Accessory Digestive Organs Flashcards

1
Q

Major functions of liver:

A
  • Detoxification of metabolic waste (e.g., deamination of AA’s
    ➔ urea)
  • Metabolism & detoxification of drugs & toxins (e.g., alcohol,
    antibiotics)
  • Destruction of senescent RBC’s
  • Recycling of Hb via synthesis & secretion of bile
  • Synthesis of plasma proteins (clotting factors, albumin,
    lipoproteins)
  • Miscellaneous metabolic functions (fat, carbohydrate,
    proteins, etc.)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

(Liver function) *Detoxification of metabolic waste (e.g., deamination of AA’s
➔ _____)

A

urea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Products of digestion enter liver via ________

A

hepatic portal V

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

hepatic portal V Also carries potentially toxic compounds absorbed from ___
to liver to be conjugated or detoxified

A

diet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Oxygenated blood supplied to liver by _____, a branch of
celiac trunk ➔ R/L hepatic Aa in hepatic lobules

A

hepatic A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Oxygenated blood supplied to liver by hepatic A, a branch of
celiac trunk ➔ ______ in hepatic lobules

A

R/L hepatic Aa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

R/L hepatic Aa – Carries only ~20-25% of blood to liver; mixes with
_____ blood from portal V to perfuse liver cells

A

unoxygenated blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Liver is a nutrient rich, but ____ poor environment

A

O2 poor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Venous drainage of lobules via ____ ➔ hepatic V ➔
IVC

A

central Vv

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Venous drainage of lobules via central Vv ➔ hepatic V ➔
___

A

IVC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Cell types found in liver:

A

hepatocytes, endothelial cells, kupffer cells, and stellate cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

(cells in liver) – main functional cell, arranged in plates or cords
around sinusoids

A

Hepatocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

(cells in liver
– line the sinusoids

A

Endothelial cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

(cells in liver)
* liver-specific macrophages

A

Kupffer cells –

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

(cells in liver)
–storage of Vitamin A

A
  • Stellate cells (Ito cells)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Describe Hepatocytes

A

Polyhedral, round nucleus,
displaced chromatin &
prominent nucleolus
* Most hepatocytes diploid,
but some polyploid &/or
binucleate
* Contain large #’s of
cytoplasmic granules (rER
& lysosomal products) &
storage products
* Aging hepatocytes
accumulate brown
pigment, lipofuscin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Hepatocytes–Contain large #’s of
______ (rER
& lysosomal products) &
storage products

A

cytoplasmic granules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Aging hepatocytes
accumulate brown
pigment, _____

A

lipofuscin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Individual hepatocytes
polygonal, arranged in
_______ paralleled
by venous sinusoids

A

anastomosing cords

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Individual hepatocytes
polygonal, arranged in
anastomosing cords paralleled
by ______

A

venous sinusoids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Sinusoids lined by sinusoidal
lining cells, a _____
endothelium, with gaps
between endothelial cells

A

discontinuous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Hepatic cords & sinusoids
supported by meshwork of
_____

A

reticulin fibers (Type III
collagen)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Within sinusoids & space of
Disse are _______ cells

A

phagocytic Kupffer
cells (M)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Occasional _____ cells
between hepatocytes—fat-
storing cells containing lipid
droplets, used for Vit A & D
storage

A

stellate or Ito cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

storing cells containing lipid
droplets, used for Vit A & D
storage

A

stellate or Ito cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

The liver has its own version of macrophage known
as the ______ .
Not only do these remove foreign particles,
they also work with the spleen to destroy old RBCs.

A

Kupffer cell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

remove foreign particles,
they also work with the spleen to destroy old RBCs

A

Kupffer cell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

major storage site
for vitamin A.

A

stellate cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

In liver injury, it becomes a
transitional cell or
myofibroblast-like cell capable
of synthesising collagen types I,
III and IV as well as laminin.

A

stellate cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Thin, discontinuous, highly fenestrated
endothelium that does not rest on a
basement membrane

A

Hepatic sinusoids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Hepatic sinusoids separated from the hepatocytes by
the ___

A

space of Disse or the
perisinusoidal space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Found in the liver between a
hepatocyte and a sinusoid. It contains
the blood plasma.

A

Hepatic sinusoids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Microvilli of hepatocytes extend into
this space, allowing proteins and other
plasma components from
the sinusoids to :

A

be absorbed by the
hepatocytes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Low resistance vascular channels that
allow blood to come into contact with
hepatocytes over a large surface area.

