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Old 02-20-2014
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Default Goljan audio mistake (about liver) ??????

Hi guys I am going to post some notes written about Goljan audio, I would like you to correct me if I am wrong but I believe a mistake was made. Here is what is written

Blockage of hepatic vein leads to budd chiari and liver becomes congested. Which part of liver is most susceptible to injury normally? Around central vein, b/c it gets first dibbies on O2 coming out of the sinusoids (zone 1). Zone 2 is where yellow fever will hit (midzone necrosis) due to ides egypti. Zone 3, around portal vein, which will have least O2 (analogous to renal medulla, which only receives 10% of the blood supply, and the cortex receives 90%). Fatty change is around zone 3 (part around central vein). Therefore, when asking about acetaminophen toxicity, which part is most susceptible? Around the central vein b/c it gets the least amount O2, and therefore cannot combat free radical injury.

In my belief

Zone 1= area closest to the portal triad ( hepatic artery , portal vine, bile/hepatic duct).

zone 2= area in between the portal triad (area) and the central vein(area).

zone 3 = area immediately surrounding central vein. = "last dibbies on oxygen not first"

Also I believe that :

zone 1= most oxygen, least susceptible to oxygen deprivation injury).

zone 3= least oxygen most suceptible to oxygen deprivation necrosis a la coagulation necrosis (possible causing a hemorrhagic infarct)?

zone 2= yellow fever--> in mid zone necrosis in the area in between triad and central vein?

If I am worng please correct me !

PS,I have a question someone please describe fatty change in liver due to oxygen deprivation or free radical injury.

thanks in advance !!!!!
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