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Flashcards in Liver Deck (21):
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Liver specs

Weighs 1.4 kg 3 pounds for 1400 g largest gland of the body second largest organ in the body located in right upper quadrant behind right costal margin diaphragm superiorly adherent to liver

1

Location of liver

Not palpable on normal exam except on inspiration with inspiration deliver moves downward and is palpable below the right costal margin

2

Liver anatomy

Covered by connective tissue also known as glistens capsule it has four loves right left Caudate and quadrate the right and left lobes are divided by falciform ligament

3

Portal system

Carries blood between two capillary network's without going to the heart first G.I. capillaries go to the sinusoids of the liver with the deoxygenated blood full of nutrients liver metabolizes stores modifies before sending to general circulation

4

Villi of gut

Food medications passed through liver prior to general circulation this is called first pass metabolism as a result medications can be activated or in activated in the liver before creating any systemic effects dosage should be adjusted

5

Liver blood supply

Hepatic artery 30% and portal vein 70%

6

Hepatic artery

Branches off the Celiac artery and contains high oxygen from aorta

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Portal vein

Formed by mesenteric and splenic vein contains poorly oxygenated blood and is high in nutrients from the gut

8

Portal Triad

Portal vein hepatic artery common bile duct

9

Common bile duct

Forward by cystic and common hepatic ducts empties into duodenum

10

Lobule

Functional unit of the liver

11

Hepatocytes

Each lobule made up of these

12

Lobules are arranged around a

Central vein

13

Sinusoids

Instead of capillaries these carry blood throughout the lobule they carry mixed blood

14

Bloodflow through lobules

Blood flows into lobules via portal veins blood exit lobules via central vein the central veins drain into the hepatic veins hepatic veins drain into IVC

15

Functions of liver

Produce bile detoxify chemicals or drugs storage of glycogen and blood pigment breakdown

16

Liver transplants

Second most common transplant performed approximately 6000 done in the US every year

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Survival rates for liver transplants

First month 95% first year 86% 3rd year 79%.58% chance of surviving to 15 years failure rate approximately 10 to 15%

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Diseases lead into liver transplantation

Hepatitis with cirrhosis biliary cirrhosis biliary atresia hepatocellular carcinoma alcoholism Wilson's disease and hemochromatosis

19

Liver anastomosis sites

Superior vena cava inferior vina cava bile duct hepatic artery portal vein duodenum

20

Test clamp

Done to see if patient has enough collateral flow to sustain hemodynamic stability without the use of Vino Vino bypass the inferior and superior Ivc is clamped and portal vein is clamped