Clinical Aspects, Gallbladder, Liver

Question 1

What are the two general causes of peptic ulcers?

Answer 1

insufficient protection from HCl and pepsin, helicobacter pylori

Question 2

How could there be insufficient protection from HCl?

Answer 2

damaged mucous coat

too much HCl and pepsin

Question 3

How long does it take for lumen to repair after damage?

Answer 3

1-2 months if the luminal activity is decreased

Question 4

What are some examples of factors that delay healing of a peptic ulcer?

Answer 4

cigarette smoking, alcochol, caffiene, calcium, aspirin

Question 5

What can aggravate an ulcer, but not cause it?

Answer 5

stress and spicy foods

Question 6

What is the cause of gastroesophageal reflux?

Answer 6

stomach chyme backing up into the lower esophagus

Question 7

What are some possible contributing factors to reflux?

Answer 7

chronic gastritis (inflammation of stomach lining)
hiatal hernia
pregnancy
incompetent lower esophageal sphincter
subluxations

Question 8

What are some ways to reduce reflux?

Answer 8

keep a food diary of food, spices and drinks consumed along with reflux episodes

limit how much is eaten at one time

do not eat less than 3 hours before bed

Question 9

What are some problem foods for reflux?

Answer 9

spices (pepper, garlic, onion, peppermint, cinnamon)

acidic foods (citrus, tomatoes)

acidic beverages (fruit juices, carbonated drinks, coffee, tea)

fatty foods

alcohol

Question 10

What is Barrett’s Esophagus?

Answer 10

stratified squamous epithelium is replaced by mucus-secreting simple columnar epithelium in lower (proximal) esophagus. This is metaplasia due to a chronic problem.

Question 11

Where is the gallbladder located?

Answer 11

inferior to the liver

Question 12

What is the function of the gallbladder?

Answer 12

store bile (can hold ~70mL)
concentrate bile

Question 13

What is Hepatic Bile?

Answer 13

primary bile from the liver

Question 14

What is Cystic Bile?

Answer 14

concentrated bile from gallbladder

Question 15

What is bile release controlled by?

Answer 15

CCK and vagus nerve

Question 16

What is the surface epithelium

Answer 16

simple columnar

Question 17

What are some cell types within the surface epithelium of the gallbladder?

Answer 17

clear cells (cholangiocytes)
few brush cells

Question 18

What is the function of the clear cells? What do they have a lot of?

Answer 18

concentrate bile by absorbing water

many microvilli

Question 19

What is the function of brush cells?

Answer 19

produce mucinogen

Question 20

What is the lamina propria made of?

Answer 20

loose and very vascular CT

Question 21

What does the neck of the lamina propria contain?

Answer 21

small mucous glands

Question 22

What is the function of the lamina propria?

Answer 22

lubricate the narrow neck lumen

Question 23

What is the muscularis musoca made of in the gallbladder?

Answer 23

nothing! it’s absent!

Question 24

What is so significant about the submucosa of the gallbladder?

Answer 24

it’s absent!!

Question 25

What is special about the muscularis externa?

Answer 25

it doesn't have a normal patterns. it consists of a thin smooth muscle layer with a disorganized muscle arrangement

Question 26

Does the gallbladder have serosa or adventita?

Answer 26

mostly serosa, but some adventitia where it attaches to the liver

Question 27

What is the pancreas surrounded by?

Answer 27

a thin CT capsule

Question 28

What creates lobules of the pancreas?

Answer 28

septa, they dive into the organ to create them

Question 29

What is the endocrine pancreas?

Answer 29

Islets of langerhans (pancreatic islets) producing hormones

Question 30

What is the exocrine pancreas?

Answer 30

serous acini producing digestive enzymes

Question 31

What is the largest portion of the pancreas?

Answer 31

exocrine portion

Question 32

What controls the secretion of the serous (pancreatic) acini?

