It is divided into upper and lower leaves, front and rear edges, and left and right leaves. Adult liver weighs about1400g (male1500g, female).
Sex is about 1300g), accounting for 1/30- 1/50 of body weight. ?
The liver is located in the upper right part of the abdominal cavity and occupies a part of the upper abdomen, and a small part is located in the left upper abdomen. When lying down, the liver
The upper boundary of clavicle is between the fifth ribs of the right clavicle line, and the upper boundary can be found by percussion. Generally speaking, the upper abdomen
You can't touch the lower edge of the liver, but a small number of people can touch the lower edge of the liver under the costal margin if the liver is drooping.
The position of the liver in childhood is slightly lower than that in adults, and the lower edge of the liver is under the ribs 1 cm-2 cm. After puberty,
It's not easy to touch under the ribs. The position of the liver can change with the change of posture and breathing, and the liver will also change when standing and inhaling.
Move down 1-2 cm, rise in supine position and exhale.
Proximity of liver
The adjacent organs of the liver are: the left lobe is connected with diaphragm, adjacent to pericardium and heart; The right lobe is connected to the diaphragm, and
The right pleural cavity is adjacent to the right lung, so the abscess of the right lobe of the liver sometimes erodes the diaphragm and spreads to the right pleural cavity and the right lung. correct
The inner side of the trailing edge of the leaf is adjacent to the esophagus; The lower part of the left lobe touches the anterior wall of the stomach; Contact the pylorus under the quadrate lobe; The lower front of the right lobe is touched.
Right curvature of colon; The middle part is close to the duodenum and the door; The back touches the kidneys and adrenal glands. When the liver is sick, it will affect
The function of these organs, similarly, the pathological changes of these organs will also invade the liver.
Liver is based on intrahepatic blood vessels and intrahepatic fissure, which can be divided into five lobes and four segments: left inner lobe and left outer lobe.
, right anterior lobe, right posterior lobe and caudal lobe; The left lateral leaf is divided into upper and lower segments of the left lateral leaf, and the right posterior leaf is divided into upper and lower segments of the right posterior leaf.
The next paragraph. The liver is fixed in the abdominal cavity by many ligaments, and the surface of the liver is wrapped by a gray-white liver capsule. liver
Three quarters of the blood supply comes from portal vein, and 1/4 comes from hepatic artery. The terminal branch of portal vein expands into venous sinus in the liver.
It is the conduit of blood circulation in hepatic lobule. Hepatic artery is arterial blood from the heart, which mainly supplies oxygen.
The pulse takes venous blood from digestive tract, which mainly supplies nutrition.
Understand the liver
To effectively prevent and treat liver diseases, we must first have a correct understanding of the liver. Understand the role of the liver in the body
Location, know what kind of organ the liver is, know what role it plays in the movement of life, and how it works.
Protect the liver from viruses and harmful substances, and how to treat and recuperate after suffering from liver disease.
In the human body, besides the heart, lungs, stomach and kidneys, there are also the largest digestive glands-
-liver, these organs are what we often call "five internal organs".
The liver is the largest gland and the largest parenchymal organ in human body, mainly located in the right rib and upper quadrant.
Abdomen. Adult liver weight in China: male 1230? 450g, female 1 100? 300 grams, accounting for about
65438+ 0/40 of the weight? /50。
Because the liver is rich in blood supply, it is brownish red, soft and brittle. Most of the liver is located in the right quarter.
Ribs and upper abdomen, a small part is located in the left quarter rib. Most of the liver is covered by the rib arch, only around the upper abdomen.
Exposed between ribs and arch 3? Cm, close to the anterior abdominal wall, so it is not easy to touch the lower edge of the liver under the right costal margin, but
Can you reach 2 under xiphoid process? Centimeter. If the upper margin of adult liver is normal, but the liver can be touched down at the right costal margin.
It is pathological hepatomegaly, and the degree of visceral enlargement can be roughly judged by palpation. Lower limit of liver in children
Can be lower than rib arch. Because the liver is connected with the diaphragm through the coronary ligament, the liver can move up and down with the diaphragm when breathing.
Move, move up and down to 2? Centimeter. If the upper abdomen and the right rib area are violently hit or the ribs are broken,
, can cause liver rupture.
The liver is an important immune organ of human body.
Liver is an important part of reticuloendothelial system and an important organ of immunity, and actively participates in it.
Normal immune activities, although not directly produce antibodies, but there are a large number of macrophages, which play an important role in immunity.
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Macrophages in the liver are fixed, called kupffer cells, and antigen particles from the intestine are mostly in the liver.
