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Block 4 > Liver And Gallbladder > Flashcards

Liver And Gallbladder Flashcards

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1
Q

What are the characteristics of liver

A

It is the largest organ (1.5kg in adults)
Covered by peritoneum
Located in upper right hypochondrium below diaphragm
two lobes right (large) and smaller left separated by falciform ligament
Two smaller lobes (anterior) quadrate lobe (posteria) caudate lobe on inferior surface

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2
Q

What is the smallest unit of liver

A

Numerous tiny lobules surrounded by delicate fibrous membrane

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3
Q

What is the vessel running through all lobules

A

Central vein / introlobular vein

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4
Q

What are the vessels that are surrounding every lobule

A

Hepatic artery
Portal vein / interlobular vein
Hepatic duct/interlobular bile duct

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5
Q

What are the capillaries that mover within the hepatocytes called

A

Sinusoids

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6
Q

What are the other cells that roam within sinusoid

A

Endothelial cells

Phagocytic kupfer cells

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7
Q

Functions of liver and gallbladder

A
  1. Blood reservoir= contains about 350 ml of blood
  2. Blood filters= bacteria from intestines are removed by kupffer cells
  3. Blood production in fetus
  4. destruction of aged blood
  5. production of plasma proteins
    6 detoxification/inactivation of substances= hormones and toxic substances
    By conjugation to glucoronic acid or sulphuric acid or by methylating or oxidation
  6. Metabolism of proteins, fats and carbohydrates= synthesis of amino acids
    Most plasma proteins such as albumin fibronogen and globulin,
  7. Stores iron vitamins and copper
    9.Biler formation and excretion and secretions= secretory product:bile salts
    Excretory products: bile pigment
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8
Q

Explain pathway of bile

A 
Starts as canaculi
Bile duct
Common hepatic duct
Cystic duct
Common bile duct
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9
Q

Where does common bile duct open

A

Duodenum 8cm below pyloric duodenal junction

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10
Q

What encloses bile in duodenum

A

Sphincter of oddi

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11
Q

Explain function of splinter of oddi

A

The sphincter contracts so that bile is collected in common bile duct
And goes back to cystic duct and to gallbladder for storage

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12
Q

Which duct connects with common bile duct before entering duodenum

A

Pancreatic duct

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13
Q

How much bile is secreted dailyq

A

250 ml - 1100 ml

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14
Q

Where is bile stored

A

Gallbladder

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15
Q

Which mechanism are responsible in bile secretion

A

Parasympathetic system
Hormone secretion
CCK and gastric

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16
Q

What aver the substances that stimulate bile secretion

A

Cholerectics

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17
Q

Name products contained in bile

A

Bile salts, bile pigment, cholesterol, steroid hormone metabolites, T3 hormone, sodium bicarbonate.

18
Q

What is bile role in fat digestion

A

Emulsify fats into small droplets making them more accessible to fat digesting enzyme lipase

19
Q

What forms bile salts

A

Cholesterol and amino acids

20
Q

Name the two primary bile acids

A

Cholic acid and chenodeoxychdic acid

21
Q

What are the secondary bile acids

A

Glycocholic and taurocholic acid

22
Q

Explain production of bile salts using primary and secondary acids

A

Primary acids are synthesised from cholesterol
They are conjugated to glycine and taurine to form secondary acids

They react with sodium and potassium in alkaline bile to form bile salts

23
Q

What do bile acids do

A

Inudued in digestion and absorption of fat
they regulate their ow synthesis from cholesterol by hepatocytes
Function as choleretics
May increase colon motility/ laxative

24
Q

What are your primary acids converted to?

A

Cholic acid= deoxycholicacid

Chenodeoxycholic acid = lithocholic acid

25
Q

How many percent do the primary acid occupy

A

75% pass unaltered along intestine and 25% of the primary are converted into secondary acids by intestinal bacteria

26
Q

Name the principal bile pigments

A

Biliverdin and metabolite bilirubin

27
Q

80% of pigments are derived from where?

A

Haemoglobin

28
Q

20% of pigments are derived from!

A

Myoglobin and cytochromes and bind to albumin

29
Q

What replaces albumin in liver

A

Glucoronic acid

30
Q

Explain jaundice in adults

A

Bilirubin glucoronide complex exerted in bile

Excessive bilirubin production or reduced excretion due to liver disease or bile duct obstruction leads to jaundice

31
Q

What are the important excretion mechanism

A

Conjugation of glucuronic acid and bilirubin

Or glucuronic acid and other substances this produces excess water

32
Q

Explain conjugation

A

Occursin hepatocyts and catalysed by glucuronyl transferase

33
Q

Explain jaundice in neonates

A

Glucuronide formation is impaired due to transferase deficiency

34
Q

What does morphines and phenobarb do to bile

A

Morphine increases bile duct pressure

Phenobarb stimulates glucoronyl transferase activity

35
Q

What is bilirubin replaced with in intestines

A

Stercobilin causing brown discolouration of faeces
Some pigment reabsorbed and excreted by kidneys as urobilin
With hepatitis excretion fails= jaundice

36
Q

Functions of gallbladder

A

Storage of bile
During interdigestive perils sphincter of odds closes
Bile flows into relapsed gallbladder
Bile becomes concentrated 5-10 fold
Mucosa reabsorbs water and electrolytes rapidly

37
Q

Name two mechanism for bile contraction

A

Neurogenically= via vagus nerve
Chemically-when chyme e reaches intestines, fatty acids and protein products stimulate release of
Cholecystokinin this hormone stimulates contraction

38
Q

What do gallstones contain

A

Cholesterol and calcium bilirubinate

39
Q

How do gallstones form

A

It bilirubin glucuronide is deconjugated the free bilirubin combines with calcium toform calcium bilirubinate which is highly insoluble this leads to cholecystitis needing cholecystectomy

40
Q

What is hepatio regeneration

A

The ability for the liver to regenerate

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