University:
University of Wolverhampton
Course:
4PY019 | Pharmacy
Academic year:

2024
Views:

97

Pages:

31
Author:

Sara

The Liver Anatomy and physiology – functions of the liver Q: Why do we need to know about the liver? Anatomy Q: Where is the liver located? Gross anatomy • Location Q: What are the liver’s major features? Gross anatomy • Circulation: Gross anatomy • Segments Q: Where does the liver receive its blood supply from? Circulatory System incl. Portal Circulation … Gross anatomy • Location • Circulation • Segments Fine anatomy: Lobules • Lobules Fine anatomy: Lobules • Sinusoids and bile canaliculi Fine anatomy: Lobules • Lobules • Sinusoids and bile canaliculi Alternative view • The hepatic acinus/hepatic triads Q: What is bile and where is it made and stored? The biliary system • Gross anatomy The biliary system • Bile canaliculi The biliary system • Gross anatomy • Bile canaliculi Q: What physiological functions does the liver perform? Functions of the liver Proteins • Synthesis – Albumin – Coagulation factors – Others • Catabolism – Amino acids – Fatty acids Glucose homeostasis • Storage of glucose as glycogen • Glycogenolysis • Gluconeogenesis Lipid metabolism • Cholesterol synthesis • Triglycerides Bile synthesis and recirculation Bilirubin metabolism • End product from breakdown of haem • Circulating unconjugated bilirubin taken up in to hepatocytes for conjugation • Excreted in bile and converted in the gut to urobilinogen which is either – Excreted in stools as stercobilinogen – Reabsorbed and either • re-circulated then re-excreted hepatically • excreted renally Detoxification Other: • Immunological function • Storage – Vitamins – Minerals Q: What would happen if the liver’s function was impaired? Signs and symptoms of liver disease? • General/non-specific • Decompensated liver failure – Varices – Ascites – Encephalopathy Further reading • Greene R.J., Harris, N.D. (2008) Pathology and therapeutics for pharmacists: A basis for clinical pharmacy practice. (3rd ed) London: Pharmaceutical Press • Kennedy P and O’Grady J. (2012) Liver Disease. in Walker, R. and Whittlesea, K. (eds.) Clinical Pharmacy & Therapeutics, 5th ed., London: Churchill and Livingstone, pp. 238-254 • Kumar, P & Clark M. (2017) Clinical Medicine. 9th ed. London: Saunders Elsevier, pp 437-488