Hepatic Pathophysiology
Hepatic includes the liver, gallbladder and pancreas
2 things to look at: 1. Function of the liver 2. Structure or the liver
Both have implications in the manifestations of disease
Som
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Hepatic Pathophysiology
Hepatic includes the liver, gallbladder and pancreas
2 things to look at: 1. Function of the liver 2. Structure or the liver
Both have implications in the manifestations of disease
Some DOs impact more the structure of the liver and that will present in a
certain, vice versa
Physiology and Function of Bile Flow
Bile flow- starts intrahepatic then goes extrahepatic
Bile is composed of primarily water, but cholesterol, bile acids (primary and
secondary), pigments are present
Bile produced by hepatocytes in liver; they have intrahepatic ducts, ends up
being stored in gallbladder
o Primary bile acids: choli, chenodeoxycholic acid
o Secondary bile acids: deoxycholic acid, ursodeoxycholic acid,
lithocholic acid
o Composed primarily of H2O, electrolytes, organic solute; low protein
content
o Additional components include pigment cholesterol phospholipids
Physiology and Function of Bile Flow
Gallbladder
Purpose of the gallbladder (GB) is not just to store the bile for use when we
need extra bile for fatty foods (emulsification of fats?), but also to concentrate
the bile
Once bile is in the GB, lot of the water is reabsorbed (bile is now more
concentrated)
Concentrates and stores bile
Parts
o Liver
o Hepatic duct
o Cystic duct
o GB
o Common bile duct- that secretes bile into the duodenum
During the fasting state, the sphincter contracts and bile moves from the liver,
down the hepatic ducts, ends up going into the GB.
When eating fatty foods, the sphincter opens up (along with contraction of
the GB) and bile moves from GB down into the small intestines
Fasting state
o Muscular sphincter at ampulla of Vater is contracted; promotes flow of
bile into gallbladder (doesn’t allow bile to move into the small
intestines, diverts it to the GB)
o Half of bile stored; half flows into duodenum
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