Anatomy + physiology of the liver Flashcards
What is the colour of the liver dependent on?
fat content
What is the name of the fibrous capsule covering the liver?
Glisson capsule
What parts of the liver are not encapsulated in the visceral peritoneum?
gallbladder fossa, porta hepatis and bare area
What attaches the liver to the anterior abdominal wall?
falciform ligament
How does the falciform divide the liver?
into anatomical left and right lobes
What is the bare area of the liver?
where the liver contacts directly the diaphragmatic surface and no peritoneum is present
Name the impressions on the liver
gastric impression
oesophageal impression
colic impression
renal impression
where other organs press onto the liver and leave outlines
What is the lesser omentum?
double layer of the peritoneum that runs from the inferior surface of the liver to the lesser curvature of the stomach and proximal part of the duodenum
What does the porta hepatis contain?
portal vein
hepatic artery proper (supplies liver + gallbladder)
hepatic nervous plexuses
common hepatic duct
lymph vessels
Where does the gallbladder lie?
visceral surface of anatomical right lobe, between right lobe + quadrate lobe
How many anatomical lobes of the liver are there?
4
How many functional segments of the liver are there?
8
What marks the border between the 2 functional lobes of the liver?
marked by IVC and gallbladder - Cantlie’s line
What 2 veins form the main hepatic portal vein?
confluence of superior mesenteric vein and splenic vein
What type of cell is a Kupffer cell?
macrophage
Lymphatic drainage of liver
deep hepatic lymph vessels surround liver and follow hepatic portal veins
drain to hepatic lymph nodes as porta hepatis which further drain into colecial lymph nodes
coeliac lymph nodes drain to thoracic duct
What are the stem cells of the liver called?
oval cells
present where canaliculus joins bile duct
Describe bile salt production
primary bile acids synthesised from cholesterol
bile salts are conjugated to increase solubility
secreted into bile, concentrated in gallbladder during fasting, expelled into intestine in response to dietary fat
2 pathways:
- classical
- alternate
- common steps at end
Components of bile
bile acids
phospholipid
cholesterol
proteins
bilirubin
Role of bile salts
digestion + absorption of intestinal cholesterol, triglycerides, fatty acids and fat-soluble vitamins
gut liver axis
feedback regulatory mechanisms of hepatic bile acid synthesis and gallbladder motor function
Where is albumen made?
hepatocytes
What clotting factors does the liver make? and therefore what test can be used in prognosis of liver disease?
2, 7, 9, 10
INR
Extrinsic pathway blood test
prothrombin time (and INR)
Intrinsic pathway blood test
APTT
What happens to the prothrombin time (and INR) in liver disease?
increases
What is the function of the urea cycle?
removes excess ammonia
(therefore ammonia can accumulate in liver disease)
Why can hypoglycaemia be seen in acute liver failure?
failure of liver to metabolise glycogen
What does the cori cycle do?
clears lactate from blood and makes it into glucose
happens in liver
(lactic acidosis can be seen in liver failure)
