Liver structure and functions. What are the functions of the liver in the human body

In human anatomy, special attention is paid to the structure of the liver, since the functions of this organ are so important that it is often called the “second heart.” Being the largest gland in the body, " building material» for the liver are prism-shaped cells. This organ has the highest regenerative ability, and its precise functioning directly influences normal life activity in general.

The liver is an important organ in the human body

If you decide to “tackle” your liver, you need to understand well what and why you are treating or want to protect preventive measures. It is probably known that the liver is a truly unique organ, from which very strong degree human health depends.

On the one hand, the liver is an important human organ with a phenomenal ability to regenerate, i.e. self-healing (which is understandable, considering how many vital functions - more than five hundred! - it performs). On the other hand, in our time, the liver can be called with the same degree of confidence the organ that is most at risk. After all, certain disturbances in the structure and function of the liver are observed in the majority of people, even those who are generally relatively healthy and certainly do not suffer from specific liver diseases. How so? It seems that the whole point here is in the notorious scientific and technological progress. It makes our life more convenient, but the side effects of all this comfort hurt many organs, and especially the liver.

Nowadays, it is necessary to clearly understand that when dealing with such an important organ as the liver (and it is not without reason that it is even called the “second heart”), it is very important not to overestimate your strengths and capabilities, this is too big a risk.

Do you know that in the old days, having vague ideas about anatomy in general and the structure of the liver in particular, our Slavic ancestors considered this organ the most important in human body? Yes, these people did not know modern medicine, in some ways their ideas were naive, but it is difficult to argue with the fact that their ancestors were actually healthier than us and at the same time lived in a world that was incomparably cleaner than ours today. The notorious scientific and technological progress has not improved our health, rather the opposite. And people who lived long before us were right in many ways, at least in that they considered the liver to be the most important organ. Without the information that modern medicine has about the structure and functions of the liver, they considered this organ as containing almost all vital responsibilities, and they were not at all mistaken in this. The liver has more than five hundred functions in the body, and most of them are truly vital for the person as a whole.

What does the human liver consist of?

What does the human liver consist of and what functions does it perform? Speaking about the structural features of the liver, it should be noted that it is the largest human gland. Its weight on average ranges from 1.5 to 2 kg. The internal structure of the liver is a cluster of prism-shaped liver cells called hepatocytes.

As can be seen in the photo, in terms of its structure, the liver is an organ that has a complex branched tubular structure, supplemented by bile ducts:

These ducts perform the most important function of the liver - excretory, that is, cleansing the body of decay products, metabolites, poisons, toxins and other “waste” and often very harmful substances.

The organ consists of lobes and smaller structural elements - lobules - between which there is connective tissue, in which the so-called triads are located - the bile duct, artery and vein. This is an excellently adjusted and smoothly functioning system for cleaning the entire body, a natural protection against a huge number of diseases. The whole trouble is that today we put an unbearable load on the liver, not only due to the constant clogging of the body with harmful substances and all kinds of “chemicals” (including often excessive consumption medicines), but also due to many factors that simply inhibit normal liver function. This soon leads to changes in the structure of the organ, often at the cellular level, and the body’s drainage system can no longer cope.

Watch the video “Structure of the Liver” to better understand what this most important organ in the body consists of:

It does not matter which factor had the most depressing effect. Whether it is a virus, poisoning from medications or chemicals (of which there are so many in “fast food” and processed foods), or excessive alcohol consumption, the result is the same. If a person has a liver disease, this is followed by severe disruption in the functioning of the whole organism. The latter is extremely important, since it is not so rare that we begin to treat not the cause - dysfunction of the human liver - but the symptoms of the disease, which was a direct result of these disorders.

What functions does the liver perform in the human body?

What functions does the liver perform in the human body, and why are they so important? As a small but very indicative illustration of the above, we present the following data.

What is the liver made of and how does it function? The liver's circulatory system includes the hepatic artery (which delivers oxygenated blood to nourish liver tissue cells). Also, the structure of the human liver includes the so-called portal vein (it, in turn, already collects blood from the organs gastrointestinal tract, including the spleen). In the portal vein, the blood is purified and neutralized, again becoming suitable for use by all organs and tissues of the body. That is, the liver performs functions such as cleansing and drainage, and they are directly determined by the condition of the portal vein. But at the same time, this vein, being an integral part of the circulatory system as a whole, is connected to the rectal veins. Without going into unnecessary anatomy descriptions circulatory system, let’s just say that thereby the liver ensures normal activity:

• kidney;
• spleen;
• stomach;
• endocrine glands in general;
• hearts.

Here is an example of what functions the liver performs, and why the work of the entire body depends on this organ. In other words, if the liver is diseased, any therapy for all organs is unlikely to be effective.

Very often the liver fights, but cannot cope. Why is this happening? If you are asked what has such a destructive effect on the liver, then, leaving aside infectious diseases of this body, you will probably answer:

• overeating or poor nutrition;
• many drugs of chemical origin;
• poisons, especially those of the organophosphate structure, as well as mercury, arsenic, etc.;
• drinking alcohol, smoking.

But here it should be taken into account that the liver is “programmed” for some situations, for example, for intoxication with the same drugs. But what if we take not excessive consumption of any “chemicals” forcibly, say, during illness, but addiction to drugs, when intoxication is maintained by the person himself for a very long time? The liver is not ready for this.

What are the most important functions of the liver?

What other functions does the liver perform in the body and how can a malfunction in its functioning affect human health?

The regenerative capacity of the liver is enormous. And yet, today everything is susceptible to liver pathology. larger number of people. And this is due to changed living conditions, with an increase in the number of completely new factors that injure the liver. Disturbed ecology (increasing environmental pollution), frantic pace of life, constant stress, unfavorable climate changes, including geomagnetic processes that can cause pathological shifts in the body’s circadian rhythms - all these are new factors that are destructive to the liver, which the organ is simply not ready to deal with. The regenerative system of the liver is simply not “programmed” to withstand these and many other sad realities of today.

That is why these days the need to constantly “help” the liver stay healthy and fully functional is becoming increasingly important.

The main functions of the liver are extremely important for the normal functioning of the body as a whole. If for some reason violations occur, the body can no longer effectively perform its work. And when the liver ceases to cope with its basic functions, at least to one degree or another, the real chain reaction. It manifests itself in the fact that an increasing number of other organs and even entire systems of the body are experiencing “failures” in their work, problems are multiplying and growing like a snowball. Finally, a disease develops (and often several at once) - but its symptoms, obvious and painful, “mask” the root cause, liver dysfunction. What is the result? Having cured, it would seem, an illness that caused considerable suffering, a person very soon encounters another. Thus, the liver should be considered as one of the most important and vital (along with even the heart) organs, not only due to the importance of its functions, but also due to the fact that liver pathology can lead to a kind of “cascade” of diseases of other organs and systems . And a kind of vicious circle arises. Diseases increase the load on an already unhealthy organ. And a decrease in liver function in the human body provokes the development of more and more new ailments.

Normalization, maintenance and strengthening of the main functions of the liver

You probably know a lot about the functions of the liver, and even have quite sufficient knowledge about several types of its pathology. This is good, but it is not enough. Because today the list of causes of liver damage is growing, as they say, by leaps and bounds. In addition, if almost everyone, apparently, knows the benefits of cleansing the body in general and the liver in particular, then not everyone still understands: ecology, nutrition, as well as the abundance of all kinds of chemicals that we take in the form of medicines, with food, etc. Today we are forced to consider the problems of caring for the liver from a completely different perspective. Namely: the above and many other factors modern life(this especially applies to residents of megacities) force us to take care of liver health, strengthening it in every possible way, in addition to cleansing and prevention, with a whole range of measures on a strictly regular basis. One such measure aimed at maintaining liver function, for example, is oral hygiene. Yes, these are the sad realities of today; and the most seemingly protected organ by nature now needs help, perhaps like no other.

One of the features of the liver is its widely developed venous system. It is divided into the portal (sometimes also called portal) vein and a system of smaller hepatic veins. The portal vein begins and ends with a huge number of small veins and abundantly branched capillaries. The described system is a structure designed to cleanse the blood of toxins, waste, decay products, etc. At the same time, the performance of this system is enormous: More than one and a half liters of blood passes through the liver in one minute. That is, in an hour the liver passes through about 100 liters of blood.

Liver - great worker! Meanwhile, in many cases we are without special effort we can make her tasks easier.

An example like this: it is known that the bactericidal ability of blood (i.e., its ability to destroy pathogenic organisms) depends on its temperature. No wonder the blood, passing through the liver, warms up. Therefore, such a simple action aimed at normalizing liver function, such as regularly warming the organ by applying a regular heating pad to it, allows you to warm up in an hour those same hundred liters of blood that pass through the liver during this period. And this increases the bactericidal effect by about ten times! From here you can imagine how much we can help the liver by not only regularly cleansing it, but also regularly warming it, and these are quite basic procedures and accessible to everyone.