It is swallowed and cleared by Kupffer cells. Unlike ordinary macrophages, kupffer cells did not increase antigen immunity.
Pathogenicity has the effect of eliminating or weakening antigenicity. Can Kupffer cells be swallowed from the blood circulation?
Harmful substances such as antigen-antibody complexes, etc., in order to eliminate the damage of these substances to the body.
Kuhn's cells are phagocytes in hepatic sinuses, which can effectively treat circulating immune complexes.
Sinus is the largest place to clear serum circulating immune complex. The liver can also synthesize a variety of complement components, and the liver function is attenuated.
At this time, the complement content decreased obviously, so the liver plays an important role in regulating the immune function of the body.
The chemical structure of the liver
The liver is composed of hepatocytes, rich in vascular network, reddish brown, soft and fragile, and vulnerable to violence.
The rupture caused by the blow caused fatal bleeding.
Liver cells are very small and must be seen through a microscope. The human liver has about 2.5 billion hepatocytes and 5,000 livers.
Cells form a hepatic lobule, so the total number of hepatic lobules in human liver is about 500 thousand, and the shape and diameter of hepatocytes are polygonal.
It is about 20 ~ 30 microns, with 6-8 faces and a volume of about 4,900 square microns, which varies in size under different physiological conditions.
Different, for example, when you are hungry, the size of liver cells becomes larger.
The surface of each hepatocyte can be divided into three types: sinus surface, hepatocyte surface and bile duct surface. Hepatocytes contain
Many complex fine structures: such as hepatocyte nucleus, hepatocyte cytoplasm, mitochondria, endoplasmic reticulum, lysosomes, high.
Kyrgyzstan, microsomes and drinking vacuoles. Each fine structure has its extremely important and complex functions.
These functions ensure the existence of human life and the survival of human beings.
Hepatocyte nucleus
It has the function of copying genetic information. When suffering from hepatitis, hepatitis virus invades the nucleus of liver cells, and the virus gene can
Binding (integration) with DNA in hepatocyte nucleus. Once integrated, HBsAg is difficult to remove, resulting in long HBsAg.
Period carry-over
mitochondria
Each liver cell has 1000-2000 mitochondria, including more than 70 enzymes and coenzymes, such as glutathione.
Ammonia enzyme (SGPT or ALT, referred to as transaminase), cellular respiratory enzyme, adenosine triphosphate, etc. When hungry and weak.
Mitochondria are the earliest and most sensitive victims of oxygen, hepatitis or cholestasis, which will lead to the increase of transaminase due to extreme expansion.
Biochemical dysfunction such as elevation.
endoplasmic reticulum
It is a flat cystic or tubular structure in the cytoplasm of hepatocytes. Rough endoplasmic reticulum and smooth endoplasmic reticulum.
Rough endoplasmic reticulum is the basis of protein synthesis in hepatocytes, which can transform one redundant amino acid into another.
There are few amino acids. Hepatocytes absorb amino acids and rapidly synthesize protein. It is generally believed that albumin is composed of crude oil.
Synthesis of polynucleosomes on endoplasmic reticulum membrane. Smooth endoplasmic reticulum is widely distributed in the cytoplasm of hepatocytes, often on the rough surface.
Plasmodesmata is connected with Golgi apparatus, and their functions are also closely related.
Smooth endoplasmic reticulum is 2.5 ~ 3.2 times that of rough endoplasmic reticulum. There are many enzyme systems on its plasma membrane, such as redox.
Enzymes, hydrolases, synthetases, etc. Synthesis and decomposition of liver glycogen, fat metabolism, hormone metabolism, medicine
Metabolism, detoxification and bile synthesis are all carried out in smooth endoplasmic reticulum. In addition, many hepatocytes ingest
Organic compounds undergo biochemical reactions such as synthesis, decomposition and combination on smooth endoplasmic reticulum.
When suffering from hepatitis, due to the damage of endoplasmic reticulum, albumin production is reduced and protein metabolism is abnormal, which leads to the onset.
The ratio of serum albumin to globulin (A/G) was inverted, and the flocculation test and turbidity test were abnormal. Because of the fiber
The decrease of prothrombin and prothrombin production leads to bleeding tendency. Hypoglycemia is caused by glycogen reduction. Thanks to this solution
The toxic effect is weakened, which leads to the enhancement of drug toxicity. Because in bilirubin metabolism, indirect bilirubin becomes
The process of direct bilirubin is also carried out in the endoplasmic reticulum, so hepatocellular jaundice will occur when the endoplasmic reticulum is damaged.
