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The page below is a sample from the LabCE course Fundamentals of Hemostasis. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Secondary Hemostasis – The Intrinsic Pathway

  • Exposure to contact substances, such as collagen, can activate the intrinsic pathway.

  • The exposed collagen is the location where a complex between High Molecular Weight Kininogen (HMWK), Prekallikrein (also known as Fletcher Factor, which activates to Kallikrein), and factor XII (Hageman Factor) forms.

  • Together, this three biochemical complex, adhered to the collagen binding site, catalyzes the conversion of factor XII to its activated form, XIIa, thereby triggering the intrinsic pathway.