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lagest gland in the body, over 500 function
liver
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has 2 lobes divided by the falciform ligament
liver
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has a round ligament and Glisson capsule
liver
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how many blood supplies does the liver has
2
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what are the blood supplies to the liver
- 1. portal vein
- 2. hepatic artery
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the 2 blood suppies to the liver can contain what
can contain 13% of blood supply at any one time (lot of blood in the liver)
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how does the portal vein flow and where does it empty
portal vein blood flows into large capillaries called sinusoids, then along with blood from the hepatic artery, progresses to the hepatic vein from which it is emptied into the inferior vena cava
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liver is innervated by what
sympathetic and parasympathetic nervous system
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what is the functional unit of the liver
the liver lobule
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what removes bacteria and other foreign substances from the blood
Kupffer cells
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what is the physiology of the liver
- 1. Carbohydrate metabolism
- 2. Protein Metabolism
- 3. Fat Metabolism
- 4. production of bile salts
- 5. bilirubin metabolism
- 6. blood reservoir
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what are more physiology of the liver
- 1. detoxification of endogenous and exogenous substances
- -ammonia
- -steroids drugs
- 2. storage of minerals and vitamins
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-glycogen formation and storage
-glucose formation from glycogen
carbohydrate metabolism
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glucose formation from gycogen
glycogenolysis
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glucose formation from amino acids
lactic acids
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glucose formation from glycerol
gluconeogenesis
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what is protein metabolism (protein catabolism and protein synthesis)
- Albumin
- alpha and beta globulins
- clotting factors
- c reative protein
- cerulosplasmin
- enzymes
- transferrin
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with protein metabolism what is needed
formation of needed amino acids
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Fat metabolism in the liver
- 1. oxidation of fatty acids for energy
- 2. ketone formation
- 3. synthesis of cholesterol and phospholipids
- 4. formation of triglycerides from dietary lipids and excessive dietary carbs. and proteins
- 5. formation of lipoproteins
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Drugs processed by the liver can become toxic in liver patients what should not be given
tylenol
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what should be done in a liver assessment (Health Assessment)
- -comfort status
- -nutritional status
- -fluid and electrolyte status
- -elimination patterns
- -energy level
- -perception, motion and cognition (if ammonia levels are off will be confused)
- -exposure to toxins
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what should be assessed in the physical assessment of liver patients
- -Jaundice, malnourished, ab enlargement, ascites etc.
- -palmer erythema
- -change in secondary sex characteristics
- -bruises (clotting factors in the liver)
- -muscle wasting, edema, petechiae
- -spider agiomas
- -mental status changes
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what diagnostic tests for liver problems
- -multiple lab tests
- -abdominal films
- -barium swallow
- -endoscopy
- -ultrasound
- -CT scans
- -MRI
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what are some other diagnostic tests performed
- -liver scans in nuclear medicine
- -Angiography
- -Liver Biopsy
- -Paracentesis
- -peritoneal lavage
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what labs will be elevated just because of liver disease and pt. is more likely to bleed
PT, INR and PTT
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