Chapter 38 Flashcards
functions of the liver
- detoxifies/removes drugs and alcohol.
- stores glycogen, vitamins A, D, E, K, iron, and cholesterol
- activates vitamin D
- phagocytosis
- metabolizes absorbed food and molecules
hepatic portal vein leads to the
digestive tract and major abdominal organs
hepatic veins are valveless veins that
empty into the inferior vena cava
physiologic and metabolic functions of the liver
- drug and hormone metabolism
- bile production, digestive secretion
- synthesizes clotting factors
- filter blood and bacterial and foreign particle removal
- conversion of amonia to urea
- synthesizes plasma proteins
- maintenance of blood glucose
metabolic functions:
sugars ->
stored as glycogen, converted to glucose, used to make fats
metabolic functions:
proteins ->
synthesized from amino acids; ammonia made into urea
metabolic functions:
fats ->
oxidized for energy, synthesized, packaged into lipoproteins
what is the major cause of prehepatic jaundice
excessive hemolysis of red blood cells
intrahepatic jaundice is caused by
disorders that directly affect the ability of the liver to remove bilirubin from the blood or conjugate it so it can eliminated in the bile
posthepatic occurs when
bile flow is obstructed between the liver and the intestine
what are the causes of jaundice?
- excessive destruction of rbc
- impaired uptake of bilirubin by the liver cells
- decreased conjugation of bilirubin
- obstruction of bile flow i the canaliculi of the hepatic lobules or in the intrahepatic or extrahepatic bile ducts
liver disease causes:
- drugs and alcohol
- biliary disorders
- nonalcoholic fatty liver disease and nonalcoholic steatohepatitis
- cirrhosis
alcohol-induced liver disease stages
1- fatty liver disease
2- alcoholic hepatitis (start to see symptoms)
3- alcoholic cirrhosis (blood flow impairment)
what are some things that increase drug elimination?
alcohol and barbituates and increased enzymes
a person has a poor diet and is consuming grapefruit juice… what could this lead to?
decreased drug elimination
autoimmune destruction of bile ducts
primary biliary cirrhosis
prolonged obstruction of extrabiliry tree
secondary biliary cirrhosis
liver disease to failure is
cirrhosis
in cirrhosis, nodular and fibrotic liver tissue replace
hepatic tissue
hematologic disorders are characterized by
anemia, thrombcytopenia, coagulation defects, leukopenia
endocrine disorders are characterized by
fluid retention, hypokalemia, disordered sexual functions
skin disorders are characterized by
jaundice, red palms, spider nevi
hepatorenal syndrome
azotemia, increased plasma creatinine, oliguria
hepatic encephalopathy
asterixis, confusion, coma, convulsion
obstructive jaundice
gallstones and tumors of the pancreas or bile duct
hemolytic jaundice
overactive spleen, cancers, rbc abnormailty with increased destruction
distensible, pear-shaped, muscular sac locared on the ventral surface of the liver
gallbladder
what is the function of the gallbladder?
store and concentrate bile
process of formation of gallstone:
entrance of food into the intestine cuases the gallbladder to contract and the sphincter of the bile duct to relax. –> bile moves into duodenum
the two primary factors that contribuate to the formation of gallstones
- abnormalities in the composition of bile
2. stasis of bile
exocrine pancreas releases
digestive juices through a duct to the duodenum
endocrine pancreas releases
hormones into the blood
insulin and glucogon is _________ function
endocrine
amylase (carbohydrates), trypsin (proteins), lipase (fats) = ________ function
exocrine
common causes of acute pancreatitis
gallstones/reflux, alcohol abuse
biliary reflux:
- gallbladder contracts
- bile is sent down common bile duct
- blockage forms in ampulla of vater: bile cannot enter duodenum- usually from a gallstone.
- bile goes up pancreatic duct
- bile in pancreas disrupts tissues; digestive enzymes activated
explain acute pancreatitis
happens when activated enzymes digest the pancreas cells. these enzymes cause autodigestion of pancreatic tissue and leak into bloodstream to cause injury to blood vessels and other organs
patients with chronic pancreatitis often have
digestive problems because of inability to deliever enzymes to the duodenum, glucose control problems because of damage to islets of Langerhans, signs of biliary obstruction because of underlying bile tract disorders .
