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Lecture 8
Hepatic Physiology
| Question | Answer |
|---|---|
| Liver Blood Supply: hepatic artery proper (HAP) | delivers oxygen rich blood |
| Liver Blood Supply: bile duct | delivers bile to the biliary system |
| Liver Blood Supply: portal vein ** | delivers oxygen poor blood but nutrient-rich blood |
| Liver Blood Supply: central vein | delivers nutrient and oxygen poor blood |
| Liver Microanatomy: acinus | located at the end of a vascular stalk |
| Liver Microanatomy: acinus | contain terminal branches of portal veins, hepatic arteries, bile ducts |
| Liver Microanatomy (BIHHB) | bile canaliculi --> interlobular bile ducts --> right and left hepatic duct --> common hepatic duct --> common bile duct |
| Blood flow ** | portal vein --> central vein --> hepatic vein --> inferior vena cava (IVC) |
| Kupffer Cell ** | phagocytic cell/Macrophage which forms the lining of sinusoids of liver and is involved in breakdown of red blood cells; first innate immune cells and protect the liver from bacterial infections |
| Functions of Liver (6) | filtration and storage of blood, regeneration, metabolism, formation of bile, formation of coagulation factors, storage of vitamins and iron |
| Functions of liver | liver is expandable, can act as a reservoir (0.5-1 L), can also supply blood in times of need, 10% of the body's total blood volume |
| Functions of liver | hepatic sinusoids are permeable, allows for passage of fluid and proteins, allows for large quantities of lymph to form, half of all the lymph formed in the body arises in the liver (resting conditions) |
| Functions of liver ** | lymph drainage from the liver has a protein concentration like plasma; helps with lymphatic system |
| Functions of liver: regeneration | not well understood, hepatocyte growth factor (HGF), 20 fold increase following partial hepatectomy, hepatocytes replicate 1-2 times, once the liver is returned to its normal size then cell division is terminated |
| Functions of liver: blood cleansing function | high bacteria from intestines --> liver, kupffer cells, estimated less than 1% of bacteria passes into systemic circulation |
| Functions of liver: metabolism | break down of carbohydrates, proteins, lipids, hormones |
| Functions of liver: carbohydrate metabolism ** | glycogen storage, conversion of galactose and fructose to glucose, gluconeogenesis |
| Functions of liver: carbohydrate metabolism ** | formation of many chemical compounds from intermediate products of carbohydrate metabolism |
| Functions of liver: carbohydrate metabolism ** | maintaining glucose in the post prandial period = removes excess glucose from the blood, returning glucose as needed |
| Functions of liver: carbohydrate metabolism glucose buffer function ** | liver maintaining blood glucose concentration; monitoring glucose in blood at all times for too high or too low and fixes it |
| Functions of liver: lipids | oxidation of fatty acids, synthesis of cholesterol, synthesis of phospholipids, synthesis of most lipoproteins, synthesis of fat from proteins and carbohydrates |
| Functions of liver: synthesis of plasma proteins ** | albumin, acute phase proteins, thrombopoietin, proteins to transport steroids and other hormones in plasma |
| Functions of liver: synthesis of plasma proteins coagulation(clotting factors) ** | proteins that are mostly produced in liver |
| Functions of liver: storage for vitamins and iron | vitamin A, D, B12, E, K, B9; blood iron buffer, apoferritin-ferritin system |
| Functions of liver: processing drugs, hormones, substances | substances originating in the gut or elsewhere in the body, physical function = broken down by kupffer cells, biochemical function = cytochrome P450 enzymes, "first pass metabolism" |
| Functions of liver: processing drugs, hormones, substances | essentially all steroid hormones, degradation of ammonia into urea, ethanol breakdown, breakdown of bilirubin --> excreted into bile, excretion of calcium |
| Functions of liver: degradation of ammonia ** | ammonia (NH3), toxic to CNS, freely permeable across the BBB (cause brain functions to be abnormal) |
| Functions of liver: degradation of ammonia | the liver converts circulating ammonia to urea, excreted in the urine |
| Functions of liver: bilirubin | end product of hemoglobin degradation = breakdown of hemoglobin, can be measured |
| Functions of liver: bilirubin | RBC "dies" they are phagocytized by tissue macrophages, eventually forms free bilirubin (unconjugated), combines with albumin --> transported to the liver, where it is conjugated --> bile canaliculi --> intestines, urobilinogen --> kidneys |
| Functions of liver: bile | formation and secretion of bile, approx 500-1000mL is secreted per day, bile aids in fat digestion (emulsify), bile consists of bile acids, bile pigments, other substances |
| Liver: intro to labs - liver function tests - total protein | albumin and globulins |
| Liver: intro to labs - liver function tests - albumin | synthesized by liver, decreased during liver disease |
| Liver: intro to labs - liver function tests - AST (aspartate aminotransferase) | elevated during liver disease |
| Liver: intro to labs - liver function tests - ALT (alanine transaminase) | elevated during liver disease |
| Liver: intro to labs - liver function tests - ALP (alkaline phosphatase) | enzyme produced in liver, bones, kidneys, digestive system |
| Liver: intro to labs - liver function tests - PT (prothrombin time) | prolonged during liver disease |
| Liver: intro to labs - liver function tests - aPTT (partial thromboplastin time) | prolonged during liver disease |
| Liver: intro to labs - liver function tests - total bilirubin | elevated during liver disease |
| Liver: intro to labs - liver function tests - direct (conjugated) bilirubin | elevated during liver disease |
| Liver: intro to labs - liver function tests - indirect (unconjugated) bilirubin | elevated during liver disease |
Created by:
bluedolphin7
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