Anatomy Of The Liver Flashcards
LIVER
The largest _____ of the body.
_____ kilograms in adults.
Located below the_____
internal organ
1.2 - 1.5 kilograms
diaphragm
LIVER
• Divided into right and left lobes by______
• The right lobe is____ bigger than the left.
falciform ligament
6x
LIVER
Approximately_____ of blood passes through the liver per minute.
Chief_____ organ
1,500 mL or 1.5 L
metabolic
Two (2) Main Blood Vessels supplying blood:
Hepatic Artery (25%)
Portal Vein (75%)
Receiving well oxygenated blood from the systemic circulation via the hepatic artery with a direct branch of aorta.
Hepatic Arterv (25%)
Larger volume of poorly oxygenated but nutrient-rich blood from the intestinal tract.
Portal Vein (75%)
• The two blood supplies (hepatic artery and portal vein) eventually merge into the_______.
• From the sinusoid, blood flows to the_______.
• It is through the______ that blood leaves the liver.
hepatic sinusoid
central canal
central canal
The excretory system of the liver begins at the______
The ______are small spaces between the hepatocytes that form intrahepatic ducts, where excretory products of the cell can drain.
bile canaliculi
• The_____ ducts join to form the right and left hepatic ducts, which drain the secretions from the liver.
• The right and left hepatic ducts merge to form the______, which is eventually joined with the______ duct of the gallbladder to form the _____duct.
• Combined digestive secretions are then expelled into the______
intrahepatic ducts
common hepatic duct
cystic duct
common bile duct
duodenum
*________ -> The space between two adiacent hepatocyte; responsible for the transport of bile and drainage of bile into the bile duct.
*________ -> The duct of the gallbladder.
Bile Canaliculi
Cystic Duct
The liver is divided into microscopic units called_____.
functional units of the liver
responsible for all metabolic and excretory functions performed by the liver.
lobules
Each lobule is roughly a six-sided structure with a centrally located vein (called the______) with_____ at each of the corners.
central vein
portal triads
PORTAL TRIAD:
- Hepatic artery
- Portal vein
- Bile duct
Contains two major cell types:
Hepatocytes
Kupffer cells
making up approximately
80% of the volume of the organ
• Perform the major functions associated with the liver and are responsible for the regenerative properties of the liver.
Hepatocytes
• Macrophages that line the sinusoids of the liver and act as active phagocytes capable of engulfing bacteria, debris, toxins, and other substances flowing through the sinusoids
Kupffer cells
- Process of removing a portion of the liver
Lobectomy
LIVER
Can regenerate by_____ and _____
Difficulty in regenerating if >_____% are lost
Cell Division & Hypertrophy
65%
FUNCTIONS OF THE LIVER
EMDS
Excretion/Secretion
Metabolism
Detoxification
Storage
SYNTHETIC FUNCTION
• Ability of liver to synthesize substances
- Plasma Proteins
- Carbohydrates
- Lipids
- Clotting Factors
- Ketone Bodies
- Enzymes Normal Liver
The liver is capable of producing the most abundant protein in the blood “______”
Albumin
FUNCTIONS OF THE LIVER
• Synthetic Function
• Conjugation Function
• Excretory and Secretory Functions
• Detoxification and Drug Metabolisms
• Storage Function
CONJUGATION FUNCTION
•_____ metabolism
•_____mg/day = conjugated lipid
Bilirubin
200-300 mg/day
Red Blood Cells (RBC)
• Average life span of 120 days
• Phagocytized by Spleen/Liver/Red Bone Marrow Macrophage
• Broken down into (2)
Heme & Globin
_______-> Protein = further
breakdown = amino acids -› Will be put in the amino acid pool
Globin
______-› Carries iron & porphyrin ring Iron -> Ferric ion (Fe3+) will be carried by transferrin (carrier protein) toward to liver -› Some will be stored in the liver = converted to ferritin (storage form of iron
Heme
(storage form of iron
ferritin
RBC Formation ->
Breakdown of ferritin to iron -› Will be brought by_____ from the liver to the bone marrow
transferrin
Porphyrin Ring
Oxidized by heme oxygenase = produces_____