On the other hand, it is just as easy to complicate the functioning of the liver. For example, clogging the body with excess toxins. We are not talking about chemicals, but “just” about poor nutrition! Poor nutrition provokes the formation of “aggressive” bile. In addition, it is known that blood flows through the liver more slowly than through other organs, since it takes time to cleanse the blood of toxins. Therefore, the pressure in the portal vein is stronger than in other veins. Thus, if we eat incorrectly, it makes our blood too acidic, which leads to the formation of acidic, i.e. “aggressive” bile. Blood, deprived of natural organic minerals and vitamins due to improper nutrition, quickly leads to clogging of the biliary system, and then to its gradual destruction!

Meanwhile, blockage of the bile ducts is fraught with the reflux of “aggressive” bile into the pancreas. And this not only negatively affects its function - the so-called islets of Langerhans are destroyed, i.e. structural cellular formations that produce insulin, which may well become primary cause development of diabetes mellitus. It turns out that just poor nutrition can cause a terrible disease.

We can safely say that approximately 90% of the good condition of the liver depends on a healthy lifestyle, compliance with certain safety measures, as well as the regular implementation of some basic procedures to cleanse and heal the organ. Meanwhile, as was said just above, strengthening the function of the liver, taking care of its health is nothing more than taking care of general health body. Thus, often everything is in your hands and depends only on yourself. But, of course, not always. And if a problem with the liver does occur, for example, an infectious disease or a disease requiring surgical intervention, then you should not postpone a visit to the doctor. In addition, the liver is too serious an organ to self-medicate without seeking advice from your doctor. For example, herbs can be really useful if you follow the recipe and dosage, as well as honey or other naturopathy remedies.

But the unknown “liver pills” that are rumored to have helped someone, and even those widely advertised today (dietary supplements) can do you no good. Thus, timely appeal See your doctor, carry out the necessary diagnostic measures, and then comply with treatment instructions are the only reasonable course of action when it comes to the liver.

Where is the liver located?

The location of the liver in the abdominal cavity, on the way between the intestines, where food is digested and absorbed, and the rest of the body, sheds some light on its function. It is no coincidence that all the blood flowing from abdominal organs, flows into a powerful venous collector - the portal vein. This blood, as is known, carries nutrients broken down during the digestion process, and, before entering the general circulation, passes through the liver.

Liver functions

The liver is wedge-shaped. This is the largest and in a certain sense the most complex organ. One of its main functions is the destruction of harmful substances absorbed from the intestines or formed in other parts of the body. The liver excretes them in the form safe products exchanged with bile or released into the blood. Metabolic products enter the intestines along with bile and are then removed from the body with feces. Those that enter the blood are filtered by the kidneys and excreted from the body in the urine.

The liver produces almost half of the cholesterol the body needs, and the rest comes from food. About 80% of this component, synthesized by the liver, is used in the production of bile. Cholesterol is an essential component of cell membranes and is also needed for the synthesis of several hormones, including estrogens, testosterone and adrenal hormones.

The liver converts substances resulting from the digestion of food into proteins, fats and carbohydrates. It is in the liver that sugar is deposited in the form of glycogen. When needed (for example, when blood sugar gets too low), it is broken down into glucose and released into the bloodstream.

The functions of the liver include the synthesis of many important compounds necessary for the functioning of the body, in particular proteins. The liver produces substances that help form a blood clot when bleeding occurs. These are called blood clotting factors.

Blood flows to the liver from the intestines and from the heart. The smallest capillaries in the intestinal wall open into veins that empty into the portal vein, which carries blood to the liver. Inside the liver, the portal vein again breaks up into capillaries and passes through a network of tiny channels. They are formed by liver cells, where digested nutrients and all harmful products are processed. The hepatic artery carries blood from the heart to the liver. This blood delivers oxygen to the liver tissue, as well as cholesterol and a number of other substances that are processed by the liver. Blood from the intestines and heart then mixes and flows back to the heart through the hepatic veins.

Functions of the liver in the human body

No other organ in the human body provides as many functions as the liver performs. These include:

Detoxification of the body - neutralization of all toxic compounds that enter the blood from the environment (alcohol, toxins, medications);

Recycling and inactivation of toxic metabolic products formed in the body during vital activity (protein breakdown products, phenol, ketone compounds and acetone);

Participation in vitamin and mineral metabolism: deposition of water-soluble vitamins B, C, PP, as well as fat-soluble D, E, K, microelements iron, copper and cobalt;

Participation in the synthesis of steroid sex, thyroid, adrenal hormones and neutralization of their excess;

Regulation of carbohydrate metabolism;

Deposition and distribution of energy substrates in the body (glucose, glycogen) through the processes of glycogenolysis, gluconeogenesis, glycolysis;

Participation in lipid metabolism (metabolism of cholesterol, phospholipids, fatty acids, lipoproteins);

Implementation of central processes of protein metabolism: synthesis of protein components for cell membranes and transport proteins, redistribution of amino acids;

Participation in the synthesis of immunogobullins, antibodies and other important proteins immune system;

Synthesis of plasma coagulation factors and blood anticoagulation system;

Function of hematopoiesis, especially in the prenatal and childhood periods;

Synthesis of bile and enzymes that are involved in digestion processes. Their main role is the breakdown of fats;

Carrying out bilirubin metabolism and its neutralization by conjugation with glucuronic acid;

Depositing blood, which allows it to be redistributed in case of need (release of blood into the vessels when it is deficient during blood loss or concentration during congestive heart failure);

The liver is the largest gland human body, which performs the most functions among all organs. Liver damage can be accompanied by a violation of one or all of its functions, which underlies the severity of the disease.

The group of liver diseases can include any types of damage to all structures that do not go beyond the anatomical limits of this organ. These can be hepatocytes and the hepatic lobules that they form, intrahepatic arterial and venous vessels, and bile ducts. Extrahepatic diseases bile ducts and gallbladder should be considered under a separate heading.

The main common liver diseases are shown in the table:

Any liver disease, if progressing, ends in cirrhosis and is accompanied by varying degrees of hepatocellular failure.

Symptoms of liver disease considered frequent nausea, heartburn, very unpleasant, Strong smell sweat, yellowish skin color, dark yellow urine, diarrhea, change in color of feces to dark brown or light yellow color, sometimes green.

Also, liver disorders can lead to acne in adulthood, frequent feelings of hunger or strong and frequent thirst, itching of some thin areas of the skin, and blurred vision. For example, a person may begin to confuse white with yellow, sharply feeling either cold or hot, not sleeping at night, while experiencing fever, rapid heartbeat. Hair and eyebrows may begin to fall out. Convulsions occur, papillomas form, and the development of atherosclerosis of the brain, heart, intestines, and blood vessels of the legs begins.

Typical cases of organic and functional liver problems are easily recognized by their characteristic symptoms. But some situations create difficulties for correct setting diagnosis even by experienced hepatologists (specialists who deal with liver diseases). It all depends on the specific type of disease, the individual characteristics of the body, the presence or absence of concomitant pathology.

The main clinical manifestations of liver pathology may be:

Discomfort and pain in the projection of the liver;

Enlargement of the liver;

General weakness and malaise;

Headache;

Impaired mental and thinking abilities;

Excessive sweating skin and swelling;

Yellowness of the skin and sclera;

Skin rash;

Severe itching of the skin;

Increased fragility of blood vessels and tendency to bleeding;

Signs of hypovitaminosis;

Stool instability, changes in the nature and color of stool;

Increase in abdominal size;

Increased venous pattern on the skin of the abdomen;

Unmotivated weight loss;

Bitterness in the mouth;

Mother-in-law on the surface of the tongue and its coating with a white or brown coating;

Temperature response varying degrees expressiveness.

How does your liver hurt?

Pain due to liver damage may be different character. They can be interpreted like this:

Minor painful sensations in the right hypochondrium in the form of aching pain, bloating and heaviness. Characterize a sluggish pathological process of inflammatory toxic or other origin. This type of pain in the liver is most likely caused by an increase in the size of the organ and overstretching of the liver capsule. Patients cannot clearly identify one pain point;

Intense widespread pain in the right hypochondrium. They are rare and speak of either a pronounced inflammatory, purulent, traumatic pathological process, or damage to the bile ducts by stones;

Severe local point pain in the projection of the liver. It is not typical for liver damage and in most cases is associated with pathology of the gallbladder and extrahepatic bile ducts;

Complete absence pain in the liver. It is very common in indolent liver diseases, which go unnoticed for a long time and are detected only at the stage of liver failure or cirrhosis.

Based on the characteristics of the skin, one can determine the functioning of various organs, including the liver.

