Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

HYMS Y1 > Block 3 W3 > Flashcards

Block 3 W3 Flashcards

1
Q

What are the functions of the liver?

A
  • production and secretion of bile
  • detoxification
  • storage of glycogen and triglycerides
  • plasma protein synthesis
  • production of coagulants and anticoagulants
  • storage of vitamins, Fe and Cu
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Where does the liver lie?

A

Inferior and posterior to diaphragm, covered by costal margin so impalpable. Ascends to 4th rib.
Right hypochondriac and epigastric.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How is the liver separated into right and left?

A

Falciform ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which ligaments attaches the liver to diaphragm?

A

Coronary, falciform and left/right triangular ligaments.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What do the lesser and greater sacs contain?

A

Peritoneal fluid - acts as lubricant and defence mech.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the surfaces of the liver?

A

Diaphragmatic - anterosuperior

Visceral - posteroinferior

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Where does the fundus of the gallbladder lie?

A

Tip of 9th costal cartilage, where linea semilunaris meets costal cartilage and transpyloric plane.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the bare area?

A

Area on the diaphragmatic surface of liver with no peritoneal lining.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the 3 hepatic veins?

A

Right, middle and left hepatic veins - blood comes from portal system and drains into IVC.
IVC deeply imbedded in posterior aspect of liver.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Where is the fissure for ligamentum teres located?

A

Between left lobe and quadrate lobe.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Where is the fissure for ligamentum venosum located?

A

Between left lobe and caudate lobe.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Where is the fossa for gallbladder located?

A

Between quadrate lobe and right lobe.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Where is the fissure for IVC located?

A

Between caudate lobe and right lobe.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Where is the caudate lobe?

A

Between IVC and fissure of ligamentum venosum.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Where is the quadrate lobe?

A

Between gallbladder and fissure of ligamentum teres.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Define porta hepatis.

A

Doorway to liver, hilum of liver.
Situated in transverse fissure between caudate and quadrate lobes.
Transmits all vessels, nerves and ducts entering and leaving the liver.
Travels through hepatoduodenal ligament.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Define portal triad.

A

Hepatic artery proper + hepatic portal vein + common bile duct.
Also contains lymphatic vessels and vagus nerve fibres.
Occurs at every corner of lobules.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Describe the lobules of the liver.

A

Each anatomical lobules is hexagonal-shaped and is drained by central vein.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Where does the hepatic artery proper stem from?

A

From coeliac trunk after gastroduodenal artery splits from hepatic artery.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Where does hepatic portal vein contain?

A

Accumulations of blood vessels containing nutrient rich blood from lower GI tract.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Define omental foramen.

A

Opening into the lesser sac (can insert finger).

Epiploic foramen/foramen of Winslow.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Describe the blood supply of the liver.

A

O2 - HA 80% / HPV 20%
Volume - HA 20% / HPV 80%
Venous blood is drained by hepatic veins into IVC.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Define liver sinusoids.

A

Type of sinusoidal blood vessel that allows mixing of oxygen rich blood from HA and nutrient rich blood from HPA.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Describe the blood supply and ducts of quadrate and caudate lobes.

A

Quadrate - receives blood from left hepatic artery and drains bile into left hepatic duct.
Caudate - receives blood from right and left hepatic arteries and drains bile into both right and left hepatic ducts.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Why can some lobes of liver be removed?

A

There are 8 sub-lobes of liver - each with own blood supply and duct.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Describe the innervation of the liver.

A

Hepatic plexus:
Sympathetic - coeliac plexus
Parasympathetic - vagus nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Describe the lymphatic drainage of the liver.

A

Anterior - hepatic lymph nodes (cisterna chyli)

Posterior - phrenic and posterior mediastinal nodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Describe the location of the pancreas.

A

Retroperitoneal organ except for tail, lying in epigastrium and left hypochondriac region.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Describe the structure of the pancreas.

A

Tail -> body -> neck -> head -> uncinate process.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Describe the head of the pancreas.

A

Lies within the C-shaped concavity of duodenum.
Contains the hepatopancreatic ampulla (of Vater).
Beginning site of accessory pancreatic duct.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Describe the body of the pancreas.