A

Hepatic sinusoids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Made by hepatocyte & secreted into bile canaliculi between cells

A

bile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Concepts of liver lobules:

A

Classical Hepatic Lobule
* Portal Lobule
* Hepatic Acinus of Rappaport

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Cords of hepatocytes
arranged in _____

A

lobules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

—based on
blood flow; roughly
hexagonal, with central V in
middle of lobule

A

Classic lobule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Classic lobule—based on
blood flow; roughly
hexagonal, with central V in
middle of lobule
(= centrilobular V, terminal
hepatic venule)

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

(hepatic lobule) Outer margin of each lobule
delimited by ___

A

thin, connective
tissue septum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

____
located at each
“corner”, contain
hepatic A, br. portal
V, L, & bile duct

A

Portal tracts/ triads

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

(Portal tracts/triads)
Portal tracts/ triads
located at each
“corner”, contain
___

A

hepatic A, br. portal
V, L, & bile duct

43
Q

(Portal tracts/triads)
Blood enters from
_____,
percolates through
sinusoids of lobule,
drains via central V

A

portal tracts

44
Q

(Portal tracts/triads)
Blood enters from
portal tracts,
percolates through
sinusoids of lobule,
drains via ____

A

central V

45
Q

____—triangular
area; based on bile flow
(opposite to blood flow)
–Portal triad in center &
central Vv at corners

A

Portal lobule

46
Q

—diamond–shaped
region between neighboring
central Vv

A

Acinus

47
Q

(Hepatic Ascini)
–Combines aspects of blood
flow, oxygenation, metabolism and pathology
–Acinus divided into zones 1,
2, & 3—
* Hepatocytes in different
zones have different
metabolic environments

A
48
Q

(Hepatic Ascini)

closest to portal tract, receives most
oxygenated blood;
also most susceptible to toxic injury

A

Zone 1—(perilobular zone = periportal)

49
Q

(Hepatic Ascini)
(intermediate zone)

A

zone w

50
Q

(Hepatic Ascini)
—furthest
from portal tract, closest to central V
Receives least oxygenated blood; most
susceptible to ischemic injury

A

zone 3-(centrolobular zone)

51
Q

Which Acinus zone is most susceptible to ischemic injury?

A

zone 3

52
Q

Liver functions in detoxification or
metabolism of various drugs, toxins,
metabolites (e.g., ethanol, pesticides, &
carcinogens) via microsomal mixed function
oxidase system of ____

A

sER, or peroxidases of
peroxisomes (P450 system

53
Q

A common sequela to repeated
insults or chronic disease is
____

A

cirrhosis

54
Q

cirrhosis–Characterized by hepatic
degeneration & necrosis, followed
by fibrosis & nodular _____

A

regeneration

55
Q

cirrhosis: Characterized by hepatic
____ & necrosis, followed
by fibrosis & nodular regeneration

A

degeneration

56
Q

—associated
with cirrhosis (due to fibrosis,
blockage of blood flow)

A

Portal hypertension

57
Q

T/F: Liver has ability to regenerate

A

True

58
Q

Muscular sac located in depression
along surface of liver
* Used to store & concentrate bile;
volume ~100 ml

A

gallbladder

59
Q

Gallbladder is lined by ______ epithelium with _____

A

simple columnar epithelium
with apical microvilli

60
Q

Apical microvilli are used for:

A

resorption of water

61
Q

T/F: Gallbladder has a thick muscularis mucosae

A

False–Gallbladder lacks a muscularis mucosae

62
Q

(Gallbladder) Lamina propria highly folded with
____

A

occasional tubuloalveolar mucus
glands

63
Q

____ stimulates
contraction of gallbladder

A

CCK (cholecystokinin)

64
Q

Components of bile:

A

Water, ions, electrolytes, cholesterol +
phospholipids (= lecithin), bile acids (= bile salts) &
bile pigments

65
Q

_____ is best known bile pigment—non-sol
breakdown product of Hb

A

Bilirubin

66
Q

Pathology: Failure to absorb _____ or failure to
conjugate it & secrete => accumulation of bile
pigments & jaundice

A

bilirubin

67
Q

Pathology: Failure to absorb bilirubin or failure to
conjugate it & secrete => accumulation of bile
pigments & ____

A

Jaundice

68
Q

Supersaturation of bile => ____

A

gallstones (biliary
calculi, cholelithiasis)