With such diseases, the skin may be:

Pale or dark-skinned with severe sweating and swelling of the subcutaneous tissue, especially in the face and limbs;

Dry, flaky with multiple scratch marks and cracks;

Prone to allergic rashes, the occurrence of atopic dermatitis, psoriasis, eczema;

Jaundice. By the nature of this type of skin changes, one can determine the origin of jaundice. In case of liver problems, jaundice is of moderate intensity and is represented by an orange tint. When carrying out the differential diagnosis of jaundice, this criterion allows us to exclude mechanical types (brown skin tone) and hemolytic types, accompanied by a lemon-yellow skin tone;

With the presence of striae. Striae are stretch marks of the skin, mostly of the abdomen, in the form of bluish stripes of thinning. The reason for their appearance is a hormonal imbalance, both in the male and female body, when the liver is not able to neutralize excess steroid hormones.

Rash due to liver disease

In most patients with liver pathology, along with changes in skin color, various rashes appear.

The mechanisms of occurrence and types of rash can be as follows:

Pustular elements, tendency to folliculitis and furunculosis. They are based on an immune imbalance that occurs against the background of a decrease in the liver’s ability to synthesize immunoglobulins;

• What causes cholelithiasis to develop?

  The professor shows on video the causes of the development of the disease in the gallbladder. Causes of pancreatic pain. And he associates this with fine motor skills. Treatment like this is not necessary. If you start motility, the gallbladder will dissolve its stones on its own.

  Video about cholelithiasis

  How to treat the liver using traditional methods at home?

  Baths for liver disease:
  Warm baths with decoctions have a very beneficial effect on a sick body. They are prepared like this. Take 50g of any of the herbs: wild rosemary, wormwood or juniper, add one liter of water and boil for 30 minutes. The broth is filtered into the bath and sit in it for 20-30 minutes, no more. The course of admission is 3 weeks every three days. Such baths reduce body temperature, relieve fatigue, joint pain and exacerbation of liver disease. After the bath, it is recommended to drink hot milk or a little dry natural red wine.

  
  Oats for liver disease:
  Oats can be purchased at a pharmacy or pet store. Take 2 tablespoons of unhulled oats and add 1 liter of water, boil for 15-20 minutes over low heat, then add 2 tablespoons of milk (preferably goat's) and boil for another 5 minutes. Strain the broth and add 2 tablespoons of honey. Take 1/3 cup 3 times a day 30 minutes before meals. The course of treatment is two weeks. Thereby folk remedy A large amount of bile will be released.

  
  Herbal decoctions for liver disease:
  Traditional medicine recommends taking decoctions of yellow herbs. Take any herb: tansy, St. John's wort, chamomile, immortelle, milk thistle in the proportion of 1 tablespoon per glass of boiling water. Boil over low heat for 1-2 minutes, strain and take 3 times a day, 1/3 cup, 30 minutes before meals. Before going to bed, it is useful to take decoctions of motherwort and St. John's wort. They relieve irritability and promote restful sleep. You can buy alcoholic tinctures of these herbs at the pharmacy. Take 10 drops of tincture of each herb and pour a glass of warm water. Take one hour before bedtime for 10 days.

  
  Corn fiber for liver disease:

  If you pick the leaves off an ear of corn, you will see a lot of hairs or fibers underneath. For successful treatment pick only ripe cobs. Unripe ones have no healing power. Take these fibers and pour boiling water, after 30-40 minutes take the infusion. You can add honey. Take 1 glass of infusion twice a day before meals. The duration of the infusion can reach six months. The longer the infusion period, the more beneficial qualities it contains.

  Grapefruit juice and Provençal oil for liver disease:

  If you begin to feel pain in the right hypochondrium, then most likely this is a signal from the liver. Don't forget that it requires constant liver cleansing. A good remedy in this case would be a mixture of a quarter glass of Provençal oil with a quarter glass of grapefruit juice. It should be taken at night, no earlier than 2 hours after eating. Be sure to do an enema before this. Lie in bed on your right side. It is recommended to do the enema again in the morning. Do this procedure after four to five days and within a month you will feel the result.

• optimal composition of active components;
• anti-inflammatory effect;
• favorable safety profile;
• over-the-counter release from pharmacies.

The human liver: where is it located, what functions does it perform and why is the prevention of diseases of this organ so important?

One of the most important organs of our body is the liver. It performs many functions. That is why the manifestations of liver diseases are so varied. At the same time, non-specialists, as a rule, have little idea of ​​the role of the organ and the consequences of failures in its operation. The heart pumps blood, we breathe through the lungs, food is digested in the stomach, and what is the liver doing at this time? Let's try to understand the tasks of the organ and understand what can cause it to fail.

The structure and location of the human liver

The liver is a fairly large organ: its weight is 1/40 of the body weight of an adult and 1/20 of a newborn. The liver is located under the diaphragm and occupies almost the entire upper right part of the abdominal cavity. Therefore, diseases of the organ manifest themselves as pain and discomfort in the right hypochondrium. It is worth saying that the liver does not have pain receptors, so all the unpleasant sensations in the area where the organ is located are associated with an increase in its size and stretching of the liver capsule, caused by various lesions.

The functions of the liver in producing bile are closely related to the work of the gallbladder, a small sac located directly under the liver. It stores the unused part of the bile.

Functions of the organ

The liver performs about 70 important functions. It is involved in 97% of all processes in the body. It is difficult to list everything in one article, so we will limit ourselves to the main ones:

• Protecting the body from toxins . The liver filters the blood and neutralizes all toxins that enter our body from the outside or are formed as a result of decay reactions.
• Participation in regulation hormonal levels . The human liver is involved in the synthesis of hormones, as well as in the elimination of their excess.
• Participation in digestion . The liver produces bile, without which digestion is impossible. Thanks to it, fats are broken down in the intestines. Nutrient storage . A healthy human liver can store vitamins and minerals and use them when the need arises. In addition, it itself converts some substances into vitamins - for example, carotene - into vitamin A.
• Protecting the body from infections and bacteria . The liver is one of the main outposts on the path of pathogenic microorganisms. It passes through all the blood of our body, and during the filtration process, special cells of the immune system neutralize most bacteria.
• Participation in exchange processes . The liver is involved in the metabolism of fats, proteins and carbohydrates.

Major diseases

The most common liver diseases include hepatosis, hepatitis (inflammation in the liver) And cirrhosis.

Hepatosis, or, as it is also called, fatty degeneration, is a disease caused by the accumulation of fat in the liver. Most often, people aged 40 to 56 years suffer from this disease. Very often, hepatosis develops against the background of obesity and diabetes. The risk group also includes overweight people and those who do not adhere to a healthy diet, leaning on fatty and fried foods, as well as drinkers. Hepatosis develops unnoticed and can manifest itself as heaviness in the right side, nausea, heartburn, weakness, and problems with stool. According to statistics, fatty hepatosis in 40% of cases subsequently develops into hepatitis, fibrosis and cirrhosis.

Hepatitis- a term that combines acute and chronic inflammatory liver diseases of various etiologies. Most often, the cause of hepatitis is a viral infection (hepatitis A, B and C) or toxic liver damage, including alcohol. The most dangerous is hepatitis C, which is difficult to cure completely. There are no characteristic signs of hepatitis. However, it may be accompanied by pain in the right side, yellow discoloration of the skin and whites of the eyes, and changes in the color of urine and feces. The Russian Ministry of Health characterizes the epidemic situation in the country regarding viral hepatitis as unfavorable.

Cirrhosis- the disease is even more serious. In cirrhosis, liver cells die and are replaced by fibrous connective tissue. The prognosis is alarming - the liver increases in size or, conversely, shrinks, blood circulation is disrupted and ultimately the liver ceases to function. According to statistics, from cirrhosis of the liver every year in different countries 15–40 people die out of every 100 thousand, and up to 40 million people die from cirrhosis every year in the world. Cirrhosis is especially dangerous because in 80% of cases it is asymptomatic and manifests itself only when the situation becomes critical.

Due to the deplorable situation regarding liver diseases, doctors believe that in the next 10–20 years the number of patients with liver cirrhosis will increase by 60%, liver cancer - by 68%, and mortality from other liver diseases will double. And this is also a relatively optimistic forecast, suggesting that the rate of spread of diseases will remain the same or slow down.

Important!
According to statistics, cirrhosis sooner or later develops in 5% of overweight people, and fatty liver in 65% of cases.

Causes of pathological processes

The most can destroy the liver (and at the same time - health) various factors. Here are the most common ones:

Alcohol and toxins

Alcohol and toxic injuries account, according to various estimates, from 40 to 50% of all human liver pathologies. Alcohol is broken down in the liver, but if consumed excessively, this organ simply does not have time to cope with the amount of work. For liver cells, ethyl alcohol is a highly toxic poison. It promotes the growth of connective tissue, which leads to liver fibrosis. The most common causes of alcohol are fatty liver disease, alcoholic hepatitis and fibrosis. Without timely treatment all these diseases can outgrow cirrhosis - even if a person refuses to drink.

