Objectives of this presentation

Introduction to the liver and pancreas

Functions of liver and pancreas

Blood supply to the liver.

Anatomy and histology of liver and pancreas

Common diseases of liver and pancreas.

LIVER
 Liver
Hepar is the Latin name for the
liver.
Largest internal/gland organ in the
body (1.5 Kg )
Location: In the upper right
portion of your abdomen,
beneath the diaphragm and
above your stomach.
Liver Functions
1. Detoxification: remove of the poisonous substances.
2. Change the excess of glucose into glycogen.
3. Bile formation.
4. Maintain vitamins such as vitamin(A, D, K and B12).
5. Deamination: change the excess of amino acids into ammonia.
Liver Anatomy
Histology of the liver
Liver Cells
◦ Liver cells are called hepatocytes
◦ They are hexagonal in shape
◦ Liver cells are separated by a space called
Sinusoidal space
Liver Cells
◦ The structural unit of the liver is called a
Hepatic lobule

◦ It is a hexagonal structure made up of

hepatocytes (liver cells) arranged in a
chord like manner radiating from a
central vein to the boundaries of the
hepatic lobule.

◦ The central veins collect together to

form the heapatic vein
Portal Triad
◦ It is located in the peripheral area of the
lobule
◦ Contains three structures
◦ Portal Vein: Carries nutritious blood
from the digestive system
◦ Hepatic artery: carries oxygenated
blood
◦ Bile duct : Carries bile produced by
liver cells
Blood supply to the liver
The liver is supplied by two main blood vessels on its right lobe: the hepatic
artery and the portal vein. The portal vein brings venous blood from the spleen,
pancreas, and small intestine so that the liver can process the nutrients and
byproducts of food digestion.
The Hepatic vein takes deoxygenated blood ( blood  without oxygen)
from liver to the heart.
The Hepatic artery take oxygenated blood  ( blood  with oxygen) from
heart to the liver.
The Hepatic portal vein take blood containing digested food from the
small intestine to the liver.
PANCREAS
 Pancreas
 It is a big gland ( 6 inches long ).
 location: behind the stomach, it looks like plant
leaf between the c-shaped of the duodenum and
the spleen.
 Pancreas means “All Flesh” in Greek.
 This gland is the only gland called compound
gland (heterocrine gland) because it do two
functions at the same time(Endocrine+ Exocrine)
function while the other glands in the human
body just do only one function ( Endocrine).
 The Endocrine function
This function is done without duct (ductless).

Islets of Langerhans contain two types of cells:

Beta cells which secrete insulin hormone
Alpha cells which secrete glucagon hormone

Both of insulin and glucagon goes directly into

the blood with out duct
The Exocrine function
This function is done by ducts
(By Pancreatic duct)
Pancreatic acini produce  pancreatic
juice which contain digestive enzymes,
the pancreatic duct take the
pancreatic enzymes to the small
intestine (duodenum).
Pancreas Anatomy
Histology of pancreas
 Overview
◦ The pancreas is both an exocrine accessory digestive organ and a
hormone secreting endocrine gland(Compound Gland).
◦ The endocrine function is done without the aid or use of ducts.
◦ The pancreas is covered by a thin capsule made of
loose connective tissue.
◦ The parenchyma consists of pancreatic acini and sparsely scattered
pancreatic islets surrounded by stroma of loose connective tissue.

*Stroma: the supportive tissue of an epithelial organ, tumour, gonad, etc., consisting of connective tissues and blood vessels
*Parenchyma: the functional tissue of an organ.
Exocrine pancreas(Secretory units)
◦ The exocrine component of the pancreas makes up about 98% of the
pancreatic tissue.
◦ The bulk of the pancreatic tissue is formed by the exocrine
component, which consists of many serous pancreatic acini cells.
◦ These acini synthesize and secrete a variety of enzymes essential to
successfully “rest and digest”.
◦ They are formed out of simple epithelium
◦ Pancreatic acini are lined with columnar cells(which majorly are for
absorption but in this case secretion)

