Exam 3 - Liver Flashcards
What is the largest internal organ in the human body?
Liver
What is the average weight of the liver in males?
4 lbs
What is the average weight of the liver in females?
3 lbs
What percentage of adult body mass does the liver represent?
2%
In which quadrant of the chest area is the liver located?
Right upper quadrant
What ribs does the liver span in the right mid axillary line?
7th to 11th ribs
What is the name of the capsule that covers the liver?
Gibson’s Capsule
How many lobes does the liver have?
4 lobes
List the lobes of the liver.
- Right
- Left
- Caudate
- Quadrate
How many segments is the liver separated into?
8 segments
What is one major function of the liver?
Breaking down or converting substances from food
What is produced by the liver to help break down fat?
Bile
How much bile does the liver manufacture daily?
800 to 1,000 mLs
What toxic by-product of protein breakdown is released by the liver?
Ammonia
What is the form in which ammonia is excreted in urine?
Urea
What are the types of regulation of the liver?
- Autoregulation
- Metabolic control
- Buffer response
- Extrinsic control
What type of anesthesia preserves hepatic blood flow?
Isoflurane & Sevoflurane
By what percentage does upper abdominal surgery decrease hepatic blood flow?
60%
What can a spinal block at T4 reduce hepatic blood flow by?
20%
What is the major protein produced by the liver?
Albumin
Which coagulation factor is not produced by the liver?
Factor VIII
What does the liver degrade lipids to for ATP production?
Acetylcoenzyme
What function does the liver have regarding bilirubin?
Conjugation and secretion
What does the liver clear from the bloodstream?
Fibrin degradation products
Which hormones are inactivated by the liver?
- Insulin
- Aldosterone
- Estrogen
- Androgen
- ADH
What system does the liver use for drug biotransformation?
Cytochrome P450 system
Name a drug with a high extraction ratio that can be affected by hepatic blood flow.
- Propranolol
- Lidocaine
- Demerol
Name a poorly extracted drug that is sensitive to liver function.
- Diazepam
- Dilantin
- Coumadin
What unique metabolism characteristic does Ketamine have?
Induces its own metabolism
What is the Acinus in the liver?
The liver acinus is the microvascular unit of the liver, consisting of three zones.
What are the three zones of the liver acinus?
Zone 1: oxygen rich, oxidative metabolism, synthesis of glycogen.
Zone 2: transition zone.
Zone 3: lowest in oxygen, anaerobic metabolism, responsible for biotransformation of drugs, chemicals & toxins.
Which zone of the liver acinus is most sensitive to damage?
Zone 3 is most sensitive to damage due to ischemia and hypoxia.
What is cirrhosis?
Cirrhosis is a condition where scar tissue replaces healthy liver tissue, causing a loss of liver function that results in chronic liver failure.
What are some causes of cirrhosis?
Causes include long-term excessive alcohol use, chronic hepatitis, rare genetic disorders (e.g., Wilson’s disease), taking too much acetaminophen, insufficient blood supply to the liver, drug overdose, and certain herbal or dietary supplements.
What complications can arise from cirrhosis?
Cirrhosis can cause high pressure in the liver’s portal vein, leading to portal hypertension, ascites, and potentially spontaneous bacterial peritonitis.
What is ascites?
Ascites occurs when fluids leak into the abdomen, causing swelling and pain. It can also cause edema.
What happens if ascites become infected?
If ascites become infected, it is called spontaneous bacterial peritonitis, which can be fatal if not treated.
What should you see about total protein, albumin, globulin, A/G ratio, alkaline phosphatase, ALT, AST in hepatitis patterns?
Normal protein
Normal albumin
Normal globulin
AG ratio > 1
ALkaline phosphatase: elevated 1-2 times normal
ALT: increased into thousands
AST: increased into the thousands.
ALT always > AST
What should you see about total protein, albumin, globulin, A/G ratio, alkaline phosphatase, ALT, AST in cirrhosis patterns?
Protein: decreased
albumin: decreased
globulin: increased
AG ratio < 1
ALkaline phosphatase: elevated 1-2 times normal
ALT: increased upto 300
AST: increased upto 300.
AST always > ALT
What is the normal range for AST (aspartate aminotransferase)?
11–47 IU/L
What is the normal range for ALT (alanine aminotransferase)?
7–56 IU/L
What is the normal range for ALP (alkaline phosphatase)?
30–120 IU/L
Where is AST primarily located in the body?
Found throughout the body, predominantly in heart and liver cells.
Where is ALT primarily located in the body?
Found mostly in the liver and kidney cells.
When is AST most useful?
Detecting liver damage due to hepatitis, drugs toxic to the liver, cirrhosis, and alcoholism.
When is ALT most useful?
Detecting liver damage due to hepatitis and hepatotoxic drugs.
How are AST and ALT typically used?
Often ordered in conjunction to evaluate liver function.
What does the AST/ALT ratio indicate?
The ratio is usually increased in alcoholic hepatitis, cirrhosis, and early acute hepatitis or bile duct obstruction.
Where is ALP found and what does it indicate?
Found in bone and bile duct cells; indicates bile duct blockage, liver cancer, hepatitis, cirrhosis, or hepatotoxic drug use.
