Gallbladder Function and Bile Production

Question 1

kupffer cells

Answer 1

macrophages of liver

Question 2

activation of hormones in liver?

Answer 2

T4 to T3
thyroxine to triiodothyronine

hydroxylation of Vit D

Question 3

sinusoid

Answer 3

capillary spaces between hepatocytes in liver lobule

hepatic a and portal vein dump blood here
-drains to central vein

Question 4

hepatocyte

Answer 4

cell of liver

in contact with sinusoid and bile canaliculus

Question 5

ito cells

Answer 5

stellate cells of liver

• fat cells
• store fat or Vit A

with inflammation turn to myofibroblasts, become fibrotic - collagen

Question 6

space of disse

Answer 6

albumin production and secretion

Question 7

classic lobule

Answer 7

drain to central vein

Question 8

portal lobule

Answer 8

drain to bile duct

Question 9

portal acinus

Answer 9

oxygenation gradient to hepatocytes

Question 10

biliary tree structure

Answer 10

canaliculi > terminal bile ductules > perilobular ducts > interlobular ducts > septal ducts > lobar ducts > R/L hepatic ducts > common hepatic duct merge with cystic > common bile duct merge with main pancreatic duct > ampulla of vater

Question 11

gallbladder and sphincter of oddi

Answer 11

CCK (stronger) and ACh
contract gallbladder
relax sphincter of oddi

bile secretion!

Question 12

bile secretions

Answer 12

hepatocytes - bile acids, cholesterol, organic constituents

secretory epithelial cells - ducts and ductules

• secretes water solution of sodium and bicarbonate
• stimulated by secretin

Question 13

bile concentration?

Answer 13

isotonic from hepatocyte
-actilvely secreted

concentrated in gallbladder - hypertonic

Question 14

gallbladder and bile?

Answer 14

concentrates
iso-osmotically
-active transport of Na
-secondary transport of Cl, H2O, etc.

Question 15

primary bile salts

Answer 15

cholic acid
chenodeoxycholic acid

produced in liver from cholesterol

Question 16

secondary bile salts

Answer 16

deoxycholic acid
lithocholic acid

produced by bacteria in intestines

Question 17

bile reabsorption

Answer 17

in distal ileum
-95% reabsorbed

enterohepatic circulation of bile**

Question 18

resection of distal ileum

Answer 18

liver taxed to create bile

-steatorrhea and cholesterol gallstones

Question 19

fecal bile acids

Answer 19

deoxcholic and lithocholic acids (secondary)

Question 20

components of bile

Answer 20

bile salts (cholates, chenodeoxycholate, deoxycholate)
cholesterol and phospholipids
bilirubin
protein and misc. (HCO3)

Question 21

hepatic blood supply

Answer 21

75% portal vein
25% hepatic a

hepatic vein - drains liver

Question 22

bile flow

Answer 22

two ways
-ductular and canalicular

both have independent and dependent flow

Question 23

cholangiocytes

Answer 23

duct cells that secrete HCO3

+ secretin, glucagon, VIP, GRP (choleretics)
- somatostatin

Question 24

mucus

Answer 24

also secreted by gallbladder

Question 25

CCK release

Answer 25

increased with fat in duodenum

Question 26

ACh

Answer 26

released by vagus and intestinal enteric NS

Question 27

cholestasis

Answer 27

suppression of bile secretion

Question 28

pathogens in gallbladder?

Answer 28

location for salmonella typhi to stay safely

-typhoid mary

Question 29

cholelithiasis

Answer 29

gallstones

Question 30

cholecystitis

Answer 30

gallbladder inflammation

Question 31

cholangitis

Answer 31

biliary duct inflammation

Question 32

gallstone formation?

Answer 32

abnormal bile composition
biliary stasis
gallbladder inflammation

causes:

• too much absorption of water from bile
• too much cholesterol in bile
• inflammation of epithelium

Question 33

during rest

Answer 33

gallstones to liver

Question 34

during digestion

Answer 34

gallstones to duodenum

Question 35

rare complications of gallstones

Answer 35

mirizzi syndrome - fistula cystic to bile duct
bouverets syndrome
cholecystoenteric fistula
gallbladder cancer

Question 36

risk factors for gallstones

Answer 36

fat
fertile
female
old

Question 37

small gallstones

Answer 37

more dangerous

“gravel”

Question 38

lithocholic acid

Answer 38

secondary bile acid- toxic

Question 39

bile salt important action

Answer 39

detergent to break down fat particles

help with absorption (for micelles)

Question 40

secretin

Answer 40

stimulates pancreatic secretion and bile secretion

released wit decreased duodenal pH