Answer 32

CCK and acetylcholine from parasympathetic nerves

Question 33

What do the pancreatic ducts secrete?

Answer 33

water and HCO3

Question 34

What is the secretion of the pancreatic duct controlled by?

Answer 34

secretin and acetylcholine from parasympathetic nerves

Question 35

What are some characteristics of pancreatic ducts?

Answer 35

centroacinar cells, centroacinar cells, collagen-rich CT wraps pancreatic ducts

Question 36

Where are centroacinar cells of the pancreas located?

Answer 36

next to acinar cells

Question 37

What do centroacinar cells of the pancreas do?

Answer 37

produce alkaline fluid with large quantities of bicarbonate ions which are released into the duodenum to buffer stomach chyme

Question 38

What is the function of collagen rich CT of the pancreas?

Answer 38

provide extra protection from the possible leading of digestive enzymes

Question 39

What else produces alkaline fluid in the pancreas?

Answer 39

cuboid cells

Question 40

What is the largest gland in the body?

Answer 40

liver, has endocrine and exocrine functions

Question 41

What are the general functions of the liver?

Answer 41

metabolism of lipids, carbs and proteins production of blood proeins, factors and non-essential vitamins detoxify blood produce hepatic bile primarily (exocrine function) store certain vitamins (A and B12)

Question 42

What is the classic liver lobule?

Answer 42

hexagonal-shaped lobules are difficult to distinguish in humans due to the lack of CT between the lobules

Question 43

What kind of cells are hepatocytes?

Answer 43

microvillated cuboidal cells possessing lateral bile canaliculi between adjecent hepatocytes

Question 44

What is the function of the hepatocytes?

Answer 44

most general functions

Question 45

What do the bile canaliculi collect?

Answer 45

bile

Question 46

How does bile flow through a liver lobule?

Answer 46

bile moves from the hepatocytes toward the bile duct branch in the portal triad

Question 47

What is the arrangement of hepatocytes in the liver?

Answer 47

in rows between hepatic sinusoids like spokes of a wheel

Question 48

What are Kupffer cells?

Answer 48

stellate macrophages, resident macrophages that develop from monocytes

Question 49

What is the function of Kupffer cells?

Answer 49

phagocytosis of debris and aged RBCs, act as an antigen presenting cell

Question 50

What are Ito cells?

Answer 50

hepatic stellate cells

Question 51

What is the function of Ito cells?

Answer 51

store lipids for immediate use, store vitamin A, produce collagen I, III, IV and growth factors

Question 52

What are pit cells?

Answer 52

natural killer cells?

Question 53

What are hepatic progenitor cells?

Answer 53

likely present and responsible for regenerative capabilities

Question 54

What is the portal triad?

Answer 54

hepatic artery, portal vein, bile duct, (lymph vessels)

Question 55

What are hepatic sinusoids?

Answer 55

dilated, fenestrated thin walled vessels found between the rows of hepatocytes; carry a mixture of venous and arterial blood

Question 56

What is the ratio of venous to arterial blood in the hepatic sinusoids?

Answer 56

venous- 75% | arterial- 25%

Question 57

What is the central vein?

Answer 57

fenestrated thin walled vessel that collects blood from hepatic sinusoids

Question 58

What is the direction of blood flow within a liver lobule?

Answer 58

blood flows from the portal triad toward the central vein

Question 59

What is the space of Disse (perisinusoidal space)?

Answer 59

space between hepatocytes and fenestrated hepatic sinusoids where blood can directly contact the microvilliated surfaces of the hepatocytes

Question 60

Why is the blood flow slow in the perisinusoidal space?

Answer 60

so the cells can interact with the blood and its contents, this is why the liver can take over the job of the spleen in 24-48 hours

Question 61

What is Glisson's capsule?

Answer 61

dense irregular CT covered with serosa

Question 62

What occurs after a splenectomy?

Answer 62

liver takes over blood filtration in 24-48 hours