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Page Title: THE HEART
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CIRCULATORY  SYSTEM
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BLOOD  VESSELS

Blood  Coagulation To protect the body from excessive blood loss, blood  has  its  own  power  to  coagulate,  or  clot.  If blood constituents and linings of vessels are nor- mal,  circulating  blood  will  not  clot.  Once  blood escapes  from  its  vessels,  however,  a  chemical  reac- tion begins that causes it to become solid. The clot formed  is  at  first  fluid  but  soon  becomes  thick and then sets into a soft jelly that quickly becomes firm enough to act as a plug. This plug is the result of  a  swift,  sure  mechanism  that  changes  one  of the soluble blood proteins, fibrinogen, into an in- soluble  protein,  fibrin,  whenever  injury  occurs. Other  necessary  elements  for  blood  clotting are  calcium  salts,  a  substance  called  prothrom- bin, which is formed in the liver, blood platelets, and various factors necessary for the completion of the successive steps in the coagulation process. Once  the  fibrin  plug  is  formed,  it  quickly enmeshes  red  and  white  blood  cells  and  draws them  tightly  together.  Blood  serum,  a  yellowish clear liquid, is squeezed out of the clot as the mass shrinks. Formation of the clot closes the wound, preventing blood loss. A clot also serves as a net- work for the growth of new tissues in the process of healing. Normal clotting time is 3 to 5 minutes, but if any of the substances necessary for clotting are  absent,  severe  bleeding  will  occur. HEMOPHILIA   is   an   inherited   disease characterized  by  delayed  clotting  of  the  blood  and consequent  difficulty  in  controlling  hemorrhage. Hemophiliacs  may  bleed  to  death  as  a  result  of even  a  trivial  wound. THE  HEART The heart is a hollow, muscular organ, some- what  larger  than  the  closed  fist,  located  anteri- orly  in  the  chest  and  to  the  left  of  the  midline. It is shaped like a cone, its base directed upward and to the right, the apex down and to the left. Lying obliquely in the chest, much of the base of the  heart  is  immediately  posterior  to  the  sternum. The  heart  is  enclosed  in  a  membranous  sac, the PERICARDIUM. The smooth surfaces of the heart and pericardium are lubricated by a serous secretion, the pericardial fluid. The inner surface of the heart is lined with a delicate serous mem- brane, the ENDOCARDIUM, similar to and con- tinuous  with  that  of  the  inner  lining  of  blood vessels. The interior of the heart (fig. 3-30) is divided into   two   parts   by   a   wall   called   the   INTER- VENTRICULAR  SEPTUM.  In  each  half  is  an Figure  3-30.—Diagram  of  the  heart. 3-21

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