GI system IV

Question 1

What makes up the portal triad?

Answer 1

1. Portal vein2. Hepatic artery3. Bile duct

Question 2

What makes up a classic hepatic lobule?

Answer 2

1. Hepatocytes2. Sinusoids3. Central vein

Question 3

What is the periportal space?

Answer 3

Located between CT and adjacent hepatocytes; presumed to be of lymphoid origin

Question 4

What are hepatic sinusoids?

Answer 4

1. Discontinuous endothelium with large fenestrations and discontinuous basal lamina2. Kupffer cells present3. Perisinusoidal space (of Disse)

Question 5

What is contained in the perisinusoidal space of Disse?

Answer 5

1. Hepatic stellate cell - contractile and CT elaboration2. Microvilli of hepatocytes

Question 6

What is the dual blood supply to the liver?

Answer 6

Portal vein (75%) and proper hepatic artery (25%)

Question 7

What is the unique feature of the stellate cell?

Answer 7

Large lipid droplet

Question 8

What are the components that define the hepatic acinus?

Answer 8

Diamond shaped area bound by:1. 2 central veins2. 2 portal spaces

Question 9

Which acinus zone has regenerative capacty?

Answer 9

Zone 1

Question 10

Which acinus zone is first to show fat accumulation?

Answer 10

Zone 3

Question 11

Which acinus zone is more susceptible to damage?

Answer 11

Zone 3

Question 12

Which acinus zone has more detoxification enzymes?

Answer 12

Zone 3

Question 13

What happens to colloid osmotic pressure with severe liver injury?

Answer 13

Decreases

Question 14

What happens to blood clotting time with severe liver injury?

Answer 14

Increases

Question 15

What is Gilbert syndrome?

Answer 15

Bilirubin conjugation is reduced

Question 16

What is Crigler-Najjar syndrome?

Answer 16

Bilirubin conjugation is reduced (type II) or absent (type I)

Question 17

What is Dubin-Johnson syndrome?

Answer 17

Decreased secretion of conjugated bilirubin due to absence of mdr-2 canalicular transport protein

Question 18

What is the role of the perisinusoidal cell (stellate cell) in cirrhosis?

Answer 18

Collagen elaboration, contractility, fibrosis

Question 19

What are the elements of the biliary tract?

Answer 19

1. Bile canuliculi2. Canals of Hering3. Bile ducts4. Hepatic ducts

Question 20

What are the features of the bile canaliculi?

Answer 20

1. Limited by plasma membranes of two hepatocytes2. Tight junctions

Question 21

What are the features of the canals of Hering?

Answer 21

1. Lined by simple cuboidal cholangiocytes and hepatocytes2. Stem cell niche

Question 22

What type of epithelium makes up the bile ducts?

Answer 22

Simpel cuboidal to columnar

Question 23

What type of epithelium makes up the hepatic ducts?

Answer 23

Simple columnar

Question 24

What are the three layers of the gall bladder wall?

Answer 24

1. Mucosa2. Muscularis3. CT layer

Question 25

What facilitates spread of gall bladder cancer to the liver?

Answer 25

Absence of submucosa and serosa on hepatic surface of gall bladder

Question 26

What do the pancreatic acinar cells secrete?

Answer 26

Enzymes

Question 27

What do the pancreatic ductal cells secrete?

Answer 27

Water and bicarbonate

Question 28

What arrangement is unique to the pancreas?

Answer 28

Centroacinar cells - nuclei project into centers of acini; form intra-acinar portion of intercalated duct

Question 29

What are the two primary causes of acute pancreatitis?

Answer 29

Alcohol and gallstones

Question 30

Where are pancreatic enzymes stored?

Answer 30

Acinar cells (inactive form)