biliverdin
biliverdin
• Reduced by_______ =
Unconjugated Bilirubin (B1)
biliverdin reductase
Unconjugated Bilirubin (B1)
o Needs a carrier protein =____
Albumin
Albumin
• Will go to______ through passive diffusion or receptor-mediated endocytosis
Y & Z proteins will form a complex w/_____ bilirubin
_____ will be attached to the complex
Will go to the Hepatocyte____
hepatocytes
unconjugated bilirubin
Ligandin
SER
= bilirubin conjugation takes place
Hepatocyte SER
Unconjugated Bilirubin to Conjugated
Bilirubin (B2)
• Catalyzed by the enzyme
Uridine Diphosphate Glucuronosyltransferase
(UDPGT)
B2
Excreted by_____
Will go to the bile canal = intrahepatic duct = right/left duct = common hepatic duct = common bile duct =_____
hepatocytes
small intestine duodenum
B2 in duodenum
Will encounter intestinal bacteria
• B2 becomes_____
mesobilirubin
mesobilirubin
Converted into______
• 80% becomes______ = responsible for brown color of feces
• 20% either absorbed by extrahepatic circulation or_____
urobilinogen
stercobilin
systemic circulation
(Stool color) if inadequate bilirubin/liver damage
Dark white
•_______ -› Goes back to the liver = undergoes same process
•_______ -> Urobilinogen will go to the kidneys
Extrahepatic Circulation
Systemic Circulation
Systemic Circulation -> Urobilinogen will go to the kidneys
Will reach the urinary bladder
Urobilinogen is oxidized into_____ = minor contributor for yellow color of urine
______= primary contributor
for yellow urine
urobilin
Urochrome
• Look for #1: Red blood cells that were ingested by the macrophage in the____.
RBC will undergo lysis and they will release the____.
• In #2: The hemoglobin is broken into____ and ____
• In #3: The amino acids will be reused by the body for____ synthesis.
• In #4: The released iron will be reused by the body, some of it will be utilized to form hemoglobin in the bone marrow and some will be stored in the liver in the form of_____
• The remaining portions of the heme will be converted to the____.
• Biliverdin will be acted upon by_____ converting it into yellow colored bilirubin.
• In #9 and #10: The bilirubin formed from biliverdin should be transported towards the liver.
spleen
hemoglobin
heme and globin
protein
ferritin
biliverdin
biliverdin reductase
BILIRUBIN 1
• Water ______ -
insoluble
B1 requires_____ for it to be transported to the liver for excretion.
So, for this to be eliminated in the body, it must be converted by the hepatocytes to a water-soluble form
albumin
• Unconjugated bilirubin
• Indirect bilirubin
B1
Cannot be removed from the body unless it is conjugated with______ in the liver, converting it to a water-soluble form and that is excretable form of bilirubin.
BILIRUBIN 1
glucuronic acid
• Bilirubin Monoglucuronide
B1
• Non-polar bilirubin
B1
• Conjugated bilirubin
• Direct bilirubin
BILIRUBIN 2
• Water soluble
• Polar bilirubin
B2
• Bilirubin diglucuronide
B2
• Secreted by the hepatocyte into the bile canaliculi then into the gallbladder or into the common bile duct.
B2
DELTA BILIRUBIN
BILIRUBIN 2 + ALBUMIN
Total Bilirubin =
B1 + B2 + Delta Bilirubin
B1 =
Total Bilirubin - B2
DETOXIFICATION AND DRUG METABOLISM
Every substance that is absorbed from the gastrointestinal tract (GIT) must first pass through the____ -› first pass effect.
liver
• It allows important substances to reach the systemic circulation and serves as a barrier to prevent toxic and harmful substances from reaching the systemic circulation.
LIVER
• Anything that is absorbed from the GIT will have to pass through the___.
• Important chemicals are allowed to reach the systemic circulation.
• Anything that is toxic and harmful, should be detoxified by the_____.
liver
hepatocytes
• Is the byproduct of protein metabolism.
• It is converted by the liver into urea and urea is then excreted by the kidneys.
Ammonia
Liver diseases -› high ammonia levels in blood which can lead to____.
coma
_______is the major component of the bile pigment
Derived from the breakdown of_____ in red cells.
