Accessory Digestive Organs Flashcards
1
Q
What is another name for the space of Disse?
A
perisinusoidal space
2
Q
Where would you find a portal triad?
A
at the corners of a liver lobule
3
Q
Where do drugs and toxins (alcohol, antibiotics) get metabolized and detoxified?
A
liver
4
Q
What do acinar cells contain that are the inactive enzyme precursors of many enzymes, such as trypsinogen?
A
zymogen granules
5
Q
___ of the liver contain large numbers of cytoplasmic granules (rER and lysosomal products) and storage products.
A
Hepatocytes
6
Q
What results if you are unable to absorb bilirubin?
A
jaundice
7
Q
What are choleliths?
A
gallstones
8
Q
How does the liver function to detoxify or metabolize various drugs and toxins?
A
- via the microsomal mixed function oxidase system of sER
OR - via peroxidases of peroxisomes (P450 system)
9
Q
Cholesterol + phospholipids = _____.
A
lecithin
10
Q
_____ contain large amounts of glycogen as part of their cytoplasmic granules.
A
glycogen
11
Q
Hormones secreted by which type of cells are the principle regulators of the exocrine pancreas?
A
APUD (enteroendocrine) cells
12
Q
What causes bile stasis?
A
obstruction of the bile ducts
13
Q
Can the liver recycle hemoglobin via bile synthesis?
A
YES
14
Q
Where are interlobular ducts located at in regard to pancreatic lobules?
A
these ducts are located between lobules
15
Q
What hormone stimulates contractions of the gallbladder?
A
CCK (cholecystokinin)
16
Q
What are sinusoids lined by in the liver?
A
sinusoidal lining cells
17
Q
Does the pancreas have both exocrine and endocrine components?
A
YES
18
Q
Cholecystitis is the _____ of the gallbladder.
A
chronic inflammation
19
Q
What is the purpose of water resorption in the gallbladder?
A
withdrawing water concentrates the bile
20
Q
Amylase breaks down ____ and lipases digest ____.
A
carbohydrates; lipids
21
Q
What is the lining of the gallbladder like?
A
it is lined by simple columnar epithelial cells with apical microvilli
22
Q
The liver and pancreas are _____ organs.
A
accessory digestive
23
Q
How are hepatocytes arranged?
A
they are arranged in anastomosing cords paralleled by venous sinusoids
24
Q
The storage and release of glycogen, lipids, and lipoproteins, and vitamin A and D storage are _____ functions of the liver.
A
endocrine
25
What cells form the entrance to intercalated ducts?
centroacinar cells
26
What happens if the body does not secrete glucuronide?
bilirubin will fail to be conjugated, leading to buildup of pigment and eventual jaundice
27
Which zone of an acinus receives the LEAST oxygenated blood?
Zone 3 (centrolobular zone)
28
What pathology results if you are unable to conjugate bilirubin or fail to secrete glucuronide?
jaundice
29
____ lobules are based on blood flow; ____ lobules are based on bile flow.
Classic; portal
30
What is the space called that is located in between the hepatocytes and sinusoidal lining cells?
space of Disse
31
____ is secreted by G cells of the pyloric stomach.
Gastrin
32
____ is characterized by hepatic degeneration and necrosis, followed by fibrosis and nodular regeneration.
Cirrhosis
33
Where would you find the ductless endocrine pancreatic tissue?
within the Islets of Langerhans
34
Gluconeogenesis from non-carbohydrate sources (amino acids and lipids) is an ____ function of the liver.
endocrine
35
Are hepatocytes diploid?
YES - but some are polyploid or binucleate
36
What might the accumulation of bilirubin pigment stem from?
- failure to absorb bilirubin
- failure to conjugate bilirubin
- failure to secrete glucuronide
37
____ converts trypsinogen into trypsin, which then converts chymotrypsinogen into chymotrypsin.
Enterokinase
38
What accounts for the differences we see in the size of hepatocytes?
the diploid, polyploid AND/OR binucleate cells we see
39
You are a pathologist looking at the liver and see necrosis. You notice that the necrosis is concentrated in the perilobular or periportal areas. What kind of insult are you looking at and need to investigate?
a toxic insult
40
What is the purpose of the microvilli located within the gallbladder?
the microvilli are used for water resorption
41
You are a pathologist looking at the liver and see necrosis. You notice that the necrosis is concentrated in the centrolobular area. What kind of insult are you looking at and need to investigate?
an ischemic insult (lack of oxygen)
42
What are the components of bile?
