Back To CoursePathophysiology Textbook
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Every cartoon character, from Batman on down, has a sidekick. Those sidekicks were incredibly important although many times unsung heroes in their own right. Sometimes they saved the main hero, and other times they gave important advice.
It would be great if our own body had a similar sidekick. This lesson isn't going to be a downer because I'm pleased to introduce your body's very own action hero sidekick: the liver! And just like cartoon character sidekicks sometimes suffer terrible fates, your liver is not immune from some pretty bad things as well, which is what this lesson will cover.
The reason I like to think of the liver as your body's sidekick is because of the many things it does for you that you probably seldom think about.
The liver gives you energy by way of gluconeogenesis, or the formation of glucose. In this respect, it's like a giant refrigerator for your body. Hungry? Just ask the liver for some food!
The liver also detoxifies your body. It's like a refrigerator's filter, but for your blood instead of cold fridge water.
Your liver also forms important things like the protein albumin, a water-soluble protein responsible for the transportation of drugs and for maintenance of colloid osmotic pressure. Maintenance of colloid osmotic pressure is a fancy term for making sure you don't look all swollen. If there was no albumin or too little, fluid would leak out of the blood vessels and into your tissues, making you look bloated. So, your liver actually makes you look pretty swell. Seriously.
Other than making you look beautiful, the liver also produces compounds, such as bile, which help you absorb nutrients so you can grow and stay healthy.
If that wasn't enough, your liver produces many coagulation factors, substances responsible for the clotting of blood, so you don't bleed to death due to a tiny scratch.
So in effect, even Batman, Superman, Catwoman, and the Incredible Hulk all have their livers to thank for not bleeding to death during a fight. And you thought I was exaggerating the liver's role as a sidekick before!
But the sad note here is that if your sidekick, your liver, is sick or damaged, then you, the big and burly superhero that you are, will die. You are completely and utterly dependent on that big brown hunk of tissue sitting in the middle of your torso.
Just about anything you can think of can damage your sidekick:
Now that your mouth is agape from the realization that your own pancreas can hurt your liver, it's time we move onto a super important part of this lesson. We must learn how to recognize liver disease through lab results or a physical exam of a patient. Let's look at just a few of the more famous problems doctors encounter in people with liver disease.
First off, jaundice, or yellowing of the skin, eyes, and mucous membranes as a result of increased levels of bilirubin, which the liver helps dispose of, can occur. If the liver is sick, it cannot process the garbage-like bilirubin, leading to the garbage backing up, causing you to get sick. This is just like real life; people get sick if they live in filth. Liver disease causes elevations of conjugated or unconjugated bilirubin in a sick person.
Hypoalbuminemia, or low levels of albumin in the blood, may show up on blood work as well. If the liver is damaged for a long time, it can't make enough albumin. If you don't have enough albumin as a result of something like alcohol abuse damaging the liver's ability to produce it, then your body begins to swell, just like I intimated at before. So if you look a little swollen in the morning, maybe holding off on the alcohol to save your liver for the future is a good idea.
One severe form of swelling associated with liver disease is ascites, or the accumulation of fluid in the peritoneal cavity. This basically means the person's stomach or belly area will swell like that of a pregnant woman.
A person who doesn't know any better may think a person with ascites is just fat, but if you look closely, these patients may have ribs that stick out and skinny legs and arms, indicating that something far more serious is going on. Cirrhosis, scarring of the liver due to chronic liver disease, is a major cause of ascites.
People with liver disease are also at an increased risk of bleeding due to a loss of clotting factors, especially during acute liver damage. In this case, blood tests, such as prothrombin time, can be used to measure how long it takes your blood to clot. If the time it takes the blood to clot is prolonged (longer than normal) on this test, then it may be an indicator of liver disease that has decreased the amount of clotting factors the liver is able to produce.
As if that wasn't bad enough, liver failure can result in thrombocytopenia, or a low level of platelets in the blood. This occurs because the liver produces thrombopoietin, a hormone responsible for stimulating the production of platelets, a.k.a. thrombocytes, which help your blood clot.
Furthermore, increased amounts of liver enzymes, such as AST, ALT, and ALP, may be found on blood tests. These enzymes are released into the blood by a damaged liver.
Finally, and obviously, people with liver damage are at an increased risk of toxicosis, or damage to the body due to a toxin or poison the liver is no longer able to neutralize.
All of what I have gone over are indicators of liver problems. But one important sequela of severe liver damage must be mentioned as well. This is known as hepatic encephalopathy. It is a condition causing the brain to malfunction as a result of the liver's inability to detoxify the body. In short, the liver is so severely damaged that toxins from outside and within the body cannot be removed. These toxins build up, causing brain damage. This brain damage can show itself as personality changes, memory loss, a coma, and eventually death.
One principal toxin responsible for causing hepatic encephalopathy is ammonia, a byproduct of protein breakdown. The liver removes ammonia by way of the urea cycle. This is where ammonia is converted to urea, which is then excreted out of the body in urine. In cases of liver failure, this cannot occur, and therefore, elevated level of ammonia, hyperammonemia, will result.
As you can clearly tell, if the liver, your sidekick, is damaged, you are in peril for a lot of terrible things. Treat your sidekick well and it will help you massively!
Okay. Let's review how your liver helps you and what can go wrong. The liver gives you energy by way of gluconeogenesis, or the formation of glucose.
Your liver also forms important things like the protein albumin, a water-soluble protein responsible for the transportation of drugs and for maintenance of colloid osmotic pressure.
If that wasn't enough, your liver produces many coagulation factors, substances responsible for the clotting of blood so you don't bleed to death due to a tiny scratch.
Everything from trauma to toxins to viruses can damage your liver. This damage, if severe enough, can be caught by your doctor by looking for jaundice; hypoalbuminemia; ascites, which is the accumulation of fluid in the peritoneal cavity; cirrhosis, which is the scarring of the liver due to chronic liver disease; thrombocytopenia, or a low level of platelets in the blood; a prolonged prothrombin time; and increased amounts of liver enzymes, such as AST, ALT, and ALP.
In severe cases hepatic encephalopathy may occur. This is a condition that causes the brain to malfunction as a result of the liver's inability to detoxify the body.
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Back To CoursePathophysiology Textbook
20 chapters | 274 lessons