{"id":5744,"date":"2017-06-05T01:23:45","date_gmt":"2017-06-04T17:23:45","guid":{"rendered":"http:\/\/https:\/\/medicine.nus.edu.sg\/pathweb\/?page_id=5744"},"modified":"2023-04-03T13:26:31","modified_gmt":"2023-04-03T05:26:31","slug":"i-overview-what-is-normal","status":"publish","type":"page","link":"https:\/\/medicine.nus.edu.sg\/pathweb\/pathology-demystified\/hepatobiliary-system\/i-overview-what-is-normal\/","title":{"rendered":"I. Overview: What&#039;s Normal"},"content":{"rendered":"\n\n\t<p>Understanding the pathology of hepatobiliary disease requires one to understand:<\/p>\n\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--label-0\" tabindex=\"0\" aria-controls=\"fl-accordion--panel-0\">Structure (Click to expand)<\/a>\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--icon-0\" tabindex=\"0\" aria-controls=\"fl-accordion--panel-0\"><i>Expand<\/i><\/a>\n\t\t\t\t\t<p>The main structural components of the hepatobiliary system :<\/p>\n<ul>\n<li>\n<ul>\n<li>Gross &#8211; Liver, intrahepatic and extrahepatic bile ducts, common bile duct, gallbladder<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2017\/06\/Anatomy-u5ldoz.jpg\" alt=\"\" width=\"1024\" height=\"799\" \/><\/p>\n<ul>\n<li>\n<ul>\n<li>Microscopic:\n<ul>\n<li>\n<ul>\n<li>Hepatocytes, bile duct cells (biliary tract epithelium), sinusoids within liver<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<ul>\n<li>\n<ul>\n<li>Organisation: Lobules vs Acini<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n&nbsp;<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>Refer to your excellent lecture notes on the Microanatomy of the liver<\/p>\n<ul>\n<li>\n<ul>\n<li>Note: Knowing the 2 main parenchymal cellular components helps make sense of the primary tumours that arise in the liver &#8211; hepatocellular or biliary epithlelial (glandular) in origin<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li>\n<ul>\n<li>Note that the liver is special because of dual blood supply:\n<ul>\n<li>\n<ul>\n<li>Portal vein (revise where it drains from!) \u00e0 main blood supply to liver<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<ul>\n<li>\n<ul>\n<li>Hepatic artery \u00e0 supplies biliary tract; provides minor proportion of blood supple to liver<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n&nbsp;<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--label-0\" tabindex=\"0\" aria-controls=\"fl-accordion--panel-0\">Function (Click to expand)<\/a>\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--icon-0\" tabindex=\"0\" aria-controls=\"fl-accordion--panel-0\"><i>Expand<\/i><\/a>\n\t\t\t\t\t<p>The main structural components of the hepatobiliary system :<\/p>\n<ul>\n<li>\n<ul>\n<li>The main <strong>FUNCTIONS<\/strong> of the liver :\n<ul>\n<li>\n<ul>\n<li><strong>Metabolism<\/strong>\n<ul>\n<li>\n<ul>\n<li>endogenous substances (lipids, carbohydrates, protein breakdown products)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<ul>\n<li>\n<ul>\n<li>exogenous substances (alcohol, drugs, toxins)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n&nbsp;<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<ul>\n<li>\n<ul>\n<li><strong>Synthesis of proteins<\/strong>\n<ul>\n<li>\n<ul>\n<li>Albumin, clotting factors<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<ul>\n<li>\n<ul>\n<li>Note: think about how liver failure may present clinically if these synthetic functions are lost<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n&nbsp;<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<ul>\n<li>\n<ul>\n<li><strong>Bile production<\/strong>\n<ul>\n<li>\n<ul>\n<li>Functions of bile &#8211; fat emulsification and hence absorption in gut; elimination of bilirubin and other waste products<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n&nbsp;<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n&nbsp;<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>\u00a0Note: The biliary tract does NOT produce bile. Hepatocytes do. Biliary tract drains bile into the gut.<\/p>\n\t<p><strong><u>The main Functions are elaborated on in the video in the next section<\/u><\/strong><\/p>\n\t\t\t<a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/pathology-demystified\/hepatobiliary-system\/i-overview-what-is-normal\/\" target=\"_self\" role=\"button\" rel=\"noopener\">\n\t\t\t\t\t\t\tI. Overview: What&#8217;s Normal\n\t\t\t\t\t<\/a>\n\t\t\t<a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/pathology-demystified\/hepatobiliary-system\/hepato-ii-clinicopathologic-correlates\/\" target=\"_self\" role=\"button\" rel=\"noopener\">\n\t\t\t\t\t\t\tII. Clinicopathologic Correlates\n\t\t\t\t\t<\/a>\n\t\t\t<a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/pathology-demystified\/hepatobiliary-system\/iii-main-diseases-approach\/\" target=\"_self\" role=\"button\" rel=\"noopener\">\n\t\t\t\t\t\t\tIII. Main Diseases: Approach\n\t\t\t\t\t<\/a>\n\t\t\t<a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/pathology-demystified\/hepatobiliary-system\/iv-liver-pots-approach\/\" target=\"_self\" role=\"button\" rel=\"noopener\">\n\t\t\t\t\t\t\tIV. Liver Pots: Approach\n\t\t\t\t\t<\/a>\n\t\t\t<a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/pathology-demystified\/hepatobiliary-system\/hepatobiliary-system-quiz\/\" target=\"_self\" role=\"button\" rel=\"noopener\">\n\t\t\t\t\t\t\tV. Hepatobiliary System: Quiz\n\t\t\t\t\t<\/a>\n\t\t\t<a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/pathology-demystified\/hepatobiliary-system\/hepatobiliary-system-one-page-summary-study-notes\/\" target=\"_self\" role=\"button\" rel=\"noopener\">\n\t\t\t\t\t\t\tHepatobiliary System: Study Notes and One Page Summary\n\t\t\t\t\t<\/a>\n\t\t\t<a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/pathology-demystified\/hepatobiliary-system\/\" target=\"_self\" role=\"button\" rel=\"noopener\">\n\t\t\t\t\t\t\tHepatobiliary System Chapter Home\n\t\t\t\t\t<\/a>\n\t\t\t<a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/pathology-demystified\/\" target=\"_self\" role=\"button\" rel=\"noopener\">\n\t\t\t\t\t\t\tPathology Demystified\n\t\t\t\t\t<\/a>\n\n","protected":false},"excerpt":{"rendered":"<p>Understanding the pathology of hepatobiliary disease requires one to understand: Structure (Click to expand) Expand The main structural components of the hepatobiliary system : Gross &#8211; Liver, intrahepatic and extrahepatic bile ducts, common bile duct, gallbladder &nbsp; Microscopic: Hepatocytes, bile duct cells (biliary tract epithelium), sinusoids within liver &nbsp; Organisation: Lobules vs Acini &nbsp; &nbsp; [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":5737,"menu_order":0,"comment_status":"open","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-5744","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v25.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>NUS Pathweb<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/pathology-demystified\/hepatobiliary-system\/i-overview-what-is-normal\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:description\" content=\"Understanding the pathology of hepatobiliary disease requires one to understand: Structure (Click to expand) Expand The main structural components of the hepatobiliary system : Gross &#8211; 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