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It interacts with the cardio- Disse order 300 mg lopid mastercard, is separated from the sinusoid by a layer of sinu- vascular and immune systems order 300mg lopid with mastercard, it secretes important sub- soidal endothelial cells. Hepatocytes possess numerous, 514 CHAPTER 28 The Physiology of the Liver 515 The hepatic portal vein provides about 70 to 80% of the liver’s blood supply, and the hepatic artery provides the Stellate cell rest. Hepatic portal blood is poorly oxygenated unlike that from the hepatic artery. The portal vein branches repeat- Pericellular space edly, forming smaller venules that eventually empty into the sinusoids. The hepatic artery branches to form arteri- Tight junction oles and then capillaries, which also drain into the sinu- Bile canaliculus soids. As mentioned earlier, the hepatic sinusoid is Hepatocyte extremely porous and allows the rapid exchange of materi- Perisinusoidal space als between the perisinusoidal space and the sinusoid. The sinusoids empty into the central veins, which subsequently join to form the hepatic vein, which then joins the inferior Kupffer cell vena cava. Hepatic blood flow varies with activity, increasing af- Sinusoid ter eating and decreasing during sleep. Blood flow to the intestines and spleen and, in turn, in the portal vein is predominantly regulated by the splanchnic arterioles. In Sinusoidal this way, eating results in increased blood flow to the in- endothelial cells testines followed by increased liver blood flow. Portal hy- pertension is the most common complication of chronic liver disease and accounts for a large percentage of the finger-like projections that extend into the perisinusoidal morbidity and mortality associated with chronic liver space, greatly increasing the surface area over which hepa- diseases (see Clinical Focus Box 28. Endothelial cells of the liver, unlike those in other parts of the cardiovascular system, lack a basement membrane.

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As a result lopid 300 mg otc, the the apical surface of the cell discount lopid 300 mg with mastercard, where iodination takes place. The iodide used for iodination of the thy- Thyroid Hormones Are Formed From the roglobulin precursor protein comes from the blood perfus- Hydrolysis of Thyroglobulin ing the thyroid gland. The basal plasma membranes of fol- licular cells, which are near the capillaries that supply the When the thyroid gland is stimulated to secrete thyroid follicle, contain iodide transporters. These transporters hormones, vigorous pinocytosis occurs at the apical mem- move iodide across the basal membrane and into the cy- branes of follicular cells. The iodide transporter is an ac- brane reach into the lumen of the follicle, engulfing bits of tive transport mechanism that requires ATP, is saturable, the colloid (see Fig. Endocytotic vesicles or colloid and can also transport certain other anions, such as bro- droplets formed by this pinocytotic activity migrate to- mide, thiocyanate, and perchlorate. Lysosomes, cell to concentrate iodide many times over the concentra- which are mainly located in the basal region of resting fol- CHAPTER 33 The Thyroid Gland 599 Blood Follicular cell Lumen Tight junction Iodination and - coupling I MIT I- I- H2O2 Tg DIT Iodide T4 Tg transporter T3 Thyroglobulin (Tg) ER precursor Golgi Deiodination Endosomes Micropinocytosis DIT MIT T4 T4 Macropinocytosis Colloid T3 T3 Proteolysis droplet Secretion Lysosomes Pseudopod FIGURE 33. The lysosomes fuse with the colloid droplets with a buffer against drastic changes in circulating thyroid and hydrolyze the thyroglobulin to its constituent amino hormone levels as a result of sudden changes in the rate of acids. As a result, T4 and T3 and the other iodinated amino T4 and T3 secretion. T4 and T3 formed from the roid hormones have long half-lives in the bloodstream. The DIT and MIT Thyroid Hormones Are Metabolized by generated by the hydrolysis of thyroglobulin are deiodi- Peripheral Tissues nated in the follicular cell. The released iodide is then re- utilized by the follicular cell for the iodination of thy- Thyroid hormones are both activated and inactivated by roglobulin (see Fig.