Liver structure, function, cirrhosis Flashcards
Liver functions:
- protein, carbohydrate and fat metabolism
- plasma protein and enzyme synthesis
- production of bile
- detoxification
- storage of proteins, glycogen, vitamins, minerals
Structure
–arranged as portal tracts and parenchyma
Vasculature
- portal vein brings in 2/3 blood from gut - deoxygenated , food
- hepatic artery coming in 1/3
- bile duct - leaving
Hepatocytes:
-lie in plates and cords
-exchange material with blood at sinusoidal surface
-3 types of surface:
sinusoidal, intercellular & canalicular
Liver cells
- hepatocytes
- endothelial cells
- Kupffer cells (macrophages)
- perisinusoidal cells (fat storing)
- liver-associated lymphocytes
Liver connective tissue
- Glisson’s capsule
- portal tracts (Van Gieson stain)
- parenchymal reticulum
Biliary system
- bile canaliculi
- (bile ductules)
- bile ducts
Portal tract
PASdiastase (PASD)
Cirrhosis
-Diffuse process with fibrosis and nodule formation
=end stage liver disease
-result of chronic inflammation over many years
-fibrous scarring and hepatocyte regeneration
-irreversible
Causes of Cirrhosis
-aquired and inherited
-
Fatty change due to alcohol
- steatosis
- identify on slide
Steatohepatitis
=fatty change + inflammation
Complications of cirrhosis
- portal hypertension (portal-systemic shunts and varices, ascites, splenomegaly)
- liver failure
- hepatocellular (liver) cancer
Impaired production of secretory proteins
- Albumin
- transport proteins
- coagulation and fibrinolysis proteins
- complement
- protease inhibitors
Other effects of liver failure:
- jaundice
- coagulation disorders
- altered intermediary and xenobiotic metabolism
- immune, circulatory and endocrine disturbances
Hepatocellular Carcinoma
-85% of malignant primary liver tumours
-geographical variation in incidence
80% occur in males
80% arise in cirrhotic livers
