55999640 Fisiologi Hati Dan Kandung Empedu

7/23/2019 55999640 Fisiologi Hati Dan Kandung Empedu

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FISIOLOGIFISIOLOGI

HATI

KANDUNG EMPEDU


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ANATOMI-FISIOLOGIANATOMI-FISIOLOGI

(LOBULUS)(LOBULUS)1. SEL HEPATOSIT (RADIER)

2. VENA SENTRALIS

3. KANALIKULI

4. SINUSOID

5. SEL KUPFFER

6. SPACE OF DISSE

V.PORTA SINUSOID V.HEPATKA

KANALIKULI DUKTUS BILIARIS


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A.A. FUNCTION OF THE HEPATICFUNCTION OF THE HEPATICVASCULARE SYSTEMVASCULARE SYSTEM

A.A. FUNCTION OF THE HEPATICFUNCTION OF THE HEPATIC

VASCULARE SYSTEMVASCULARE SYSTEMBlood flow through the liver 1450 ml/min (29% COP)

1100 ml : from the portal vein

350 ml : from hepatic artery

!he pre""#re of portal vein : 9 mm$

!he pre""#re in the hepatic vein : 0 mm$Chirro"i" of the liver (al&oholic' caron tetachlorie'

vir! "i!#$!#!' infectio#" in the ile #ct) :loc&ae of the portal "y"tem


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Reservoir function of the liverReservoir function of the liver

450 ml can e "tore in the hepatic vein an

hepatic "in#"e"

0'5 to 1 liter : hih pre""#re in the riht

atri#m


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High hepatic vascular pressuresHigh hepatic vascular pressures

causing fluid transudation into thecausing fluid transudation into theabdominal cavity from the liver andabdominal cavity from the liver and

portal capillariesportal capillaries ASCITESASCITES

BLOCKAGE OF PORTAL FLOWALSO CAUSES ASCITES, BUT ISLESS

Bicause the c!!ate"a! #ascu!a"cha$$e! %e#e!& "a&i%!' " the&"ta! #ei$s t the s'steic#ei$s*


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Blood cleansing funcion ofBlood cleansing funcion of

!e li"e#!e li"e#

Blood cleansing funcion ofBlood cleansing funcion of

!e li"e#!e li"e#

Hepatic macrophage system (kupffer

cells, the large macrophage thatline the hepatic sinuses) can cleanseblood (sach as many bacteria from

the intestines)Kupffer cells also phagocytize old redand white cells and bacteria.


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B.B. METABOLIC FUNCTIONMETABOLIC FUNCTION

OF THE LIVEROF THE LIVER


OF THE LIVEROF THE LIVER ARBOHYDRATE METABOLISM

Maintains normal blood glucose

level glu!ostat"

onvert glucose to gl#cogen and

gl#cogen to glucose

onvert amino acids$ lactic acid$

%ructose and galactose to glucose

onvert glucose to trigl#cerides


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OF THE LIVEROF THE LIVERLIPID METABOLISM

Stores triglycerides

Convert fatty acids to acetyl co A thanto ketone bodies

Syntheizes lipoproteins

synthesizes which is used to make bilesalt


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OF THE LIVEROF THE LIVERPROTEIN METABOLISMRemove NH2 (deaminates) amini aids

!"i" an t"an #e $sed to %o&m ATP o&onve&t to %ats o& ao"'d&ateonve&t toi NH* to t"e +ess toi $&ea

t"an e&eted in $&ine

S'nt"esi,es -+asma -&otein (a+#$min./+o#$+in. %i#&ino/en. -&ot&om#in.+i-o-&otein)


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C. E!"CRIE #$CTI"C. E!"CRIE #$CTI"

Sec"ete IGF I a$% sate%i$i$ "es&$se t +"th h"$e

F"s T " T.

Sec"ete a$+ite$si$+e$

Acti#ati$ #itai$ /

Sec"ete e"'t"&iti$ (01 2)


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$% $ETO&IFICATION FUNCTION$% $ETO&IFICATION FUNCTION

*emoval of r#"' hormon" etc :

+eto,ifie" r#" : "#lfonamie"' penicillin'

erytromicin-ltere or e,crete hormone" : thyro,ine'

"teroi hormon" (e"troen' corti"ol'

alo"teron)+eto,ifie" pro#ct" of metaoli"m

+eto,ifie" forin" chemical"


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E% OTHERS FUNCTION ' E&CRETIONE% OTHERS FUNCTION ' E&CRETIONE% OTHERS FUNCTION ' E&CRETIONE% OTHERS FUNCTION ' E&CRETION

STORAGE :

%&'%#*+ ,$-!+ vi-$i*! A+ B12+ D+ E+ K+ //#r $*"F# (0i*#" i- /r-#i* $&" ,#rri-i*)