* Serous: producing serum

 Exocrine pancreas(Secretory units)
DUCT SYSTEM:
1. Intercalated ducts: ducts through which the pancreatic secretions
leave the acini.
The initial of it is lined by simple squamous epithelial cells called
centroacinar cells, then these cells are continued by simple cuboidal
ductal cells that line the extra-acinar portion of the intercalated ducts
which extends outside the acinus.
2. Intralobular ducts: ducts which the intercalated ducts drain into,
which are lined by simple cuboidal epithelium.
3. Interlobular ducts: larger caliber ducts which the intralobular ducts
flow into, they are located within the interlobular connective tissue
septa. These are also lined by cuboidal epithelium that becomes
taller and more stratified as the size of the ducts increases.
◦ The blood supply of the pancreas is transported by two main vessels, arteries
and veins.
◦ We have:
I. Intralobular pancreatic vein: from lobule (inside)
II. Interlobular pancreatic vein: from between lobules (outside)
III. Intralobular pancreatic artery: to lobule (inside)
IV. Interlobular pancreatic artery: from between lobules (outside)
◦ And as mentioned earlier there are the intralobular and interlobular pancreatic
ducts.
Endocrine pancreas
◦ The endocrine component makes up about 2% of the pancreas, which is
represented by about 1-2 million pancreatic islets (of Langerhans).
◦ These islets are demarcated from the rest of the parenchyma by a delicate sheath
of reticular fibers.
◦ The endocrine component is a much smaller, but equally important,
portion of the pancreas. It is composed of pancreatic islets, which appear
as islands of cells dispersed between the pancreatic acini.
◦ These islet cells produce and secrete hormones that regulate glucose,
lipid and protein metabolism.

*Demarcate: separate or to set boundaries or limits of.

* Islets of Langerhans: islands of Langerhans(name of scientist who discovered it).
HISTOLOGY OF ENDOCRINE PANCREAS
The endocrine units of the pancreas are scattered among the exocrine acini as
isolated, pale-staining, and highly vascularized units called pancreatic islets (of
Langerhans). Each islet is surrounded by fine fibers of the reticular connective
tissue. With special immunocytochemical staining processes, four cell types can be
identified in each pancreatic islet: alpha, beta, delta, and pancreatic polypeptide
(PP) cells. Th e principal cells are the alpha, beta, and delta. Other cells in the
pancreatic islets, including the PP cells, are considered minor cells. Alpha cells
constitute about 20% of the islets and are located primarily around the islet
periphery. Th e beta cells are most numerous, constituting about 70% of the islet
cells, and are primarily concentrated in the center of the islet. Th e remaining cell
types are few in number and are located in various places throughout the islets
SECTION VIEW OF
PANCREATIC ISLET
FUNCTION OF ENDOCRINE
PANCREAS
The endocrine components of the pancreas are scattered throughout the organ as islands of
endocrine cells called pancreatic islets (of Langerhans). Pancreatic islets secrete two major
hormones that regulate blood glucose levels and glucose metabolism. Alpha cells in the pancreatic
islets produce the hormone glucagon, which is released in response to low levels of glucose in the
blood. Glucagon elevates blood glucose levels by accelerating the conversion of glycogen, amino
acids, and fatty acids in the liver cells into glucose, which is then released into the bloodstream.
Beta cells in pancreatic islets produce the hormone insulin, whose release is stimulated by elevated
blood glucose levels after a meal. Insulin lowers blood glucose levels by accelerating membrane
transport of glucose into liver cells, muscle cells, and adipose cells. Insulin also accelerates the
conversion of glucose into glycogen in liver cells. The effects of insulin on blood glucose levels
are exactly opposite to that of glucagon Delta cells secrete the hormone somatostatin. This
hormone decreases and inhibits secretory activities of both alpha (glucagon-secreting) and beta
(insulin-secreting) cells through local action within the pancreatic islets. Pancreatic polypeptide
cells produce the hormone pancreatic polypeptide, which inhibits the production of pancreatic
enzymes and alkaline secretions from the acinar cells
Endocrine pancreas
◦ Islets of Langerhans are composed of two types of cells:
1. Alpha cells(α):
 These secrete glucagon hormone, which increases the blood glucose level. How?