A

Lies on transpyloric plane.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Describe the tail of the pancreas.

A

Projects towards spleen, beginning site of main pancreatic duct.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Describe the uncinate process of the pancreas.

A

Hook-like projection of the head behind the superior mesenteric vessels.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What are the functions of the pancreas?

A

Exocrine - produces digestive enzymes (pancreatic acini cells).
Endocrine - secretes insulin and glucagon (islets of Langerhans).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What are the 2 ducts of the pancreas?

A
  1. Main pancreatic duct - originating in tail, carries pancreatic juice.
  2. Accessory pancreatic duct - originating in head.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Describe the spleen.

A

Large vascular lymphatic organ.
Reticuloendothelial.
Developed as a thickening of the mesenchyme in the dorsal mesogastrium and shares blood supply due to embryonic origin with GI system.

37
Q

Describe the location of the spleen.

A
  • left hypochondria

- against diaphragm and ribs 9-11 posteriorly (vulnerable space)

38
Q

Describe the surfaces of the spleen.

A

Diaphragmatic surface - convex and smooth

Visceral surface - concave and irregular due to impressions by stomach, colic flexure and kidney.

39
Q

What are the ligaments of the spleen?

A

Lienogastric (splenogastric) ligament

Lienorenal (splenorenal) ligament.

40
Q

What are the functions of the spleen?

A

White pulp - primary lymphatic tissue -> site of immune and phagocytic action.
Red pulp - filters blood (removes damaged/old erythrocytes and platelets by macrophages), blood reservoir (of blood and platelets).

41
Q

Describe the vasculature of the pancreas.

A

Pancreatic branches of splenic artery.
Head supplied by superior and inferior pancreaticoduodenal arteries.

Splenic vein
Head drained by superior mesenteric veins.

42
Q

Describe the lymphatic drainage and innervation of the pancreas.

A

Pancreaticosplenal nodes (coeliac nodes)

Innervated by coeliac plexus.

43
Q

When is the spleen palpable?

A

Normally impalpable until it enlarges and drops below costal margin. Use ridges/notches of spleen to differentiate from kidneys.

44
Q

Define hepatosplenomegaly.

A

Due to common blood supply of liver and spleen, blockage in liver backlogs into splenic vein -> enlargement of spleen.

45
Q

Describe the vasculature, innervation and lymphatic drainage of spleen.

A

Supplied by splenic artery.
Drained by splenic vein.
Innervated by coeliac plexus.
Lymphatic drained by pancreaticosplenic nodes.

46
Q

Where is the gallbladder located?

A

Lies on visceral surface of liver, 9th costal cartilage.

47
Q

Describe the structure of the gallbladder.

A

Fundus - rounded distal portion (midclavicular line)
Body - largest part lies next to superior duodenum and transverses colon
Neck - narrowest and gives rise to cystic duct with spiral valves (contains mucosal fold, Hartmann’s pouch - common site of gallstones).
Cystic duct.

48
Q

Define the function of the gallbladder.

A

Receives, concentrates, stores and releases bile.

49
Q

Describe the biliary tree.

A

Right + left hepatic ducts = common hepatic duct + cystic duct = common bile duct.

CBD joins with main pancreatic duct = hepatopancreatic ampulla (of Vater) - releasing at major duodenal papilla.

50
Q

Describe the vasculature, innervation and lymphatic drainage of the gallbladder.

A 
Supplied by cystic artery.
Drained by cystic veins.
Sympathetic innervation - coeliac plexus
Parasympathetic - vagus nerve
Lymph - cystic lymph nodes.
51
Q

Describe the function of the kidney.

A

Homeostasis, removal of excess organic molecule from blood - excretes urine/waste into ureter -> bladder.

52
Q

Describe the vasculature and lymphatic drainage of the kidneys.

A

Renal arteries and veins.
Right renal artery is longer and posterior to IVC due to position of abdominal aorta.
Left renal vein is longer and anterior to abdominal aorta.

Lateral aortic nodes

53
Q

Why is the right kidney lower than left?

A

Right kidney is lower than left due to large size of liver (rib 12 vs. rib 11).
T12-L3

54
Q

Where do the adrenal glands sit on the kidneys?

