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Anatomy and Physiological roles of liver

Anatomy of liver

Liver is the heaviest gland (1.4 kg) of healthy adult, positioning in the inferior to the diaphragm most of the right hypochpndriac annd epigastric region of abdominal caviety. In the right part of liver, the pear shaped gall bladder is present, which stores the bile salts, secreted by hepatocytes (liver functional cells). Hepatocytes are hexagonal (may have 5-12 sides) epithelial cells, occupying 80% of liver volume [Gerard 2015]. To make a clear idea about liver histology, please see[Gerard 2015]. The blood supply and bile flow (opposite in direction) are shown in figure below.

Blood and bile flow routes in liver

Classification of liver cirrhosis

Physiological roles of liver

To understand the pathology, related to cirrhosis, it is obvious that we must know the physiological roles of liver in detail. It is mention bellow:
  • Production of bile (800-1000 mL per day): Sodium or potassium salts od cholic acid or chenodeoxycholc acid are produced by liver. Excess bile (bile salts, water, cholesterol, iron, bile pigments (bilirubin) and phospholipids), produced by hepatocytes, stored in gall bladder (transported via. cystic duct). Bile salts are produced in peroxisome.
  • Bile salts play role in emylsifying larger lipid particles into smaller one, which fascilates triglyceride digestion by pancreatic lipase.
  • Bile salts promote absorption of lipids from duodenum.
  • Bile salts help in metabolism of bilirubin (breakdown product of matured RBCs) into stercobilin (after passing in small intestine), to eliminate it via. feaces.
  • Glycogen, certain amino acids and lactic acids are converted into glucose in liver to maintain blood glucose level normal.
  • Fatty acids are converted into ketone bodies in the liver. This is used as resource for ATP in heart and kidney.
  • Amino acids are oxidised and detoxified in the liver to produce ATP.
  • Protein metabolism: Deamination of amino acids as well as intoxication of ammonia (converting into less toxic urea) occure in liver.
  • Detoxification of alcohol and other chemical substances including drugs.
  • Storage of glycogen, fat soluble vitamins (A, D, E, K) and vitamin $B_{12}$, iron and copper for further use.
  • Phagocytosis of red blood corpuscles (RBCs), white blood cells (WBCs) and bacteria.
  • Liver, aling with kidney and skin participates in the activation of vitamin D.
  • Liver is responsible for the chemical alteration and elimination of thyroid hormones, estrogens and aldosterone.
  • Synthesis of most of the plasma proteins (albumin, $\alpha$ and $\beta$ globulin, prothrombin, fibrinogen and other clotting factors, angiotensinogen etc.) occur in liver.
  • Liver produces glucose from certain amino acids and fats by gluconeogenesis.
  • Oxidation of fats and production of triglycerides from other fats occur in liver.
  • Anti thrombins, responsible for the inactivation of coagulatory proteins are produced by liver cells.
  • Production of C reactive protein in response to inflammation (within two hours of inflammatory attack) as a second line defense of inflammation.
  • Reference

    [Gerard 2015] Gerard JT, Bryan D, Anatomy and Physiology, 2015 Indian Edition, Willey, 1-999, 2015.

    Anatomy and Physiological roles of liver

    Classification of liver cirrhosis

    Phenomena associated with liver cirrhosis

    Clinical representation and management of liver cirrhosis