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HEPATITIS B (Link to (Liver Histology (portal triad (hepatic portal…
HEPATITIS B
Link to
Hepatobililary System
The hepatobiliary system is essential for digestion and includes: the liver, pancreas, bile ducts and the gallbladder. Many disorders and diseases can affect these organs, some of which are specified below.
Organ Involved
Liver,Gall Bladder,Bile Duct,Pancreas
Importances
Bile Salt enables the body to excrete cholesterol and potential toxic compound which is bilirubin and drug.
Bile salt is excreted into Bilirubin before it is removed from body through the stool. Bilirubin present in bile is a product of the liver’s digestion of worn out red blood cells
Bilirubin Metabolism
Stools
abnormal colour
clay - grey colour
flow of bile out of the liver is blocked
liver infection which reduce bile production
define as
a piece of feces
normal colour
brown
urine's colour
abnormal colour
dark brown
excess billirubin in the urine
Hepatic Portal System Process
4.The hepatic portal vein supplies about
75% of the blood the liver requires
, with the other
25% supplied by the hepatic artery
.
3.The hepatic vein also drains blood coming from the cystic veins as well as the inferior mesenteric gastric veins.
The hepatic vein is one of the most important portal venous systems in the human body and it is integral to the circulatory system in general.
2.The hepatic portal vein is one of the largest veins in the area and it carries blood to
liver
from the spleen and the gastrointestinal tract. The hepatic vein begins where the splenic veins and the superior mesenteric meet.
1.One of many primary components of the circulatory system that can be found in the abdominal cavity.
5.Blood from either source passes into cavities between the hepatocytes of the liver called
sinusoids
, which feature a fenestrated, discontinuous endothelium allowing for the effecient transfer and processing of nutrients in the liver.Blood from the hepatic artery is
oxygenated but nutrient-poor
compared to that supplied by the
hepatic portal vein
.
Since blood received from the hepatic portal vein may be contaminated with pathogens such as bacteria, the liver is rich in specialized immune cells called Kupffer cells that can detect and destroy foreign organism.
Liver Function
Metabolism
Metabolizing carbohydrate, lipids, and proteins into biologically useful materials.
Storage
Storage of many essential nutrients, vitamins, and minerals obtained from blood passing through the hepatic portal system.
Digestion
Active role in the process of digestion through the
production of bile
.Bilirubin present in bile is a product of the liver’s digestion of worn out red blood cells
Production
Production of several vital protein components of blood plasma
Detoxification
The hepatocytes of the liver monitor the contents of the blood and remove many potentially toxic substances
Immunity
The liver functions as an organ of the immune system through the function of the Kupffer cells.
Liver Histology
Kupffer cells
macrophages
attach to endothelial lining
in sinusoid
bile
produced by hepatic cells
collected first in small bile canaliculi
then in small hepatic ductules
carried away by larger branches of bile duct
axis of liver
central vein
organised into
hepatic sinusoids
separate radial plates
lobes subdivided into lobules
by looser connective tissue
Glisson's capsule
hexagonal in shape
lobes
surrounded by thick connective tissue capsule
liver cells
hepatocytes
form radial plates
portal triad
hepatic portal vein
hepatic artery
bile duct
Pathophysiology
Specific disease and affected structures
Acute Viral Hepatitis - Hepatocellular Injury (infections) 2. Primary Biliary Cirrhosis - Impairment of biliary secretion (Autoimmune Disease)
Cryptogenic Cirrhosis - Liver Fibrosis (Drugs & Toxins)
MUltiple Liver Structure Destruction - Sever Alcoholic Liver ( Toxins)
results from
Infections, Drugs, Toxins & Autoimmune diorders
