Cirrhosis of the liver

Cirrhosis of the liver

During the progression of liver cirrhosis the hepatocytes and liver lobules are destroyed. This causes the metabolic functioning of the liver to decline. The functional liver tissue is replaced by scar tissue, forming nodules that are wrapped with the scar tissue. As scar tissue is very fibrous, it essentially strangles the functional tissue. The constriction within the lobules of the liver then causes the flow of bile and blood to be restricted. The restriction of blood flow causes an increased pressure in the portal venous system (portal hypertension), due to the blood not having a free flow through the liver and into the inferior vena cava.

Alcoholic Cirrhosis

Alcoholic Cirrhosis is caused by an excessive amount of alcohol consumption over a long period of time. The metabolism of the liver is altered by alcohol and causes an increased production of triglycerides and fatty acids. This eventually leads to the hepatocytes being filled with fat, at this stage it is reversible.

Post-necrotic Cirrhosis

Post-necrotic cirrhosis or post-hepatic cirrhosis is an advanced liver disease which has been caused by chronic hepatitis B, chronic hepatitis C, or from a cause that is not known. 

Biliary Cirrhosis

Biliary cirrhosis is caused by a blockage in the flow of bile within the liver. The retention of bile destroys some of the functional liver tissue, namely near the bile ducts.

Treatment is multifaceted and is designed to slow down the progression of the disease.

Possible Diet Restrictions

• A restricted salt intake to help reduce fluid retention.

• Fluid restrictions, also to reduce fluid retention.

• Possible vitamin supplements including the B group vitamins and vitamins A, D and E.

Some Medications Used

• Diuretics to increase urine output.

• Laxatives to remove excess ammonia from the colon and bowel.

• Antibiotics if an infection is present.

• Beta blocker to lower hepatic venous pressure.

• Vitamin K, folic acid and ferrous sulphate for anaemia and to lower the bleeding risk.

Paracentesis

To reduce the amount of fluid accumulation in the peritoneal cavity (abdominal cavity) fluid is drawn out in a procedure called paracentesis. This can be done in an attempt to reduce shortness of breath the person may be experiencing due to extra pressure being placed on the lungs, or to reduce the ascites if diuretics are not working, or for diagnostic testing of the fluid. A doctor provides local anaesthesia and has the patient sitting up comfortably so that the organs are sitting towards the posterior of the body. The doctor then inserts a catheter or needle into the abdominal cavity to draw out the fluid.

Read more about liver cirrhosis.

Anatomical and Directional Language Basics

Anatomical and Directional Language

Superior - towards the head or above. eg. your thigh is superior to your knee.

Inferior - away from the head or below. eg. your abdomen is inferior to your neck.











Anterior or ventral - towards the front of the body. eg. your sternum is anterior to your spine.

Posterior or dorsal - towards the back of the body. eg. your spine in posterior to your sternum.

Medial - towards the middle of the body. Imaging a vertical line down the center of your body when standing. This is the medial line. eg. your oesophagus is medial to your shoulder.

Lateral - away from the middle of the body. Imagine the same vertical line, except this time we are moving away from it. eg. your shoulder is lateral to your oesophagus.

Proximal - we use this with limbs. It means that the specific part of the limb is closer to where it attaches to the body. eg. your knee is proximal to your ankle.

Distal - also used with limbs. It means that the specific part of the limb is further from where the limb attaches  to your body. eg. your wrist is distal to your elbow.

Superficial - nearer to the body's surface. eg. your skin is superficial to your bones.

Deep - further away to the body's surface. eg. your bones are deep to your skin.

Axial - the main trunk of the body. Including abdomen, head and neck.

Appendicular - the limbs. Arms, legs and their attachments.

Welcome

Picture Source: Nurse Uncut

Welcome to Nurses Need to Know Anatomy and Physiology. As a student nurse I have struggled to find the money needed for essential textbooks used by my lecturers. I want to be able to help future student nurses to be able to access the essential information needed for their courses, so I am creating a series of blogs to provide the needed information. It will take me some time to build up the amount of information you all need, but I hope to assist as many future nurses as possible.

While I am directing the blogs at nurses, the information contained in these blogs may be just as useful for other students.

I am still a student myself, so there may be a delay in posting when I have assignments due!