Liver Cirrhosis

our mother has to do ground biology admit is in videos please make sure to subscribe to our deployment group for the latest videos please visit Facebook at mon-sol they're going to please like and here you could also ask questions answer questions and post some interesting things including your outwards P also change the quality settings to the highest one for better graphics in this video we're going to talk about the complications and symptoms that can be associated with liver cirrhosis liver cirrhosis is when we have fibrosis and starring of the liver healthy liver cells is replaced with inflammatory cells and fibrous tissues this will lead to cell death of the liver cells the scarring and fibrosis and the cell death in a company in cirrhosis will cause the liver to shrink before we delve into the complications associated with liver cirrhosis we need to familiarize ourselves with some organs that can be affected by liver cirrhosis so here is a human body and here is a liver suffering cirrhosis notice the nodules below the liver we have the gallbladder the liver and gallbladder will release bile from the common bile duct into the small intestines here the common bile duct will actually join with the duct coming from the pancreas as well the bile is used to emulsify fat for absorption as well as many other things and we won't focus on the pancreas in this video other organs that can be affected in cirrhosis include the esophagus that is part of the digestive tract and connects the mouth with the acidic stomach here the stomach then connects to the small intestines the small intestines will connect to the large intestines the ascending colon of the large intestines that is and then the ascending colon will join with the transverse and then the descending colon where feces will then be expelled from the rectum here so what is important to know with all these digestive organs is that they are supplied with fresh oxygenated blood from the heart this red artery here coming from the heart this spleen is also an organ that is supplied by this fresh oxygenated blood and is also affected or damaged in liver cirrhosis so when all these organs have received this fresh blood from this red artery then they will blood will that leave through the veins and will relieve from these digestive organs via the vein with deoxygenated blood and nutrients the veins leaving most of these digestive organs will not travel directly to the heart but will travel travel to the liver first so all the blood leaving these digestive organs will connect and travel into the liver through what's called the portal vein the liver not only receives this blood supply from all these digestive organs this intestine stomach and spleen but also receives fresh oxygenated blood from the heart through the hepatic artery so the liver receives blood from two sources hepatic artery fresh oxygenated blood and the portal vein which is blood supply coming from the digestive organs the liver will then process this and the blood will then travel out of the liver through the hepatic vein and connect to the inferior vena cava where it will return to the heart now if they did not make any sense to you I have a video on a liver blood supply which is very useful other organs that can be affected by cirrhosis which I will talk about in this video include the lungs and the brain and the kidneys which I am NOT drawing yet liver cirrhosis in general can cause two main problems which can then cause other problems but they are all associated together essentially these two problems are liver cirrhosis can cause is liver damage itself and also portal hypertension let us focus on port hypertension first as this can have a significant impact on the human body remember the portal vein is the blood supply that travels through the liver from the veins coming out of other digestive organs so portal hypertension is hypertension of this portal vein portal hypertension is where the fibrosis and scarring of the liver will lead to the block would leave to the blocking of blood flow through the liver and so we will have a portal vein bypass the pressure in the portal vein will increase because it cannot get through the liver and will result in blood flow going backwards essentially I hope that makes sense let us zoom into the liver area and portal vein to understand more about the complications associated with portal hypertension due to liver cirrhosis let us review quickly the organs that can be affected with a portal hypertension first so here is a liver the gallbladder the esophagus connected to the stomach stomach the small intestines small intestines large intestines I've only drawn the ascending and descending colon of the large intestines here and in the rectum and finally the spleen all the veins returning deoxygenated blood and nutrients from these organs will flow through the liver first before joining into the inferior vena cava and so here the gastric vage will join the portal vein the splenic vein will join the portal vein the intestine veins which are made up of predominantly the inferior mesenteric vein will return blood from the descending large intestines and the superior mesenteric vein will return blood to the portal vein from connected to the portal vein from the ascending transverse and small intestines so all these veins will join to the portal vein which will not only provide the liver with deoxygenated blood but will provide the liver with nutrients for processing because the veins leaving the intestines for example are absorbing nutrients of we eat the blood entering the liver will then leave the liver through the hepatic vein and connect with the inferior