gallbladder and bile production

Question 1

functions of liver

Answer 1

metabolism
synthesis
storage
detox
inactivation
activation
bile production

Question 2

bile flow

Answer 2

hepatocytes -> bile canaliculus ->perilobular ducts -> interlobular ducts -> septal ducts -> lobar ducts -> r/l hepatic duct -> hepatic duct -> common bile duct -> duodenum

Question 3

sinusoids

Answer 3

spaces btwn hepatocytes
filled w/blood
wider than cappilaries, fenestrated
lined w/endothelial cells and kupffer cells

Question 4

space of Disse

Answer 4

stella cells present
plasma sloutes, not blood cells
kupffer cells cleanse blood of bacteria, toxin, paracites, and old RBCs as it passes before returning to circulation

Question 5

bile formation

Answer 5

hepatocytes actively secrete isotonic bile
intrahepatic and extrahepatic ducts secrete bicarb rich fluid into it as well
this can create a liter of hepatic bile/day
half diverted to gallbladder for storage

Question 6

primary bile acids

Answer 6

cholic acid

chenodeoxycholic acid

Question 7

four major components of bile

Answer 7

bile salts
cholesterol and phospholipids
bilirubin
protein and miscellaneous (such as bicarb)

Question 8

functions of bile

Answer 8

fat digestion and absorption

waste product excretion (bilirubin, cholesterol, lipophilic drugs, trace minerals)

Question 9

total bile flow

Answer 9

canalicular flow + ductular flow

Question 10

canalicular flow

Answer 10

independent flow + dependent flow

Question 11

ductular flow

Answer 11

constant

Question 12

choleretics

Answer 12

increase bile secretion
secretin
glucagon
VIP
GRP

Question 13

somatostatin

Answer 13

inhibitory to bile secretion by:
enhancing fluid absorption
inhibits secretion

Question 14

Mucus

Answer 14

secretion by gallbladder epithelial cells protects apical surface of gallbladder epi from toxic effects of bile salts
excessive mucin deleterious can lead to cholesterol cholelthiasis

Question 15

CCK

Answer 15

presence of fatty foods trigger release
causes contraction of gallbladder
causes relaxation of spinchter of oddi

Question 16

acetlycholine

Answer 16

secreted from vagus and intestinal enteric NS

stimulates gallbladder less strongly then CCK

Question 17

circulation of bile

Answer 17

47% returned via active transport through hepatic portal vein from terminal ileum
lose less then 5% of bile salts/day in stool
called enterohepatic circulation of bile salts
47% diffuse through mucosa in early portions of small intestines

Question 18

cholestasis

Answer 18

suppression of bile secretion
3 major negative effects:
-regurgitation of bile components into blood -> jaundice and pruritus
-damages hepatocytes (increase in liver enzymes in blood)
-lipid digestion and absorption impaired

Question 19

cholelithiasis

Answer 19

formation of stones w/in gallbladder or duct system

Question 20

cholecystitis

Answer 20

inflammation of gallbladder

Question 21

cholangitis

Answer 21

inflammation of biliary ducts

Question 22

gallstone causes

Answer 22

-too much water absorption from bile
-too much absorption of bile acids from bile
-too much cholesterol in bile
inflammation of epi

Question 23

contributing factors of chlethiasis

Answer 23

supersaturation
gallbladder hypomotility
crystal nucleation
accretion w/in mucous layer