Bile, Biliary Tree and Gall Stones Pathophysiology Flashcards
What lies at the centre of liver lobules?
Central vein
What carries blood to the central veins?
Sinusoids
Which cells produces bile?
Hepatocytes
What conducts bile into the interlobular bile ducts?
Bile canaliculi
What shape are liver lobules?
Hexagons
What structure lies in 3 corners of the liver lobule?
Interlobular portal triad
What constitutes the interlobular portal triads?
1) . Interlobular hepatic portal vein
2) . Interlobular hepatic artery
3) . BInterlobular biliary duct
What are the 3 parts of the gall bladder?
1) . Fundus
2) . Body
3) . Neck
What duct conducts bile from the gall bladder?
Cystic duct
Describe the constitution of bile?
Approx:
- 70% bile salts and acids
- 10% cholesterol
- 5% Phopholipids
- 5% Proteins
- 1% Conjugated Bilirubin
- The rest is water, bicarbonate and electrolytes (E.g. Ca2+)
What are the 2 types of stones?
1) . Cholesterol stones
2) . Pigmented stones (bilirubin stones)
What percentage of stones are cholesterol stones?
75-90%
What is the purpose? of bile
To emulsify fats
What is the name of a molecule with both a water-soluble portion and a lipid-soluble portion?
Amphipathic
What are bilirubin stones usually made from?
Unconjugated bilirubin + Ca2+
Are cholesterol stones radio-opaque?
Not usually although sometimes they can be?
How might a cholesterol stone become radio-opaque?
Adoption of CaCO3
Are bilirubin stones radio-opaque?
Yes - because of the calcium in them
What kind of bilirubin is usually in bilirubin stones?
Unconjugated bilirubin (1-2% of total bilirubin in the bile is unconjugated)
How can bacteria cause stones?
Bacteria (such as E. Coli) tend to hydrolyse bilirubin and cause more unconjugated bilirubin that becomes pigmented stones
Name 3 risk factors for stones and say why
- Being female (+ being on the contraceptive pill)
- Linked to estrogen
2) . Obesity
- Increased cholesterol
3) . Rapid weight loss
- Increased lipids