There are a lot of myths around alcohol and its effects on the liver, and they should be discussed separately. You can often hear from various “experts” that the main thing is to drink wisely, drink certain drinks, or carry out “rehabilitation” after a party with brine, broth and a shot of vodka. These are all myths and nothing more. For the liver, the concept of a “safe dose” does not exist. WHO has calculated a conditionally safe daily dose, and it is approximately 20 grams ethyl alcohol per day (±5 grams depending on a person’s height, weight, age and even nationality), provided that the alcohol is of the highest quality, the liver and all other body systems are ideally healthy, the person leads a healthy lifestyle and at least 2 days I don't drink alcohol at all for a week. This dose is equivalent to one small glass of vodka or cognac, a glass of wine or a small bottle of beer. For women, the generally safe dose is half as much. “Conditionally safe” does not in any way mean “useful”. For the liver, even a teaspoon of vodka is already extra work and unnecessary harm. But if she can still cope with one glass normal mode, then two or three is already an emergency mode, overload and, as a result, the death of liver cells. It doesn’t matter at all whether you feel intoxicated or not.

Infections

Viral hepatitis is a common cause of viral liver disease. Hepatitis A is transmitted through dirty water or food, this type of hepatitis is easily treated and does not cause irreversible processes in the liver. Hepatitis B and C spread through the blood and other body fluids; they often become chronic and lead to cirrhosis. In the case of hepatitis C, the main goal of therapy is eradication (removal) of the virus from the body.

Poor nutrition

Fast food, an abundance of fatty and fried food, addiction to spicy and salty foods, a poor diet - all this leads to excess weight gain and a lack of vitamins B, C, E, D and A necessary for the liver. Not only excess weight can be harmful, but also its sudden loss - the body considers this situation as an emergency, and the liver begins to accumulate carbohydrates and fats, as it receives a signal from the brain: “hunger has come!” Let's stock up on nutrients!"

Diabetes

Common companions of diabetes are fatty hepatosis and liver failure. Fatty liver in diabetes is caused by the process of fat breakdown getting out of control and causing fat to accumulate in the liver cells.

Signs of a diseased liver

Only a doctor can determine the presence of liver disease, and only after a blood test and instrumental studies- for example, ultrasound, CT and MRI. But the patient himself may suspect liver damage based on some signs.

Asthenic symptoms . Weakness, fatigue, constant drowsiness are the first “bells” of a diseased liver. These symptoms are a consequence of impaired neutralization of nitrogen metabolism products in the liver.

Pain . There are no nerve cells in the liver, and it cannot hurt on its own. But with lesions, it increases in size and puts pressure on the capsule surrounding it - but in this capsule there are already pain receptors. Therefore, disturbances in liver function are accompanied by extreme unpleasant sensations. How does a person’s liver hurt? It all starts with a feeling of heaviness in the right hypochondrium, which is replaced by a dull aching pain. After eating, the discomfort intensifies. Pain that increases every day is a sign of a tumor or cyst. A sharp, almost unbearable pain, called hepatic colic, means that one of the ducts is blocked by a stone. Digestive disorders. People with liver disease often complain of flatulence, diarrhea, nausea or even vomiting, decreased appetite and a bitter taste in the mouth.

Jaundice . Yellowing of the skin and whites of the eyes is a sure sign of a diseased liver. This is due to a violation of bile transport or bilirubin metabolism.

Bad skin . A diseased human liver cannot properly protect the body from toxins and bacteria. The attack of poisons and pathogenic microorganisms is instantly reflected on the skin - pimples and rashes appear. Liver diseases are also characterized by the appearance of spider veins - they appear due to the fact that the vessels become fragile and blood clotting is impaired.

By the way
The number of people in the world suffering from liver disease is 200 million. Liver disorders are among the top 10 most common causes of death. In most cases, the liver suffers due to viruses and toxins.

Prevention of liver diseases

What can be done to protect the liver and help this vital organ cope with its responsibilities?

Firstly, review your diet and give up foods that negatively affect liver function - first of all, fatty and fried foods, trans fats (margarine, etc.), hot spices, vinegar, marinades, White bread and baked goods, mushrooms, and many full-fat dairy products. The majority of the diet should consist of a variety of vegetables, cereals and pasta, lean boiled or baked meat and fish, and wholemeal bread. It has been noticed that Asian peoples, who eat mainly vegetables and rice with a small amount of chicken or seafood, suffer from liver diseases much less often than Europeans. Needless to say, alcohol and a healthy liver are incompatible?

Secondly, you should monitor your body weight, without justifying your laziness by saying that “there should be a lot of good people.” Slimness is a matter not only of attractiveness, but also of health and, ultimately, life expectancy.

Thirdly, never take medications without a doctor's prescription. Many seemingly harmless pills for colds, migraines and other ailments create a serious burden on the liver, which only increases if you take several medications at the same time. Antibiotics should be taken with extreme caution.

Fourth, protect yourself from exposure to toxins. Sources of poisons can be the most common things - household chemicals, low-quality repair and finishing materials, synthetic fabrics and plastic products. Buy only safe products that have all the necessary certificates of conformity, do not walk along roads and be careful when working with potentially dangerous chemicals- acetone, chlorine, solvents, paints and enamels.

And finally, if you have risk factors, you can help your liver by taking hepatoprotective medications. This will strengthen the liver cells and minimize the damage that we cause to this organ every day.

Prophylactic drugs

Hepatoprotectors - means for preventing liver diseases and improving its activity - are very widespread today. They have proven their effectiveness and saved the health of many people. The hepatoprotector market is very large and includes hundreds of items. Particularly popular are hepatoprotectors, which include phospholipids - substances plant origin, which in the human body are the main component of cell walls, including liver cells. Medicines with phospholipids help restore damaged liver cells and stimulate their regeneration. However, phospholipids alone cannot cope with inflammation, which is common cause liver diseases. That is why pharmacists around the world are looking for a combination of substances that would simultaneously stop inflammatory processes and protect liver cells from destruction. Today, one of the most effective combinations is phospholipids with glycyrrhizic acid. Glycyrrhizic acid, which occurs naturally in licorice root, not only eliminates inflammation, but has antioxidant and antifibrotic effects. The effectiveness of glycyrrhizic acid and essential phospholipids has been proven in clinical studies, and in practice. That is why the combination based on glycyrrhizic acid and essential phospholipids is the only one included in the list of vital and essential medicines in the section “Drugs for the treatment of liver diseases”, annually approved by the Government of the Russian Federation. Thanks to its inclusion in this list, its price is regulated by the state.

Tuesday, 04/10/2018

Editorial opinion

Hepatoprotectors are drugs whose effect appears gradually. You need to take such drugs in a course (usually from 3 months, depending on the condition of the liver). The vast majority of hepatoprotectors are safe and are sold in pharmacies without a prescription, however, some of them have contraindications, so you should consult your doctor before taking them.

One of the most important organs in the human body is the liver. This gland is responsible for many functional processes, as during intrauterine development both in the fetus and in the adult. Knowing the structure of the liver, it is easy to diagnose it and identify possible pathological changes.

The human liver is located in the upper abdominal cavity. It is located in the anterior part of the subcostal space, under the lungs, from which it is separated by the diaphragm. The main part of the gland occupies space on the right side, a smaller portion goes to the left side, approaching the heart. Adjacent to it below are the internal organs of the digestive tract - the gallbladder, stomach, spleen, pancreas and part of the intestine.

As a result of a rare biological abnormality, the liver can develop transpositionally, located in the left part of the hypochondrium.

The role of the gland in the body is quite multifunctional. She is responsible for the following processes and functions:

• accompanies the digestive process, synthesizes bile acids and bilirubin, regulates the secretion of bile;
• participates in protein synthesis - produces albumin, fibrinogen, globulins;
• synthesizes cholesterol, produces lipids and phospholipids, regulates lipid metabolism;
• produces thrombopoietin, IGF-1, angiotensin;
• performs detoxification – neutralizes and removes toxic substances, poisons and allergens;
• regulates carbohydrate metabolism, converting glucose into glycogen, storing it and releasing it into the bloodstream when blood sugar levels are low;
• accumulates vitamins, calcium, iron, which are involved in the process of hematopoiesis and synaptic neural processes;
• removes metabolic breakdown products (ammonia, ketone bodies, phenol, uric acid, etc.);
• as a reserve blood storage facility for emergency blood replenishment in case of extensive bleeding.

In the prenatal period, the liver's work consists of hematopoietic function. It synthesizes red blood cells, proteins albumin and globulin, alpha and beta fetoprotein, fetal hemoglobin.