PULSE RATE, FBC TEST & SEROLOGY TEST
Liver Function Test
PULSE RATE :
Average pulse rate of adults
60-100 beats/min
Average pulse rate of kids
80-110 beats/mins
Average pulse rate of an elderly man
67-74 beats/ min
FBC TEST
• Common blood test to check a person's general health and to detect a wide range of disorders including ANAEMIA, LEUKEMIA & INFECTIONS
MEASURES SEVERAL COMPONENTS
(i) RBC
(ii) WBC
(iii) HAEMOGLOBIN
(iv) HEMATOCRIT
(v) PLATELETS
Serology Test Explanation
(i) ANTI - HCV
~ Negative on patient's test
~ To look for antibodies in the blood. If the test is positive, it indicates that the person is suffering from Hepatitis C
~ Can cause both acute and chronic infection
(ii) HBs AG ( Hepatitis B surface antigen) & HBe AG ( Hepatitis B viral protein )
~ Both positive on patient's test
~ Indicating that the person has Hepatitis B
(iii) ANTI - HBe IgM ( Immunoglobulin M antibodies)
~ Positive on patient's test
~ Indicates that the person has/ have had previous infection of Hepatitis B
(iv) ANTI- HBs ( Hepatitis B surface antigen)
~ Negative on patient's test
~ It indicates recovery and immunity from Hepatitis B virus infection. It will be present if the person is vaccinated against Hepatitis B
Liver Function Test
Liver Enzyme
Alkaline Phosphatase (ALP) test
Normal range within 124-341 U/L
Mr FSY level is 356 U/L which exceeds the normal range
Alanine Transaminase (ALT) test
Used by body to metabolize protein
Normal range is 5-56 IU/L
Mr FSY AST level is 1600U/L which is higher than normal range
Aspartate Aminotransferase (AST) test
AST-to-ALT ratio taken for diagnosis
Normal range is less than 37 IU/L
Mr FSY AST level is 1200U/L which is higher than normal range
Liver Protein
Albumin
Low level indicate liver damage
Normal range 38-54 g/L
Mr FSY's albumin level is 40 g/L and it is still under normal range
Prothrombin Time Test
Measure the time taken for the blood to clot
Longer time indicates liver damage
Normal is 10-13.5 s but the patients result showed that he had 17 s
Activated Partial Thromboplastin Time (aPTT)
Same function as PTT Test but in a narrower range of time because of an activator that was added
Normal time is 26-42 s but the patients result showed beyond the normal which is 47 s
Bilirubin Test
Amount of conjugated and unconjugated bilirubin is calculated in this test
Abnormalities in amount of both bilirubin indicates liver damage
Normal conjugated bilirubin should be less than 5.1 micromol/L but the patient had 13 micromol/L
Normal unconjugated bilirubin should be lessthan 12 micromol/L but the patien had 27 micromol/L instead
Jaundice
Hemolytic jaundice
occurs as a result of hemolysis (an accelerated breakdown of red blood cells) leading to an increase in production of bilirubin
Obstructive jaundice
occurs as a result of an obstruction in the bile duct (a system of tubes that carries bile from the liver to the gallbladder and small intestine), which prevents bilirubin from leaving the liver
Hepatocellular jaundice
occurs as a result of liver disease or injury
Hepatitis: This infection can occur in the liver and can heal itself without treatment or develop into liver damage or liver cancer
Types of liver inflammation
Hepatitis C
: inflammation it is one of the most dangerous types of liver damage
Hepatitis D
: inflammation is similar hepatitis B
Hepatits B
: inflammation serous liver
Hepatitis A:
infectionous gastric liver
Hepatitis E
: inflammation is similar hepatitis A in transit routes
Hepatitis G
: inflammation new discovery has a link to hepatitis
DEFINE CAUSE OF LIVER INFLAMMATION
:
Alcohol consumption
take a large quantity of medication
SYMPTOM :
-Fever
-Weakness
-Anorexia
-Nausea
-Dark Urine
-Joint Pain
REGIONS OF ABDOMINAL AREA
right hypochondrium
organs included
right kidney
ascending colon
gall bladder
transverse colon
liver
patient experiences tenderness
inflammation
possible liver diseases
hepatitis
hepatoma (cancer)
hepatid cyst
liver abcess
Presented by
