Basic

Question 1

Extra-hepatic biliary tract development may require the expression of

Answer 1

Extra-hepatic biliary tract development may require the expression of sex determining region Y-box 17 (SOX17), which is regulated by the homolog of hairy/enhancer-of- split (Hes1).

Question 2

Intrahepatic biliary development

Answer 2

begins at 6 weeks when a subset of hepatoblasts close to the portal mesenchyme strongly express biliary-specific antigens

Question 3

These biliary precursor cells form a continuous single-layered ring around the portal mesenchyme

Answer 3

called the ductal plate.

Question 4

he earliest sign of biliary differentiation is expression of SOX9

Answer 4

a transcription factor that regulates the timing of biliary duct development.

Question 5

maintenance of duct structure during the elongation phase requires that mitoses be aligned uniformly along the axis of the duct, a process called planar cell polarity, which is controlled by

Answer 5

non-canonical Wnt signaling and is defective in fibropolycystic liver disease.

Question 6

The extra-embryonic venous systems are the omphalomesenteric (vitelline) and umbilical (placental) veins, and the intraembryonic system

Answer 6

includes the cardinal veins that drain the venous blood of the embryo to the heart

Question 7

Vascular development

Answer 7

The right umbilical vein regresses, whereas the left umbilical vein forms 2 left-right shunts, one with the right vitelline vein (the portal sinus) and one with the right hepatocardiac channel (the venous duct).

Question 8

After birth,

Answer 8

the obliterated prehepatic segment of the left umbilical vein becomes the round ligament of the liver (ligamentum teres hepatis) in the free edge of the falciform ligament, and the ductus venosus collapses and becomes the ligamentum venosum.

Question 9

Anatomy

Answer 9

Parietal peritoneum covers the liver except for the bare area

Question 10

Anatomy

Answer 10

The peritoneal reflections that surround the bare area comprise the superior and inferior coronary ligaments and the right and left triangular ligaments, which attach the liver to the diaphragm;

Question 11

4 lobes are distinguished in the liver based on its external appearance:

Answer 11

right, left, caudate, and quadrate. On the anterior surface, the falciform ligament divides the liver into the right and left anatomic lobes.

Question 12

This plane, which has no external indications, is called the

Answer 12

Cantlie line.

The true right and left lobes of the liver are of roughly equal size and are divided not by the falciform ligament, but by a plane passing through the bed of the gallbladder and the notch of the inferior vena cava.

Question 13

The liver receives approximately 70% of its blood supply and 40% of its oxygen from the ____and 30% of its blood supply and 60% of its oxygen from the hepatic artery

Answer 13

.portal vein

formed from the confluence of the superior mesenteric vein and the splenic vein.

Question 14

The hepatic artery

Answer 14

_____
commonly arises from the celiac trunk, although occasionally it
arises from the superior mesenteric artery

Question 15

Three major hepatic veins drain into the

inferior vena cava,

Answer 15

although in 60% to 85% of persons, the left

and middle veins unite to enter the inferior vena cava as a single vein.

Question 16

is composed of the common hepatic duct, cystic duct, gallbladder, and right and left hepatic ducts.

Answer 16

extra hepatic biliary tract

Question 17

formerly known as “Ito cells” or fat- storing cells, are perisinusoidal cells that, in their quiescent state, are the main site of vitamin A storage.

Answer 17

Hepatic stellate cells

They encircle the sinusoidal wall and may regulate the width of the lumen.

Question 18

____ remains between the sinusoidal lining and the vascular pole of hepatocytes and communicates with the sinusoidal space through multiple fenestrations

Answer 18

A perisinusoidal space, the space of Disse

this space contains plasma and collagen types I, III, IV, and V, which act as the scaffolding of the organ

Question 19

is a space between the periportal hepatocytes and portal connective tissue.

Answer 19

The space of Mall

Question 20

the following 3 zones exist

Answer 20

(1) the periportal zone (zone 1), which is supplied by blood with high oxygen content;
(2) the intermediate zone (zone 2)
(3) the perivenular zone (zone 3), receives blood that is relatively low in oxygen content

Question 21

The convex aspect of the sickle abuts a portal tract, its arms extend along septal branches, and the concave aspect faces the central vein.

Answer 21

This arrangement defines 2 zones: the peripheral part of the classic lobule composed

Question 22

The zonal arrangement of the lobule gives rise to functional

heterogeneity of hepatocytes in the lobule, or “metabolic zonation”

Answer 22

gluconeogenesis occurs
largely in the periportal region (zone 1),

whereas glycolysis
occurs predominantly in the centrilobular region (zone 3)

Question 23

lobe denotes a prominent right liver lobe that extends

below the level of the umbilicus.

Answer 23

Riedel lobe

Question 24

Riedel lobe

Answer 24

an anatomic variation that occurs more often in women
Liver biochemical test levels are
normal, and the diagnosis is established by US.

Question 25

Abernethy Malformation

Answer 25

congenital extra-hepatic portocaval shunt.

Question 26

Abernethy Malformation Two types of shunts are known to occur.

Answer 26

type 1 shunt, portal blood is diverted completely into the inferior vena cava, with absence of the portal vein. T
his type of shunt occurs more often in girls and is associated with other congenital abnormalities such as cardiac defects, biliary atresia, and polysplenia; may manifest with hypergalactosemia, hyperbilirubinemia, hyperammonemia, or variceal bleeding; and may be complicated by the formation of hepatic tumors such as focal nodular hyperplasia

type 2 Abernethy malformation, the portal vein is intact, but a side-to-side anastomosis with the inferior vena cava leads to shunting; technically, not a true absence of the portal vein.
A type 2 shunt occurs in both girls and boys and is not associated with other malformations

Question 27

Type 1 Abernethy malformation can be further divided into subtype

Answer 27

1a, in which the superior mesenteric vein and the splenic vein do not join and thus there is no anatomic portal vein

type 1b, in which the superior mesenteric vein and splenic vein do join to form a portal vein, which then drains into a systemic vein.