Anatomical structure of the organ

The liver has a triangular wedge-shaped shape and a lobar structure. It is red-brown in color and soft to the touch. How much does a healthy liver weigh in an adult, and what size does it reach? Its weight varies, but in adulthood it reaches 1500 g. The size of the gland does not depend on gender.

Average dimensional values ​​correspond to the following parameters:

• length from 25 to 30 cm;
• height from 9 to 15 cm;
• width from 15 to 20 cm.

The main liver tissue is called parenchyma. It consists of many hepatic lobules, which are its structural and functional unit.

Liver sections

The structural anatomy of the liver is represented by lobes, which are divided into segments. The gland consists of two main lobes - the large right one and the smaller left one. The right lobe consists of two secondary ones - quadrate and caudate.

The figure shows the lobar and segmental structure of the liver in section:

Some people have structural features of the gland, which are expressed in the presence of additional lobes and grooves. The most characteristic anomaly is the tongue-like lobe of Riedel. It forms more often in women and is localized on the large right lobe and is not an additional segment.

Another type of anomaly is cough grooves, which are parallel depressions on the diaphragmatic surface of the right lobe. Such features do not pose a danger and do not interfere with the full functioning of the organ.

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The formation of liver lobes occurs on its different surfaces.

The gland has two surfaces, which are distinguished by the type of organ location:

1. Diaphragmatic(top). This surface is smooth and dome-shaped, since due to its connection to the diaphragm it follows its contours. There is a hole on it from cardiac depression. The diaphragmatic surface is connected to the diaphragm by the falciform ligament, which forms the right and left lobes of the liver. On the posterosuperior side, the falciform ligament forms the coronary ligament, which is attached to the peritoneum, holding the organ.
2. Visceral(lower). This side has a concave relief and fits tightly to the abdominal organs. On its surface there are impressions from surrounding organs (gall bladder, right kidney, stomach and esophagus, part of the intestine) and three grooves that form several lobes (right, left, quadrate, caudate). Two grooves run along the gland, and the third is located transversely. At the intersection of the grooves, the gates of the liver are formed, which consist of the main portal vein, hepatic artery, common bile duct, nervous network and lymphatic vessels. The round and venous ligaments are also located on the lower surface.

The entire liver is covered with a dense membrane of fibrous tissue. This is Glisson's capsule. The internal division of the gland into lobes and segments occurs due to its penetration into the organ. The fibrous membrane penetrates inward through the hilum of the liver, forming the internal boundaries of the lobes and segments.

Segments

Segmentation is necessary in the diagnosis of liver diseases for precise localization of the pathological process. Segments are usually counted from the caudate lobe, counterclockwise. They are located around the gates of the liver and are grouped into larger sectors.

The table shows the correspondence of the segments to their anatomical location and sector:

The segments have a pyramidal shape. Their functionality is ensured by a conditionally isolated triple system, which is responsible for innervation, blood supply and bile outflow. This is the hepatic triad, consisting of branches of the portal vein, hepatic vein and bile duct.

INTERESTING! The segmental diagram of the liver, which modern specialists use, was developed by the French anatomist C. Quinot.

Blood supply

The circulatory network is formed from portal vein and hepatic artery. Penetrating into the segments, these main highways branch into right and left streams, forming smaller vessels and capillaries.

The branches correspond to the structural division of the gland:

• lobar veins and vessels;
• segment branches;
• interlobular;
• lobular.

Interlobular arterial and venous branches run along the interlobular bile duct. These highways form the hepatic triad, which is responsible for the work of individual segments. Further, the artery branches into capillaries, which merge into a sinusoidal hemocapillary inside each lobule. These vascular formations merge to form branches that connect to the inferior vena cava.

Blood collected throughout the body enters the liver through the portal vein. She carries within herself toxic substances that enter the bloodstream as blood passes through organs. Contaminated blood passes through all segments and is released into the sinusoidal hemocapillaries.

There she mixes with arterial blood, entered through the own hepatic artery. As it passes through the small blood vessels, the blood is cleared of toxins and released into the general bloodstream, draining into the central and then into the inferior vena cava.

Hepatic lobule and bile ducts

The entire liver is penetrated by bile ducts, through which produced bile is excreted. They are formed in the liver lobules, which form the parenchyma. Each lobule consists of hepatic beams formed by a double row of hepatocytes (structural cells).

The lobe looks like a hexagonal polygon. The central vein runs through its center, and the beams act as rays diverging radially to the periphery.

There are two types of liver lobules:

• triangular portal lobule, with a triad in the center and central veins at the corner points (blood flow is directed from the center to the side walls);
• rhomboid acinus, with a triad in obtuse angles and a central vein in acute ones, with three zones of blood supply (periportal, intermediate, perivenous).

In the space that forms between the beams, a sinusoidal capillary and bile duct are formed. At the base of the central vein, the ducts are closed, and at the periphery they unite, forming interlobular ducts. The fusion of small ducts forms the large bile ducts, the right and left, corresponding to the lobes of the liver. At the hepatic porta they unite into the central common duct.

Cellular structure of liver tissue

What does liver tissue consist of? Parenchyma consists of several types of cells. The main structural cells are. They make up about 60% of total number cellular elements. The hepatocyte contains polyploid double nuclei, EPS, Golgi complexes, glycogen, lipid inclusions and provides functional processes in the liver.

In addition to this type, the parenchyma consists of the following cells:

Cellular processes in the liver are energy-intensive, since the gland is the most active metabolic organ. The main processes (synthesis of proteins, hormones and enzymes, carbohydrate metabolism) occur in hepatocytes.

Knowledge of the anatomical structure of the liver helps to understand the functional processes occurring in this organ. Having a clear understanding of internal structure, tissues, blood and bile ducts, it is easy to diagnose various liver pathologies and determine the location of the negative process.

Judging by the fact that you are reading these lines now, victory in the fight against liver diseases is not yet on your side...

Have you already thought about surgery? This is understandable, because the liver is a very important organ, and its proper functioning is the key to health and well-being. Nausea and vomiting, yellowish tint to the skin, bitterness in the mouth and bad smell, dark urine and diarrhea... All these symptoms are familiar to you firsthand.

But perhaps it would be more correct to treat not the effect, but the cause? We recommend reading the story of Olga Krichevskaya, how she cured her liver...

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The human liver is located below the diaphragm, occupies the right hypochondrium, epigastric and part of the left hypochondrium.

The human liver has a soft consistency, but a dense structure due to the connective tissue membrane covering it called Glisson's capsule and many connective tissue septa extending deep into the organ.

Externally, the organ is surrounded by peritoneum, with the exception of a separate small area at the back, tightly adjacent to the diaphragm. At the junction of the peritoneum with the organ, folds are formed that play the role of ligaments. The human liver ligaments provide fixation primarily to the diaphragm, some provide connection to neighboring organs and the anterior abdominal wall. The largest of them is crescent-shaped, dividing the organ in the sagittal plane into two largest lobes - right and left. The location of the liver in humans is stable due to these supporting ligaments.

In the anatomy of the human liver, there are lower (visceral, slightly concave) and upper (diaphragmatic, convex) surfaces, two edges, three grooves.

The bottom surface deserves special mention. The grooves located there further divide the right lobe into the caudate and quadrate. The sagittal grooves contain the gallbladder (on the right) and the round ligament ( anterior section left). In the transverse groove (connects the sagittal) is located essential structure- gate of the liver.

The anatomy of the human liver structure is such that all its elements (vessels, ducts, lobules) are connected to neighboring similar structures and undergo transformations in a radial order: small ones merge, join into larger ones, and, conversely, large ones are divided into smaller ones.

Thus, the smallest structural and functional elements of the liver - the hepatic lobules - are combined with each other, forming segments (8 of them), then sectors (5), and ultimately - two main lobes.

The hepatic lobules are separated by connective tissue septa with vessels and a bile duct passing through them, called interlobular septa. The lobule itself is prismatic in shape and contains a group of liver cells (hepatocytes), which are also the walls of the smallest bile ducts, capillaries and a central vein. Both bile formation and nutrient exchange occur in the lobules.

Further formation of the bile ducts occurs according to the same ascending principle: the ducts pass into the interlobular ducts, from which the right and left hepatic ducts are formed and united into a common hepatic duct. The latter, after exiting through the portal of the liver, connects with the duct of the gallbladder, and the thus formed common bile duct exits into the duodenum.

Human anatomy and the location of the liver interact so that normally the organ does not extend beyond the costal arch and is adjacent to organs such as the esophagus (abdominal section), aorta, 10-11 thoracic vertebrae, right kidney with adrenal gland, stomach, right part of the colon, upper part of the duodenum.

The blood supply to the liver in human anatomy has some features. Most of the blood entering the organ is venous from the portal vein (about 2/3 of the blood flow), the smaller part is arterial blood delivered through the common hepatic artery (a branch of the abdominal aorta). Such a distribution of blood flow contributes to the rapid neutralization of toxins coming from the remaining unpaired organs of the abdominal cavity (the outflow of blood from them is carried out into the portal vein system).

