2010 LIVER AND GLALLBLADDER Complete +lab - LIVER AND...

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Barry Rittman, PhD. Reading: Gartner and Hiatt pp 303-321; Learning Objectives: 1. Understand the normal liver architecture with special emphasis on the blood flow, bile flow and microscopic anatomy of the liver. 2. Identify the different structural units of the liver and their roles. 3. Understand the roles the different cell types have in the liver. 4. Identify the microscopic anatomy of the gallbladder and its function. Key Words: Portal tract, sinusoid, Kupffer cell, hepatic artery, portal vein, central vein, limiting plate, bile INTRODUCTION: The liver is involved in many biochemical and functional processes that are vital for homeostasis. It is currently one of the few organs for which at least a temporary mechanical or biochemical backup is not available. Knowledge of the anatomy, histology and physiology is essential to an understanding of its role in the maintenance of the body’s status quo. I. NORMAL ANATOMY- MACROSCOPIC a. Gross Features 1. Largest single organ in the body (1400-1600 g), weighing 1,400 to 1,600 g in an adult (2% of body weight). In the newborn, 5% of body weight. 2. Mostly covered by the rib cage and can be palpated along the right costal margin, particularly if the patient inspires. 3. Divided into a larger right lobe and a smaller left lobe by the falciform ligament. 4. Covered by peritoneum except at three places on its surface. “Bare area” is small triangular area beneath diaphragm. b. Blood Supply 5. Dual afferent blood supply: hepatic artery and portal vein. 6. Hepatic artery is branch of celiac, provides 1/3 blood flow to liver and 70% of the oxygen. 7. About 60-70% of the blood supply comes from the portal vein which is rich in nutrients and fairly well oxygenated (but not as well oxygenated as the hepatic artery blood). Portal vein receives drainage from the splenic, superior mesenteric, inferior mesenteric veins and veins from the duodenum and stomach. 8. Both portal vein and hepatic artery enter through the portal tracts and give off branches which empty into the sinusoids. 9. In addition, the hepatic artery gives off a capillary plexus which surrounds the bile ducts and portal areas. 10. There is a single venous drainage system by the central veins (terminal hepatic veins) to the hepatic veins which segmentally drain the liver and run a fairly straight course to the inferior vena cava. 11. Afferent and efferent vessels, along with the hepatic duct, lymphatic vessels and sympathetic nerves (from the hepatic plexus), enter and leave the liver via the porta hepatis (hilum) . c. Function – Maintains body’s metabolic homeostasis 12. Processes dietary amino acids, carbohydrates, lipids and vitamins. a.
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This note was uploaded on 12/25/2010 for the course NEUROBIOLO MSI taught by Professor Rogerj.bick during the Spring '10 term at University of Texas Health Science Center at San Antonio.

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2010 LIVER AND GLALLBLADDER Complete +lab - LIVER AND...

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