The Liver as an Organ

Chapter 71
Functions:

1. filtration and storage of blood;

2. metabolism of carbohydrates, proteins, fats, hormones, and foreign chemicals;
3. formation of bile;
4. storage of vitamins and iron;
5. formation of coagulation factors.
Figure 71-1. Basic structure of a liver lobule,
showing the liver cellular plates, the blood vessels,
the bile-collecting system, and the lymph flow
system composed of the spaces of Disse and the
interlobular lymphatics.

Hepatic plates
Sinusoids, fenestrae

Portal system
Capillaries ⇒ vein ⇒ capillaries ⇒ vein.
Liver lobules (0.8 to 2 mm in diameter).
Total-50,000 to 100,000 lobules.

Bile canaliculi, bile ducts, hepatic ducts

Spaces of Disse or the perisinusoidal spaces
Formation of the lymph

High blood flow

The liver as a blood reservoir

Regulation of liver mass—regeneration:

Hepatocyte growth factor (HGF)
Epidermal growth factor
Tumor necrosis factor
Interleukin 6
Transforming growth factor-β
Phagocytic Kupffer cells

Metabolic functions of the liver:

• Carbohydrate metabolism

• Fat metabolism

• Protein metabolism

• Stores vitamins

• Stores iron as ferritin

• Forms blood substances used in coagulation

• Removes or excretes drugs, hormones, and other

substances.
The enterohepatic circulation of urobilinogen.
Jaundice—Excess Bilirubin in the Extracellular Fluid

0.5 mg/dl – normal

1.5 mg/dl < Jaundice

Hemolytic jaundice:
↑ unconjugated bilirubin in plasma
↑ urobilinogen in the urine

Obstructive jaundice:
↑ conjugated bilirubin in the plasma
No urobilinogen in the urine
↑ conjugated bilirubin appears in the urine
Spectrum of alcoholic liver disease.