Jaundice, resulting in yellowing of the skin and sclera.
lysosome
Hepatocytes are rich in lysosomes, which are mainly distributed in the cytoplasm near the capillary bile duct and surrounded by a single membrane.
Dense body, with a diameter of 0.4 micron, contains a variety of digestive hydrolases, which can decompose protein, sugar, fat and nucleic acid.
And phosphoric acid. It can also digest degenerated and aged organelles such as endoplasmic reticulum and mitochondria. Foreign matter, so as to keep
The self-renewal of hepatocytes is called "digestive system" and "cleaner" in cells. Obstructive yellow
In gangrene, hepatitis, hypoxia, hypercholesterolemia or partial hepatectomy, lysosomes actively participate in the transfer of bile pigment.
, lysosomes increased significantly. Hepatitis virus can directly destroy lysosomes, leading to the lysis of normal and adjacent hepatocytes.
Necrosis.
Golgi apparatus
There are about 50 Golgi bodies in each liver cell, which are distributed near the nucleus of liver cells and occupy the volume of cytoplasm.
10%。 Golgi apparatus is closely related to the endocrine and exocrine functions of hepatic fine cells, such as bile secretion.
This is closely related. It can also participate in the synthesis of plasma membrane glycoprotein and the formation of primary lysosomes. Eggs synthesized by hepatocytes
White matter and lipoprotein, some of which are transferred to Golgi apparatus for storage and processing, are discharged into the sinus space.
microsome
The enzymes in the particles are mainly catalase and peroxidase. In order to prevent hydrogen peroxide from accumulating in cells
Products. Microsomes can also oxidize reduced coenzyme. There are also enzymes related to alcohol metabolism and gluconeogenesis in microsomes.
Class. It is also related to cholesterol metabolism. The microsomes of liver cancer cells decreased.
Drinking vacuole
It has the function of absorbing and transporting intracellular substances.
Understand the function of the liver
The liver is the largest gland in human body, which plays an important role in human metabolism, bile production, detoxification, coagulation, immunity and heat dissipation.
It plays a very important role in the production of quantity and the regulation of water and electrolyte, and is a huge "chemical substance" in human body.
Factory. "
First, metabolic function:
① Sugar metabolism: Starch and sugar in the diet are digested into glucose, which is absorbed by the intestine and combined by the liver.
Liver glycogen is stored; When the body needs it, liver cells can break down glycogen into glucose for the body to use.
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② protein metabolism: the liver is the only synthetic organ of human albumin; Globulins other than gamma globulin,
Liver is involved in the production, maintenance and regulation of enzyme protein and plasma protein. Amino acid metabolism such as deamination reaction,
Urea synthesis and ammonia treatment are carried out in the liver.
③ Fat metabolism: synthesis and release of fat, decomposition of fatty acids, formation and oxidation of ketone bodies, cholesterol and cholesterol.
The synthesis of phospholipids and lipoprotein are all carried out in the liver.
④ Vitamin metabolism: The synthesis and storage of ABC, D, K and other vitamins are closely related to the liver.
Abnormal vitamin metabolism will occur when the liver is obviously damaged.
⑤ Hormone metabolism: The liver is involved in the inactivation of hormones. When the liver function is damaged for a long time, there may be imbalance of sex hormones.
Bile production and excretion: the intake, combination and excretion of bilirubin, as well as the production and excretion of bile acids are all caused by
Liver commitment. Bile produced and secreted by liver cells is transported to gallbladder through bile duct, concentrated and discharged into small intestine.
Help the digestion and absorption of fat.
Third, detoxification: some harmful wastes and foreign poisons and toxins,
The metabolism and decomposition products of drugs are detoxified in the liver.
Immune function: the liver is the largest phagocytic system of reticuloendothelial cells, which can be phagocytized, separated and
Eliminate invasive and endogenous antigens.
5. Coagulation function: Almost all coagulation factors are made by the liver, which has two functions: coagulation and anticoagulation.
It plays an important role in the dynamic balance of this system. The severity of liver function damage is often related to the course of coagulation disorder.
The degree is parallel, and some patients with liver cirrhosis often bleed or even die because of liver failure.
6. Others: The liver participates in the regulation of human blood volume, the generation of heat and the regulation of water and electrolytes. such as
When the liver is damaged, the adjustment of electrolytes such as sodium, potassium, iron and phosphorus. It is unbalanced, and it is common for water and sodium to stay in the body.
Edema and ascites, etc.
