Liver & Gall Bladder Function

What are the functions of the liver?

Bile production, metabolism & detoxification of the blood

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What is the structure & cells of the liver?

Lobules: vascular or bile channels. Oxygenated & deoxygenated blood mix in hepatic sinusoids -> comes into hepatocytes via gaps in endothelium -> hepatocyes secrete substances in bile cells. Kupffer cells are immune, contain breakdown produce of RBCs

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What is the process of bile production?

Primary secretion by hepatocytes -> bile canal -> bile passes along duct cells & is modified (HCO3- added to neutralise acidity when it passes into duodenum)

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What do hepatocytes secrete?

Bile salts (cholesterol derivatives, for lipid digestion/absorption), phospholipids, bile pigments (bilirubin), cholesterol & inorganic ions

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What do bile salts undergo?

Enterohepatic recycling: at ileum transporter proteins reabsorb bile salts -> liver (portal venous network), active transport mechanisms in hepatocytes reabsorb bile salts so they're available for secretion again

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What are bile pigments & how are they involved in the production on faeces?

Breakdown products of Hb, unconjugated bilirubin transported to liver via plasma albumin -> glucaronic acid added -> conjugated bilirubin -> SI -> bacterial reaction, remove glucuronide -> urobilinogen -> excreted in faeces (brown pigment)

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How are bile pigments involved in the production of urine?

Some urobilinogen is reabsorbed by the liver. It then travels to kidneys, interacts with O2 -> urobilin -> urine (yellow pigment)

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What does bile production depend on?

Hepatocyte secretions: flow to duodenum prevented by sphincter of Oddi & so enters gall bladder. Bile salts/pigments increases in concentration from reabsorption of salts and water in gall bladder

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How is the liver involved in metabolism?

Liver determines plasma glucose/amino acid concs as a consequence of absorbed nutrients. Liver is site of synthesis of plasma protein albumin & clotting factors and storage of fat soluble vitamins (A/D/E/K), iron, copper, some protein etc

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What is the purpose of detoxification? What are the 2 types & mechanisms?

Multiple enzyme systems allow modification of chemical structures to increase water solubility. Types: endogenous e.g. insulin, glucagon, aldosterone or exogenous e.g drugs. Mechanisms: oxidation -> methylation, reduction -> conjuction

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What is jaundice? What is it treated with? What are the 4 sub-types?

Bilirubin accumulation in plasma, treat wit UV light. Haemolytic (excessive haemolysis), intrahepatic (hepatocyte defect in uptake/secretion), obstructive (blocked bile duct), physiological jaundice of the newborn (poor capacity for conjugation)

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What is hepatitis? What causes acute & chronic hepatitis?

Infection/inflammation of liver. Acute: viral infections (hep A/B/C, drugs (paracetamol). Chronic: > 6 months, viral infection (hepatitis B/C only)

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What is cirrhosis? What causes it?

Necrosis of liver cells, replaced by fibroblasts. Major cause is alcohol or hepatitis B/C. No reversing treatment, stop causative effect or transplant.

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Liver & Gall Bladder Function

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