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The Liver and digestion

The Liver and digestion. Dr. Than Kyaw 7 May 2012. The Liver  . largest organ in the body located behind the diaphragm divided into lobes performs multiple complex life sustaining functions. Many functions – related to the numerous liver enzymes

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The Liver and digestion

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  1. The Liver and digestion Dr. Than Kyaw 7 May 2012

  2. The Liver   • largest organ in the body • located behind the diaphragm • divided into lobes • performs multiple complex life sustaining functions • Many functions – • related to the numerous liver enzymes • -- Some enzymes for "break down" of molecules • -- Some for "combination" of molecules forming new essential substances • for the body • -- intermediate metabolism • Produces bile

  3. Liver lobule

  4. Non-digestive and Digestive Functions of the Liver

  5. Non-digestive Functions • Detoxification • (most medicines, alcohol, harmful substances from the body) • Production of blood clotting factors • Storage of glycogen • Storage of vitamins and minerals • Destruction of old non-functional red blood cells • Removal of hormones • Removal of ammonia from the body (urea formation)  • Formation of plasma proteins • (globulin and albumin -- used for the building blocks of the body and the immune system.)

  6. Digestive Function • Bile production Bile -- synthesized in the liver; stored in the gall bladder -- released when stimulated by CCK which is secreted when chyme enters duodenum -- Bile duct joins with pancreatic duct before opening into the duodenum Bile -- contains no digestive enzyme -- contains -- bilirubin (derived from break down of hemoglobin) -- cholosterol -- bile salts -- phospholipids (lecithins)

  7. (Man)

  8. Digestive Function • Bile production Bile salts – a range of lipids that assist in the break up of lipid droplets to smaller droplets increasing surface areas for digestion by lipase -- emulsifying action. -- also aids the absorption of fatty acids and glycerol along the small intestine NOTE: Equine digestive feature include: 1. low levels of amylase in saliva2. absenceof a  gall bladder (there is a constant releaseof bile into the intestine) 3. a relatively small stomach (about 1 gallon) 4. Large caecum - about 4 gallon

  9. Impaired Liver Function and Jauncice Jaundice or icterus - Characterized by yellowish discolouration of skin, mucous membranes, and/or sclera - Resulted from accumulation of bilirubin (bile pigment) in the blood and tissues

  10. Jaundice or icterus Causes of jaundice - liver damage - occlusion of bile duct - increasedrate of erythrocyte destruction (hemolytic diseases, e.g: anaplasmosis – the bile pigments are liberated into the blood faster than the liver can conjugate and secrete them – icterus results Any factor that disrupts the movement of bilirubin from the blood to the liver and then out of the body -- causes jaundice

  11. Senescent RBCs Hemolysed* RBCs In MPS cells releasing HB *What are hemolytic agents? (bacterial toxins, snake venoms, blood parasites, hypotonic solutions) Fate of Erythrocytes

  12. Classifications of causes of jaundice Three primary types: Prehepatic Causes- Those occurring before the blood passes through the liver - Also referred to as hemolytic causes (result from a breakdown of red blood cells – parasites:anaplamosis, babesiosis). - Fatty infiltration of the liver (hepatic lipidosis) - Inflammatory diseases of the liver (hepatitis), bile duct system (cholangitis), or both (cholangiohepatitis) - Toxins (e.g, heavy metals, chemical flea and tick dips and sprays) - Certain drugs (e.g, diazepam, acetaminophen, griseofulvin) - Cancer - Infections - viral, bacterial, protozoal

  13. Hepatic icterus Chronic hepatitis: • Hereditary hepatitis • Drug-induced chronic hepatitis (e.g.; dog - phenobarbital) Acute hepatitis: • Toxic materials • Infectious (leptospirosis, canine, infectious hepatitis, Yersinia, Salmonella) Neoplasia: • Lymphoma, hepatic metastases, etc. Acute cholangitis

  14. Posthepatic Causes - Disorders that occur after blood passes through the liver • - Disorders or gallbladderdiseasesthat block the bile flow from the liver (gall stones, Fasciola hepatica, Ascaris, cancer, or inflammation of the gall bladder and bile duct) - Pancreatic diseases (pancreatitis and pancreatic cancer or abscess) - Intestinal diseases that block the bile ducts

  15. Moderate yellow discoloration of the mucosal membranes (sub-icterus).

  16. Yellow discoloration of pig viscera and carcass caused by cirrhosis of the liver.

  17. Liver Enzymes (Human) • Automatic biochemistry analyzer: • - aspartateaminotransferase (AST or SGOT) • - alanineaminotransferase (ALT or SGPT), • ALT: < 35U/L, AST: <40U/L • Elevated ALT, AST : acute hepatitis (viral or toxic), • chronic hepatitis and cirrhosis, biliary obstruction • Alkaline phosphatase (ALP) : 30-130 U/L ( 36-92 U/L) • Elevated ALP: bile duct obstruction, primary • hepatocellular carcinoma, hepatitis

  18. END OF LECTURE VIDEO CLIPS ONGASTRIC MOTILITY

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