APPLIED PHYSIOLOGY | Liver and Anesthesia

Question 1

This is the basic functional unit of the LIVER

Answer 1

Acinus

Question 2

Which zone receives oxygen and nutrient-rich blood?

Answer 2

ZONE ONE
The zone 1 or periportal hepatocytes are closer to the portal triad, hence, the close proximity makes it richer in O2 and other nutrients.

Question 3

TRUE OR FALSE

The LIVER receives 25% of the cardiac output

Answer 3

TRUE

The Hepatic Artery is responsible for 25% blood supply

The portal vein is responsible for 70-75% blood supply

• They each deliver 50% of TOTAL OXYGEN to the liver

Question 4

TRUE OR FALSE

Chronic hepatitis can safely undergo Elective procedure

Answer 4

TRUE

Acute Hepatitis or LIVER FAILURE is contraindicated to undergo elective surgery.

Question 5

Coagulation Factors synthesized from the LIVER except:

Answer 5

ALL Coagulation factors EXCEPT: Factor 8 & von Willebrand factor

Source: Morgan&Mikhail

Question 6

Anticoagulants produced by the LIVER

Answer 6

CS3

Protein C
Protein S
Antithrombin III

Question 7

Which of the following is best describes the cardiac manifestations of LIVER CIRRHOSIS?

Answer 7

A. High cardiac output, low arterial blood pressure, low SVR, and normal PVR
B. Low cardiac output, low arterial blood pressure, low SVR, low PVR
C. Hypodynamic state as a result of hypoalbuminemia
D. Hyperdynamic state resulting to high SVR and elevated arterial blood pressure

Question 8

Drugs with HIGH HEPATIC EXTRACTION ratios:

Hence, short HALF-LIFE

Answer 8

Morphine
Propranolol
Labetalol
Lidocaine

Question 9

Normal PT

Answer 9

11-14 seconds

Prolongation of PT to greater than 3-4 seconds corresponds to an INR of > 1.5
This INR reflects liver dysfunction but not the degree of coagulopathy.

Morgan | 2022 Edit