A

Immediately superior.

55
Q

What are the lobules of the liver made of?

A

Hepatocytes + hepatic sinusoids + reticuloendothelial cells + bile canaliculi + central vein + portal triad.

56
Q

List the broad functions of the liver.

A
  1. Carbohydrate metabolism
  2. Non-carbohydrate metabolism
  3. Lipid metabolism
  4. Protein metabolism
  5. Storage of fat, vitamins and minerals
  6. Destruction of RBCs
  7. Catabolism of hormones, toxins, drugs
  8. Bile production
57
Q

Describe the carbohydrate and non-carbohydrate metabolism functions of the liver.

A

Glucose stored in liver as glycogen.
AA and lactate stored in liver -> can be converted to glucose by gluconeogenesis.
Glucose homeostasis via insulin and glucagon.

58
Q

Describe the lipid metabolism functions of the liver.

A

Phospholipid and cholesterol synthesis

59
Q

How is cholesterol synthesised?

A

Acetyl CoA converted to isopentenyl pyrophosphate by enzyme HMG-CoA Reductase -> inhibited by statins.
Cholesterol is important for building blocks of bilayer and hormones.

60
Q

Describe the transport of cholesterol in the blood.

A
  1. chylomicrons from intestine enters capillaries -> broken down by lipoprotein lipase in tissues
  2. chylomicrons lose lipids -> remnant -> taken back to liver.
  3. in liver, converted to VLDL -> travels back to capillaries and tissues for further breakdown by lipase -> IDL -> goes back to liver or converted to LDL.
  4. LDL is transported back to liver or taken up by other tissues -> unloads lipids and converted to HDL.
61
Q

Describe the reverse cholesterol transport.

A

HDL precursors released from liver and intestine, picks up excess fatty acids from tissues and takes back to liver.

62
Q

Describe how LDL is taken up by cells?

A

LDL binds receptors -> internalised -> lysosomal hydrolysis separates amino acids and cholesterol.

63
Q

Define familial hypercholesterolaemia.

A

No LDL receptors so LDL builds up in circulation -> fatty deposits around the body.
Macrophages try to remove LDL.

64
Q

Describe the protein metabolism function of the liver.

A

Synthesises nonessential AAs and plasma proteins.

Liver produces albumin and clotting factors.

65
Q

Describe urea formation.

A

Proteins can’t be stored, either used up or excreted:

Protein -> AA -> ammonia -> urea -> secreted in urine via deamination.

66
Q

Describe the storage of fat, vitamins and minerals.

A

Liver stores iron, vitamin A, D, E and B12.

Stored fatty acids as hepatic lipid droplets - these used for TAG synthesis or VLDL synthesis.

67
Q

Describe the breakdown of RBCs by the liver.

A

Haemoglobin -> globin and haem.

Globin -> AAs (recycled for use)
Haem -> iron and bilirubin

Iron - recycled to liver/spleen
Bilirubin - excreted in urine/used in bile.

68
Q

Describe the catabolism of hormones, toxins and drugs function of the liver.

A

Toxin substances are presented to liver via portal circulation. Liver modifies these substances in first-pass metabolism.

  • phase I (P450 system) -> inactivates drugs
  • phase II (glycoronide) -> secretion in urine.
69
Q

Describe the bile production function of the liver.

A

Produces 700ml/day

Contains mucin, bilirubin, cholesterol, antibodies phospholipids.

70
Q

What are the disorders associated with liver?

A
  • hepatitis -> inflammation of liver due to bacteria/viral infection
  • hepatoma -> liver tumour
  • cirrhosis -> normal liver tissue replaced by scar tissue - fatty liver
  • jaundice -> hyperbilirubinemia - yellowish corners of eyes and skin.
71
Q

What are the causes of jaundice?

A
  • RBC destruction -> neonatal jaundice as babies born with more RBC than required.
  • Infectious hepatitis
  • Obstruction of bile duct
72
Q

What are the liver enzyme tests?

A

Alanine amino transferase (ALT) - occurs in cytosol of hepatocytes. High levels = high hepatocyte destruction.
Normal = 40
Asperate amino transferase (AST) - present in heart, liver, kidney, brain, skeletal muscle cells. Normal = 40.

