LIVER ASSIGNED BY DR NAVEED ASLAM Sb.

(PhD PHARMACOLOGY)
SUPERVISOR PHARMACOLOGY III
PGMI. THE ISLAMIA UNIVERSITY BAHAWALPUR

PRESENTED BY
DR MOHAMMAD SARFRAZ
STUDENT MPhill PHARMACOLOGY(SESSION 2013-15)
PGMI THE ISLAMIA UNIVERSITY BAHAWALPUR

Largest gland in the body, performs large number of tasks that impact all body systems .
Hepatic disease has widespread effects on virtually all other organ systems.
HEPATIC STRUCTURE
1. The hepatic vascular system
2. The biliary tree
3. The three dimensional arrangements of the liver cells

The Hepatic Vascular System
Majority of the liver's blood supply is venous blood!
Roughly 75% of the blood entering the liver is venous blood from the portal vein.
All of the venous blood returning from the small intestine, stomach, pancreas and spleen converges
into the portal vein.
liver gets "first pickings" of everything absorbed in the small intestine
The remaining 25% of the blood supply to the liver is arterial blood from the hepatic artery.



Terminal branches of the hepatic portal vein and hepatic artery empty together
and mix as they enter sinusoids in the liver
SINUSOIDS
Sinusoids are distensible vascular channels lined with highly fenestrated or "holey" endothelial cells and
bounded circumferentially by hepatocytes.
LIVER ASSIGNED BY DR NAVEED ASLAM Sb. (PhD PHARMACOLOGY)
SUPERVISOR PHARMACOLOGY III
PGMI. THE ISLAMIA UNIVERSITY BAHAWALPUR

PRESENTED BY
DR MOHAMMAD SARFRAZ
STUDENT MPhill PHARMACOLOGY(SESSION 2013-15)
PGMI THE ISLAMIA UNIVERSITY BAHAWALPUR



As blood flows through the sinusoids, a considerable amount of plasma is filtered into the space between
endothelium and hepatocytes (the "space of Disse"), providing a major fraction of the body's lymph.

Blood flows through the sinusoids and empties into the central vein of each lobule.


Central veins coalesce into hepatic veins, which leave the liver and empty into the venacava.

LIVER ASSIGNED BY DR NAVEED ASLAM Sb. (PhD PHARMACOLOGY)
SUPERVISOR PHARMACOLOGY III
PGMI. THE ISLAMIA UNIVERSITY BAHAWALPUR

PRESENTED BY
DR MOHAMMAD SARFRAZ
STUDENT MPhill PHARMACOLOGY(SESSION 2013-15)
PGMI THE ISLAMIA UNIVERSITY BAHAWALPUR


The Biliary System
The biliary system is a series of channels and ducts that conveys bile - a secretory and excretory
product of hepatocytes - from the liver into the lumen of the small intestine.


Hepatocytes are arranged in "plates" with their apical surfaces facing and surrounding the sinusoids.
The basal faces of adjoining hepatocytes are welded together by junctional complexes to form canaliculi, the
first channel in the biliary system.
A bile canaliculus is not a duct, but rather, the dilated intercellular space between adjacent
hepatocytes.
Hepatocytes secrete bile into the canaliculi, At the ends of the canaliculi, bile flows into bile
ducts (true ducts lined with epithelial cells).
The grouping of bile duct, hepatic arteriole and portal venule is called a portal triad.


Small bile ducts, or ductules, anastomose into larger and larger ducts, eventually forming the
common bile duct, which dumps bile into the duodenum
Architecture of the Hepatic Parenchyma
The liver is covered with a connective tissue capsule that branches and extends throughout the
substance of the liver as septae.
The HEPATIC LOBULE is the structural unit of the liver
LIVER ASSIGNED BY DR NAVEED ASLAM Sb. (PhD PHARMACOLOGY)
SUPERVISOR PHARMACOLOGY III
PGMI. THE ISLAMIA UNIVERSITY BAHAWALPUR

PRESENTED BY
DR MOHAMMAD SARFRAZ
STUDENT MPhill PHARMACOLOGY(SESSION 2013-15)
PGMI THE ISLAMIA UNIVERSITY BAHAWALPUR

It consists of a roughly hexagonal arrangement of plates of hepatocytes radiating outward from a
central vein in the center.
At the vertices of the lobule are regularly distributed portal triads, containing a bile duct and a
terminal branch of the hepatic artery, and portal vein
FUNCTIONS OF LIVER
SYNTHETIC FUNCTIONS
amino acid synthesis
gluconeogenesis
glycogenesis
Cholesterol synthesis
Lipogenesis, the production of triglycerides (fats).
Lipoproteins synthesis
The liver produces coagulation factors
In the first trimester fetus, the liver is the main site of red blood cell production
Proteins synthesis, albumin.
amino acid synthesis
Insulin-like growth factor 1 (IGF-1), a polypeptide protein hormone that plays an important role in
childhood growth and continues to have anabolic effects in adults.
The liver is a major site of thrombopoietin production. Thrombopoietin is a glycoprotein hormone
that regulates the production of platelets by the bone marrow
BREAKDOWN FUNCTIONS
The breakdown of insulin and other hormones
Glucoronidates bilirubin, facilitating its excretion into bile.
The liver breaks down or modifies toxic substances, the toxins are conjugated to avail excretion in
bile or urine.
The liver converts ammonia to urea (urea cycle).
STORAGE FUNCTIONS
Glycogen,
vitamin A (12 years' supply)
vitamin D (14 months' supply )
vitamin B12 (13 years' supply)
vitamin K
iron
copper
Synthesis of angiotensinogen
Relation to medicine and pharmacology
The oxidative capacity of the liver decreases with aging and therefore
Benzodiazepines (BZDs) that require oxidation are more likely to accumulate to toxic levels.
Drugs with shorter half-lives, such as lorazepam and oxazepam are preferred
DISEASES OF THE LIVER
LIVER ASSIGNED BY DR NAVEED ASLAM Sb. (PhD PHARMACOLOGY)
SUPERVISOR PHARMACOLOGY III
PGMI. THE ISLAMIA UNIVERSITY BAHAWALPUR

PRESENTED BY
DR MOHAMMAD SARFRAZ
STUDENT MPhill PHARMACOLOGY(SESSION 2013-15)
PGMI THE ISLAMIA UNIVERSITY BAHAWALPUR


hepatitis A, B, C, D, E
alcoholic hepatitis
fatty liver
cirrhosis
cancer
drug damage (particularly by acetaminophen
LIVER FUNCTION TESTS
serum albumin (associated with functionality, levels are decreased in chronic liver disease)
Prothrombin time
bilirubin (direct and indirect)
liver transaminases ALT(raised in acute liver damage)
S. alkaline phosphatise(enzyme in the cells lining the biliary ducts of the liver, also present in bone
and placental tissue, so it is higher in growing children (as their bones are being remodelled) and
elderly patients with Paget's disease. In the 3rd trimester of pregnancy, ALP is ~2-3X higher.)
gamma-glutamyl transferase(chronic alcohol toxicity )
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