fibrinogen into ''fibrin'' (I).

A first clue as to the complexity of the system of coagulation was the discovery of ''proaccelerin'' (initially and later called Factor V) by Paul Owren (1905-1990) in 1947. He also postulated that its function was the generation of accelerin (Factor VI), which later turned out to be the activated form of V (or Va); hence, VI is not now in active use.

Factor VII (also known as ''serum prothrombin conversion accelerator'' or ''proconvertin'', precipitated by barium sulfate) was discovered in a young female patient in 1949 and 1951 by different groups. Factor VIII turned out to be deficient in the clinically recognised but etiologically elusive [[haemophilia A|hemophilia A]]; it was identified in the [[1950s]] and is alternatively called ''antihemophilic globulin'' due to its capability to correct hemophilia A.

Factor IX was discovered in 1952 in a young patient with [[haemophilia B|hemophilia B]] by the name of [[Stephen Christmas]] (1947-1993). His deficiency was described by Dr Rosemary Biggs and Professor R.G. MacFarlane in Oxford, UK. The factor is hence called Christmas Factor or Christmas Eve Factor. Christmas lived in Canada, and campaigned for blood transfusion safety until succumbing to transfusion-related [[AIDS]] at age 46. An alternative name for the factor is ''plasma thromboplastin component'', given by an independent group in California.

Hageman factor, now known as factor XII, was identified in 1955 in an asymptomatic patient with a prolonged bleeding time by the name of John Hageman.

Factor X followed, in 1956. This protein was identified in a Ms Audrey Prower of London, who had a lifelong bleeding tendency. In 1957, an American group identified the same factor in a Mr Rufus Stuart. The factor is therefore termed Stuart-Prower factor.

Factors XI and XIII were identified in 1953 and 1961, respectively.

The usage of [[Roman numeral]]s rather than eponyms or systematic names was agreed during various annual conferences (starting in 1955) of hemostasis experts. This committee evolved into the present-day International Committee on Thrombosis and Hemostasis (ICTH). Assignment of numerals ceased in 1963 after the naming of Factor XIII, but the names Fletcher Factor and Fitzgerald Factor were given to further coagulation-related proteins, namely [[prekallikrein]] and [[high molecular weight kininogen]] respectively.

Factors III and VI are unassigned, as thromboplastin was never identified and actually turned out to consist of ten further factors and accelerin was simply activated Factor V.

== References ==
* Giangrande PL. ''Six characters in search of an author: the history of the nomenclature of coagulation factors''. Br J Haematol 2003;121:703-12. {{PMID|12780784}}.

{{Blōd}}
-->

{{Commonscat|Coagulation}}
[[Flocc:Blōd]]

[[de:Hämostase#Übersicht über Gerinnungsfaktoren und Inhibitoren]]
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 
right|framed|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: -
 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.
 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. 
 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.

Flocc:Blōd

de:Hämostase#Übersicht über Gerinnungsfaktoren und Inhibitoren