August 12, 2015 - Liver Podcasts 1-7

Question 1

Liver Blood Supply

Answer 1

Has two inflows of blood and one outflow.

Blood flows in through the hepatic artery (20%) and the portal vein (80%).

Question 2

Portal Vein

Answer 2

Brings in 80% of the blood from the liver. The blood comes from the GI tract and is rich with nutrients that need to be filtered. Blood then flows back to the heart through the right hepatic vein, the middle hepatic vein, and the left hepatic vein. These then flow into the inferior vena cava.

Question 3

Portal Triad

Answer 3

The portal vein, hepatic artery, and bile duct travel together throughout the liver.

Hepatic artery and portal vein flow in the same direction, while the bile duct flows in the opposite direction towards the bile duct, which in turn empties into the common bile duct before being dumped into the second part of the duodenum.

Question 4

Acinus

Question 5

Cirrhosis

Answer 5

A condition in which the liver does not function properly due to long-term damage. Symptoms as they come on may include weakness, tiredness, itchiness, swelling in the lower legs, yellow skin, fluid buildup, or the development of spider-like blood vessels on the skin.

Question 6

Conjugated Bilirubin

Answer 6

Formed by UGT acting on bilirubin. The conjugated bilirubin is then excreted into the bile which makes it to the stool and turns it brown, as well as urine yellow.

Question 7

Blockage of Bile Flow

Answer 7

As caused by a bile duct stone or a cancer in the head of the pancreas. The bile duct will become dilated and conjugated bilirubin will no longer make it to the colon. This will cause the stool to turn clay-coloured, dark tea-coloured urine, and jaundice.

Question 8

Composition of Bile

Answer 8

90%: Bile salts

Lecithin

Cholesterol

10%: Bilirubin

Proteins

Ions

Question 9

Cholestasis

Answer 9

Lack of bile flow.

Question 10

Bilirubin

Answer 10

Comes from the breakdown of red blood cells and is conjugated in the liver for the elimination in the bile.

Question 11

Increase in Bilirubin

Answer 11

Can result in jaundice and may be pre-hepatic (before conjugation), hepatic (due to hepatocellular or cholestatic liver disease), or post-hepatic (due to blockage of the extra-hepatic bile ducts) in origin.

Question 12

Albumin

Answer 12

One of the main proteins manufactured by the liver and is important for transporting many things (including unconjugated bilirubin and drugs) in the blood stream while helping to maintaing oncotic pressure in blood vessels.

A decrease in albumin may be associated with chronic liver disease, but may also be seen with malnutrition or acute inflammation in the body.