- water
- ions
- electrolytes
- cholesterol + phospholipids = lecithin
- bile acids (= bile salts)
- bile pigments
43
Which artery carries only about 20-25% of blood to the liver, perfusing oxygenated blood with the deoxygenated blood of the hepatic portal vein?
hepatic artery
44
___ function utilizes ducts; ___ function does not.
Exocrine; endocrine
45
Where are senescent red blood cells destroyed?
liver
46
Secretin, CCK, and gastrin are all secretions from ____ cells.
enteroendocrine (APUD)
47
Where would you find Kupffer cells (a type of macrophage)?
within the hepatic sinusoids and space of Disse (perisinusoidal space)
48
What must bilirubin be conjugated with in order to keep it from clogging the system?
glucuronide
49
What is the pathway of blood from the portal tracts through a lobule?
blood enters from the portal tracts, passes through the sinuses of the lobule and drains via the central artery (centrilobular or terminal hepatic vein)
50
Which zone of an acinus is called the intermediate zone?
Zone 2
51
____ cells would contain protrypsin, prochymotrypsin, amylase, and lipase in their zymogen granules.
Acinar
52
Does bile from canaliculi flow into progressively larger or smaller ducts?
larger
53
What is the surgical removal of the gallbladder called?
cholecystectomy
54
Does bile get secreted instantly from the bile ducts?
NO - it eventually enters the duodenum after a period of storage and modification in the gallbladder
55
_____ is the water-soluble form of bilirubin conjugated with glucuronide.
Bilirubin glucuronide
56
What is choledocolithiasis?
obstruction of bile ducts
57
What does the P450 system do?
functions in the liver to detoxify or metabolize drugs and toxins
58
What artery supplies the liver?
hepatic artery
59
Where are the portal tracts located in an acinus? Where are the central veins?
at the sides; at the tips of the "diamond" (longitudinal axis)
60
____ is secreted by I cells.
CCK
61
Which organ is a highly lobulated gland with a very thin connective tissue capsule, located adjacent to the duodenum?
pancreas
62
Did the pancreas form from a primitive gut outgrowth?
YES
63
What do intercalated ducts empty into?
intralobular ducts
64
How do both the liver and pancreas develop in the embryo?
as embryological outgrowths of the primitive gut
65
Which vitamins would you most likely find in the liver?
fat-soluble vitamins ADEK
66
What type of collagen supports hepatic cords and sinusoids?
Type III collagen
67
The ____ is a muscular sac located in a depression along the posterior surface of the liver and its function is to store and concentrate bile.
gallbladder
68
Would the actions of intercalated ducts be considered exocrine? Why or why not?
YES; because the intercalated ducts from the pancreas secrete a solution to neutralize acidic chyme from the stomach
69
What are the two categorized functions of the liver?
exocrine functions
| endocrine functions
70
Which 4 hormones are the principle regulators of the exocrine pancreas?
gastrin
secretin
CCK
enterokinase
71
What are the spaces between hepatocytes of the liver called?
sinusoids
72
Can the liver regenerate?
YES - but not always as organized as it was
73
Where does bile eventually enter the duodenum?
at the major duodenal papilla
74
The hepatic artery is the branch of the _____.
celiac trunk
75
How are the cords of hepatocytes arranged?
arranged in lobules
76
The ____ of the gallbladder is highly folded with occasional tubuloalveolar mucus glands.
lamina propria
77
The _____ of bile leads to gallstones, or biliary calculi.
supersaturation
78
What pigment do aging hepatocytes accumulate?
lipofuscin
79
Cholecyst refers to the ____.
gallbladder
80
Where would you find the portal artery?
hepatic lobules
81
Hemolytic anemia and liver disease can also cause ____.
jaundice
82
Synthesis of plasma proteins (fibrinogen, urea, albumin, prothrombin) is an ____ of the liver.
