GI IV Flashcards

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1
Q

What is the liver covered in?

A

connective tissue capsule called Glisson’s capsule

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2
Q

What lies external to Glisson’s capsule?

A

mesothelium of visceral peritoneum

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3
Q

What supports hepatocytes?

A

delicate reticular framework (type III collagen fibers)

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4
Q

Describe a classic hepatic lobule

A

stack of hexogonal plates of hepatocytes, sinusoids and central vein

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5
Q

What’s in portal canals?

A

connective tissue, portal triad, lymphatic vessels and autonomic nerve fibers

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6
Q

Where are portal canals found?

A

angles of the liver lobule (3-6 portal canals)

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7
Q

What’s in a portal triad?

A

1) branches of hepatic artery
2) portal vein
3) bile duct

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8
Q

What is another name for periportal space?

A

space of Mall

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9
Q

Where is periportal space located?

A

between connective tissue and adjacent hepatocytes

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10
Q

What is presumed to be the site of lymph origin?

A

periportal space

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11
Q

Are lymphatic vessels part of the portal triad?

A

NO

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12
Q

What type of epithelium do bile ducts have?

A

simple cuboidal

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13
Q

What does it mean by dual blood supply to liver?

A

portal vein (nutrients) provides 75% of the blood while hepatic artery proper (oxygen) provides the rest

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14
Q

What are the three features to sinusoids?

A

1) discontinuous endothelium with large fenestrations and discontinuous basal lamina
2) Kupffer cells
3) Perisinusoidal space (of Disse)

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15
Q

What are Kupffer cells?

A

hepatic macrophages (professional phagocytic cells that line the capillaries)

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16
Q

What is found in the perisinusoidal space (of Disse)?

A

1) hepatic stellate cell

2) microvilli of hepatocytes

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17
Q

What are other names for hepatic stellate cell?

A

perisinusoidal cell and cell of Ito

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18
Q

What’s the function of hepatic stellate cell?

A

contractile and CT elaboration

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19
Q

What’s another name for central vein?

A

terminal hepatic venule

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20
Q

What’s the purpose of microvilli in the sinusoidal capillaries?

A

increases surface area

21
Q

How many zones are in hepatic acinus?

A

3

22
Q

Which zone is this?

1) increased O2
2) decreased CO2
3) decreased metabolic waste products
4) increased nutrients
5) bile stasis, iron toxicity and alfatoxin (perilobular damage)
6) regenerative capacity

A

Zone 1

23
Q

Which zone is this?

1) decreased O2
2) increased CO2
3) increased metabolic waste products
4) decreased nutrients
5) first to show fat accumulation
6) more susceptible to damage

A

Zone 3

24
Q

Which zone is susceptible to ischemic-induced necrosis?

A

zone 3

25
Q

Which zone is more susceptible to several drug (such as acetaminophen) and toxic reactions? Why?

A

zone 3 because more detoxification reactions occur there

26
Q

Which zone will you find most of these enzymes?

glucose-liberating enzymes

A

zone 1

27
Q

Which zone will you find most of these enzymes?

fatty-acid synthesizing enzymes

A

zone 3

28
Q

Which zone will you find most of these enzymes?

fatty acid oxidation enzymes

A

zone 1

29
Q

Which zone will you find most of these enzymes?

glycolysis enzymes

A

zone 3

30
Q

Which zone will you find most of these enzymes?

detoxification enzymes

A

zone 3

31
Q

Which zone will have more extrahepatic hormones?

A

zone 1

32
Q

What is the function of mdr-2?

A

transport conjugated bilirubin

33
Q

Absence of mdr-2 can lead to which disease?

A

Dubin-Johnson syndrome

34
Q

Which two diseases are related to reduced bilirubin conjugation?

A

Gilbert syndrome (benign condition) and Crigler-Najjar syndrome type II

35
Q

Which disease is caused by absent of conjugation?

A

Crigler-Najjar syndrome type I

36
Q

How fast can liver regenerate if someone were to donate a portion of it?

A

1 week

37
Q

Is conjugated bilirubin direct or indirect?

A

direct

38
Q

Is unconjugated bilirubin direct or indirect?

A

indirect

39
Q

Which condition is reversible, fatty liver or cirrhosis?

A

fatty liver

40
Q

Beginning portion of bile duct

A

bile canaliculus

41
Q

Stem cell niche!

Lined by simple cuboidal cholangiocytes and hepatocytes

A

canals of Hering

42
Q

What type of epithelium is in hepatic ducts?

A

simple columnar epithelium

43
Q

What occurs to stellate cells when there’s injury or insult to liver?

A

increase in number and elaborate CT, becomes contractile and contricts blood flow = not good stuff

44
Q

What are the three layers to the wall of gallbladder?

A

1) mucosa
2) muscularis
3) CT layer of serosa/adventitia

45
Q

What type of epithelium does gallbladder have?

A

simple colunmar

46
Q

Does the wall of gallbladder contain muscularis mucosa?

A

NO

47
Q

What do acinar cells secrete?

A

enzymes

48
Q

What do ductal cells secrete?

A

water and ions (ie bicarbonate)

49
Q

What are the two primary causes of acute pancreatitis?

A

alcohol and gallstones