Lecture on Liver and Associated Structures

Jul 17, 2024

Lecture on Liver and Associated Structures

Formation and Function of the Biliary System

  • Common Hepatic Duct and Cystic Duct join to form the common bile duct.
  • The common bile duct opens into the duodenum.

Liver Lobules

  • Liver Lobules: Tiny, hexagonal, sesame seed-sized structures; functional units of the liver.
  • Portal Triad: Found at each corner of a liver lobule consisting of:
    • Hepatic Artery (brings oxygen-rich blood).
    • Hepatic Venule (branches from the portal vein, bringing nutrient-rich blood from the digestive organs).
    • Biliary Duct (carries bile).
  • Hepatocytes:
    • Arranged like bricks, interspersed with sinusoidal capillaries.
    • Functions include processing blood-borne nutrients, storing glucose as glycogen, storing fat-soluble vitamins (A, D), detoxifying ammonia into urea, and producing various plasma proteins.
    • Contains rough/smooth endoplasmic reticulum, Golgi bodies, peroxisomes, and mitochondria.

Bile Production and Function

  • Bile: Yellowish-green alkaline fluid produced by the liver (about 900 mL/day).
    • Bile Salts: Cholesterol derivatives; emulsify fats for absorption.
    • Bilirubin: Pigment formed from the breakdown of hemoglobin, giving bile its color.
    • Other components include cholesterol, triglycerides, phospholipids, and electrolytes.
  • Hepatoportal System: Recirculates 95% of bile salts back to the liver, aiding reuse.
  • Gallstones: Form from cholesterol crystallization due to an imbalance of cholesterol and bile salts, causing pain and potentially obstructive jaundice.

Common Diseases and Conditions

  • Obstructive Jaundice: Caused by bile duct blockage, leading to bile pigment deposition in the skin.
  • Hepatitis: Inflammation of the liver due to viral infection, drug toxicity, etc.
  • Cirrhosis: Chronic liver inflammation often due to alcoholism, leading to liver tissue replacement by fibrous tissue and potential liver failure.

Regenerative Capacity of the Liver

  • Regeneration: Liver regenerates to full size in 6-12 months after 80% removal, provided the source of injury is removed.
  • Liver Transplants: Necessary if the extent of damage is too severe; requires blood matching.

Gallbladder

  • Structure: Thin-walled muscular sac located beneath the liver, stores and concentrates bile.
  • Function: Releases bile through cystic duct into the common bile duct upon contraction, stimulated by cholecystokinin in response to fatty food in the duodenum.
  • Gallstones: Obstruct bile flow, leading to pain during gallbladder contraction; treatable by various methods.

Pancreas

  • Location: Retroperitoneal, in the J-shaped curvature of the stomach.
  • Structure includes the head (encircled by duodenum), body, and tail (near spleen).
  • Endocrine Function: Pancreatic islets produce insulin (lower blood glucose) and glucagon (increase blood glucose).
  • Exocrine Function: Acinar cells produce pancreatic juice (1200-1500 mL/day), a watery, alkaline fluid containing digestive enzymes.