- Section 1 ICU organization and management
- Section 2 Pharmacotherapeutics
- Section 3 Resuscitation
- Section 4 The respiratory system
- Section 5 The cardiovascular system
- Section 6 The gastrointestinal system
- Part 6.1 Physiology
- Chapter 172 Normal physiology of the gastrointestinal system
- Chapter 173 Normal physiology of the hepatic system
- Part 6.2 Gastrointestinal monitoring
- Part 6.3 Gastrointestinal haemorrhage
- Part 6.4 Disordered gastric motility
- Part 6.5 The acute abdomen in the ICU
- Part 6.6 Pancreatitis
- Part 6.7 Jaundice
- Part 6.8 Acute hepatic failure
- Part 6.9 Acute on chronic hepatic failure
- Section 7 Nutrition
- Section 8 The renal system
- Section 9 The neurological system
- Section 10 The metabolic and endocrine systems
- Section 11 The haematological system
- Section 12 The skin and connective tissue
- Section 13 Infection
- Section 14 Inflammation
- Section 15 Poisoning
- Section 16 Trauma
- Section 17 Physical disorders
- Section 18 Pain and sedation
- Section 19 General surgical and obstetric intensive care
- Section 20 Specialized intensive care
- Section 21 Recovery from critical illness
- Section 22 End-of-life care
(p. 815) Normal physiology of the hepatic system
- Chapter:
- (p. 815) Normal physiology of the hepatic system
- Author(s):
William Bernal
and Alberto Quaglia
- DOI:
- 10.1093/med/9780199600830.003.0173
Hepatic blood inflow is from two sources—high-pressure, well-oxygenated blood from the hepatic artery and low-pressure, partly deoxygenated blood from the portal vein. Hepatic inflow is maintained by variation in flows in these two systems. Although less than a third of total blood flow is delivered via the hepatic artery, it is responsible for the majority of hepatic oxygen supply. The liver can be subdivided into eight functionally independent segments, each with its own vascular inflow, outflow, and biliary drainage. The tri-dimensional hepatic microstructure is complex with geographic heterogeneity of hepatocellular function, and resistance to toxic, ischaemic, and metabolic damage. The liver is central to a wide variety of synthetic, metabolic, and detoxification functions. The overall balance of activity may be altered rapidly in response to systemic inflammatory stimuli.
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- Section 1 ICU organization and management
- Section 2 Pharmacotherapeutics
- Section 3 Resuscitation
- Section 4 The respiratory system
- Section 5 The cardiovascular system
- Section 6 The gastrointestinal system
- Part 6.1 Physiology
- Chapter 172 Normal physiology of the gastrointestinal system
- Chapter 173 Normal physiology of the hepatic system
- Part 6.2 Gastrointestinal monitoring
- Part 6.3 Gastrointestinal haemorrhage
- Part 6.4 Disordered gastric motility
- Part 6.5 The acute abdomen in the ICU
- Part 6.6 Pancreatitis
- Part 6.7 Jaundice
- Part 6.8 Acute hepatic failure
- Part 6.9 Acute on chronic hepatic failure
- Section 7 Nutrition
- Section 8 The renal system
- Section 9 The neurological system
- Section 10 The metabolic and endocrine systems
- Section 11 The haematological system
- Section 12 The skin and connective tissue
- Section 13 Infection
- Section 14 Inflammation
- Section 15 Poisoning
- Section 16 Trauma
- Section 17 Physical disorders
- Section 18 Pain and sedation
- Section 19 General surgical and obstetric intensive care
- Section 20 Specialized intensive care
- Section 21 Recovery from critical illness
- Section 22 End-of-life care