Entering the liver blood vessels undergo traditional division in descending order. Inside the hepatic lobule there are both arterial and deoxygenated blood due to the connection of arterial and venous capillaries, which ultimately flow into the central vein. The latter emerge from the hepatic lobules and ultimately form 2-3 common hepatic veins, flowing into the inferior vena cava.

A distinctive feature of the venous vessels of the liver in anatomy is also the presence of numerous anastomoses between the portal vein and neighboring organs: the esophagus, stomach, anterior abdominal wall, hemorrhoidal veins, and the inferior vena cava. The venous blood supply to the liver in humans is such that during venous stagnation in the portal vein system, outflow through collaterals is activated, and this has a number of clinical manifestations.

LIVER FUNCTIONS

The main function of the liver in the human body is detoxification (neutralization). But other functions are also important because they affect the functioning of almost all organs and the body as a whole.

Main functions:

• detoxification: substances entering the blood from the intestines (after completion of the digestion process of food) and other organs of the abdominal cavity, as well as from external environment, are toxic, and hepatocytes, using a number of biochemical reactions, convert them into final products that are low-toxic for the body (urea, creatinine), and a number of hormones and biologically active substances are also deactivated;
• digestive – breakdown of fats due to the production of bile;
• metabolic: the liver takes part in all types of metabolism;
• excretory (excretory) - the production of bile and its secretion, due to which a number of metabolic products are eliminated (bilirubin and its derivatives, excess cholesterol);
• immune;
• hemodynamic: filtration of blood from the abdominal organs through the portal vein, deposition of up to 700 ml of blood removed from the bloodstream (for blood loss and other critical situations it enters the bloodstream).

Features of participation in metabolic processes:

Carbohydrate metabolism: maintaining a constant level of blood glucose due to its accumulation in the liver in the form of glycogen. Violation of this function – hypoglycemia, hypoglycemic coma.

Fat metabolism: breakdown of food fats by bile, formation and metabolism of cholesterol, bile acids.

Protein metabolism: on the one hand, the liver breaks down and transforms amino acids, synthesizes new ones and their derivatives. For example, proteins involved in immune reactions, blood clotting and blood clotting (heparin, prothrombin, fibrinogen) are synthesized. On the other hand, the formation of end products of protein metabolism occurs with their detoxification and excretion (ammonia, urea, uric acid). The consequence of these violations is hemorrhagic syndrome(bleeding), edema (due to a decrease in the concentration of proteins in the plasma, its oncotic pressure increases).

Pigment metabolism: synthesis of bilirubin from expired, hemolyzed red blood cells, transformation of this bilirubin and excretion in bile. Bilirubin formed directly after the destruction of red blood cells is called indirect, or free. It is toxic to the brain, and in hepatocytes, after combining with glucuronic acid, it enters the bile and is called direct. Problems with pigment metabolism are manifested by jaundice, changes in the color of feces, and intoxication phenomena.

Metabolism of vitamins, microelements: the liver accumulates vitamin B12, microelements (iron, zinc, copper), biological formation occurs in it active forms vitamins from their precursors (for example, B1), the synthesis of certain proteins with a specific function (transport).

LIVER DISEASES

The physiology of the liver is such that each of its functions listed above corresponds to many diseases, both congenital and acquired. They occur in acute, subacute, and chronic forms and are manifested by a number of common symptoms.

Many diseases ultimately lead to the development of hepatic cell failure and cirrhosis.

The main symptoms of liver disease:

• jaundice, that is, yellowness skin and visible mucous membranes. It occurs as a consequence of increased destruction (hemolysis) of red blood cells (hemolytic), disruption of the outflow of bile (mechanical, or obstructive), direct disruption of the processes of bilirubin conversion in the hepatocytes themselves (parenchymal);
• pain: localized in the right hypochondrium, usually a feeling of heaviness or mild, aching pain;
• asthenia (general weakness, fatigue);
• dyspepsia (bitterness in the mouth, nausea, vomiting, flatulence);
• discoloration of stool, red urine;
• skin manifestations: itching, dry skin, spider veins, pigmentation of physiological folds, redness of the skin of the palms (palmar erythema, or “liver palms”), xanthomas (subcutaneous lumps with yellowish skin above them);
• ascites (presence of free fluid in the abdominal cavity);
• “liver” odor from the mouth: as a consequence of disturbances in protein metabolism (neutralization of its final products).

The most common diseases and pathological conditions:

• Viral hepatitis A, B, C. The viral agent directly affects hepatocytes. Type A hepatitis is the most common, affecting children more often and is transmitted by the fecal-oral route. Viral hepatitis is manifested by jaundice and symptoms of intoxication. Subtypes B and C often lead to liver failure due to cirrhosis, the mode of infection is parenteral (through blood and other body fluids).
• Fatty hepatosis (fatty degeneration) – fats (triglycerides) accumulate in hepatocytes excessively (exceeding the norm many times), the process is focal or diffuse.
• Cirrhosis is a chronic process of inflammatory or degenerative nature, occurring with fibrosis and restructuring of the normal structure of the organ.
• Hepatocellular failure. A consequence of damage to a significant number of hepatocytes by various pathogenic agents (poisonous substances, toxins, alcohol, some medications, hepatitis viruses). In this case, all functions of the organ suffer, and hepatocerebral insufficiency syndrome occurs - headaches, sleep disturbances, psycho-emotional disorders, followed by impaired consciousness and the development of hepatic coma.
• Ascites. Accumulation of free fluid (transudate) in the abdominal cavity. A consequence of portal hypertension and a number of diseases not related to the liver. A frequent companion to ascites of hepatic origin is bleeding from varicose veins of the esophagus, dilatation of the saphenous veins abdominal wall(“jellyfish head”)

If you have liver problems, you can help:

• gastroenterologist;
• hepatologist – specialist in liver diseases;
• surgeon;
• oncologist;
• transplantologist;
• infectious disease specialist

The stable functioning of the entire body depends on the normal functioning of the liver and, conversely, malfunctions in other systems and organs, the influence of exogenous factors (infections, toxins, nutrition) can lead to problems with the liver, so you should be careful about your body as a whole, healthy image life and seek medical help in a timely manner.

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The human liver comes into contact with the following organs:

• diaphragm - a muscle that separates the chest and abdominal cavity;
• stomach;
• gallbladder;
• duodenum;
• right kidney and right adrenal gland;
• transverse colon.

The liver is located on the right under the ribs and has a wedge-shaped shape.

The organ has two surfaces:

• Diaphragmatic (upper) – convex, dome-shaped, corresponding to the concavity of the diaphragm.
• Visceral (lower) - uneven, with impressions of adjacent organs, with three grooves (one transverse and two longitudinal), forming the letter H. In the transverse groove is the portal of the liver, through which nerves and vessels enter and lymph vessels and bile ducts exit. In the middle of the right longitudinal groove is the gallbladder, in the posterior part is the IVC (inferior vena cava). The umbilical vein passes through the anterior part of the left longitudinal groove; the remainder of the ductus venosus of Aranti is located in the posterior part.

The liver has two edges - a sharp lower edge and a blunt upper-posterior edge. The upper and lower surfaces are separated by a lower sharp edge. The superior posterior margin looks almost like the posterior surface.

The structure of the human liver

It consists of very soft fabric, its structure is granular. It is located in a Glissonian capsule made of connective tissue. In the area of ​​the hilum of the liver, the Glissonian capsule is thicker and is called the hilar plate. On top, the liver is covered with a layer of peritoneum, which tightly fuses with the connective tissue capsule. There is no visceral layer of peritoneum at the site of attachment of the organ to the diaphragm, at the site of entry of blood vessels and exit of the biliary tract. The peritoneal layer is absent in the posterior area adjacent to the retroperitoneal tissue. At this point, access to the posterior parts of the liver is possible, for example, to open abscesses.

In the center of the lower part of the organ there is Glisson's gate - the exit of the biliary tract and the entrance of large vessels. Blood enters the liver through the portal vein (75%) and the hepatic artery (25%). The portal vein and hepatic artery in approximately 60% of cases are divided into right and left branches.

Take this test and find out if you have liver problems.

The falciform and transverse ligaments divide the organ into two unequal-sized lobes - right and left. These are the main lobes of the liver; in addition to them, there is also the caudal and quadrate lobes.

Parenchyma is formed from lobules, which are its structural units. In their structure, the lobules resemble prisms inserted into each other.

The stroma is a fibrous membrane, or Glissonian capsule, of dense connective tissue with septa of loose connective tissue that penetrate the parenchyma and divide it into lobules. It is pierced by nerves and blood vessels.