What important work does the liver do?
The liver is the largest digestive gland in human body, and it is also the central station of metabolism in the body. Changes that occur in the liver
There are 1500 kinds of chemical reactions. Experiments show that even after the liver is completely removed, animals will be treated accordingly.
It can only survive for more than 50 hours at most. This shows that the liver is an indispensable part of life-sustaining activities.
Organ. The blood flow of the liver is extremely rich, accounting for about 1/4 of the cardiac output. The blood flowing into the liver every minute is
1000? 200 ml. The main functions of the liver are:
(1) makes bile and helps fat digestion. When the liver function is not good, the production and excretion of bile appear obstacles, while the fat in food
Dyspepsia often causes diarrhea and emaciation.
② Storage and release of sugar. The liver is like a water storage tank, which absorbs chaff at any time and releases it when it is used.
Keep the concentration in the blood. When liver function is damaged, people will feel weak, tired, cold sweat, palpitation, shortness of breath and so on.
Suitable.
(3) Making various protein necessary for human body. The liver is the only place where human albumin is produced, for example
If the liver injury is too serious, albumin in the blood is seriously reduced, and edema may occur, which is life-threatening.
④ The liver can secrete protein related to coagulation, such as various coagulation factors. If the liver is damaged,
The wound will not stop bleeding, and it may even lead to death due to massive internal bleeding.
5 detoxification. Liver is the largest chemical plant in human body, and some chemicals such as alcohol are related to human metabolism.
Toxic substances produced in metabolism may be excreted through urine after detoxification in the liver.
In addition, the liver is also involved in the metabolism of fat, vitamins and hormones, as well as phagocytosis and defense.
And regulating blood volume, water-electrolyte balance and generating heat. During the embryonic period, the liver also has hematopoietic function.
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In a word, the liver plays a more important role in maintaining life than other organs. hepatic
Impaired function can cause general discomfort, so protecting the liver means protecting life.
How does the liver metabolize protein?
Amino acids absorbed by digestive tract are synthesized by protein in liver. After a series of processes of deamination and transamination
Synthetic protein enters the blood circulation to meet the needs of the whole body and tissues and organs. The liver synthesizes plasma proteins.
The main place. There are many kinds of protein synthesized by liver, except plasma protein, fibrinogen and prothrombin.
Globulin and albumin are also synthesized in the liver. Plasma protein can be used as the renewal of various tissue proteins in the body.
Use, so it plays an important role in maintaining protein metabolism.
The deamination reaction of amino acid metabolism and the treatment of waste ammonia continuously produced in protein metabolism are all in the liver.
Inside. Ammonia is a serious toxic substance in the body, and the liver can turn it into non-toxic urea, which passes through the kidney.
Urine is excreted to achieve the purpose of detoxification. When the liver function of patients with liver disease is damaged, the plasma protein will decrease, and at the same time,
Blood ammonia will rise.
Liver disease in the advanced stage, liver failure, loss of the ability to deal with ammonia, can be produced. "
Ammonia poisoning ",patients with liver coma, personnel do not know, may die at any time.
When the liver function is damaged, the synthetic albumin is obviously reduced, the plasma osmotic pressure is reduced, and double
Lower limbs can be depressed and swollen, forming ascites.
How does the liver metabolize sugar?
When the blood sugar concentration of the liver changes, it will automatically adjust to keep the blood sugar concentration normal.
After the sugar in food is converted into glucose, part of it is converted into glycogen in the liver. Glucose passes through small intestinal mucosa
After absorption, it reaches the liver from the portal vein, where it is converted into glycogen and stored. The average adult liver is about 100.
Gram of glycogen can be decomposed into glucose and released into the blood when the body needs it, and its decomposition and synthesis are guaranteed.
Keep your balance. But this 100 gram of glycogen is only enough for fasting for 24 hours. Hepatic glycogen regulates blood sugar concentration to maintain it.
Determinants of stability. The liver can synthesize glycogen from glucose and store it in the liver. At work, when you're hungry,
When fever occurs, blood sugar is consumed a lot, and liver cells break down glycogen into glucose and enter the blood circulation to maintain the human body.
Body temperature provides energy for human activities.
The liver is also a storage organ, which can synthesize glycogen from glucose, vitamins and protein.
Store it. If the human body ingests excessive nutrients, the fat that cannot be consumed will accumulate in the liver, resulting in
Fatty liver.
How does the liver metabolize fat?
After digestion and absorption, part of the fat enters the liver and then is converted into body fat for storage. Store when you are hungry.
