ANATOMY AND

PHYSIOLOGY
HEPATOBILLARY TREE
 GALLBLADDER
1. A pear-shaped membranous sac on the undersurface of the
right lobe of the liver just below the lower ribs.
2. It is generally about 7.5 cm (about 3 in) long and 2.5 cm (1 in)
in diameter at its thickest part;
3. It has a capacity varying from 1 to 1.5 fluid ounces.
a. The body (corpus)
b. Neck (collum) of the gallbladder extend backward, upward,
and to the left.
c. The wide end (fundus) points downward and forward,
sometimes extending slightly beyond the edge of the liver.
4. Structurally, the gallbladder consists of:
a. An outer peritoneal coat (tunica serosa)
b. A middle coat of fibrous tissue and unstriped muscle (tunica
muscularis)
c. An inner mucous membrane coat (tunica mucosa).
HEPATOBILLARY TREE
 GALLBLADDER

Function:
a. Store bile secreted by the liver
b. Transmission of bile from gallbladder via the
cystic and hepatic ducts, until it is needed in the
digestive process.
c. Releases bile through the biliary ducts into the
duodenum to aid digestion by promoting
peristalsis and absorption, preventing
putrefaction, and emulsifying fat.
LIVER
Some of the functions are:
a. Produce substances that break down fats
b. Convert glucose to glycogen
c. Produce urea (the main substance of urine)
d. Make certain amino acids (the building blocks
of proteins)
f. Filter harmful substances from the blood (such
as alcohol)
g. Storage of vitamins and minerals (vitamins A,
D, K and B12)
h. Maintain a proper level or glucose in the blood
HEPATOBILLARY TREE
DUODENUM
Largely responsible for the breakdown of food in the small
intestine.
Brunner's glands - secrete mucus
- found in the duodenum
Wall is composed of:
a. A very thin layer of cells that form the muscularis
mucosae.
b. The duodenum is almost entirely retroperitoneal.
c. The pH in the duodenum is approximately six.
d. It also regulates the rate of emptying of the stomach
via hormonal pathways.
DUODENUM
CYSTIC DUCT

Functions:
a. Bile can flow in both directions
between the gallbladder and the common
hepatic duct and the (common) bile duct.
b. Bile is stored in the gallbladder in
between meal times and released after a
fatty meal.
CYSTIC DUCT
TRANVERSE COLON

Functions:
The large intestine is mainly responsible
for storing waste, reclaiming water,
maintaining the water balance, and
absorbing some vitamins, such as
vitamin K.
GALLBLADDER
BILIRUBIN
1. A substance that gives bile its color.
2. It is formed from senescent red blood cells.

Process of degradation:
a. The hemoglobin from the red blood cell is broken down from
biliverdin, which is rapidly converted to free bilirubin thru
biliverdin reductase.
b. Free bilirubin, which is not soluble in plasma, is transported in
the blood attached to plasma albumin. (Even when it is bound to
albumin, this bilirubin is still called free bilirubin.)
c. As it passes through the liver, free bilirubin is released from its
albumin carrier molecule and moved into the hepatocytes.
d. Inside the hepatocytes, free bilirubin is converted to
conjugated bilrubin thru glucoronyl transferase, making it soluble
to bile.
 e. Conjugated bilirubin is secreted as a constituents of bile, and in
this form, it passes through the bile ducts into the small intestine.
f. In the intestine, approximately one half of the bilirubin is
converted into a higly soluble substance called urobilinogen by the
intestinal flora.

g. Urobilinogen is either absorbed into the portal circulation or

excreted in the feces. (Most of the urobilinogen that is absorbed is
returned to the liver to be re-excreted into the bile.)

h. A small amount of urobilinogen, approximately 5% is absorbed

into the general circulation and then excreted by the kidneys.

3. Usually, only a small amount of bilirubin is found in the blood; the

normal level of total serum bilirubin is 0.1 to 1.2 mg/dL.

4. Laboratory measurements of bilirubin usually measure the free and

the conjugated bilirubin as well as the total bilirubin. These are
reported as the direct (conjugated) bilirubin and the indirect
(unconjugated or free) bilirubin.
BILIRUBIN
PANCREAS
1. A small organ located near the lower part of the
stomach and the beginning of the small
intestine.
2. Two main functions:
a. As an Exocrine organ
1. Producing digestive enzymes
b. As an Endocrine organ
2. Producing hormones
Insulin - most important hormone
produced by the pancreas.
3. Secretes its digestive enzymes
4. Secretes its variety of hormones directly into the
bloodstream.
PANCREAS
GALLSTONE
GALLSTONE PANCREATITIS
GALLSTONE PANCREATITIS
CHOLELITHIASIS