Anatomy Of The Liver Flashcards

1
Q

LIVER

The largest _____ of the body.
_____ kilograms in adults.
Located below the_____

A

internal organ

1.2 - 1.5 kilograms

diaphragm

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2
Q

LIVER

• Divided into right and left lobes by______

• The right lobe is____ bigger than the left.

A

falciform ligament

6x

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3
Q

LIVER

Approximately_____ of blood passes through the liver per minute.

Chief_____ organ

A

1,500 mL or 1.5 L

metabolic

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4
Q

Two (2) Main Blood Vessels supplying blood:

A

Hepatic Artery (25%)

Portal Vein (75%)

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5
Q

Receiving well oxygenated blood from the systemic circulation via the hepatic artery with a direct branch of aorta.

A

Hepatic Arterv (25%)

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6
Q

Larger volume of poorly oxygenated but nutrient-rich blood from the intestinal tract.

A

Portal Vein (75%)

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7
Q

• 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.

A

hepatic sinusoid

central canal

central canal

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8
Q

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.

A

bile canaliculi

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9
Q

• 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______

A

intrahepatic ducts

common hepatic duct

cystic duct

common bile duct

duodenum

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10
Q

*________ -> 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.

A

Bile Canaliculi

Cystic Duct

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11
Q

The liver is divided into microscopic units called_____.

functional units of the liver

responsible for all metabolic and excretory functions performed by the liver.

A

lobules

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12
Q

Each lobule is roughly a six-sided structure with a centrally located vein (called the______) with_____ at each of the corners.

A

central vein

portal triads

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13
Q

PORTAL TRIAD:

A
  1. Hepatic artery
  2. Portal vein
  3. Bile duct
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14
Q

Contains two major cell types:

A

Hepatocytes
Kupffer cells

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15
Q

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.

A

Hepatocytes

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16
Q

• 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

A

Kupffer cells

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17
Q
  • Process of removing a portion of the liver
A

Lobectomy

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18
Q

LIVER

Can regenerate by_____ and _____

Difficulty in regenerating if >_____% are lost

A

Cell Division & Hypertrophy

65%

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19
Q

FUNCTIONS OF THE LIVER

EMDS

A

Excretion/Secretion
Metabolism
Detoxification
Storage

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20
Q

SYNTHETIC FUNCTION
• Ability of liver to synthesize substances

A
  1. Plasma Proteins
  2. Carbohydrates
  3. Lipids
  4. Clotting Factors
  5. Ketone Bodies
  6. Enzymes Normal Liver
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21
Q

The liver is capable of producing the most abundant protein in the blood “______”

A

Albumin

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22
Q

FUNCTIONS OF THE LIVER

A

• Synthetic Function
• Conjugation Function
• Excretory and Secretory Functions
• Detoxification and Drug Metabolisms
• Storage Function

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23
Q

CONJUGATION FUNCTION
•_____ metabolism
•_____mg/day = conjugated lipid

A

Bilirubin

200-300 mg/day

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24
Q

Red Blood Cells (RBC)

• Average life span of 120 days
• Phagocytized by Spleen/Liver/Red Bone Marrow Macrophage
• Broken down into (2)

A

Heme & Globin

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25
Q

_______-> Protein = further
breakdown = amino acids -› Will be put in the amino acid pool

A

Globin

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26
Q

______-› 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

A

Heme

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27
Q

(storage form of iron

A

ferritin

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28
Q

RBC Formation ->
Breakdown of ferritin to iron -› Will be brought by_____ from the liver to the bone marrow

A

transferrin

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29
Q

Porphyrin Ring
Oxidized by heme oxygenase = produces_____

A

biliverdin

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30
Q

biliverdin

• Reduced by_______ =
Unconjugated Bilirubin (B1)

A

biliverdin reductase

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31
Q

Unconjugated Bilirubin (B1)
o Needs a carrier protein =____

A

Albumin

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32
Q

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____

A

hepatocytes

unconjugated bilirubin

Ligandin

SER

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33
Q

= bilirubin conjugation takes place

A

Hepatocyte SER

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34
Q

Unconjugated Bilirubin to Conjugated
Bilirubin (B2)
• Catalyzed by the enzyme

A

Uridine Diphosphate Glucuronosyltransferase
(UDPGT)

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35
Q

B2

Excreted by_____

Will go to the bile canal = intrahepatic duct = right/left duct = common hepatic duct = common bile duct =_____

A

hepatocytes

small intestine duodenum

36
Q

B2 in duodenum

Will encounter intestinal bacteria
• B2 becomes_____

A

mesobilirubin

37
Q

mesobilirubin

Converted into______

• 80% becomes______ = responsible for brown color of feces

• 20% either absorbed by extrahepatic circulation or_____

A

urobilinogen

stercobilin

systemic circulation

38
Q

(Stool color) if inadequate bilirubin/liver damage

A

Dark white

39
Q

•_______ -› Goes back to the liver = undergoes same process

•_______ -> Urobilinogen will go to the kidneys

A

Extrahepatic Circulation

Systemic Circulation

40
Q

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

A

urobilin

Urochrome

41
Q

• 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.