73
Q

What are the liver non-enzyme tests?

A

Albumin levels - since liver produces this (35-40 g/L)

Prothrombin time - since liver produces coagulation factors (11-13.5 secs / INR = 0.8-1.1)

74
Q

Describe the process of bile release from the gallbladder.

A
  • chyme with fat enter duodenum -> stimulates I cells to secrete CCK into blood
  • CCK stimulates muscular layer of gallbladder wall to contract
  • bile passes down from cystic duct and CBD to duodenum
  • hepatopancreatic sphincter relaxes and bile enters duodenum.
75
Q

What are the functions of bile?

A
  1. alkaline bile - neutralises excess acid from stomach before chyme enters ileum.
  2. carries antibodies (IgA) - destroys microbes on food.
  3. emulsifies fat
  4. route of exception for bilirubin.
76
Q

Describe the formation of bilirubin and breakdown of haem.

A

(RBC -> haem -> biliverdin -> unconjugated bilirubin)spleen macrophage —> (unconjugated bilirubin + albumin = unconjugated bilirubin albumin complex)bloodstream —> (complex converted to conjugated bilirubin by glucuronyl transferase)liver —> (conjugated bilirubin released in bile -> gut bacteria converts to urobilinogen)small intestine -> 20% enterohepatic circulation / 80% converted to stercobilin -> faeces.

77
Q

Describe unconjugated bilirubin.

A
  • insoluble so combines with soluble albumin in blood
  • absent in bile (if present -> liver disorder)
  • asent in urine as should be converted to urobilinogen in instestine.
78
Q

Describe conjugated bilirubin.

A
  • water soluble
  • present in bile
  • normally absent in urine
79
Q

Describe the direct measurement of the Van Den Bergh reaction.

A

Agent + conjugated bilirubin = change to red colour
Agent + unconjugated bilirubin = no change in colour
Unconjugated bilirubin is attached to albumin so not dissolved and free in plasma.

80
Q

Describe the indirect measurement of the Van Den Bergh reaction.

A

Agent + methanol + unconjugated bilirubin = change to red colour.
Methanol dissolves unconjugated bilirubin so freed from albumin.

81
Q

Explain the serum and urine bilirubin levels in haemolytic anaemia.

A

Premature destruction of RBC - high amounts so liver can’t cope -> increased unconjugated bilirubin.

82
Q

Explain the serum and urine bilirubin levels in hepatitis.

A

Liver not functioning, no capacity to conjugate bilirubin so high conjugated and unconjugated bilirubin.
Micro-obstruction in bile duct leads to backlog into blood -> filtered and bilirubin present in urine.

83
Q

Explain the serum and urine bilirubin levels in obstructive jaundice.

A

Obstruction of bile duct -> more conjugated bilirubin.

84
Q

Describe the formation of cholesterol stones.

A

Bile supersaturated with cholesterol -> cholesterol precipitates as solid cholesterol monohydrate crystals -> aggregate with other elements to form recognisable macroscopic concretion.

85
Q

Describe how biliary colic occurs?

A

High fat diet -> release of CCK -> contraction of gallbladder wall -> stones pushed into cystic duct and blocks it so bile is not released -> biliary colic (gallbladder attack - stones fall back into gallbladder).

86
Q

Define choledocholithiasis.

A

Position of cholesterol stones obstruct CBD -> build up of bile as not emptying due to blockage -> backlogs into liver and hepatic arteries.
Conjugated and unconjugated bilirubin builds up in circulation -> hyperbilirubinaemia.

87
Q

What are the consequences of choledocholithiasis.

A
  • Conjugated bilirubin in urine as kidney filters blood full of bilirubin.
  • Jaundice
  • Clear-coloured stools - bilirubin not in intestine for breakdown into stercobilin by bacteria.
  • Dark-coloured urine - conjugated bilirubin in urine.
88
Q

Define ascending cholangitis.

A

Inflammation of bile duct due to untreated gallstones as antibodies not descending so bacteria from food build up and ascend bile duct.

HYMS Y1 (25 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions