digestive system part 4 Flashcards
what is the largest internal organ of the body
liver
where is the liver located?
RUQ of abdomen
the liver is inferior to
diaphargm
what is the liver attached by?
coronary ligament
the liver is what kind of capsule
CT
the bare areas of the liver lack what
visceral peritoneum
what are the four lobes of the liver
left
right
caudate
quadrate
the right and left lobes are separated by
CT
what ligament anchors to anterior abdomen
falciform
what extends off inferior of the liver
ligamentum teres
in the inferior view what do you see
cuadate and quadrate and porta hepatis
what is the storage and concentrates sites for bile; made in liver
gallbladder
what is a transverse fissue; BVs/ nerves enter and bile ducts/ lymph vessels leave liver
porta hepatis
what do the hepatic ducts form
right and left lobes
blood into liver through what (2) things
hepatic portal vein and hepatic artery
porta hepatis separates what from what
caudate from quadrate lobes
5 steps for the ductwork for bile and pancreatic enzymes from liver, gallbladder, and pancreas to duodenum
- the right and left hepatic ducts first unite to form a single common hepatic duct
- the cystic duct from the gallbladder joins the common hepatic duct to form the common bile duct
- bile can flow from the gallbladder through the cystic duct into the common bile duct, or it can flow back up the cystic duct into the gallbladder
- the common bile duct joins the pancreatic duct at the hepatopancreatic ampulla which is an enlargement where the two ducts merge. the hepatopancreatic ampulla empties into the duodenum at the major duodenal papilla. a smooth muscle sphincter surrounds the common bile duct where it enters the hepatopancreatic ampulla
- the accessory pancreatic duct empties pancreatic secretions in the duodenum at the minor duodenal papilla
the liver is divided into what kind of lobules
hepatic
what are the hepatic lobules surrounded by
CT septa
where is the portal triad
at each corner
what is in the center of each lobule
central vein
what two things travel in opposite directions
blood and bile
blood from hepatic artery and hepatic portal vein-> ____________->____________
hepatic sinusoids-> central vein
what lines sinusoids
kupffer cells
kupffer cells play a role in what
innate immunity
bile is made in what
hepatocytes-> bile canaliculi-> hepatic duct-> common bile duct
what does the portal triad consist of
hepatic portal vein, hepatic artery, hepatic duct
what collects blood leaving lobule
central vein
how much bile is produced per day
600-1000 ml
composition of bile
bile salts
bile pigments
cholesterol
lipids and lipid soluble hormones
lecithin
what do bile salts do
emulsify lipids and neutralizes stomach acid
what are bile pigments
excretory products
what are the color of feces
greenish-yellow to brown
what removes glc from blood
hepatocytes
when hepatocytes remove glc from blood it stores what
glycogen, lipids, vitamins
what is processing of nutrients
transformation substances into more readily usable substances
what is detoxification
Make less toxic or enhance elimination NH3 Urea (remove in urine)
kupffer cells have a role in what
phagocytosis
what happens during synthesis of new molecules
produce plasma proteins
cholesterol synthesis for PM and steroid hormones
what is a sac for bile concentration and storage
gallbladder
bile salts and pigments are 5-10x more concentrated than?
the liver
where is gallbladder located
inferior to liver
what drains into common bile duct
cystic duct
what are the 3 tunics of the gallbladder
inner mucosa
muscularis
serosa
what is the inner mucosa
rugae
what does rugae do
allow expansion
bile is released from GB by what?
contractions stimulated by CCK and vagal stimulation
do large amounts of concentrated bile dump into small intestine shortly after a meal
yes
what are insoluable aggregates ade in GB
biliary calculi
if biliary calculi is stuck in cystic duct what happens
bile blockage
would surgical removal be necessary is bad bile blockage
yes
if stuck such that blocks pancreatic duct what happens
pancreatitis
where is the pancreas located
behind stomach
head is wrapped by duodenum
tail extends to left abdomen toward spleen
endocrine =
islet of langerhans for BS control
what is controlled by langerhan cells
glucagon, insulin and somatostatin
exocrine=
acinar cells for digestive functin
what do acinar cells produce
digestive enzymes
main pancreatic duct drains what
pancreas
when the main pancreatic duct drains pancreas, it joins what
common bile duct at hepatopancreatic ampulla and sphincter of oddi regulates opening to drain into duodenum
where does the accessory pancreatic duct open at
minor duodenal papilla
what are pancreatic secretions
pancreatic juice- aqueous and enzymatic components of duodenum
what is included in aqueous
bicarbonate ions that neutralizes acidic chyme entering small intestine
what is included in enzymatic secretions
enzymes that digest: trypsin, chymotrypsin, carboxypeptidase, pancreatic aymlase, pancreatic lipase
what is painful inflammation of pancreas acute or chronic
pancreatitis
what type of pancreatitis can resolve on its own
acute
what is pancreatitis due to
alchoholism, certain medications, biliar calculi, pancreatic duct blockage, cystic fibrosis, high triglyceride and calcium levels
viral infection and pancreatic cancer
risk factors of pancreatits
obesity
EtOH
smoking
FH pancreatisis
DM
symptoms of pancreatitis
Mild abdominal pain in LUQ/middle & Radiates to back, Worse after eat, Fever,
Tachycardia, Vomiting. Chronic – Unintentional weight loss, Oily, stinky stools
Systemic shock & Coma possible.
treatment for pancreatitis
IV fluids, Low fat diet/Abstain from food & drink, Pain meds, Cholecystectomy
when and where do patients with pancreatitis likely experience pain
upper abdominal pain after food or when lying down
