13.3 - Liver and Hepatic Pathologies

Question 1

Hepatic diverticulum

Answer 1

= the structure of the liver that arises from embryonic endoderm

Question 2

Cystic diverticulum

Answer 2

• gives rise to gall bladder and pancreas (liver and pancreas both have exocrine and endocrine functions)

Question 3

Common hepatic duct

Answer 3

• in the adult
• the common hepatic duct collects the exocrine outflow of the liver draining from the left and right hepatic duct
• cystic duct is a diversion off of the common hepatic duct connecting it with the gall bladder

Question 4

Cystic duct

Answer 4

= diversion from the common hepatic duct

- connects it with the gall bladder, which stores and concentrates the continuously-produced bile

Question 5

Common bile duct

Answer 5

• the common hepatic duct drains ingot he common bile duct
  = the outflow path to the duodenum
• joins with the main pancreatic duct
• ultimately controlled by Sphincter of Oddi

Question 6

Sphincter of Oddi

Answer 6

• controls the flow from the common bile duct which is joined by the main pancreatic duct
• relaxes in response to cholecystokinin (CCK) –> secreted in the duodenum

Question 7

Describe the dual blood supply received by the liver

Answer 7

1) Arterial blood from hepatic artery
2) venous blood from (hepatic) portal vein
- both of these vessels with the common bile duct transit the liver in a transverse fissure = port hepatic
- Blood leaves the liver via the separate hepatic vein

Question 8

Porta hepatis

Answer 8

= a transverse fissure in the liver

- the site of entry for the hepatic artery, hepatic portal vein and common bile duct

Question 9

Portal triads

Answer 9

= common tubes of CT in the liver where entering blood and exiting bile travel alongside one other
= portal canals
- lymph circulation in liver also uses this route

Question 10

What is the route for blood leaving the liver

Answer 10

• not through the portal triads

- blood goes into central veins –> drain to sublobular veins–> drain to hepatic vein

Question 11

Describe the varying organizational structures of the liver

Answer 11

• interlacing tubes of portal triads and central veins divide the stroma of the liver into lobules
  a) hepatic (or classic) lobule = tissue centered around central veins
  b) portal lobule = tissue centered around a portal triad
  c) hepatic acinus = roughly corresponds to one incoming central artery and its drainage area to two central veins

Question 12

Hepatic sinuses

Answer 12

• surround the hepatocytes arranged in plates
• route for blood from the portal triad to the central vein
• contains mixed arterial and venous blood
• within he sinuses = Kupffer cells (resident macrophages)

Question 13

Space of Disse

Answer 13

= between the sinus endothelium and the hepatocyte

= functionally important area –> hepatocytes have access to components of the plasma

Question 14

Kupffer cells

Answer 14

= resident macrophages of the liver

- are within the hepatic sinuses

Question 15

Hepatic stellate cells

Answer 15

= perisinusoidal cells
= fat-storing cells
= Ito cells
--> generate collagen in pathological states
- are within the space of Disse

Question 16

Bile

Answer 16

= exocrine product of the liver

- secreted via a different surface of the hepatoctye into bile canaliculi

Question 17

Briefly Describe the vessel system the carries bile from hepatocytes out of the liver

Answer 17

• hepatocytes membranes form the bile canaliculi
• bile canaliculi join and tavel through short Canals of Hering –> to form bile ductules of the portal triad
• Bile ductules are lined by distinctive cuboidal cholangiocytes

Question 18

Bile ductules

Answer 18

• are formed from the canals of Hering
• part of the portal triad
• lined by distinctive cuboidal cholangiocytes

Question 19

Glisson’s Capsule

Answer 19

• CT that largely surrounds the liver, except where it is adventitial to the gall bladder
• glisson’s capsule + serosal surface of the gall bladder are continuous with the serosa lining the peritoneal cavity