Low blood glucose Glucagon goes to liver

level • Stimulates hepatocytes Normal blood glucose
• α secrete glucagon • Breakdown of glycogen level is maintained
Endocrine pancreas
2. Beta cells(β):
These secrete insulin hormone, which decreases the blood glucose level. How?

High blood glucose level Insulin goes to liver

• β secrete insulin • Stimulates hepatocytes Normal blood glucose
• Excess glucose is converted to
glycogen(storage)
level is maintained
Exocrine pancreas Endocrine pancreas

Secretory units: Secretory units:

pancreatic acini islets of Langerhans

Cells: acinar cells, Cells: A α-(alpha)

centroacinar cells cells, B β-(beta) cells 

Products: peptidases, Products: insulin,

lipases, amylolytic glucagon,
enzymes, nucleolytic
enzymes
Diseases associated with the pancreas
Diseases associated with Liver
Liver diseases
◦ There are many kind of liver disease:
Diseases caused by viruses such as hepatitis A,B,C,D,E
Diseases caused by drugs , poisons, or too much
example include fatty liver diseases and alcohol
cirrhosis.
Liver cancer.
 inherited diseases, such as hemochromatosis and
Wilson disease
The 5 types of viral hepatitis
Viral infections of the liver that are classified as hepatitis include hepatitis
A,B,C,D and E.
A different virus is responsible for each type of virally transmitted hepatitis.
Hepatitis A is always an acute , short-term disease.
while hepatitis B,C and D are mostly likely to become ongoing and chronic .
Hepatitis E is usually acute but can be particularly dangerous in pregnant
women.
Hepatitis E
◦ It is an inflammation of the liver caused by the infection with the Hepatitis E Virus (HEV).
◦ It is transmitted mainly by fecal or oral transmission
◦ Its symptoms are nausea and jaundice(yellowish or greenish pigmentation of the skin or white
part of the eye)
◦ It spreads by the means of contaminated water, undercooked seafood and is endemic in pork
◦ It mainly acute and does not require treatment but can be chronic in HIV patients
Liver cancer
Liver cancer is cancer that begins in the cells of your
liver.
 there are several types of cancer can form in the
liver.
The most common type of liver cancer is
hepatocellular carcinoma, which begins in the main
type of liver cell (hepatocyte)
Other types of liver cancer, such as intrahepatic
cholangiocarcinoma and hepatoblastoma, are much
less common.
Pancreatitis
What is it ?
An inflammation in the pancreas
Causes
Gallstones and scorpion stings
Types
Acute Pancreatitis
 Symptoms : Fever , Higher Heart Rate , vomiting , etc.
Chronic Pancreatitis
Symptoms : Constant Pain , Diarrhea, weight loss , etc.
Treatment
Diabetes
What is it ?
Increase in the blood glucose level
Types
Type 1 Diabetes
Type 2 Diabetes
 Gestational Diabetes
Symptoms: Thirst , weight loss , Extreme hunger , presence of ketones in the urine.
Treatment
 DIABETES
Diabetes is a syndrome of impaired carbohydrate, fat, and protein metabolism caused
by either lack of insulin secretion or decreased sensitivity of the tissues to insulin.
Types
Type I diabetes: is caused by lack of insulin secretion
Type II diabetes: is initially caused by decreased sensitivity of target tissues to the
metabolic effect of insulin
Gestational diabetes: caused by production of insufficient insulin during pregnancy
Symptoms
These include thirst, weight loss, extreme hunger and presence of ketones in urine
Treatment
Type I is treated through injection of insulin, while in type II dieting and exercise are
usually recommended on an attempt to induce weight loss If this fails, drugs may be
administered to increase insulin sensitivity or to stimulate increased production of
insulin by the pancreas.
Pancreas cancer
◦ A disease in which malignant cells form in the tissue of the pancreas.
◦ Causes : Changes in your DNA cause cancer
◦ Symptoms: Treatment:
Chemotherapy