Hepatic Blood Flow, and Zones- HIGH YEILD - USMLE Forums
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Old 11-30-2011
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Liver Hepatic Blood Flow, and Zones- HIGH YEILD

Quick question on a high yeild subject. I am a bit confused about blood flow to the liver and injuries.

Is this correct, and if not, can someone correct me?

The Liver has a dual blood supply: Portal Vein and Hepatic Artery.
Portal Vein- recieves blood from the GI system (SMA, IMA) and the Spleen. This accounts for the majority of the blood to the liver.

Hepatic Artery- comes off of the celiac artery, and is in the triad along with the portal vein and common bile duct.

They both dump blood into the sinusoids - goes to the central vein- then to the hepatic vein which drains in the IVC

Is this correct?
------------

Zones:

Blood flow goes from Zone III (portal vein, hepatic artery) to Zone I (central vein) and then the hepatic vein then IVC

Zone I-central vein- most susepctible to viral hepatitis.
Zone III- most suspectible to acetaminophen toxicity and fatty change. This is where P450 is, and this is where drug toxicities, alcohol hepatitis occurs

----

I'm pretty either all of this, or some of it is wrong.. Any help? My friend said she had 2 questions on this on her step... HIGH YEILD!!!!
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Old 11-30-2011
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yes thats pretty much it!!
ur pretty clear on that
jus an addition. hepatocytes hav pores in the basal side of their cells, which faces the sinusoides . this is so that drugs or large sized molecules can enter them.. and thei apical sides face the bile canaliculi!!!
all from FA
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Old 11-30-2011
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So I have a question then...


Which zone gets the least amount of o2? Is it the central vein or the portal vein?

I would assume its the central vein- thus no o2 means can't make free radicals, and thus you get acetaminophen toxicity there (centrilobular fatty change) and viral hepatitis.

ZONE III- damaged 1st with ischemia and alcoholic hepatitis, and p450. ??
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Old 12-01-2011
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Hey mate you are confused about zones and hepatic blood flow
Functionally, the liver can be divided into three zones, based upon oxygen supply. Zone 1 encircles the portal tracts where the oxygenated blood from hepatic arteries enters. Zone 3 is located around central veins, where oxygenation is poor. Zone 2 is located in between.
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Old 12-02-2011
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thanks for sharing this high yield stuff .you are correct sadke, Zone 3 is affected in ischemia first like in right heart failure where there is pooling of blood. Also druga cause centrilobular necrosis which is in Zone 3. But not sure about what all is specific for Zones 1 and 2.

Could some one answer this.
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