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Questions and Answers
What is the approximate weight of the liver in an adult?
What is the purpose of the falciform ligament in the liver?
What is the main function of the hepatic artery?
What is the function of the sinusoids in the liver?
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What percentage of the liver mass is composed of hepatocytes?
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What is the function of the smooth endoplasmic reticulum in the liver?
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What is the primary source of bilirubin production in the body?
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What is the main function of the liver regarding immunoglobulin abnormalities?
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What is a consequence of decreased synthesis of clotting factors in liver disease?
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What is the main function of the liver regarding organic anions?
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What is the average daily bilirubin production in the body?
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What is the primary transporter of bilirubin in the blood?
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What is the primary function of the Golgi complex in the liver?
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What is the normal pressure of the portal vein?
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What is the term for the accumulation of fluid within the peritoneal cavity?
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What is the characteristic odor associated with hepatic encephalopathy?
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What is the consequence of altered drug metabolism in hepatic dysfunction?
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What is the endocrine abnormality observed in men with liver disease?
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Study Notes
Anatomy of the Liver
- Largest organ in the adult human body (1.2-1.5 kg) located in the right upper quadrant of the abdomen
- Composed of two main lobes separated by the falciform ligament, with the right lobe being 6 times larger than the left lobe
- Dual blood supply: portal vein (carries blood from the alimentary tract) and hepatic artery (carries oxygenated blood)
Microscopic Anatomy
- Composed of lobules demarcated by connective tissue (CT) septa and vascular and biliary vessels
- Central hepatic vein found in the center of the lobule
- Sinusoids are blood-carrying vascular channels on either side of the liver cell plates
- Lining cells: endothelial cells or Kupffer cells (the largest group of fixed macrophages)
- Space of Disse: tissue space between endothelial cells and hepatocytes, filled with interstitial fluid for nutrient and waste product transfer
Hepatocytes
- Polygonal cells that constitute 60% of liver mass
- Specialized surface:
- Sinusoidal surface
- Intracellular surface
- Canalicular surface
Ultrastructure
- Hepatic parenchymal cells have a well-developed organellar substructure:
- Mitochondria: energy generation (oxidative phosphorylation and fatty acid oxidation)
- Lysosomes: degradative functions (hydrolytic enzymes)
- Endoplasmic reticulum: site of many functions, including drug metabolism and bile acid synthesis
- Smooth ER: bilirubin conjugation, drug detoxification, and cholesterol synthesis
- Rough ER: synthesis of specific proteins (e.g., gynecomastia and testicular atrophy due to increased estrogen effect)
Biochemical Assessment of Liver Function
- Hepatic excretory function: removal of organic anions from sinusoidal blood and excretion into bile
Bilirubin Metabolism
- Daily bilirubin production: 250-300 mg
- 85% of bilirubin is derived from hemoglobin (Hgb) catabolism
- 15% of bilirubin is derived from erythrocyte precursors destroyed in the bone marrow and catabolism of other heme-containing proteins
- Bilirubin is transported by albumin
Functions of the Liver
- Receives, processes, and stores materials absorbed from the digestive tract (e.g., amino acids, carbohydrates, fatty acids, cholesterol)
- Synthesizes multiple plasma proteins and contributes to the body's immune system
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Description
Test your knowledge of liver function tests, including bilirubin, and the anatomy of the liver, including its structure, dual blood supply, and microscopic composition. This quiz is based on a lecture and text from a clinical chemistry course.