endocrine
83
rER and lysosomal products are _____ granules.
cytoplasmic
84
Why does alcoholism cause pancreatitis?
the alcohol breaks down the cells, which allows the zymogens to be released
85
What layer is stimulated by CCK to cause contractions of the gallbladder?
muscularis externa
86
What do the densely packed serous acini contain?
pyramidal secretory cells
87
What is the best known bile pigment? What is it?
bilirubin; a non-soluble breakdown product of hemoglobin
88
Trypsinogen and chymotrypsinogen are ____.
zymogens
89
____ is the buildup of gallstones from the supersaturation of bile.
Cholelithiasis
90
What do the pyramidal secretory cells of serous acini surround?
a central lumen (which is the duct)
91
You obtain two pieces of GI tract and are told that one is the gallbladder. How would you determine which section is gallbladder, histologically?
the gallbladder section would lack a muscularis mucosae
92
In the ____, the deamination of amino acids into urea is an example of detoxification of metabolic waste.
liver
93
What are liver cells called?
hepatocytes
94
Venous draining of the liver lobules is via the ____ veins, which then drain into the ____ vein.
central; hepatic
95
In an acinus, ____ is most susceptible to toxic injury, while ____ is most susceptible to ischemic injury.
Zone 1 (perilobular or periportal); Zone 3 (centrolobular)
96
_____ add bicarbonate and water into the pancreatic secretions to neutralize acidic chyme from the stomach to generate an optimal pH for pancreatic enzymes.
Intercalated ducts
97
Where do metabolic processes such as glycogen synthesis, glycogen storage, and gluconeogenesis occur?
liver
98
Where would you find Ito cells?
between hepatocytes
99
Which zone of an acinus is furthest from the portal tract but nearest to the central vein?
Zone 3 (centrolobular zone)
100
_____ cells are fixed tissue macrophages.
Kupffer
101
Reticulin consists of type ___ collagen fibers.
III
102
What does the hepatic portal vein carry?
blood from the gut and potentially toxic compounds absorbed from the diet
103
Which hormone stimulates the secretion of pancreatic fluid?
gastrin
104
Which enzyme converts trypsinogen into trypsin within the small intestine?
enterokinase
105
____ cells are fat-storing cells containing lipid droplets, used for vitamin A and D storage in the liver.
Ito
106
What is the pathway of ducts from intercalated ducts to the extralobular ducts?
intercalated >> intralobular >> interlobular (extralobular)
107
Where are plasma proteins such as clotting factors, albumin, and lipoproteins synthesized?
liver
108
The liver is a very ____-rich, but ____-poor environment due to its blood supply.
nutrient; oxygen
109
You have your gallbladder removed. Do you still make bile? What dietary restrictions might you have?
YES; may need to limit ingestion of fats
110
What type of liver lobule is hexagonal and has a central vein in the middle of the lobule and may be bordered by a thin, connective tissue septum?
classic lobule
111
Where is bile secreted into after it is synthesized by hepatocytes?
network of bile canaliculi
112
Which zone of an acinus is closest to the portal tract and receives the MOST oxygenated blood?
Zone 1 (perilobular or periportal zone)
113
What type of liver lobule is a diamond-shaped region between neighboring central veins that combines the aspects of blood flow, oxygenation, metabolism and pathology?
acinus
114
What volume can the gallbladder hold?
about 100 mL
115
What prevents the pancreas from digesting itself?
cascase reaction
116
Bile synthesis and secretion is an ____ function of the liver.
exocrine
117
What is the role of secretin, CCK, and gastrin in bile flow?
these hormones increase bile flow from the liver
118
An individual presents to the ER with suspected poisoning. Necrosis from what portion of the liver lobule would you expect to see?
perilobular or periportal necrosis
119
CCK is cholecystokinin, but can also be called ____.
pancreozymin
120
The ____ is the largest gland and internal organ.
liver
121
____ is the autodigestion of the pancreas, most commonly brought on by alcoholism.
Pancreatitis
122
What does chymotrypsin do?
it digests proteins (it is a protease)
123
What are the duct cells called that form the beginning of the intercalated duct and are sometimes visible in the center of acini?
