Biliary System

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Biliary System. Dr. Mahvash Khan. Biliary System. Includes Liver Gallbladder Ducts. Liver is the largest organ in the body Liver Has Very High Lymph Flow (half of the lymph formed in the body under resting conditions) - PowerPoint PPT Presentation

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  • Biliary SystemDr. Mahvash Khan

  • Biliary SystemIncludes LiverGallbladderDucts

  • Liver is the largest organ in the bodyLiver Has Very High Lymph Flow (half of the lymph formed in the body under resting conditions)Liver Has High Blood Flow and Low Vascular Resistance (1350 ml/min) (27% of the cardiac output)The basic functional unit of liver is the liver lobule(50,000-1000,000)

  • Blood Supply of LiverSources (Two)Hepatic ArteryHepatic Portal VeinBlood is drained into Hepatic Vein which joins inferior venacava

  • Physiologic Anatomy of Liver Functional Units (Lobules)Hexagonal Arrangement of Tissues around central VeinBranch of Hepatic Artery, Hepatic portal vein and a bile duct at the outer edge of Lobule

  • Functions of liverMetabolic FunctionsSynthetic FunctionsStorage FunctionsBlood reservoirHemopoietic FunctionBlood Cleansing FunctionActivation of Vitamin-DExcretory FunctionsDigestive Function

  • Functions of liver- Metabolic FunctionsCarbohydrate MetabolismBlood Glucose Buffer systemStorage of GlycogenConversion of Galactose & Fructose to GlucoseGluconeogenesis Formation of Many chemical compounds from intermediate products of Carbohydrate metabolismProtein MetabolismDeamination of AminoacidsFormation of UreaSynthesis of Plasma ProteinsSynthesis of Clotting FactorsInterconversion of Various Amino acids

  • Functions of liver- Metabolic Functions (Cond)Fat MetabolismOxidation of Fatty acids to supply energySynthesis of cholesterol, phospholipids & lipoproteinsSynthesis of fat from proteins & carbohydrates

  • Functions of liver- Synthetic FunctionsSynthesis of plasma proteinsSynthesis of clotting factors (factor VII, IX, X, prothrombin, fibrinogen)Synthesis of various proteins required for the transport of Steroid & Thyroid Hormones

  • Functions of liver- Storage Functions Storage of:Iron CopperGlycogenVitamins (A,D,B12)

  • Functions of liver- Blood reservoir & Hemopoietic Function Blood Reservoir (Blood sinusoids-dilated capillaries)

    Hemopoietic FunctionIn fetal life

  • Functions of liver- Blood Cleansing Function Removal of bacteria (by Kupfer cells)Detoxification of drugs & chemicals (like penicillin, sulfonamides)Removal of old red blood cells

  • Functions of liver- Activation of Vitamin-DFormation of 25 hydroxycholecalciferol

  • Functions of liver- Excretory Functions

    Excretion of calcium through gutExcretion of bilirubinExcretion of cholesterolExcretion of hormones

  • Functions of liver- Digestive Functions

    Role of Bile salts in digestion & Absorption of fats

  • Bile Secretion by LiverBile is secreted by LiverNormally between 600 and 1000 ml/dayBile is secreted in two stages

  • Bile plays an important role in fat digestion and absorptionBile serves as a means for excretion of several waste products from the blood such as bilirubin, (end product of hemoglobin destruction), excess cholesterol, certain hormones etc

  • Composition of Bile

    Liver Bile Gallbladder BileWater97.5 g/dl92 g/dl Bile salts1.1 g/dl6 g/dlBilirubin0.04 g/dl0.3 g/dlCholesterol0.1 g/dl0.3-0.9 g/dlFatty Acids0.12 g/dl0.3-1.2 g/dlLecithin0.04 g/dl0.3 g/dlNa+145 mEq/l130 mEq/lK+5 mEq/l12 mEq/lCa++5 mEq/l23 mEq/lCl-100 mEq/l25 mEq/lHCO3-28 mEq/l10 mEq/l

  • Secretion of Bile by liver 250 ml to 1 liter per dayContinuous secretion by hepatocytesAqueous alkaline fluidImportant organic constituentBilirubinCholesterolLecithinBile saltsTaken by common bile duct to the duodenumEnterohepatic circulation

  • Bile Salts Derivatives of Cholesterol Cholic acid & Chenodeoxycholic acidConjugation with glycine & taurineSodium salts of conjugated acidsAverage amount 3 to 4 gms in the bodyOnly 5% excreted in faecesPowerful choleretics

  • Stimulus for Bile secretion Chemical Mechanism Bile SaltsHormonal MechanismSecretin Neural Mechanism Vagalstimulation

  • Gallbladder SiteSac like structure Located beneath the liverFunctionsStorage of bileConcentration of bile

  • Gallbladder Functions: Storage of bileCan store 450 ml of bile (12 hr of secretion)Transported to the Gallbladder between the meals

  • Gallbladder Functions: Concentration of bileActive transport of salts Water following osmoticallyConcentration of bile 5 to 10 times

  • Gallbladder : Emptying of GallbladderRelaxation of sphincter of ODDI Contraction of gallbladderRole of cholecystokininStimulation by fatty foods in duodenum

  • Gallbladder : Formation of Gall stonesCommon site of formation of stones75% of stones made of cholesterol25% made of bilirubinIn case of Gallbladder removal bile is stored in common bile duct which becomes dilated