Liver structure and function: lobule, zonation and hepatic metabolism
The dual blood supply, the lobule and acinus, the cells of the sinusoid, metabolic zonation and why zone 3 bears paracetamol, ischaemic and alcohol injury, the liver's roles in glucose, protein, ammonia and drug handling, and hepatic clearance worked through extraction ratio and bioavailability.
Tier 1Medical sciences concept
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- The liver receives about 1.5 L/min (25% of cardiac output) from two sources: portal vein 75% of flow, hepatic artery 25%. Each supplies about half the oxygen.
- Blood runs from portal triads through sinusoids to the central vein, so oxygen and solutes fall along the way. Hepatocytes along that path specialise, called metabolic zonation.
- Zone 3 (around the central vein) is hypoxic and rich in CYP2E1. That explains paracetamol, ischaemic and alcohol injury patterns.
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Sources
- Sleisenger and Fordtran's Gastrointestinal and Liver Disease (11th ed.)Elsevier (Feldman, Friedman, Brandt, 2021), 2021
- Sherlock's Diseases of the Liver and Biliary System (13th ed.)Wiley-Blackwell (Dooley, Lok, Garcia-Tsao, Pinzani, 2018), 2018
- Kietzmann T. Metabolic zonation of the liver: the oxygen gradient revisited. Redox Biol 2017;11:622-30Redox Biology, 2017
- Verbeeck RK. Pharmacokinetics and dosage adjustment in patients with hepatic dysfunction. Eur J Clin Pharmacol 2008;64(12):1147-61European Journal of Clinical Pharmacology, 2008
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Deploy to Cloudflare on push to main