Body fat can be transported to the liver and then broken down. In the liver, neutral fat can be hydrolyzed into glycerol and fat.
Acid and liver lipase will accelerate this reaction process. Glycerol can be utilized through glucose metabolism, while fatty acids
It can be completely oxidized into carbon dioxide and water. The liver is also the main organ for synthesizing fatty acids, cholesterol and phosphorus esters in the body.
One. Fatty liver is a disease in which fat accumulates in the liver when fat metabolism is disordered.
What other important functions does the liver have?
In addition to the above three metabolic functions, the liver has many other functions:
① Vitamin metabolism: Fat-soluble vitamins can be stored in the liver, and 95% of human vitamin A is stored in the liver.
In the liver, vitamins C, D, E, K, B 1, B6, B 12, nicotinic acid, folic acid and other nutrients are stored and stored.
The place of metabolism. Therefore, multivitamins should be supplemented when suffering from liver disease.
(2) Hormone metabolism: Under normal circumstances, various hormones in the blood maintain a certain amount, and the excess passes through the liver.
Dirty treatment has lost its activity. When suffering from liver disease, there may be inactivation obstacles such as estrogen, aldosterone and antidiuretic hormone.
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③ Making coagulation factors: There are 12 coagulation factors in human body, of which 4 are synthesized by liver. Liver disease may be
Leading to prolonged coagulation time and bleeding tendency.
④ Defensive function: The liver is an important "bacteria catching station" in the body. Hepatic venous sinus cortex contains
A large number of Kuhn's cells have strong phagocytosis, and 99% of the bacteria in portal vein blood are swallowed when passing through hepatic venous sinus.
Eat it. Therefore, when suffering from liver disease, the body's defense ability drops, which is easy to cause infection.
How does the blood flowing through the liver circulate?
The blood circulation of the liver is very rich, which is supplied by portal vein and hepatic artery: blood flows into the liver.
1/4 comes from hepatic artery which mainly supplies oxygen to the liver, and the other 3/4 comes from portal vein (composed of stomach, intestine,
Spleen, pancreas and other visceral veins together), it inputs various nutrients and harmful substances from the digestive tract into the liver,
After being treated by the liver, it enters the general circulation. The portal vein branches repeatedly, sending out many small veins and extending to the liver.
Lobules, blood flowing into hepatic sinuses; The hepatic artery branches to form the interlobular artery, and its blood is also injected into the hepatic sinus, so the liver
Sinus is formed by the confluence of portal vein and hepatic artery.
The capillary wall of hepatic sinus is not complete, and the gap between endothelial cells is large, so the permeability is large, and the plasma
Macromolecules such as protein can pass through, which is very beneficial to the function of liver cells.
The hepatic sinus starts from the peripheral part of hepatic lobule, into which the peripheral branches of portal vein and hepatic artery are injected and gathered.
To the center of hepatic lobule, return to central vein, and finally merge into hepatic vein. Hepatic vein is the outlet of hepatic blood flow and hepatic blood.
After leaving the liver, it was injected into the inferior vena cava.
How is bile produced by the liver discharged into the intestine?
Some people have the illusion that bile is made of gallbladder, but it is not. The gallbladder is just a reservoir.
The "warehouse" and "manufacturer" of fruit juice is liver. Bile duct system is the excretory system of bile and other bile substitutes from the liver to the duodenum.
The special pipeline structure system of Xie products is divided into two parts: intrahepatic bile duct system and extrahepatic bile duct system.
The intrahepatic bile duct system originates from the capillary bile duct of hepatocytes and extends from the hilum of the liver to the left and right hepatobiliary ducts.
The bile duct system consists of capillary bile duct, thin bile duct, interlobular bile duct and left and right hepatobiliary ducts.
Extrahepatic bile duct refers to the extrahepatic bile duct below the openings of the left and right hepatobiliary ducts, including the common hepatic duct and gallbladder.
Common bile duct and bile duct. Bile flows from capillary bile duct, thin bile duct and interlobular bile duct to the left and right hepatobiliary ducts, and then flows.
Enter the common hepatic duct, common bile duct and then discharge into the duodenum. Therefore, under normal circumstances, feces are yellow. Liver hair
During inflammation, the normal structure of hepatic lobule is destroyed, and the newborn hepatocytes are irregularly arranged, blocking the small bile duct and making bilirubin
Can't run through normal channels, but a lot of blood returns. The increase of bilirubin in the blood makes the sclera and skin of the eye
The skin is dyed yellow and the urine is as black as strong tea, which is called "yellow pox" in medicine.