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ESA3 > GI 7 - The Liver > Flashcards

GI 7 - The Liver Flashcards

1
Q

Name the anatomical lobes of the liver:

A
  • Left lobe
  • Right lobe
  • Caudate lobe
  • Quadrate lobe
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2
Q

Name the ligaments associated with the Liver:

A
  • Falciform ligament (containing ligamentum teres hepatitis)
  • Ligamentum venosum
  • Coronary ligaments
  • Triangular ligaments
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3
Q

What structures enter/leave the Liver at the porta hepatits?

A
  • Hepatic portal vein
  • Hepatic artery proper
  • Hepatic bile ducts
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4
Q

Name the duct formed when the hepatic bile ducts join the cystic duct:

A

Common bile duct

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5
Q

Name the duct formed when the common bile duct joins the pancreatic duct:

A

Ampulla of Vater

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6
Q

How many functional lobes make up the Liver?

A

8

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7
Q

What is the blood supply to the Liver?

A
  • Hepatic artery proper ~ 30%

- Hepatic portal vein ~ 70%

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8
Q

Describe the breakdown of haem:

A

Haem

  • into biliverdin
  • into unconjugated bilirubin
  • Liver conjugates bilirubin
  • GI breaks it down to Stercobilin + Urobilinogen
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9
Q

What volume of bile is secreted by the Liver per day?

A

~ 250 - 1000 ml/day

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10
Q

What is the main function of bile?

A

Emulsifies fats to increase surface area for lipases

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11
Q

List the contents of bile:

A
  • Bile salts ~ 60%
  • Fatty acids ~ 12%
  • Cholesterol ~ 9%
  • Proteins
  • Bilirubin
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12
Q

What are bile salts made up of?

A
  • Bile acids (Cholic acid + Chenodeoxycholic acid

- Amino acids (Glycine + Taurine)

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13
Q

Which of bile acids and bile salts are soluble at duodenal pH?

A

Bile salts

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14
Q

What 3 vessels are present in a hepatic triad?

A
  • Bile duct
  • Hepatic arteriole
  • Portal venule
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15
Q

What shape is a hepatic lobule?

A

Hexagonal

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16
Q

Which zone of a hepatic acinus is most susceptible to hypoxic damage? Why?

A

Zone 3

Furthest from oxygenated blood supply

17
Q

Which zone of a hepatic acinus is most susceptible to toxic damage? Why?

A

Zone 1

Closest to blood supply

18
Q

What is a Kupffer cell, and where are they found?

A

Phagocytic cell

Lining hepatic sinusoids

19
Q

What are the 2 mechanisms of bile secretion?

A
  • Bile acid independent

- Bile acid dependent

20
Q

Name the cells which produce the bile acid independent fraction of bile:

A

Hepatocytes lining the canaliculi

21
Q

Name the cells which produce the bile acid dependent fraction of bile:

A

Intra-hepatic bile duct cells

22
Q

Describe the circulation of bile salts:

A
  • Secreted by Liver
  • Emulsify fats and form micelles in GI tract
  • Fats diffuse into epithelia lining GI tract
  • Bile salts stay in gut, reabsorbed @ terminal ileum
  • Return to Liver via Portal vein
23
Q

Why does the Liver only need to synthesise very low amounts of bile salts?

A

Most bile salts are cycled back to the Liver from the GI tract, and re-used, so no need to continuously synthesise more

24
Q

What is achlorhydria, and what can cause it?

A
  • Low level or absence of HCl in gastric secretions
  • Helicobacter pylori
  • PPIs
  • H2 antagonists
25
Q

Name the 3 types of jaundice:

A
  • Pre-hepatic
  • Hepatic
  • Post-hepatic
26
Q

List some causes of pre-hepatic jaundice:

A

Haemolytic anaemia:

  • Hb abnormalities ie SCA
  • Infections
  • Drugs
  • Burns
27
Q

List some causes of hepatic jaundice:

A

Liver failure:

  • Alcohol
  • Fatty-liver disease
  • Drug overdose
  • Autoimmune
  • Viral
28
Q

List some causes of post-hepatic jaundice:

A

Obstruction:

  • Gallstones
  • Pancreatitis
  • Pancreatic cancer
29
Q

What additional symptom is associated with post-hepatic jaundice, but not pre- or hepatic jaundice?

A

Steatorrhoea due to blocked bile duct

30
Q

Liver function tests include measuring AST and ALT levels. What do AST and ALT stand for?

A 
AST = Aspartate transaminase
ALT = Alanine transaminase

ESA3 (48 decks)

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