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Pathophysiology Exam 3 > Disorders of Hepatobiliary and Exocrine Pancreas Function > Flashcards

Disorders of Hepatobiliary and Exocrine Pancreas Function Flashcards

1
Q

Liver is a highly ____________ organ

A

vascular (contains about 500-1000ml of blood)

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2
Q

What is the blood in the liver supplied by?

A

the hepatic artery and hepatic (portal) vein (which does not contain valves)

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3
Q

What does the liver serve as filter for?

A

-nutrients and toxins absorbed in the intestines
-blood cell debris from the spleen
-insulin and glucagon from the pancreas

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4
Q

Where do hepatic veins empty into?

A

the inferior vena cava then superior vena cava for transport into the right atrium

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5
Q

What do the hepatic veins supply blood with?

A

a lower O2 sat than arterial blood, but it does provide 75% of oxygen needs of the liver

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6
Q

What are the liver functions?

A

-metabolism of nutrients and vitamins
-synthesis of proteins and enzymes
-detoxification of drugs, hormones, and alcohol
-production/ excretion of bile and bilirubin

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7
Q

Liver-Metabolism Functions

A

-essential role in carbs metabolism and glucose homeostasis
-manufactures proteins for its own use and secretes proteins released into circulation for cellular needs

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8
Q

What do carbs do in liver metabolism?

A

-stores large amounts of glucose as glycogen through glycogenesis
-concerts glycogen back to glucose with hypoglycemia
-performs gluconeogenesis

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9
Q

What do proteins do in liver metabolism?

A

-albumin contributes to plasma colloid osmotic pressure and binds and transports some hormones, fatty acids, bilirubin and anions
-produces fibrinogen and clotting factors to promote clotting

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10
Q

Pathophysiology of Liver Dysfunction

A

-bleeding r/t inadequate clotting factor production

-infection risk r/t decreased immune globulins

-accumulation of toxins and drugs

-inadequate conjugation/excretion of bile leads to hyperbilirubinemia and jaundice

-biliary tract obstruction with possible gallstone formation

-hormone accumulation led to feminization in males

-increased ammonia because the liver is unable to convert ammonia to urea for excretion in stool and urine and it is toxic

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11
Q

What is the liver an important site for?

A

manufacture and break down of proteins

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12
Q

Ammonia produced by protein metabolism in the GI tract is absorbed by what?

A

the portal circulation and transported to the liver to be converted to urea for excretion in urine and stool

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13
Q

When is ammonia increased in the intestine?

A

with high protein foods and GI bleeding

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14
Q

Hepatic encephalopathy

A

central nervous system dysfunction resulting from liver disease; frequently associated with elevated ammonia levels that produce changes in mental status, altered level of consciousness, and coma

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15
Q

Liver- Exocrine Function

A

bile production (made by hepatocytes into ducts instead of blood)

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16
Q

What happens once the common bile duct delivers bile into the duodenum?

A

digestion and absorption of fats and fat-soluble vitamins

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17
Q

What does decrease bile in the duodenum produce?

A

light clay or tannish colored stools

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18
Q

Bilirubin is the end product of

A

heme degradation

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19
Q

Elevated bilirubin in the blood leads to what?

A

jaundice in the skin and eye

20
Q

Intestinal flora concerts some bilirubin to what?

A

urobilinogen that is excreted in stool and urine

21
Q

What is jaundice caused by?

A

-increased breakdown of RBCs
-liver dysfunction
-blockage of bile passage within the biliary system

22
Q

What is Hepatitis?

A

-inflammation of the liver
-can occur from specific viral infections, drugs, toxins, or an autoimmune disorder

23
Q

The viruses that cause hepatitis differ by what?

A

-manner of transmission
-incubation period
-mechanism
-extent
-chronicity of liver damage

24
Q

How can viral hepatitis cause liver damage?

A

by direct injury to cells and by immune responses

25
Q

Liver Cirrhosis

A

-as the liver is damaged, cells become replaced with fatty tissue
-the new tissue does not perform functions of normal liver cells

26
Q

Liver Cirrhosis- Pathophysiology

A

-abnormal blood vessels and bile ducts lead to hypertension inside liver
-hypertension within liver leads to compression and destruction of veins
-chronic progressive destruction of liver parenchyma is a hallmark of cirrhosis
-liver attempts to regenerate but with abnormal fibrous tissue

27
Q

Portal Hypertension

A

-portal vein drains abdominal blood to liver
-cirrhotic structural changed obstruct blood flow through the liver
-pressure increases in portal vein system
-venous blood backs up in liver and as far as into the esophageal veins
-esophageal varices

28
Q

Esophageal Varices

A

-can rupture at any time

-sudden and severe hemorrhage

-high mortality rate

29
Q

Ascites

A

-accumulation of fluid and electrolytes in abdominal cavity
-fluid leaks from liver and petal veins
-hypokalemia with ascites
-associated with low serum albumin and low protein in circulating volume
-decreased circulating volume leads to hypotension

30
Q

What is the function of the gallbladder?

A

stores and concentrates bile

31
Q

What does bile contain?

A

water, bile salts, bile pigments, cholesterol, electrolytes

32
Q

What does the gallbladder do as food enters?

A

it contracts then releases bile that moves into the duodenum

33
Q

What are gallbladder disorders?

A

-cholelithiasis: gallstones
-cholecystitis: gallbladder inflammation
-cholangitis: inflammation of common bile duct

34
Q

What can lack of bile salts lead to?

A

-light tan stools
-steatorrhea (malabsorption of fats)
-intolerance to fatty food

35
Q

Cholecystitis/ Cholelithiasis- Clinical Manifestations

A

-RUQ pain
-indigestion after fatty foods
-light stools
-steatorrhea (fatty stools)

36
Q

What is the pancreas?

A

-positioned transversely in posterior abdomen
-has both endocrine and exocrine functions

37
Q

When does pancreas become active?

A

when food enters the duodenum

38
Q

What does pancreas secrete?

A

amylase to break down starches and lipase to break down fat

39
Q

Endocrine

A

secretes substances directly into blood stream

40
Q

Exocrine

A

secretes substances into ducts instead of the blood

41
Q

What is pancreatitis?

A

Auto digestion of the Pancreas

42
Q

What are factors of pancreatitis?

A

-ethyl alcohol
-gallstones
-abdominal trauma

43
Q

Pancreatitis- Pathophysiology

A

-food in duodenum stimulates release of digestive enzymes from the pancreas to be delivered to the duodenum for digestion
-the pancreatic duct may be obstructed by a wandering gallstone
-enzymes back up and leak into pancreas
-systemic chemical mediators released by inflammation

44
Q

What is acute pancreatitis?

A

inflammation of the pancreas

45
Q

Pancreatitis- Clinical Manifestations

A

-increased serum amylase and lipase
-fluid and electrolyte abnormalities: hyperglycemia and hypokalemia
-SEVERE abdominal pain

46
Q

What could cause chronic pancreatitis ?

A

-chronic alcohol abuse
-chronic gallstone obstruction

47
Q

What can happen during chronic pancreatitis?

A

-progressive loss of pancreas tissue
-destruction of insulin producing cells leads to diabetes
-chronic pain but symptoms less severe than acute form
-acute episodes can occur

Pathophysiology Exam 3 (6 decks)

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