Gastro 3 Flashcards
Functional units of the liver are called?
Lobules
Functional cells of the liver are called?
Hepatocytes
Capillaries of the liver are called?
Sinusoids
Channels for the collection of bile are called?
Bile canaliculi
Blood travels from the GIT to the liver via the …….. ……. …….
Hepatic portal vein
Blood moves from the heart to the liver via the …….. ……….
Hepatic artery
Blood exits the liver and travels back to the heart via the ……. ……
Hepatic vein
The liver is responsible for the production of substances such as
1.
2.
3.
Cholesterol
Coagulation factors
Plasma proteins such as albumin
Do we get most of our cholesterol via production in the liver or through our dietary intake?
Why do we need cholesterol?
Through its production in the liver.
For the production of sex hormones.
Ammonia arises from amino acid metabolism, it is converted to ………. In the liver.
Urea
What nutrients are metabolised in the liver?
Fats proteins and carbs
What substances are stored in the liver?
Vitamins A B12
Glycogen
Iron
Detoxification occurs in the liver by breaking down ……
Drugs
Hormones
Wastes
Metals
(Via cytochrome p 450 enzymes)
Bile is an alkaline fluid containing …….. ……. and …………..
It is made in the ………… from …………….
Bile salts and bilirubin.
Liver
Cholesterol
What is bilirubin and where does it go?
It is a waste product from the breakdown of erythrocytes and is excreted in urine and faeces.
(It is what makes faeces brown).
Where is bile stored?
Gall bladder
Where is bile released?
In the duodenum
What is the role of bile salts?
Assists digestion and absorption of fats in duodenum.
It is recycled via enterohepatic circulation.
Enterohepatic circulation involves …………. substances from intestines to liver.
Recycling
…… ……. are released into duodenum for fat digestion and absorption.
Bile salts
What is reabsorbed into the bloodstream and returned to the liver?
In what process does this occur?
Bile salts
Enterohepatic circulation
Haemoglobin from erythrocytes is broken down into haeme and globin.
Globin is broken down into ……… ………..
Haeme is converted to ……………..
Amino Acids
Bilirubin
…………… is metabolised in the liver and is secreted in bile into the duodenum.
Bilirubin
Bilirubin is a …….. ……… from the breakdown of erythrocytes and is excreted through the ……… and ………….
Waste product
Urine and faeces
Increased concentration of ……. can lead to formation of …………. Of crystallised cholesterol (cholelithiasis).
Bile
Gallstones
Risk factors for developing gallstones include……
Age
Oral contraceptives
Pregnancy
Obesity
What do gallstones do?
What is the effect of that?
Block the cystic duct.
Causes inflammation and infection of the gallbladder
(Bilirubin backs up if gallstones block duct)
Liver disease is characterised by …………. of the liver and ………….. death.
Inflammation.
Hepatocyte.
Acute hepatitis can be due to……..
Viruses; Hep A, B, C, and D
Drugs/poisons, ethanol
What are the usual causes of chronic hepatitis?
Viruses, ethanol, drugs, metabolic syndrome.
Liver function tests help determine the cause of disease. Name the tests that are done.
Serum enzyme levels
Serum proteins
Bilirubin levels
Blood clotting tests
Alcohol abuse can lead to……
Alcoholic Chronic Hepatitis
Alcohol is detoxified in the liver, causing a harmful by-product called ……………. which damages ……………….
Acetaldehyde
Hepatocytes
The disease progression for Alcoholic chronic hepatitis is as follows….,
1.
2.
3.
Fatty liver
Alcoholic hepatitis
Alcoholic cirrhosis
Cirrhosis is the build up of ….. ……
Scar tissue
Binge drinking can cause ….. …………… In the liver and this usually presents with …….. symptoms.
Fat accumulation.
No.
Fatty liver is irreversible.
True or false?
False, it is reversible
Chronic alcohol abuse or continued binge drinking can cause………..
Inflammation
Hepatocytes death
Fibrosis (scar tissue)
Liver damage in alcoholic hepatitis may or may not be reversible.
True or false?
True
Clinical features of alcoholic hepatitis include…..
Malaise
Anorexia
Upper abdominal discomfort
Chronic alcohol abuse can cause ….. …….. alcoholic liver disease (liver failure), which causes ……………. …………
End-Stage
Irreversible damage
Pathophysiology of alcoholic cirrhosis.
Damage of ……….. leads to impaired function. Proliferation and fibrosis of ………. …….. gives a nodular appearance. This leads to impaired …… …….. in the liver.
Hepatocytes
Connective tissue
Blood flow
In alcoholic cirrhosis, blood accumulates in the liver and is redirected to collateral vessels.
What is the result of this?
Toxic substances bypass the liver.
Do not get filtered
Clinical features of alcoholic cirrhosis include……
Nausea, anorexia, malaise. Dark urine (bilirubin not being broken down) Pale stools (Absence of bilirubin) Hypoglycaemia Hepatomegaly (enlarged liver) Splenomegaly (enlarged spleen) Oedema (low albumin/proteinuria) Prolonged blood clotting time (low clotting factor)
Complications of acute or chronic liver disease include…..
Jaundice Portal hypertension Ascites Hepatic encephalopathy Renal failure
What is jaundice?
Why does it occur?
Yellowish pigmentation of the skin and eyes.
Due to high levels of bilirubin in the blood (hyperbilirubinaemia).
INTRAHEPATIC jaundice is due to obstruction of ……. …………. and/or damaged ………… in the liver.
Eg. ………. …………
Bile canaliculi
Hepatocytes
Alcoholic cirrhosis
EXTRAHEPATIC jaundice is due to obstruction of …….. ……..
Eg. ………… or ………..
Bile ducts
Gallstones, tumour
Decreased blood flow through the liver due to liver damage causes……..
Increasing venous blood pressure in hepatic portal vein.
Splenomegaly (enlarged spleen)
Ascites (oedema in abdominal cavity)
When blood flow is limited through the liver due to damage, development of ………… ……….. …………. occurs that bypass the liver.
Collateral blood vessels
What is ‘Caput medusae’?
Dilated superficial veins near umbilicus
Portal hypertension can result in ……… ………… …. ………… Which is a …………. ……………….
Treatment includes restoration of …….. …….. and treat source of……………
Acute severe GI bleeding
Medical emergency.
Blood volume
Bleeding
Accumulation of fluid in the peritoneal space is called ……….
Ascites
Portal hypertension and reduced albumin production causes……..
Capillary hydrostatic pressure to be greater than oncotic pressure.
Fluid forced out of the capillaries into the peritoneal cavity.
Clinical features of Ascites include……
Abdominal distension
Breathing difficulties
Weight gain.
Chronic liver disease can lead to liver failure causing ……… ……………
Hepatic encephalopathy (Altered cerebral function)
In liver disease, blood bypasses liver through collateral blood vessels. As a result……….
Ammonia is not converted to urea for excretion.
Ammonia accumulates in blood and alters neuronal function.
Results in impaired cerebral function (hepatic encephalopathy)
Can progress to coma and death.
Summary of some complications of liver disease.
Increased serum bilirubin = ………………………
Decreased blood flow through the liver = ……………………………….
Decreased production of plasma proteins, especially albumin = ……….……………..
Decreased detoxification of ammonia = ……………………..
Hyperbilirubinaemia. Portal Hypertension (hepatic portal vein). Ascites (fluid leaks out of capillaries into the peritoneal cavity due to hyrostatic pressure). Impaired cerebral function (hepatic encephalopathy).