Bilirubin
hemoglobin
Bile Acids
• Conjugated cholic acid -› cholate
• Conjugated chenodeoxycholic acid -> chenodeoxycholate
Cholic Acid
Chenodeoxycholic Acid
Glycine is conjugated with glycine and taurine forming_____
bile salts
STORAGE FUNCTION
• All fat-soluble vitamins
• Water-soluble Vitamins
• Glycogen
If the liver becomes completely nonfunctional for any reason, death will occur within approximately _____ due to______.
24 hours
hypoglycemia
The excretory system of the liver begins at the
bile canaliculi
e bile canaliculi are small spaces between the hepatocytes that form______, where excretory products of the cells can drain.
intrahepatic ducts
The right and left hepatic ducts merge to form the common hepatic duct, which is eventually joined with the cystic duct of the gallbladder to form the_______
common bile duct
Combined digestive secretions are then expelled into the______
duodenum
The body produces approximately____ of bile per day and excretes____ of what is produced.
3 L
1 L
is the principal pigment in bile, and it is derived from the breakdown of red blood cells
Bilirubin
Approximately____ days after the emergence from the reticuloendothelial tissue, red blood cells are phagocytized and hemoglobin is released
126
Hemoglobin is degraded to
heme, globin, and iron
The iron is bound by______ and is returned to iron stores in the liver or bone marrow for reuse.
The globin is degraded to its constituent______, which are reused by the body.
The heme portion of hemoglobin is converted to______ in 2 to 3 hours.
transferrin
amino acids
bilirubin
Bilirubin is bound by______ and transported to the liver.
This form of bilirubin is referred to as______
albumin
unconjugated or indirect bilirubin
________ is insoluble in water and cannot be removed from the body until it has been conjugated by the liver.
Once at the liver cell, unconjugated bilirubin flows into the sinusoidal spaces and is released from albumin so it can be picked up by a carrier protein called_____.
Unconjugated bilirubin
ligandin
_______, which is located in the hepatocyte, is responsible for transporting unconjugated bilirubin to the_______, where it may be rapidly conjugated.
Ligandin
endoplasmic reticulum
The conjugation (esterification) of bilirubin occurs in the presence of the enzyme_________, which transfers a glucuronic acid molecule to each of the two propionic acid side chains of bilirubin to form bilirubin______, also known as______
uridine diphosphate glucuronosyltransferase (UDPGT)
diglucuronide
conjugated bilirubin.
is water soluble and is able to be secreted from the hepatocyte into the bile canaliculi.
Once in the hepatic duct, it combines with secretions from the gallbladder through the cystic duct and is expelled through the common bile duct to the intestines.
Conjugated bilirubin
Intestinal bacteria (especially the bacteria in the lower portion of the intestinal tract) work on conjugated bilirubin to produce_______, which is reduced to form______ and then_____ (a colorless product).
mesobilirubin
mesobilirubinogen
urobilinogen
Most of the urobilinogen formed (roughly 80%) is oxidized to an orange-colored product called______ (______) and is excreted in the feces.
The urobilin or stercobilin is what gives stool its_____ color.
urobilin/ stercobilin
brown
Approximately______ of bilirubin is produced per day, and it takes a normally functioning liver to process the bilirubin and eliminate it from the body
200 to 300 mg
Almost all the_____ formed is eliminated in the feces, and a small amount of the colorless product,_____, is excreted in the urine.
bilirubin
urobilinogen
The healthy adult has very low levels of total bilirubin (_______) in the serum, and of this amount, the majority is in the unconjugated form.
0.2 to 1.0 mg/dL
approximately_____ of the daily production of cholesterol (roughly 1.5 to 2.0 g) is produced by the liver.
70%
Almost all proteins are synthesized by the liver except for the ______ and _____
immunoglobulins and adult hemoglobin
The liver serves as a gatekeeper between substances absorbed by the gastrointestinal tract and those released into systemic circulation.
Every substance that is absorbed in the gastrointestinal tract must first pass through the liver; this is referred to as_______
first pass
This is an important function of the liver because it can allow important substances to reach the systemic circulation and can serve as a barrier to prevent toxic or harmful substances from reaching systemic circulation.
First pass
