Physiology
Gastrointestinal
Regarding the liver, which of the following statements is INCORRECT:
Answer:
The liver consists of four lobes, each made up of hexagonal lobules, the functional unit of the liver. Each lobule consists of a central vein that eventually becomes part of the hepatic vein. Surrounding the central vein are single columns of hepatocytes radiating outwards; between the hepatocytes are small canaliculi which drain into the bile duct on the periphery of the lobule. At each of the six corners of the lobules lies a 'portal triad' comprising branches of the hepatic artery, the portal vein and the bile duct.Function of Liver
Physiology / Gastrointestinal / Liver and Gallbladder
Last Updated: 26th July 2024
Functional Anatomy
The liver consists of four lobes, each made up of hexagonal lobules, the functional unit of the liver. Each lobule consists of a central vein that eventually becomes part of the hepatic vein. Surrounding the central vein are single columns of hepatocytes radiating outwards; between the hepatocytes are small canaliculi which drain into the bile duct on the periphery of the lobule. At each of the six corners of the lobules lies a 'portal triad' comprising branches of the hepatic artery, the portal vein and the bile duct.
Functional Anatomy of the Liver. (Image by OpenStax College [CC BY 3.0 , via Wikimedia Commons)
Functions
The main functions of the liver are:
- Foetal haematopoiesis
- Protein metabolism
- synthesis and secretion of albumin, synthesis of plasma proteins, formation of urea from ammonia, deamination of amino acids, synthesis of coagulation factors, metabolism of polypeptide hormones
- Fat metabolism
- formation of lipoproteins and fatty acids, synthesis of cholesterol, conversion of cholesterol to bile salts, conversion of carbohydrates and protein to fat ketogenesis, metabolism and excretion of steroid hormones
- Carbohydrate metabolism
- gluconeogenesis, glycogenesis, glycogenolysis
- Bile production
- synthesis of bile salts, production of alkaline fluid for neutralisation of gastric acid in the intestines, excretion of waste metabolites and detoxified substances from the body in bile
- Storage of vitamins and minerals
- folate, B12, fat-soluble vitamins, iron, copper
- Bone metabolism in the form of hydroxylation of vitamin D
- Biotransformation and detoxification of drugs and exogenous substances, steroid hormones and nitrogenous gut toxins
- Protection by filtration of portal blood
- Phagocytosis of bacteria/antigens by Kupffer cells
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- Biochemistry
- Blood Gases
- Haematology
| Biochemistry | Normal Value |
|---|---|
| Sodium | 135 – 145 mmol/l |
| Potassium | 3.0 – 4.5 mmol/l |
| Urea | 2.5 – 7.5 mmol/l |
| Glucose | 3.5 – 5.0 mmol/l |
| Creatinine | 35 – 135 μmol/l |
| Alanine Aminotransferase (ALT) | 5 – 35 U/l |
| Gamma-glutamyl Transferase (GGT) | < 65 U/l |
| Alkaline Phosphatase (ALP) | 30 – 135 U/l |
| Aspartate Aminotransferase (AST) | < 40 U/l |
| Total Protein | 60 – 80 g/l |
| Albumin | 35 – 50 g/l |
| Globulin | 2.4 – 3.5 g/dl |
| Amylase | < 70 U/l |
| Total Bilirubin | 3 – 17 μmol/l |
| Calcium | 2.1 – 2.5 mmol/l |
| Chloride | 95 – 105 mmol/l |
| Phosphate | 0.8 – 1.4 mmol/l |
| Haematology | Normal Value |
|---|---|
| Haemoglobin | 11.5 – 16.6 g/dl |
| White Blood Cells | 4.0 – 11.0 x 109/l |
| Platelets | 150 – 450 x 109/l |
| MCV | 80 – 96 fl |
| MCHC | 32 – 36 g/dl |
| Neutrophils | 2.0 – 7.5 x 109/l |
| Lymphocytes | 1.5 – 4.0 x 109/l |
| Monocytes | 0.3 – 1.0 x 109/l |
| Eosinophils | 0.1 – 0.5 x 109/l |
| Basophils | < 0.2 x 109/l |
| Reticulocytes | < 2% |
| Haematocrit | 0.35 – 0.49 |
| Red Cell Distribution Width | 11 – 15% |
| Blood Gases | Normal Value |
|---|---|
| pH | 7.35 – 7.45 |
| pO2 | 11 – 14 kPa |
| pCO2 | 4.5 – 6.0 kPa |
| Base Excess | -2 – +2 mmol/l |
| Bicarbonate | 24 – 30 mmol/l |
| Lactate | < 2 mmol/l |
