PATH 3610 Lecture Notes - Lecture 11: Portal Triad, Portal Vein, Hepatic Veins
14 May 2018
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The liver
Acetaminophen – non-narcotic analgesic,
- Max daily dose – 4g (8 extra strength – 500mg)
- Toxic dose 7.5-10g (14-20 x 500mg)
- Toxic dose with alcohol 2.5g (5 x 500mg, 3-4 drinks)
- 56, 000 per year in USA
- COX2 inhibiter in high dose
General structure of liver
- Close proximity to blood vessels and bile ducts
- portal triad: artery, vein, bile duct
- portal vein: comes from intestines → brings in nutrients (but not fat, fat
leaves via lymphatic’s, primary flow of blood → sinusoid → terminal hepatic
vein
- hepatocyte: epithelial cell of liver, stable cell
- central vein: blood from liver goes here and then makes it way to the heart
- blood flow in liver → low pressure system → so if you have a slight change in
pressure, you have dramatic effects in liver
- tremendous regenerative ability
Anatomy and histology
- gland composed of many acini, centre of acini is portal triad (portal vein,
hepatic arterial and bile duct)
- hepatocyte (epithelium) → stable cell type
- sinusoids (mesenchymal)
o endothelial cells
o Kupffer cells (macrophages)
o Hepatic stellate cells (lipocytes, Ito)
▪ Vitamin A
▪ Fibrous tissue of liver
- Bile duct (epithelium) – takes bile from liver
o Small bile passages = canaliculi
o Gallbladder: stores bile (not in rats and horses)
- Highest oxygen tension = around portal triad and lowest = around terminal
hepatic vein and has responsibility of draining blood away from the liver to
vena cava
Anatomy
- blood supply is huge in liver
o 30% hepatic arterioles – fresh oxygenated blood
o receives blood from 70% portal vein (from intestine)
▪ portal veins connects to different organs
o sinusoidal system
Liver failure: signs
- jaundice – yellow in latin, whites of eye, skin, fingernails goes yellow one
after another)
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Document Summary
Max daily dose 4g (8 extra strength 500mg) Toxic dose with alcohol 2. 5g (5 x 500mg, 3-4 drinks) Close proximity to blood vessels and bile ducts. Portal vein: comes from intestines brings in nutrients (but not fat, fat leaves via lymphatic"s(cid:524), primary flow of blood sinusoid terminal hepatic. Hepatocyte: epithelial cell of liver, stable cell. Gland composed of many acini, centre of acini is portal triad (portal vein, hepatic arterial and bile duct) Hepatocyte (epithelium) stable cell type sinusoids (mesenchymal: endothelial cells, kupffer cells (macrophages, hepatic stellate cells (lipocytes, ito, vitamin a, fibrous tissue of liver. Bile duct (epithelium) takes bile from liver: small bile passages = canaliculi, gallbladder: stores bile (not in rats and horses) Highest oxygen tension = around portal triad and lowest = around terminal hepatic vein and has responsibility of draining blood away from the liver to vena cava.