69
Q

(biliary
calculi, cholelithiasis)

A

gallstones

70
Q

T/F: Gallstones are 1’ cholesterol & calcium salts

A

true

71
Q

Obstruction of bile ducts (choledocolithiasis) =>
_____ if severe

A

bile stasis, or jaundice (icterus)

72
Q

Obstruction of ____ =>
bile stasis, or jaundice (icterus) if severe

A

bile ducts (choledocolithiasis)

73
Q

(choledocolithiasis)

A

bile ducts

74
Q

(icterus)

A

jaundice

75
Q

Chronic inflammation =>

A

cholecystitis

76
Q

Sx removal of gallbladder is:

A

cholecystectomy

77
Q

Following cholecystectomy, unable to concentrate ___; need to
limit ingestion of ____

A

bile; fats

78
Q

Highly lobulated gland with
thin, connective tissue
capsule, located in bend of
duodenum
* Both exocrine & endocrine
components

A

pancrease

79
Q

Ductless endocrine
pancreatic tissue located in
____

A

islets of Langerhans

80
Q

Most of pancreas is
____ (i.e., with
ducts)—a compound,
acinar, serous gland

A

exocrine

81
Q

Pancrease–Densely packed ___ contain pyramidal
secretory cells
surrounding a central
lumen (duct)

A

serous
acini

82
Q

Acinar cells contain
____
(inactive enzyme
precursors)

A

zymogen granules

83
Q

Acinar cells contain
zymogen granules
(inactive enzyme
precursors)—
e.g., trypsinogen (=
protrypsin),
chymotrypsinogen (=
prochymotrypsin),
amylase, lipase

A

review

84
Q

Trypsin & chymotrypsin are
____; amylase breaks down
carbohydrates & lipases digest
lipids

A

proteases

85
Q

Trypsin & chymotrypsin are
proteases; amylase breaks down
____ digest
lipids

A

carbohydrates & lipases

86
Q

(exocrine pancrease) Empty into ______ (add
bicarbonate & water to pancreatic
sections; neutralize acidic chyme
from stomach => optimal pH for
pancreatic enzymes)

A

intercalated ducts

87
Q

Duct cells that form beginning of
_____sometimes visible
in center of acini, called centro-
acinar cells

A

intercalated duct

88
Q

Duct cells that form beginning of
intercalated duct sometimes visible
in center of acini, called ____

A

centro-
acinar cells

89
Q

Intercalated ducts empty into
larger ______,
which exit into larger
interlobular (=extralobular)
ducts

A

intralobular ducts

90
Q

Intercalated ducts empty into
larger intralobular ducts,
which exit into larger
______ ducts

A

interlobular (=extralobular)
ducts

91
Q

Pancreatic secretions enter
duodenum via _____ at major duodenal
papilla

A

pancreatic
duct

92
Q

Pancreatic secretions enter
duodenum via pancreatic
duct at ____

A

major duodenal
papilla

93
Q

Principle regulators of exocrine pancreas—

A

polypeptide hormones
secreted by enteroendocrine (APUD) cells

94
Q

Principle regulators of exocrine pancreas— polypeptide hormones
secreted by _____

A

enteroendocrine (APUD) cells

95
Q

polypeptide hormones secreted by stomach

A

gastrin

96
Q

secreted by “G” cells of pyloric stomach; stimulates secretion of
pancreatic fluid

A

gastrin

97
Q

polypeptide hormones secreted by duodenum (3)

A

secretin, CKK, enterokinase

98
Q

secreted by “S” cells; stimulates secretion of bicarbonate by cells of
intercalated ducts

A

secretin

99
Q

secreted by “I” cells, stimulates acinar
cells to secrete zymogens

A

CCK (cholecystokinin = pancreozymin)

100
Q

—converts trypsinogen ➔ trypsin (within small intestine), which
converts chymotrypsinogen ➔ chymotrypsin (digests proteins)
Cascade rxn prevents pancreas from digesting itself

A

enterokinase

101
Q

—autodigestion
of pancreas brought on by
alcoholism

A

Pancreatitis

102
Q

(Pancreatitis)
Cascade rxn breaks down =>
Premature conversion of
chymotrypsinogen to
______ & autolysis

A

chymotrypsin

103
Q

Pancreatitis—autodigestion
of pancreas brought on by
____

A

alcoholism

104
Q

Kupffer cells work with the ______ to destroy old RBCs.

A

spleen