Medical Surgical Nursing

the junction where the common bile duct enters the duodenum, controls the

flow of bile into the intestine.

FUNCTIONS OF THE LIVER

1 - Glucose Metabolism

 After a meal, glucose is taken up from the portal venous blood by the liver and

converted into glycogen, which is stored in the hepatocytes.

 Subsequently, the glycogen is converted back to glucose and released as needed

into the bloodstream to maintain normal levels of blood glucose.

 Additional glucose can be synthesized by the liver through a process called

gluconeogenesis. For this process, the liver uses amino acids from protein

breakdown or lactate produced by exercising muscles.

2. Ammonia Conversion

 Use of amino acids from protein for gluconeogenesis results in the formation of

ammonia as a byproduct. The liver converts this metabolically generated

ammonia into urea.

 Ammonia produced by bacteria in the intestines is also removed from portal

blood for urea synthesis. In this way, the liver converts ammonia, a potential

toxin, into urea, a compound that can be excreted in the urine.

3. Protein Metabolism

 The liver synthesizes almost all of the plasma proteins (except gamma

globulin), including albumin, alpha and beta globulins, blood clotting factors,

specific transport proteins, and most of the plasma lipoproteins.

 Amino acids serve as the building blocks for protein synthesis.

 Vitamin K is required by the liver for synthesis of prothrombin and some of the

other clotting factors.

4. Fat Metabolism

 Fatty acids can be broken down for the production of energy and the production

of ketone bodies.

 Ketone bodies are small compounds that can enter the bloodstream and provide

a source of energy for muscles and other tissues.

 Breakdown of fatty acids into ketone bodies occurs primarily when the

availability of glucose for metabolism is limited, as during starvation or in

uncontrolled diabetes.