ANATOMY AND PHYSIOLOGY

LIVER AND METABOLISM

Weighing 1.5kg, the liver is the body’s largest internal organ.
The wedge-shaped liver occupies much of the top right-hand side of the
abdominal cavity, immediately under the diaphragm. Its deep red color is
indicative of the large volume of blood that passes through it. The livers
500 metabolic and regulatory functions play a key part in homeostasis
by ensuring that the blood’s composition remains constant. While the
liver’s only direct role in digestion is to produce bile, many of its
functions involve processing the products of digestion after they arrive
from the small intestine.

Liver Structure
The basic uni of the liver are the billions of hepatocytes, or liver
cells, that process nutrients, produce bile, destroy poisons, and secretes
substances. They are arranged not at random but into highly organized,
microscopic structures called lobules. Each lobule consists of vertical
plates of hepatocytes that radiate from a central core. At each of the six
corners of lobule there are three vessels: a branch of the hepatic portal
veins that delivers nutrient-rich blood; a branch of the hepatic artery
that delivers oxygen rich blood; and a branch of the bile duct. Blood from
both blood spaces called sinusoids that run between the plates of
hepatocytes. It then empties into the central vein that run along the core
of the lobule before emptying into a hepatic vein. As blood flows along the
sinusoid, hepatocytes remove oxygen, as well as nutrients and other
substance to be processed, and add secretory products; nutrients
released form store, and waste products. Sinusoids contain macrophages
called Kupffer cells, that engulf worn-out red blood cells, debris, and
bacteria. Bile produced by the hepatocytes flows along the bile canaliculi
that run between plates of hepatocytes and collects in a branch of the
bile duct. It is then carried by the bile duct to be stored in the gall
bladder.

Major function of the Liver

By carrying out the 500 or so metabolic functions, the hepatocytes
control the chemical composition of the blood. The main functions are:
 Blood glucose regulation
Cells need a constant supply of glucose to provide energy to drive
their metabolic reactions. So it is essential that glucose levels stay
relatively constant. If blood glucose levels are high, after a meal,
the liver sequesters glucose and stores it in the the form of a
polysaccharide glycogen. If levels are too low, between meals, the
liver converts glycogen to glucose, which is released into the blood.
This regulatory process also involves the mediation of the
pancreatic hormones insulin and glucagon.
 Fat metabolism
If liver glycogen stores are full, the liver converts excess glucose to
fat, which can be stored either in the liver or in adipose tissue. The
liver also produces cholesterol, a precursor of some steroid
hormones and a component of the outer plasma membrane of
cells.
 Mineral storage
Iron and copper, both needed to make the hemoglobin inside the
red blood cells, are stored inside hepatocytes.
 Vitamin Storage
Vitamins A, D, and B12 are amongst the vitamins stored by the
liver. The liver can hold up to four months’ supply of vitamins D
and B12, and about two years’ supply of Vitamin A.\
 Protein Metabolism
Excess amino acids, the building blocks of proteins, cannot be
stored in the body. The liver processes the excess by deaminating
the amino acids to form urea, a nitrogen-containing waste which is
carried to the kidneys to be excreted in the urine. In addition, the
liver produces plasma proteins and fibrinogen found in blood.
 Bile Production
Bile consists of bile pigments derived from the breakdown of
RBC’s; bile salts derived from cholesterol; cholesterol itself; and
fats. Bile salts play a part in fat digestion in the small intestine and
are then absorbed back into the bloodstream, returned to the liver,
and reused. The other bile components are excreted with the feces.
 Hormone Breakdown
The liver removes hormones from the blood and breaks them
down.
 Detoxification
Poisonous substances, such as alcohol, that have been inhaled or
ingested are detoxified by the liver, which converts them into
harmless substances that can be excreted by the kidneys.
 Heat Generation
The many metabolic reactions going on inside the hepatocytes
generate a considerable amount of heat. This is distributed around
the body by the blood and helps maintain a constant body
temperature.

Liver’s blood supply

The liver has two blood supplies: 20% is provided by the hepatic
artery which supplies oxygen-rich blood; 80% arrives along the
hepatic portal vein that delivers blood poor in oxygen but rich in
nutrients, and other materials, from the small intestine. A portal
system is one that carries blood from one organ to another rather
than returning it to the heart. The hepatic artery and hepatic portal
vein enter the liver midway down its posterior surface. Inside the
liver, the oxygen-rich and oxygen-poor blood is mixed. “Processed”
blood leaves the liver through the hepatic veins that immediately
empty into the inferior vena cava vein which returns the blood to the
heart.