DIGESTIVE FUNCTIONS

S#r#-# 0i+ ri% i* HCO3

!'*-#!i#! 0i !$&- ,r !-#r&

!'*-#!i#! 0i /i%#*-! ,r $# , $#%&0i*

Er#-#! /&$!$ !-#r& $*" i-i*


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RELATION OF THE LIVER TO BLOO$RELATION OF THE LIVER TO BLOO$

COA(ULATIONCOA(ULATION

Liver %orm %ibrinogen$ &rotrombin$

accelerator globulin$ %a!tor 'II'it ( is re)uired b# t*e metabolic

&rocess o% t*e liver %or t*e %ormation

&rotrombin$ %a!tor 'II$ I+ and +


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%R"!$CTI" "# BI&E%R"!$CTI" "# BI&E

133 4 0333 !5%a'S'$thesi6e BILE SALT "

ch!este"! (c$7u+ate% ith+!'ci$e " tau"i$e)

C$#e"t 8AEM t BILE PIGMENTS(cu&!e% t +!uc"$ic aci%) "

9i!i"u9i$ +!uc"$i%e (BILE)/ischa"+e 9i!e i$t 9i!e ca$a!icu!i

he&atic %ucts GALL BLA/ER


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BILIAR: SECRETIONSBILIAR: SECRETIONS

Riquired for digestion and absorption offats and excretion of water insoluble

substaces sach as cholesterol and bilirubinFormed by hepatocytes (250-1100 mlday!"ecreted continously# stored in gallbladder

during interdigesti$e period%

Released into the duodenum duringdigesti$e periode# trigered the released of&&'


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COMPOTITION OF BILECOMPOTITION OF BILE

(0)(0)


(0)(0)Bile acids;

(&"ia"' 9i!e aci%s)s'$thesi6e% "

ch!este"! a$% c$#e"te% " bilesalt9' the he&atc'tes, a$%

(sec$%a"' 9i!e aci%s)"e% 9'%ec$7u+ati$ a$% %eh'%"


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(=)(=)Bile pigments;

bilirubin and biliverdin(t &"i$ci&a!

9i!e &i+e$ts), "e% "he+!9i$ "es&$si9!e " the+!%e$ 'e!!c!" the 9i!e

Uroblin, eta9!i6e% " 9i!i"u9i$9' i$testi$a! 9acte"ia* Res&$si9!e" the 9"$ c!" the st!

I Bi!i"u9i$ is $t sec"etet 9' the!i#e", &"%uc'$+jaundice*


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()()


()()Phospholipids(&"'a"i!'

!ecithis$)

s!u9i6e% 9' the 9i!e sa!t ice!!esCholesterol

is i&"ta$t 9i!e, 9icause it is

$e the e a's i$ ichch!ete"! "e+u!ati$

electrolytes


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#$CTI" "# THE BI&E#$CTI" "# THE BI&E#$CTI" "# THE BI&E#$CTI" "# THE BI&E

Digestion and absoption of fat

help to emulsify of the large fat

particleaid to absorption of fat through theintestinal mucosal membrane

Exretion of several important wasteproducts from the blood (bilirubin)and ecsesses of cholesterol


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ENTERO8EPATIC CIRCULATIONENTERO8EPATIC CIRCULATIONENTERO8EPATIC CIRCULATIONENTERO8EPATIC CIRCULATION

The ci"cu!ati$ 9i!e sa!t "the !i#e" t the sa!! i$testi$e

a$% 9ac> a+ai$*Necessa"', 9icause !iite% &!!

9i!e sa!t t he!& 9"ea>%$a$% a9s"&ti$ ats

?32 - ?12 a9s"9e% $!' i$the te"i$a! i!eu


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CILINICAL IMPLICATIONCILINICAL IMPLICATION

Any condition that disruptsenterohepatic circulation (ilealresection or small intestinal

diseases : sprue or Crohns diease)leads to malabsorption of fat and fatsoluble vitamins.

The clinical manivestation :steathorrea and nutritional defisiency.

Incrases in fecal losses of bile saltresults watery dirrhea, bile saltinhibit water and a absorption


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GALLBLADDERGALLBLADDERGALLBLADDERGALLBLADDER

FUNCTION :Storage : stores and concentratesduring interdigestive periode.

contraction: during digestive periode,

the gallbladder contracts, empetyingthe content into the duodenum

CONTO! :

"at and protein digestion productCC# gallbladder contruction

vagal stimulation during cephalic anggastric phase


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BILIRUBIN METABOLISMBILIRUBIN METABOLISM

Formation of bilirubin

is 'e++o!is" -i/ment %o&med as an end

-&od$t o% "emo/+o#in ata#o+ism0Jaundice

is 'e++o!in/ o% t"e s1in d$o to t"ea$m$+ation o% #i+i&$#in !it"in t"e tiss$es.

ma' &es$+t %&om eess -&od$tion o%#i+i&$#in. o& o#st&$tion o% t"e #i+e d$ts o&t"e +ive& e++s -&eventin/ t"e se&etion o%#i+i&$#in0


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THE COMMONE CAUSES )AUN$ICETHE COMMONE CAUSES )AUN$ICE

.C*-+ +!*C!.O O *+

OO+ C ($6O.!.C

7-+.C)O!*C!.OO !$ . +C! O*

+-6-8 !O !$ .*

(O!*C!. 7-+.C)

55999640 Fisiologi Hati Dan Kandung Empedu

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