3 A: Anatomy of Liver

Question 1

The liver consists of what lobes?

Answer 1

Right, left, quadrate and caudate lobes

***Which are composed of functional units called LOBULES

Question 2

What do lobules consist of ?

Answer 2

-Rows upon rows of hepatocytes

Question 3

How does blood flow past hepatocytes?

Answer 3

Via sinusoids from branches of the hepatic portal vein to the central vein of each lobule

Question 4

What do Canaliculi do?

What organ stores and makes bile?

Answer 4

-Carry bile

• Liver: makes
• Gall bladder: stores

Question 5

What does a lobule consist of (micro anatomy)

Answer 5

Central vein, hepatocytes, sinusoid, portal triad, bile duct, hepatic artery, and hepatic portal vein

**Hexagon shaped

Question 6

How does piggy liver differ from human liver lobules?

Answer 6

Microscopically the CT between the lobules is thick therefore when consuming it, it takes better.

Question 7

What is a portal triad (tetrad)?

Answer 7

1) portal vein
2) hepatic artery
3) bile duct
* 4) lymphatic vessel

Question 8

What are inside the sinusoids?

Answer 8

Hepatic macrophages called KUPFFER CELLS

Question 9

What are Kupffer cells?

Answer 9

Remove debris such as bacteria and worn-out RBCs

Question 10

What are bile canaliculi?

Answer 10

They run parallel to the sinusoids and drain bile produced by the hepatocytes

Question 11

Within each lobule, what is included?

Answer 11

Hepatocytes are arranged into HEPATIC CORDS separated by adjacent sinusoids.

Question 12

What happens to the arterial blood and venous blood?

Answer 12

They mix in the lobule

Question 13

What is the arterial blood flow through the liver?

Answer 13

1) Begins by delivering oxygenated blood from hepatic artery
2) Liver sinusoids
3) central vein
4) hepatic vein
5) inferior vena cava
6) R. atrium of heart

Question 14

What is the PORTAL blood flow through the liver?

Answer 14

1) Begins by delivering “Nutrient-rich”, deoxygenated blood from hepatic portal vein
2) Liver sinusoids
3) central vein
4) hepatic vein
5) inferior vena cava
6) R. atrium of heart

Question 15

What is the portal vein formed by?

Answer 15

1) Splenic vein (spleen)
2) inferior mesenteric vein (left colon, rectum)
3) superior mesenteric vein (right colon, s. intestine, pancreas)

Question 16

Anything going to your intestine goes thru what?

Answer 16

the portal system

Question 17

What are the sinusoids lined by?

Answer 17

Fenestrated endothelium (easy for exchange)

Question 18

What is unique about the endothelium in the sinusoids?

Answer 18

NO underlying basement membrane

Question 19

What do the fenestrations allow?

Answer 19

They permit blood plasma to wash freely over the exposed surfaces of the hepatocytes in the space of DISSE.

Question 20

What is the space of DISSE?

Answer 20

The perisinusoidal space (in between hepatocytes and sinusoids)

Question 21

Which direction does the sinusoidal blood flow?

Answer 21

Always TOWARDS the central vein

Question 22

Since substances in the plasma move freely into the spaces of Disse what must the liver do?

Answer 22

MUST have an extremely high lymph flow to PREVENT accumulation of interstitial fluid

Question 23

What happens if the pressure rises int he portal veins & sinusoids ?

Answer 23

Excessive amount sod fluid begin to transude into the lump and to leak through the outer surface if the liver capsule directly into the abdominal cavity producing ASCITES

Question 24

What is ASCITES?

Answer 24

• Greek for “bag or sac”

- Describes the condition of pathologic fluid accumulation whine the abdominal cavity.

Question 25

Do men and woman have intraperitoneal fluid? How much?

Answer 25

• Health men have little or none

- Women can have 20 ml depending on the phase of the menstrual cycle

Question 26

Why is the liver a prime site for the spread of cancerous cells (metastasis) from elsewhere in the body, especially from the GI tract, breast and lung ?

Answer 26

Because of its portal blood supply and extensive lymphatic circulation

Question 27

What is the First Pass Effect?

Answer 27

Most drugs absorbed form the GI tract enter the portal circulation and encounter the liver before they are distributed into the general circulation

Question 28

What happens to oral meds taken my mouth?

Answer 28

-They are absorbed out of the intestines into the portal system and will be first seen in the liver before circulated. Liver will degrade/metabolize medications

Question 29

What is the effect of a medication with 100% pass effect ?

Answer 29

It will be useless because all of it will get broken down by the liver
(The minute it is absorbed all of it got broken down and none went to circulation; try different method of administration of drug)

Question 30

Trace the hepatobiliary plumbing ?

Answer 30

R/L hepatic ducts–>common hepatic duct–>common bile duct