Overview of liver Function Flashcards
- look at case studies on PowerPoint
What organ is the largest, most complex and multi-tasking organ in the body?
- the liver
What is an advantage of the livers, structure?
- It has a huge reserve capacity
- approx. 80%
- a great potential to regenerate
What is the liver separated into?
- distinct lobes
- species variation
What does the gall bladder store?
- Bile, except for in horses and small rodents
The liver has a dual blood supply - where supply’s this?
- hepatic portal vein (70-80% rich)
- hepatic artery ( 20-30% oxygen rich)
Blood from the central veins opens into what?
- into the caudal vena cava
The liver plays an important role in what?
- assimilation
- storage
- release of nutrients
What does carbohydrate metabolism do?
- maintains blood glucose levels
- store glucose as glycogen if not needed
- break down glycogen to glucose if needed
What does fat metabolism do?
- break down fats to produce energy
What does protein metabolism do?
- converts protein to amino acids for energy or fat and carbohydrates
- detoxifies ammonia absorbed from the gut and produced through the urea cycle
What does the liver synthesis?
- albumin
- some globulins
- clotting factor (and activates some)
- bile
What does the liver store?
- vitamins and minerals (iron and copper)
- carbohydrate (glycogen)
Liver enzymes metabolise and or detoxify what?
- drugs
- toxins absorbed from the gut
What does the reticuloendothelial system (kupffer cells) have a role in?
- has a role in inflammation and immunity
- destroys WBCs and RBCs (good if old bad if not)
- transforms haemoglobin from old RBCs to birlirubin
- small role in RBC production
- stores excess iron
Clinical signs of liver disease can be varied and numerous what are these?
- inappetence/anorexia
- vomiting +/- diarrhoea
- jaundice/icterus
- depression/lethargy
- polydipsia/polyuria
- neurological-encephalopathy
- bleeding tendencies
- GI ulceration
- photosensitisation
- acholic faeces
How can we access liver function?
- history/clinical examination
- blood work
- urinalysis
- radiography/ultrasonography
- biopsy
What two things come under blood work?
- CBC + smear
- Biochemistry
What can you test for using biochemistry?
- liver enzymes (ALT, ALP, GGT)
- bile acids - bile acid stimulation test
- bilirubin
- blood coagulation - PT, PTT, platelet count
What does urinalysis test for?
- conjugated hyperbilirubinemia vs unconjugated)
What is ALT - Alanine Aminotransferase?
- liver specific cytosolic enzyme
- hepatocellular necrosis
What is AST - Aspartate Aminotransferase?
- not liver specific also prevent in cardiac and skeletal muscle, kidney’s, and brain
- more sensitive than ALT in detecting hepatobiliary disease although less specific
What is ALP – Alkaline Phosphatase?
- sensitive in detecting hepatobiliary disease but low specificity
What is GGT – Gamma-Glutamyl Transpeptidase?
– present in liver, kidney, pancreas, gall bladder, spleen, lung
- Increases seen with intrahepatic and extrahepatic cholestasis
What are the clinical pathological changes that can occur in liver disease?
- Any one or a combination of …
- Increased liver enzymes
- Increase bilirubin
- Increased bile acids
- Increased blood ammonia
- Decreased blood glucose
- Increased or decreased cholesterol
- Increased protein (globulins)
- Decreased protein (albumin)
- Decreased clotting factors
- Platelet dysfunction
- or none
