red (venous) blood is the result of hemoglobincombining with carbon dioxide.Red blood cells live only about 100 to 120 days inthe body. There are several reasons for their short lifespan. These delicate cells have to withstand constantknocking around as they are pumped into the arteriesby the heart. These cells travel through blood vessels athigh speed, bumping into other cells, bouncing off thewalls of arteries and veins, and squeezing throughnarrow passages. They must adjust to continualpressure changes. The spleen is the “graveyard” whereold, worn out cells are removed from the blood stream.Fragments of red blood cells are found in the spleenand other body tissues.WHITE BLOOD CELLS.—White blood cells,or leukocytes, are almost colorless, nucleated cellsoriginating in the bone marrow and in certainlymphoid tissues of the body (fig. 1-32). There is onlyone white cell to every 600 red cells. Normal WBCcount is 6,000 to 8,000 per cubic millimeter, althoughthe number of white cells may be 15,000 to 20,000 orhigher during infection.Leukocytes are important for the protection of thebody against disease. Leukocytes can squeeze betweenthe cells that form blood cell walls. This movement,called diapedesis, permits them to leave the bloodstream through the capillary wall and attackpathogenic bacteria. They can travel anywhere in thebody and are often named “the wandering cells.” Theyprotect the body tissues by engulfing disease-bearingbacteria and foreign matter, a process calledphagocytosis. When white cells are undermanned,more are produced, causing an increase in their numberand a condition known as leukocytosis. Another wayWBC's protect the body from disease is by producingbacteriolysins that dissolve the foreign bacteria. Thesecondary function of WBCs is to aid in blood clotting.BLOOD PLATELETS.—Blood platelets, orthrombocytes, are irregular- or oval-shaped discs inthe blood that contain no nucleus, only cytoplasm(fig. 1-32). They are smaller than red blood cells andaverage about 250,000 per cubic millimeter of blood.Blood platelets play an important role in the process ofblood coagulation, clumping together in the presenceof jagged, torn tissue.Blood CoagulationTo protect the body from excessive blood loss,blood has its own power to coagulate, or clot. If bloodcomponents and linings of vessels are normal,circulating blood will not clot. Once blood escapesfrom its vessels, however, a chemical reaction beginsthat causes it to become solid. Initially a blood clot is afluid, but soon it becomes thick and then sets into a softjelly that quickly becomes firm enough to act as a plug.This plug is the result of a swift, sure mechanism thatchanges one of the soluble blood proteins, fibrinogen,into an insoluble protein, fibrin, whenever injuryoccurs.Other necessary elements for blood clotting arecalcium salts; a substance called prothrombin, whichis formed in the liver; blood platelets; and variousfactors necessary for the completion of the successivesteps in the coagulation process. Once the fibrin plug isformed, it quickly enmeshes red and white blood cellsand draws them tightly together. Blood serum, ayellowish clear liquid, is squeezed out of the clot as themass shrinks. Formation of the clot closes the wound,preventing blood loss. A clot also serves as a networkfor the growth of new tissues in the process of healing.Normal clotting time is 3 to 5 minutes, but if any of thesubstances necessary for clotting are absent, severebleeding will occur.Hemophilia is an inherited disease characterizedby delayed clotting of the blood and consequentdifficulty in controlling hemorrhage. Hemophiliacscan bleed to death as a result of minor wounds.THE HEARTThe heart is a hollow, muscular organ, somewhatlarger than the closed fist, located anteriorly in thechest and to the left of the midline. It is shaped like acone, its base directed upward and to the right, the apexdown and to the left. Lying obliquely in the chest, muchof the base of the heart is immediately posterior to thesternum.Heart CompositionThe heart is enclosed in a membranous sac, thepericardium. The smooth surfaces of the heart andpericardium are lubricated by a serous secretion calledpericardial fluid. The inner surface of the heart islined with a delicate serous membrane, theendocardium, similar to and continuous with that ofthe inner lining of blood vessels.The interior of the heart (fig. 1-33) is divided intotwo parts by a wall called the interventricularseptum. In each half is an upper chamber, the atrium,which receives blood from the veins, and a lowerchamber, the ventricle, which receives blood from the1-25
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