The liver is usually divided into tubular systems, segments and sectors (zones). Segments and sectors are separated by depressions - grooves. Division is determined by the branching of the portal vein.

Tubular systems include:

• Arteries.
• Portal system (portal vein branches).
• Caval system (hepatic veins).
• Biliary tract.
• Lymphatic system.

Tubular systems, except for the portal and caval veins, run next to the branches of the portal vein parallel to each other and form bundles. Nerves join them.

There are eight segments (from right to left counterclockwise from I to VIII):

• Left lobe: caudate – I, posterior – II, anterior – III, quadrate – IV.
• Right lobe: middle upper anterior – V, lateral inferoanterior – VI and lateral inferoposterior – VII, middle upper posterior – VIII.

Segments form larger areas - sectors (zones). There are five of them. They are formed by certain segments:

• Left lateral (segment II).
• Left paramedian (III and IV).
• Right paramedian (V and VIII).
• Right lateral (VI and VII).
• Left dorsal (I).

The outflow of blood occurs through three hepatic veins, which come together on the posterior surface of the liver and flow into the inferior cava, which lies on the border of the right part of the organ and the left.

The bile ducts (right and left), which remove bile, merge into the hepatic duct at the Glissonian hilum.

The outflow of lymph from the liver occurs through the lymph nodes of the Glissonian hilum, the retroperitoneal space and the hepatoduodenal ligament. There are no lymphatic capillaries inside the liver lobules; they are located in the connective tissue and flow into the lymphatic choroid plexuses, accompanying the portal vein, hepatic arteries, bile ducts and hepatic veins.

The liver is supplied with nerves from vagus nerve(its main trunk is the Lattarget nerve).

The ligamentous apparatus, consisting of the semilunar, falciform and triangular ligaments, attaches the liver to the posterior wall of the peritoneum and the diaphragm.

Liver topography

The liver is located with right side under the diaphragm. It occupies most of the upper abdominal cavity. A small part of the organ extends beyond the midline into the left part of the subphrenic region and reaches the left hypochondrium. From above it is adjacent to the lower surface of the diaphragm, a small part of the anterior surface of the liver is adjacent to the anterior wall of the peritoneum.

Most of the organ is located under the right ribs, a small part in the epigastric zone and under the left ribs. middle line coincides with the border between the lobes of the liver.

The liver has four boundaries: right, left, upper, lower. The organ is projected onto the anterior wall of the peritoneum. The upper and lower boundaries are projected onto the anterolateral surface of the body and converge at two points - on the right and left sides.

Location upper limit liver - right nipple line, level of the fourth intercostal space.

The apex of the left lobe is the left parasterial line, the level of the fifth intercostal space.

The anterior lower edge is the level of the tenth intercostal space.

The anterior edge is the right nipple line, the costal edge, then it departs from the ribs and stretches obliquely upward to the left.

The anterior contour of the organ has a triangular shape.

The lower edge is not covered with ribs only in the epigastric zone.

In diseases, the anterior edge of the liver protrudes beyond the edge of the ribs and is easily palpable.

Functions of the liver in the human body

The role of the liver in the human body is great; gland is one of the vital organs. This gland performs many different functions. The main role in their implementation is given to structural elements– hepatocytes.

How does the liver work and what processes occur in it? It takes part in digestion, in all types of metabolic processes, performs a barrier and hormonal function, as well as hematopoietic during embryonic development.

What does the liver do as a filter?

It neutralizes toxic products of protein metabolism that come with the blood, that is, it disinfects toxic substances, turning them into less harmless ones that are easily removed from the body. Thanks to the phagocytic properties of the endothelium of the liver capillaries, substances absorbed in the intestinal tract are neutralized.

It is responsible for removing excess vitamins, hormones, mediators, and other toxic intermediate and end products of metabolism from the body.

What is the role of the liver in digestion?

It produces bile, which then enters the duodenum. Bile is a yellow, greenish or brown jelly-like substance with a specific odor and a bitter taste. Its color depends on the content of bile pigments, which are formed during the breakdown of red blood cells. It contains bilirubin, cholesterol, lecithin, bile acids, mucus. Thanks to bile acids, fats are emulsified and absorbed in the gastrointestinal tract. Half of all the bile produced by liver cells goes into the gallbladder.

What is the role of the liver in metabolic processes?

It is called the glycogen depot. Carbohydrates that are absorbed by the small intestine are converted into glycogen in the liver cells. It is deposited in hepatocytes and muscle cells and, when there is a deficiency of glucose, begins to be consumed by the body. Glucose is synthesized in the liver from fructose, galactose and other organic compounds. When accumulated in excess in the body, it turns into fat and settles throughout the body in fat cells. The deposition of glycogen and its breakdown to release glucose is regulated by insulin and glucagon, the hormones of the pancreas.

The liver breaks down amino acids and synthesizes proteins.

It neutralizes ammonia released during the breakdown of proteins (it turns into urea and leaves the body with urine) and other toxic substances.

Phospholipids and other fats needed by the body are synthesized from fatty acids obtained from food.

What function does the fetal liver perform?

During embryonic development, it produces red blood cells - erythrocytes. The placenta plays a neutralizing role during this period.

Liver diseases are caused by its functions. Since one of its main tasks is the neutralization of foreign agents, the most common diseases of the organ are infectious and toxic lesions. Despite the fact that liver cells are able to quickly recover, these capabilities are not unlimited and can quickly be lost during infectious lesions. With prolonged exposure to pathogens, fibrosis can develop, which is very difficult to treat.

Diseases can appear not only as a result of direct effects on hepatocytes harmful factors, but as a result of poor nutrition, poor circulation and other things.

Pathologies usually develop in the form of dystrophy, bile stagnation, inflammation, and liver failure. Further disturbances in metabolic processes: protein, carbohydrate, fat, hormonal, enzymatic depend on the degree of damage to the liver tissue.

Diseases can occur in chronic or acute form, changes in the organ can be reversible and irreversible.

Liver failure

Characterized by disruption of the organ. One function, several or all at once may decrease. There are acute and chronic insufficiency, based on the outcome of the disease - non-fatal and fatal.

The most severe form is acute. In acute renal failure, the production of blood coagulation factors and albumin synthesis are disrupted.

If one liver function is impaired, there is partial failure, if several - subtotal, if all - total.

If carbohydrate metabolism is disturbed, hypo- and hyperglycemia may develop.

If fat is disturbed, cholesterol plaques are deposited in blood vessels and atherosclerosis develops.

If protein metabolism is disrupted, bleeding, swelling, delayed absorption of vitamin K in the intestine.

Portal hypertension

This is a severe complication of liver disease, characterized by increased pressure in the portal vein and blood stagnation. Most often develops with cirrhosis, as well as with congenital anomalies or thrombosis of the portal vein, when it is compressed by infiltrates or tumors. Blood circulation and lymph flow in the liver with portal hypertension worsens, which leads to disturbances in the structure and metabolism in other organs.

Diseases

The most common diseases are hepatosis, hepatitis, and cirrhosis.

Hepatitis is an inflammation of the parenchyma (the suffix -itis indicates inflammation). There are infectious and non-infectious. The first include viral ones, the second - alcoholic, autoimmune, and medicinal. Hepatitis occurs acutely or in chronic form. They can be an independent disease or secondary - a symptom of another pathology.

Hepatosis is a dystrophic lesion of the parenchyma (the suffix -oz indicates degenerative processes). The most common is fatty hepatosis, or steatosis, which usually develops in people suffering from alcoholism. Other reasons for its occurrence - toxic effect medicines, diabetes, Cushing's syndrome, obesity, long-term use of glucocorticoids.

Cirrhosis is an irreversible process and the final stage of liver disease. The most common cause is alcoholism. Characterized by degeneration and death of hepatocytes. With cirrhosis, nodules are formed in the parenchyma, surrounded by connective tissue. As fibrosis progresses, the circulatory and lymphatic systems deteriorate, liver failure and portal hypertension develop. With cirrhosis, the spleen and liver increase in size, gastritis, pancreatitis, stomach ulcers, anemia, dilation of the esophageal veins, and hemorrhoidal bleeding may develop. Patients become exhausted, they experience general weakness, itching of the entire body, and apathy. The functioning of all systems is disrupted: nervous, cardiovascular, endocrine and others. Cirrhosis is characterized by high mortality.

Developmental defects

This type of pathology is rare and is expressed by an abnormal location or abnormal shape of the liver.

Incorrect location is observed with a weak ligamentous apparatus, resulting in prolapse of the organ.

Abnormal forms are the development of additional lobes, changes in the depth of the grooves or the size of parts of the liver.

Congenital defects include various benign formations: cysts, cavernous hemangiomas, hepatoadenomas.

