www.surgicalnotes.co.uk

The Liver

30% cardiac output (70% portal vein / 30% hepatic artery from coeliac axis) 

Functions of the liver

1. Storage: Vitamin ADK, folate, B12, Ferritin
2. Metabolic
   • Carbohydrate - glycogen storage, gluconeogenesis
   • Lipid: Ketone bodies, cholesterol, PLs, lipoproteins
   • Protein: protein synthesis
3. Endocrine
   • Breakdown of steroid hormones
   • Vitamin D metabolism
4. Coagulation
   • Produces clotting factors
5. Other
   • Generates heat
   • Breaks down red cells
   • Extramedullary haemopoesis

Liver function tests

1. Bilirubin / unconjugated bilirubin
2. Enzymes
   • AST, ALT: from injured hepatocytes
   • ALP: raised in cholestasis
3. Plasma proteins
   • Albumin (alpha fetoprotein is embryonic albumin)
   • Globulins
4. Clotting studies 

[Bile]