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Sistem Hepatobiliar
Sistem Hepatobiliar
Fixatie Hepar :
1.Pars affixa hepatis/bare area of the liver
2.Ligamentum falciforme hepatis
3.Ligamentum teres hepatis
4.Omentum minus ( ligamentum hepatogastrica dan ligamentum hepatoduodenale)
Permukaan hepar :
1. Facies diafragmatica terdapat :
- facies ventrale : terdapat struktur lig.faciforme, lig. teres hepatis
- facies cranialis : terdapat struktur pars.affixa hepatis,ligament coronaria Ant/Pst dan
triangulare Dex/Snt
- facies dorsalis : terdpt.struktur Vena Cava inferior + impres. oesopagus.
2. Facies visceralis (caudalis) terdapat :
- Lobus caudatus, lobus quadratus, Vesica felea pd fossa vesica felea
- Porta hepatis/hillus hepar terdpt : a.hepatica, v.porta, dt hepaticus
Lanjutan, facies visceralis hapatis terdapat :
- Tuber omentalis hepatis
- Ligament falciforme, teres hepar
- Ligament venosum Arantii
- Impressio : colica dextra, renalis dextra, gastrica duodenalis
Vascularisasi Hepar :
1. Nutritive:- aliran darah a. hepatica propria cab.a.hepatica communis
2. Fungsionil :- v. porta hepatica menerima darah vena dari organ abdomen
Fungsi Hepar:
1. Excocrin : menghasilkan empedu ikut mencernakan lemak
2. Endokrin ikut metabolime glucosa
3. Menghasilkan albumin/plasma hemoglobin
4. Metabolisme kh, lemak, protein
5. Detoksikasi racun-racun yg terserap dari usus
Letak :
Intra peritoneum, Tepi inferior hepar dengan garis mid clavicular dextra
Pembagian :
- fundus - ductus cysticus (terdapat valvula spiralis)
- collum - corpus
Vascularisasi :
A. cystica cabang dari a. hepatica
V. Cystica menuju V.hepstica
Fungsi :
1. menyimpan empedu
2. mengentalkan empedu konsentretet
Blood and Bile Flow
Enterohepatic Circulation
• Merupakan sirkulasi
dari lever dan
intestine
• Bilirubin dikeluarkan
ke usus dan
diabsorbsi,
kemudian kembali
lagi ke hepar
• Sebagian akan
dikeluarkan melalui
feces
1858
Bilirubin Production & Metabolism:
stercobilin
Etiology Of Jaundice:
Impaired of
Increase of
Clearance
production
Portal Hypertension
Physical
• Signs of portosystemic collateral
formation.
• Dilated veins in abdominal wall
• Caput medusa
• Rectal hemorrhoids
• Ascites
• Umbilical hernia
Signs of Liver Disease
• Ascites
• Jaundice
• Palmar erythema
• Asterixis
• Testicular atrophy, gynecomastia
• Muscle wasting, Dupuytren
contracture
• Splenomegaly
Caput Medusa
Tractus Hepatobiliaris
10
1 P 11
5
7 9
1 2 3 4 6 8 D
H
VF
Figure 23.25
Regulation of Bile Release
2 Cholecystokinin
and secretin enter the
bloodstream
Figure 23.25
Regulation of Bile Release
3 Bile salts
and secretin
transported via
bloodstream
stimulate liver
to produce bile
more rapidly
2 Cholecystokinin
and secretin enter the
bloodstream
Figure 23.25
Regulation of Bile Release
4 Vagal stimulation causes
weak contractions of
gallbladder
3 Bile salts
and secretin
transported via
bloodstream
stimulate liver
to produce bile
more rapidly
2 Cholecystokinin
and secretin enter the
bloodstream
Figure 23.25
Regulation of Bile Release
4 Vagal stimulation causes
weak contractions of
gallbladder
3 Bile salts
and secretin
transported via
5 Cholecystokinin bloodstream
(via bloodstream) stimulate liver
causes gallbladder to produce bile
to contract and more rapidly
hepatopancreatic
sphincter to relax;
bile enters
duodenum
2 Cholecystokinin
and secretin enter the
bloodstream
Figure 23.25
Regulation of Bile Release
4 Vagal stimulation causes
weak contractions of
gallbladder
3 Bile salts
and secretin
transported via
5 Cholecystokinin bloodstream
(via bloodstream) stimulate liver
causes gallbladder to produce bile
to contract and more rapidly
hepatopancreatic
sphincter to relax;
bile enters
duodenum
2 Cholecystokinin
and secretin enter the
bloodstream