الكبد

موضوع: الكبد الثلاثاء أكتوبر 20, 2009 12:10 am

Liver.

What is the liver

The liver the largest gland in the human body. It lies below the diaphragm in the thoracic region of the abdomen.It is present in vertebrates and some other animals. It plays a major role in metabolism and has a number of functions in the body, including glycogen storage, plasma protein synthesis, and detoxification. It produces bile, an alkaline compound which aids in digestion,
via the emulsification of lipids. It also performs and regulates a wide
variety of high-volume biochemical reactions requiring specialized tissues.

Anatomyof liver
The adult human liver normally weighs between 1.7 - 3.0 kilograms (3.5 - 6.5 pounds), and it is a soft, pinkish-brown "boomerang shaped" organ. It is the second largest organ (the largest organ being the skin)
and the largest gland within the human body.It is the heaviest organ in
the body. It is located on the right side of the upper abdomen below the diaphragm. The liver lies on the right of the stomach and makes a kind of bed for the gallbladder (which stores bile).
oFlow of blood

the portal vein, bringing venous blood from the spleen, pancreas, small intestine, and large intestine, so that the liver can process the nutrients and byproducts of food digestion.
The hepatic veins drain directly into the inferior vena cava.
The hepatic artery is generally a branch from the celiac trunk.
Approximately 60% to 80% of the blood flow to the liver is from the portal venous system, and 1/4 is from the hepatic artery.
oFlow of bile

The bile produced in the liver is collected in bile canaliculi, which merge to form bile duct .
Bile can drain directly into the duodenum via the common bile duct or be temporarily stored in the gallbladder via the cystic duct. The common bile duct and the pancreatic duct enter the duodenum together at the ampulla of Vater.

Regeneration

The liver is among the few internal human organs capable of natural regeneration of lost tissue; as little as 25% of remaining liver can regenerate into a whole liver again.
This is predominantly due to the hepatocytes acting as unipotential stem cells (i.e. a single hepatocyte can divide into two hepatocyte daughter cells). There is also some evidence of bipotential stem cells, called oval cells, which can differentiate into either hepatocytes or cholangiocytes (cells that line the bile ducts).

Traditional (Surface) anatomy

the liver is covered entirely by visceral peritoneum, a thin, double-layered membrane that reduces friction against other organs.
recognizable surface landmarks.

§Lobes

Traditional gross anatomy divided the liver into four lobes based on surface features.
The falciform ligament is visible on the front (anterior side) of the liver. This divides the liver into a left anatomical lobe, and a right anatomical lobe.
If the liver flipped over, to look at it from behind (the visceral surface), there are two additional lobes between the right and left. These are the caudate lobe (the more superior), and below this the quadrate lobe.
From behind, the lobes are divided up by the ligamentum venosum and ligamentum teres (anything left of these is the left lobe), the transverse fissure (or porta hepatis) divides the caudate from the quadrate lobe, and the right sagittal fossa, which the inferior vena cava runs over, separates these two lobes from the right lobe.
Each
of the lobes is made up of lobules, a vein goes from the centre of each
lobule which then joins to the hepatic vein to carry blood out from the
liver.
On the surface of the lobules there are ducts, veins and arteries that carry fluids to and from them.

Modern (Functional) anatomy

The central area where the common bile duct, portal vein, and hepatic artery enter the liver is the hilum or "porta hepatis".
The duct, vein, and artery divide into left and right branches, and the
portions of the liver supplied by these branches constitute the
functional left and right lobes.

الكبد Liver_inferior

liver iferior

الكبد Liver_superior

liver superior

Liver Enzymes
Four
separate liver enzymes are included on most routine laboratory tests.
They are- aspartate aminotransferase (AST or SGOT) and alanine
aminotransferase (ALT or SGPT), which are known together as
transaminases; and alkaline phosphatase (AP) and gamma-glutamyl
transferase (GGT), which are known together as cholestatic liver
enzymes. Elevations of these enzymes can indicate the presence of liver
disease.

ØAST and ALT (Transaminases

AST and ALT are jointly known
as transaminases. They are associated with inflammation and/or injury
to liver cells, a condition known as hepatocellular liver injury.
Damage to the liver typically results in a leak of AST and ALT into the
bloodstream.
Because
AST is found in many other organs besides the liver, including the
kidneys, the muscles, and the heart, having a high level of AST does
not always (but often does) indicate that there is a liver problem. On
the other hand, because ALT is found primarily in the liver, high
levels of ALT almost always indicate that there’s a problem with the
liver. (Conversely, a normal ALT level does not necessarily mean that
the liver is definitely normal- but, more about this later.)
The
normal ranges for AST and ALT are around 0 to 40 IU/L and 0 to 45 IU/L
respectively. (IU/L stands for international units per liter and is the
most commonly accepted way to measure these particular enzymes.)
there
are many other factors besides liver injury that could affect the
levels of AST and ALT. For example, males have higher transaminase
levels than females. And, African-American men have higher AST levels
compared with Caucasian men. People appear to have higher transaminase
levels in the morning and afternoon than in the evening. Food intake
does not appear to have a significant effect on transaminase levels
Finally, transaminase levels may vary from day-to-day.
Some possible causes of elevated transaminase levels include the following:
• Viral hepatitis
• A fatty liver
• Alcoholic liver disease
• Drug/medication-induced liver disease
• Autoimmune hepatitis
• Herbal toxicity
• Genetic liver diseases
• Liver tumors
• Heart failure

ØGGT and AP (Cholestatic Liver Enzymes

High levels of GGT and AP
hint at a possible blockage of the bile ducts, or of possible injury
to, or inflammation of, the bile ducts. This type of problem is
characterized by an impairment, or failure, of bile flow, which is
known as cholestasis. This type of liver injury is known as cholestatic
liver injury, and this type of liver disease is known as cholestatic
liver disease.
When
a blockage or inflammation of the bile ducts occurs, the GGT and AP can
overflow like a backed up sewer and seep out of the liver and into the
bloodstream. These enzymes typically become markedly
elevated—approximately ten times the upper limit of normal.
GGT
is found predominantly in the liver. AP is mainly found in the bones
and the liver but can also be found in many other organs, such as the
intestines, kidneys, and placenta.
Therefore,
elevated levels of AP will indicate that something is wrong with the
liver only if the amount of GGT is raised as well. Keep in mind that,
GGT can be elevated without AP being elevated. should be noted that for
unclear reasons, people who smoke cigarettes appear to have higher AP
and GGT than nonsmokers. Also, levels of AP and GGT are most accurate
after a twelve-hour fast.
Normal
levels of AP range from 35 to 115 IU/L and normal levels of GGT range
from 3 to 60 IU/L. Some causes of elevated AP and/or GGT include the
following:
• Primary biliary cirrhosis
• Primary sclerosing cholangitis
• Nonalcoholic fatty liver disease (NAFLD)
• Alcoholic liver disease
• Liver tumors
• Drug-induced liver disease
• Gallstones

موضوع: رد: الكبد الثلاثاء أكتوبر 20, 2009 9:44 pm

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موضوع: رد: الكبد الأربعاء أكتوبر 21, 2009 6:02 pm

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