The importance of the liver in the body is enormous, so you need to be able to diagnose pathologies and treat them correctly. Knowledge of the anatomy of the liver, its structural features and structural division makes it possible to find out the location and boundaries of the affected foci and the degree of coverage of the organ by the pathological process, determine the volume of its part to be removed, and avoid disruption of the outflow of bile and blood circulation. Knowledge of the projections of liver structures onto its surface is necessary for performing operations to remove fluid.

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The liver is not the only secretory gland in the human body; there is also the pancreas. But the functions of the first cannot be replaced and compensated. The human liver is an exceptional “tool”, the main “forge” of metabolism, creating conditions for life activity and communication with the environment, and is part of the digestive tract system.

The liver is a vital organ involved in a number of biochemical processes in the human body.

What kind of organ is this?

The liver is a large human gland. If the pancreas is responsible for the necessary enzymes for breaking down foods, the liver plays the role of a screen, fencing off digestive tract from other parts of the body. She's the one who plays main role in neutralizing the consequences bad habits person. It is important to know where it is, what it looks like and how much it weighs.

Location

The topography of the liver is important in surgical therapy. It includes the structure of the organ, its location and blood supply.

The human liver fills the right upper region of the abdominal cavity. Externally it looks like a mushroom cap. Skeletotopy of the liver: located under the diaphragm, the top touches the 4th–5th intercostal space, the bottom at the level of the 10th intercostal space, and the anterior part near the 6th left costal cartilage. The top face takes on a concave shape that encloses the shape of the diaphragm. The lower (visceral) is divided by three longitudinal grooves. The abdominal organs leave curves on it. The diaphragmatic and visceral edges are separated from each other by a lower sharp edge. The opposite, superior posterior face, is blunt and is considered as a posterior plane.

Ligamentous apparatus

The anatomical formations of the peritoneum cover almost the entire liver, excluding the posterior plane and the gate, which are located at the muscular septum. The transition of ligaments from the diaphragm and other gastric viscera to it is called the ligamentous apparatus; it is fixed in the area of ​​the gastrointestinal tract. The liver ligaments are divided:

• Coronary ligament - tissue runs from the sternum to the posterior wall. The coronary ligament is divided into upper and lower layers, which converge towards each other, forming a triangular coronary ligament.
• Round - begins on the left in the longitudinal groove, reaches the gate of the liver. It contains the peri-umbilical and umbilical veins, which enter the portal veins. They connect it with the veins of the abdominal septum. Round ligament The liver closes with the anterior membrane of the falciform ligament.
• Crescent - runs along the line of connection of the lobes (right and left). The falciform ligament holds the diaphragm and the top of the liver together.

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Dimensions of a healthy organ

The size and weight of an adult human organ is a series of numbers that corresponds normal anatomy. An adult liver corresponds to the following indicators:

The size of a healthy liver for children and adults has certain indicators.

1. liver weight 1500 g;
2. right lobe, layer size 112 - 116 mm, length 110 - 150 mm;
3. inclined size of the right side up to 150 mm;
4. left lobe, layer size about 70 mm;
5. length and height of the left side is about 100 mm;
6. liver length 140 - 180 mm;
7. width 200 - 225 mm.

Normal size and weight of a child's gland in healthy condition depend on age characteristics and change as the child grows.

Structure and anatomy of the organ

Internal histology

The structure of the liver involves division into right and left parts (lobes). According to anatomy human liver, the oblong shape of the right lobe from the left is divided by a main fold. In the lobules, plates unite liver cells, which are penetrated by the blood sinusoid. The plane is divided by two grooves: longitudinal and transverse. The transverse one forms a “door” through which arteries, veins and nerves pass. The ducts and lymph come out.

Parenchyma and stroma represent histology. Parenchyma - cells, stoma - auxiliary tissue. Inside the lobules, the cells are in contact, and a bile capillary operates between them. Coming out of the lobules, they penetrate the interlobular canal and exit excretory ducts. The left and right ducts connect to form the common bile duct, which, exiting through the porta hepatis, carries bile into the small intestine. The joint duct includes two channels, but sometimes there can be three or more. There are no nerve endings in the body, but the outer shell contains a large number of nerve endings. As the organ enlarges, it compresses the nerve endings and causes pain.

The gallbladder is adjacent to the lower lobule. The anatomy of the gallbladder has such an internal structure that the bladder is actually the keeper of the bile that the cells produce. The secretion of bile is necessary for the complete digestion process. After the gallbladder is connected to the pancreas, bile meets the small intestine.

Features of blood supply

The structure of the liver is a complex mechanism. The blood supply is unique; liver cells are fed with venous and arterial blood. Sinusoids represent the capillary bed where mixed blood is located. The entire blood supply is divided into three parts:

• blood supply to the lobules;
• blood circulation inside the lobules;
• blood flow.

The portal vein and aorta provide blood supply to the lobules. At the gate, each incoming hepatic vessel branches into small arteries and veins:

• longitudinal;
• interlobar;
• segmental;
• aroundlobular.

Each of them is connected to a muscular component and a bile duct. Near them are the lymphatic vessels of the liver. The circumlobular artery is replaced by an intralobular capillary (sinusoid), and together outside organs form the main vein. Through it, the blood passes into single collecting veins, which enter the posterior empty vein. The unique structure of the blood circulation allows all venous and arterial blood to pass through the liver in a short period of time.

Lymphoid vessels

The lymphatic system consists of shallow and deep vessels. Shallow vessels are located on the surface of the liver and form a network. Small sinusoids extending to the sides cover the “tool” with a film. They extend from the low side, through the porta hepatis and the posterior renal diaphragmatic region. The visceral plane is also penetrated by vessels, into which capillaries partially penetrate.

The deep vessels begin in the network of lymphatic capillaries, which permeate the interlobular groove. The lymphatic network “accompanies” the vessels, bile ducts, and, leaving through the gate, forms lymph nodes. The process occurring in the nodes affects immune status body. Leaving the nodes, the lymph passes to the diaphragmatic nodes, and then to the nodes of the chest cavity. Shallow and deep vessels are connected. As a result, the abdominal lymph nodes unite the lymph of the pancreas, upper small intestine, stomach, spleen, and partly the liver and create the abdominal lymphatic plexus. The veins of the liver, connecting with the efferent vessels, formed the gastrointestinal trunk.

Basic functions of the liver in humans

The properties of the liver allow it to play a leading role in the digestive system, rather than simply processing substances:

• the process of bile secretion;
• detoxification function, which removes rotting products and toxic substances;
• active participation in metabolism;
• management of hormonal levels;
• affects the function of digestion in the intestines;
• energy resources and vitamins are reinforced and accumulated;
• hematopoietic function;
• immune function;
• storage where blood accumulates;
• synthesis and regulation of lipid metabolism;
• enzyme synthesis.

The pH level in the blood is controlled. Proper absorption of nutrients ensures a certain pH level. Eating certain foods (sugar, alcohol) leads to the formation of excess acid, and the pH level changes. The secretion of liver bile is close to alkaline (pH 7.5−8). An alkaline environment allows you to maintain a normal pH, due to which the blood is purified and the immune threshold increases.

Heredity, ecology, unhealthy lifestyle of a person expose the liver to disease various pathologies. Return to contents

Liver diseases

Violation of any of the functions leads to a pathological condition, on which the severity of the disease depends. What reason influences the disruption of the process? There are quite a few of them, but the main ones include alcohol, excess weight and unbalanced foods. The group of diseases includes all anatomical pathologies and is divided into groups:

1. initial inflammation and cell damage (hepatitis, abscess, steatohepatosis, liver enlargement, damage due to tuberculosis or syphilis);
2. traumatic disorders (rupture, gunshot injury, open wounds);
3. pathologies of the bile ducts (stagnation of bile, inflammation of the ducts, stones in the ducts, congenital pathologies);
4. vascular diseases (thrombosis, inflammation of the vein, fistulas, fistulas);
5. neoplasms (cyst, hemangioma, cancer, sarcoma, metastases);
6. helminthic infestations (ascariasis, leptospirosis, opisthorchiasis, echinococcosis);
7. congenital anomalies and hereditary diseases;
8. damage due to diseases of other body systems (heart failure, inflamed pancreas, close connection between the liver and kidneys, amyloidosis);
9. structural changes (cirrhosis, liver failure, coma);
10. low immune response.

The rapid development of any of the above diseases leads to cirrhosis or is accompanied by liver failure.

Signs of pathologies

Typical liver diseases are diagnosed based on the main signs, which are studied by a specialist. Sometimes difficulties arise when making a diagnosis; it depends on the individual, the complexity of the pathology, and concurrent diseases. Clinical picture manifestations of the disease are accompanied by the main symptoms:

• weakness;
• headache;
• heaviness in the liver area;
• yellowness of the skin;
• swelling;
• sweating and a strong smell of sweat;
• increase in size;
• change in stool color;
• feeling of bitterness in the mouth;
• white or brown coating on the tongue;
• temperature changes are possible.