A

spleen

hemoglobin

heme and globin

protein

ferritin

biliverdin

biliverdin reductase

42
Q

BILIRUBIN 1
• Water ______ -

A

insoluble

43
Q

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

A

albumin

44
Q

• Unconjugated bilirubin
• Indirect bilirubin

A

B1

45
Q

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.

A

BILIRUBIN 1

glucuronic acid

46
Q

• Bilirubin Monoglucuronide

A

B1

47
Q

• Non-polar bilirubin

A

B1

48
Q

• Conjugated bilirubin
• Direct bilirubin

A

BILIRUBIN 2

49
Q

• Water soluble
• Polar bilirubin

A

B2

50
Q

• Bilirubin diglucuronide

A

B2

51
Q

• Secreted by the hepatocyte into the bile canaliculi then into the gallbladder or into the common bile duct.

A

B2

52
Q

DELTA BILIRUBIN

A

BILIRUBIN 2 + ALBUMIN

53
Q

Total Bilirubin =

A

B1 + B2 + Delta Bilirubin

54
Q

B1 =

A

Total Bilirubin - B2

55
Q

DETOXIFICATION AND DRUG METABOLISM
Every substance that is absorbed from the gastrointestinal tract (GIT) must first pass through the____ -› first pass effect.

A

liver

56
Q

• 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.

A

LIVER

57
Q

• 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_____.

A

liver

hepatocytes

58
Q

• Is the byproduct of protein metabolism.

• It is converted by the liver into urea and urea is then excreted by the kidneys.

A

Ammonia

59
Q

Liver diseases -› high ammonia levels in blood which can lead to____.

A

coma

60
Q

_______is the major component of the bile pigment

Derived from the breakdown of_____ in red cells.

A

Bilirubin

hemoglobin

61
Q

Bile Acids

• Conjugated cholic acid -› cholate

• Conjugated chenodeoxycholic acid -> chenodeoxycholate

A

Cholic Acid

Chenodeoxycholic Acid

62
Q

Glycine is conjugated with glycine and taurine forming_____

A

bile salts

63
Q

STORAGE FUNCTION

A

• All fat-soluble vitamins

• Water-soluble Vitamins

• Glycogen

64
Q

If the liver becomes completely nonfunctional for any reason, death will occur within approximately _____ due to______.

A

24 hours

hypoglycemia

65
Q

The excretory system of the liver begins at the

A

bile canaliculi

66
Q

e bile canaliculi are small spaces between the hepatocytes that form______, where excretory products of the cells can drain.

A

intrahepatic ducts

67
Q

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_______

A

common bile duct

68
Q

Combined digestive secretions are then expelled into the______

A

duodenum

69
Q

The body produces approximately____ of bile per day and excretes____ of what is produced.

A

3 L

1 L

70
Q

is the principal pigment in bile, and it is derived from the breakdown of red blood cells

A

Bilirubin

71
Q

Approximately____ days after the emergence from the reticuloendothelial tissue, red blood cells are phagocytized and hemoglobin is released

A

126

72
Q

Hemoglobin is degraded to

A

heme, globin, and iron

73
Q

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.

A

transferrin

amino acids

bilirubin

74
Q

Bilirubin is bound by______ and transported to the liver.

This form of bilirubin is referred to as______

A

albumin

unconjugated or indirect bilirubin

75
Q

________ 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_____.

A

Unconjugated bilirubin

ligandin

76
Q

_______, which is located in the hepatocyte, is responsible for transporting unconjugated bilirubin to the_______, where it may be rapidly conjugated.

A

Ligandin

endoplasmic reticulum

77
Q

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______

A

uridine diphosphate glucuronosyltransferase (UDPGT)

diglucuronide

conjugated bilirubin.

78
Q

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.

A

Conjugated bilirubin

79
Q

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).

A

mesobilirubin

mesobilirubinogen

urobilinogen

80
Q

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.

A

urobilin/ stercobilin

brown

81
Q

Approximately______ of bilirubin is produced per day, and it takes a normally functioning liver to process the bilirubin and eliminate it from the body

A

200 to 300 mg

82
Q

Almost all the_____ formed is eliminated in the feces, and a small amount of the colorless product,_____, is excreted in the urine.

A

bilirubin

urobilinogen

83
Q

The healthy adult has very low levels of total bilirubin (_______) in the serum, and of this amount, the majority is in the unconjugated form.

A

0.2 to 1.0 mg/dL

84
Q

approximately_____ of the daily production of cholesterol (roughly 1.5 to 2.0 g) is produced by the liver.

A

70%

85
Q

Almost all proteins are synthesized by the liver except for the ______ and _____

A

immunoglobulins and adult hemoglobin

86
Q

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_______

A

first pass

87
Q

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.

A

First pass