centroacinar cells
124
What hormones increase the amount of bile flow from the liver?
secretin
CCK
gastrin
125
The ____ carries 75-80% of blood to the liver.
hepatic portal vein
126
What are some alternate names for the central vein in a liver lobule?
centrilobular vein OR terminal hepatic venule
127
What are the primary components of gallstones?
cholesterol
| calcium salts
128
____ fibers support the hepatic cords and sinuses?
reticulin
129
Secretin, CCK, and enterokinase are secreted by the ____.
duodenum
130
What shape are individual hepatocytes?
polygonal
131
What makes up the portal tract or triad?
portal artery
portal vein
bile duct
portal lymphatics
132
A ___ is a compound, acinar serous gland.
duct
133
Necrosis from what zone of the hepatic lobules would be present in a patient who has suffered from a heart attack?
centrolobular necrosis
134
Why is portal hypertension often associated with cirrhosis?
because due to the fibrosis of liver structures, blood flow can be blocked
135
Which type of liver lobule is triangular, based on blood flow and has the portal triad at the center and central veins at the corners?
portal lobule
136
Nodular regeneration is associated with ____.
liver cirrhosis
137
____ function is through the secretion of products via ducts.
Exocrine
138
What are the 4 lobes of the liver?
left
right
caudate
quadrate
139
What layer does the gallbladder lack?
muscularis mucosae
140
What type of liver function is the synthesis of glucose?
endocrine
141
What happens to the cascade reaction in pancreatitis?
it breaks down and allows the premature conversion of chymotrypsinogen to chymotrypsin, which leads to autolysis
142
Which zone of an acinus is most susceptible to toxic injury?
Zone 1 (perilobular or periportal zone)
143
What is the connective tissue capsule called that covers the external surface of the liver?
Glisson's capsule
144
Which hormone stimulates acinar cells to secrete zymogens?
CCK
145
How do monosaccharides and amino acids from digestion enter the liver?
through the hepatic portal vein
146
____ are small canals located between adjacent hepatocytes, formed by grooves in the plasma membranes between the cells.
Bile canaliculi
147
Is most of the pancreas endocrine or exocrine?
exocrine (many ducts)
148
What is concentrated in the liver as a waste product that contains lots of nitrogen?
urea
149
How much bile does the average adult human secrete each day?
1 liter
150
Which portion of the GI tract contains the port to excrete bile?
duodenum
151
What is bile synthesized by?
hepatocytes
152
Can severe pancreatitis be fatal?
YES - within hours
153
How many zones an acinus divided into in the liver?
3 zones
154
Trypsin and chymotrypsin are ____ located within the pancreas.
proteases
155
___ inhibits gastric secretions.
Secretin
156
At what structure do the pancreatic secretions enter the duodenum?
major duodenal papilla
157
____ is an emulsifying agent and facilitates the hydrolysis of lipids by pancreatic lipases.
Bile
158
____ is secreted by S cells.
Secretin
159
Which way does bile flow?
opposite of blood flow
160
Can you still concentrate bile after a cholecystectomy?
NO
161
Gastrin is secreted by the ____.
stomach
162
What often results from repeated insults or chronic disease to the liver?
cirrhosis
163
What type of cells is the pancreas characterized by?
acinar cells
164
Which hormone stimulates the secretion of bicarbonate by the cells of the intercalated ducts?
secretin
165
Where does gluconeogenesis occur in the body?
in the liver
166
What is the space of Disse (perisinusoidal space) continuous with?
lymphatics
167
What do the products of carbohydrate and lipid digestion empty into?
intercalated ducts
168
What constitutes an accessory digestive organ?
if the organ was an outgrowth of the primitive gut
169
____ function is without the utilization of ducts, secreting products directly into the blood stream.
Endocrine
170
Bile from canaliculi flow into bile ducts from the portal triad, and eventually into larger _____ ducts scattered throughout the parenchyma.
intrahepatic
171
_____ make up a discontinuous endothelium with gaps in between endothelial cells that line the sinusoids.
Sinusoidal lining cells
172
What do the intralobular ducts empty into?
interlobular (extralobular) ducts
