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NURS 2514 > CHAPTER 2 - LIVER > Flashcards

CHAPTER 2 - LIVER Flashcards

1
Q

What is the functional units of liver

A

lobules

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2
Q

what do lobules contain

A

hepatocytes (liver cells)

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3
Q

what other stuff are in the liver?

A

capillaries ( sinusoids) lined with kupffer

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4
Q

what is kuffer

A

another type of cells that perform immune function

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5
Q

what are the 2 fuctions of Kuffer cells

A

1) remove bacteria and toxins from blood

2) Ingest and breakdown old red blood cells

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6
Q

what is hepatic portal vein

A

Vein that brings blood from the stomach, and pancreas directly to the liver. ]This blood contains products of digestion.

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7
Q

What are the functions of the liver? (8)

A

1) Destroy - destroy bacteria in portal blood
2) Metabolize - metabolize drugs, hormones, and toxins
3) Produce - Produce fatty acids, triglycerides, cholesterol, and lipoproteins ( ex. HDL and LDL)
4) Maintain - maintain blood glucose
5) Produce - Produce urea
6) Produce - produce clotting proteins, albumin, angiotensinogen, IGF
7) Produce - Produce bile salts
8) Excrete - Excrete bilirubin in the bile

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8
Q

Kupffer cells are made up of

A

macrophages

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9
Q

Immune function

A

Blood from gastrointestinal tract ( Containing bacteria, endotoxins, and microbes) flows to the liver where kupffer cells work to clean the blood

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10
Q

In severe liver disease what happens to the blood coming from intestines?

A

Shunted and not passed through the liver as a result, bacteria and toxins are not cleaned out and left circulating in the blood.

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11
Q

what does liver metabolize?

A

Metabolizes fat, carbs and proteins.

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12
Q

what emulsifies fat?

A

Bile

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13
Q

why do we need to emulsify fats?

A

it allows fat to be transported into the blood stream.

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14
Q

liver turns fatty acids and glycerol into?

A

trygleceride and cholesterol

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15
Q

the liver repackage tryglecerides and cholesterol by adding what

A

proteins

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16
Q

repackaged cholesterol and trygleceride with protein is called

A

lipoprotein

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17
Q

Lipoprotein is stored as

A

adipose tissue

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18
Q

what is glycogenesis

A

coverts glucose to glycogen

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19
Q

what is glycogenolysis

A

breaks down glycogen to glucose

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20
Q

what is gluconeogenesis

A

formation of glucose from amino acids/ fatty acids

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21
Q

what releases insulin and glucagon?

A

pancrease

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22
Q

when is glucagon released?

A

when blood sugar is low

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23
Q

when is insulin released

A

when blood glucose in high

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24
Q

Prolonged fasting will lead to

A

liver converting fatty acids and glycerol into ketone bodies and using that as the bodies source (gluconegenesis)

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25
Q

Protein

A

Synthesis of plasma proteins ( albumin and globulin)

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26
Q

how does liver work with protein

A

breaks down amino acids (deamination) –> converts ammonia into urea to be excreted by kidneys

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27
Q

what is the break down of amino acid called

A

deamination

28
Q

what is albumin?

A

major plasma protein that circulates in blood stream

29
Q

what are the 2 things that albumin do

A

1) maintains oncotic pressure

2) plays a role in transportation

30
Q

How does liver work as metabolic detoxification?

A

alters medication, hormones, and other chemicals to make them less toxic

31
Q

what is first pass effect

A

liver reduce drug concentration before it reaches circulation

32
Q

Why is first pass effect good

A

diminishes reabsorption and facilitates excretion

prevents accumulation of side effects

33
Q

what are the example of hormones in metabolic detoxification

A
  • aldosterone
  • estrogen
  • testosterone
34
Q

what are the example of chemicals in metabolic detoxification

A
  • alcohol

- barbiturates

35
Q

What is the hematologic function of liver

A

synthesize most clotting factors

36
Q

what clotting factors does liver synthesize?

A

Vitamin K - fat soluble vitamin required to synthesize clotting factors.

37
Q

what does vitamin K absorption relies on?

A

Relies on bile production in the liver

38
Q

Without fat can vitamin K be stored?

A

NO

39
Q

What does vitamin K do

A

Vitamin K helps by converting some coagulation factors into their mature form.

40
Q

what plasma protein does the liver make? what does this protein do?

A

The liver makes albumin. It helps keep fluid into the IVF via oncotic pressure in the vascular system.

41
Q

What is bilirubin

A

yellowish pigment that comes in the breakdown of old RBC

42
Q

What breaks down old red blood cells

A

Macrophages on the spleen and liver break down old RBC

43
Q

Bilirubin is a key component of what?

A

Bile

44
Q

Does bilirubin dissolve well in blood?

A

No

45
Q

what does bilirubin need to do to dissolve in blood

A

Bilirubin does not dissolve well in the blood and must be transported bound to albumin

46
Q

What do we have to do in order to make bilirubin water-soluble

A

The liver conjugates bilirubin to glucuronic acid

47
Q

In order to be excreted in the bile bilirubin has to be

A

Conjugated bilirubin ( water- soluble)

48
Q

Conjugated bilirubin is called

A

Direct

49
Q

Unconjugated bilirubin is

A

Indirect or free bilirubin

50
Q

Once in the large intestine, bacteria converts bilirubin into

A
  • Stercobilinogen and urobilinogen
51
Q

Stercobilinogen is what

A

gives feces its brown colour

52
Q

what is the path way of bilirubin

A

Unconjugated –> liver –> unconjugated + glucorinic acid –> conjgated –> Bile –> small intestine –> large intestine

53
Q

urobinilogen ( by bacteria)

A

excreated or reabsorbed

54
Q

Compare conjugated bilirubin and unconjugated bilirubin

A

Unconjugated - not water soluble

conjugated - water soluble

55
Q

What is bile required for

A

Required for emulsification and absorption of fat in the intestinal tract

56
Q

what is bile made up of

A

Made up of bile salts, cholesterol, bilirubin, electrolytes, and water.

57
Q

what is bile? where is it stored

A

Dark green yellowish fluid produces by the liver and stored in the gal bladder.

58
Q

Jaundice

A

Not a disorder but can occur with variety of disease

59
Q

What is jaundice other name

A

Hyperbilirubinemia

60
Q

Jaundice results from

A

elevated bilirubin

61
Q

What does jaundice cause

A
  • causes yellow discolouration - can be visible on skin, sclera of the eye, and soft palate.
  • May also cause pruritis ( itching)
62
Q

what are the 3 main types of Jaundice

A
  1. Prehepatic - hemolitic
  2. Hepatic - intrahepatic
  3. Posthepatic - extra hepatic
63
Q

Prehepatic jaundice

A
  • results from increase in bilirubin before reaching the liver
  • Overproduction of unconjugated bilirubin
64
Q

what is the main cause of prehepatic jaundice

A
  • excessive hemolysis - break down of RBC

- The liver cannot conjugate the bilirubin fast enough because of the increase load

65
Q

conditions examples that causes prehepatic jaundice

A

reactions such as

- hemolytic jaundice of newborn and blood transfusion reaction

66
Q

Prehepatic jaundice is characterized by

A
  1. increased unconjugated bilirubin
  2. decrease hematocrit
  3. normal liver enzymes
  4. urine will appear normal (amber)

NURS 2514 (11 decks)

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