vena cava which will then return blood to the heart when we have liver cirrhosis it can cause blockage of blood flow through the liver due to fibrosis and liver scarring the blockage can really occur anywhere along the portal vein entering the liver this will cause the this will cause portal vein bypass the blood cannot go through because the pressure in the portal vein is increasing causing blood to flow backwards towards areas such as the stomach and esophagus when the blood flow when the blood flows backwards towards the esophagus it can cause esophageal varices esophageal varices is caused by portal hypertension when we have blocking of blood flow through the liver through the portal vein and this will result an increase of pressure in the portal vein the increased pressure will cause blood to bypass and go backwards to back towards the stomach and esophagus so back towards the esophagus and gastric vein which will result an increase in pressure there the increase in pressure will cause varices esophageal varices and we can have bleeding from these varices which can be very serious the splenic vein also normally carries blood to the liver via the portal vein and so portal hypertension can cause blood flow back to the spleen causing enlargement of the spleen also known as splenomegaly so splenic vein joins to the portal vein increase in pressure in the portal vein as in portal hypertension will cause blood flow bypass back to the spleen spleen normally removes older red blood cells and white blood cells and platelets so a blocked blood flow from this blade to the liver will cause up accumulation of cells in the spleen and this will cause enlargement of the spleen also known as splenomegaly what would this mean for the body well if all these red blood cells white blood cells and platelets are accumulating in the liver and can't get out if we would check the blood of this person suffering from liver cirrhosis he would have thrombocytopenia on low blood a low platelet count which means that there would be insufficient clotting for the body and then he will have anemia which would mean that there's poor oxygen supply and he would have a leukopenia meaning that he would have low white blood cell count in the blood and this would mean that he will be more prone to infection and all these there are only their low amounts of these cells because they're all killing the liver because the blood can't really flow out properly remember another problem due to the portal hypertension can coming where the veins coming from the rectum can't flow back out this would lead to hemorrhoids a condition known as hemorrhoids so that's another condition for liver cirrhosis now portal hypertension due to cirrhosis can also cause other serious complications in chronic cases such as hepatic insula bethey normally ammonium from protein and amino acids metabolism is eliminated in bile from the liver however due to this port due to this due to the bypass digital portal hypertension detoxification of ammonia cannot occur and so excess ammonia can then reach the brain causing hepatic and xalapa thie causing loss of concentration loss of memory confusion decreased las' levels of consciousness coma and even death another complication which is related to liver damage as well as portal hypertension is hepatic pulmonary syndrome hepatic pulmonary syndrome is seen about one third of cases of cirrhosis to understand what happens in this syndrome we have to just recap about our circulatory system so remember we have here the lungs and the heart the blood from those two inferior vena cava superior vena cava enters the heart enters the right atrium and then exits out to be reoxygenate in the lungs the re oxygen bubble going to come back to the heart through the left atrium and then be pumped out of the heart to the rest of the body now the pathophysiology of hepatic pulmonary syndrome is not fully understood but there are a few ideas in advanced cirrhosis the liver will start secreting hormones such as endothelium one and also cause common bile duct ligation endothelial one is a basal constrictor it causes smooth muscles to contract for example however in Advent in in the absence of smooth muscles such as in the lung capillaries it will cause vasodilation by releasing nitric oxide and oh let's have a look so here with endothelial endothelium is traveling up to the heart and then into the lungs let's zoom into the lungs and to see what what happened how the end of sealant causes nitric oxide secreted so here we have sacks of alveoli the deoxygenated blood will come in to be reoxygenate about the alveoli and then return back to the heart let's have a closer look at one of the oldest the alveolus will essentially bring in oxygen and bring out carbon dioxide from the lungs from our body first we will look at a normal gas exchange so if here we have deoxygenated blood flow from the heart it will come to the alveolus and receive oxygen which will then bind to red blood cells and then flow back to the heart so we have fresh oxygenated blood what happens it advanced cirrhosis when we have endothelial one being secreted is that it will bind on the capillary cells and cause nitric oxide to be secreted which will cause vasodilation and increase in blood flow this would mean that a lot of red blood cells flowing through won't be replenished with oxygen because there's too much flow and a buildup of pressure so it's uneven common bile duct ligation will actually cause leukocytes to start migrating to the pulmonary capillaries as well which will further stimulate the secretion of nitric oxide therefore we could say that hepatic pulmonary syndrome is induced by pulmonary vasodilation induced by nitric oxide this will cause an insufficient oxygen supply due to different pressures in the capillaries and alveolus this will also cause difficulty in breathing and all this is due mainly by the secretion of hormones are by the livers from liver suffering advanced cirrhosis such as the hormone in those dillard one now let's focus more on liver damage due to liver cirrhosis hepatic carcinoma can occur because of uncontrolled multiplication of liver cells for recovery of lost cells hepatocellular carcinoma is cancer of the liver symptoms include pain swelling hepatomegaly and weight loss we would see a lost we would see a lot of cells dying in liver cirrhosis and so we there might be uncontrolled multiplication of liver cells because as a homeostatic mechanism complications with cirrhosis also include jordiz yellowing of the skin which is pretty obvious this is because our we might have intrahepatic obstruction of bile flow from the liver and gallbladder into the small intestines and so bilirubin which is supposed to be part of the bile being released in the small intestines will accumulate and cause an increased level of increased bilirubin bilirubin level in the plasma and so yellowing of the skin people suffering from the liver cirrhosis might have a pronounced yellowing of the skin look I'm just drawing how the common bile duct here connects with the small intestines to show how blood flow is a bile flow is meant to release bile into the small intestines but an obstruction involved flow will result in jaundice now the blood of the blood leaving the heart the atrium blood supply will supply fresh oxygenated blood to many organs for example the inferior a Horta will supply our blood to organs including that of the kidneys here we have two kidneys that is supplied with fresh oxygenated blood the blood leaving the kidneys are the kidney veins and they will connect with the inferior vena cava which will then bring the deoxy blood back to the heart it will not connect with the liver it will just connect with the inferior vena cava straight away now a complication that can occur due to debt liver damage caused by liver cirrhosis also a syndrome is known as hepatorenal syndrome there is actually no damage to the kidneys but kidney perfusion is reduced the blood flow is reduced why would Kim perfusion be reduced what an example is because of insufficient blood supply to the kidneys to see what happens we would first try to see why we would have insufficient blood supply to the kidneys it's actually all portal hypertension fault for obstruction of blood flow through the liver somewhere because remember we have all this blood flowing from all these organs back to the liver so if we have an obstruction of the portal hypertension or portal hypertension the blood will flow backwards and cause increase in pressure in different tissues around the abdominal region this can cause a condition known as aside when we have fluid leaking out of the capillaries due to the build-up of pressure in the portal vein this will cause blood to flow backwards causing a buildup of pressure elsewhere and then fluid will leak out into the abdominal cavity this will cause the stomach to look very big something like a Dean of the stomach and this is very dangerous as infections can easily occur in people with acid so because all the fluid is accumulating in the stomach and the fluid is not returning properly to the heart the heart will think that it does not have enough a blood supply hypovolemia and so will induce some homeostatic mechanism to cause an increase in fluid volume there will be arterial vasodilation not atrial vasodilation dilation or as I wrote here there will be arterial systemic values of dilation to try to include increased blood flow to the organs the kidneys because it is not receiving enough blood in a fluid it will activate the renin-angiotensin-aldosterone system this will stimulate the reabsorption of water and sodium from the kidneys which will therefore increase water and sodium levels in the body to compensate for this lack of a blood supply so capita renal syndrome is when we have no actual damage to the kidneys but due to hypovolemia low fluid volume in the blood the kidneys will activate the renin-angiotensin-aldosterone system which will cause an increase in sodium and water reabsorption but the thing is we don't really need any more water and sodium because we already have heaps it's just water and sodium are in the abdominal cavity or just aren't flowing through the liver properly this will then lead to more complications such as edema the increase in water volume will cause swelling of the hands and ankles the feed I hope that made sense now pitching is another symptom of liver cirrhosis because of the high levels of uric acid in the skin which can't be cleared by the liver I hope you enjoyed this video on liver cirrhosis it might have been boring and there might have been some mistakes but it's interesting to know how all these complications do connect with each other thank you

Channel: Armando Hasudungan

Views: 935,771

Keywords: liver cirrhosis, portal hypertension, hepatic syndrome, hepatic encelopathy, hepatic pulmonary syndrome, hepatic renal syndrome, ascite, complications, pathophysiology of cirrhosis, pathophysiology, disease, liver disease, cancer of the liver, spleenomegaly, conditions, symptoms, Cirrhosis (Disease Or Medical Condition), physiology, function of the liver, portal vein, blood supply, mesenteric artery vein, diagram, jaundice, edema, oesophageal varices, esophageal varices, anatomy

Id: f-Fxlsb2dtQ

Length: 20min 9sec (1209 seconds)

Published: Fri Jun 21 2013