HEPATIC DISORDERS Flashcards
The __ is the largest gland of the body and is a major organ.
liver
- The liver can be considered a ___ that manufactures, stores, alters, and excretes a large number of substances involved in __.
- The liver is especially important in the regulation of __ and __ metabolism.
- The liver manufactures and secretes __.
- The liver removes waste products from the __ and secretes them into the __.
- The bile produced by the liver is stored temporarily in the ___.
chemical factory
metabolism
glucose
protein
bile
bloodstream
bile
gallbladder
The liver is located behind the ribs in the upper right portion of the abdominal cavity.
- It weighs between 1200 and 1500 g in the average adult and is divided into __ lobes.
- Its functional units are called __.
- Approximately 80% of the blood supply comes from the portal vein and the rest from the __.
*___ Cells are present in the liver.
four
lobules
hepatic artery
Phagocytic cells (Kupffer cells)
FUNCTIONS
- Glucose Metabolism
- After a meal, glucose is taken up from the portal venous blood by the liver and converted into __ (stored in __).
- The glycogen is converted back to glucose (_) and released as needed into the bloodstream.
- Additional glucose can be synthesized by the liver through a process called ____ (the liver uses amino acids from protein breakdown).
glycogen
hepatocytes
(glycogenolysis)
gluconeogenesis
FUNCTIONS
- Ammonia Conversion
- ___ results in the formation of __ as a by-product.
- The liver converts this metabolically generated ammonia into __ (excreted in the urine).
Gluconeogenesis
ammonia
urea
FUNCTIONS
- Protein Metabolism
- The liver synthesizes almost all of the __ (albumin, alpha-globulins, beta-globulins, etc.).
- _ are used by the liver for protein synthesis.
plasma proteins
Amino acids
- Fat Metabolism
- __ can be broken down for the production of energy and ketone bodies.
- Fatty acids and their metabolic products are also used for the synthesis of __, lecithin, lipoproteins, and other complex ___.
Fatty acids
cholesterol
lipids
- Vitamin and Iron Storage
- Vitamins __ and several of the __ vitamins are stored in large amounts in the liver.
- Certain substances, such as ___, are also stored in the liver.
A, B, and D
B-complex
iron and copper
- __ is continuously formed by the __ and collected in the canaliculi and bile ducts.
- The functions of bile are __ (excretion of bilirubin).
- Bile salts are then reabsorbed, primarily in the distal ileum into the portal blood (__).
Bile
hepatocytes
excretory
enterohepatic circulation
- __ is a pigment derived from the breakdown of __.
- __ remove bilirubin from the blood and chemically modify it through conjugation to glucuronic acid.
Bilirubin
hemoglobin
Hepatocytes
- The liver metabolizes many __, such as barbiturates, opioids, sedatives, anesthetics, and amphetamines.
- __ generally results in drug __, although activation may also occur.
- One of the important pathways for medication metabolism involves __ (binding) of the medication with a variety of compounds.
- __ is the fraction of the given medication that actually reaches the systemic circulation (__)
medications
Metabolism
inactivation
conjugation
Bioavailability
first-pass effect
involuntary flapping movements of the hands
asterixis
Liver Function Tests
* More than __ of the parenchyma of the liver may be damaged before liver function test results become abnormal.
70%
___ is the removal of a small amount of liver tissue, usually through needle aspiration.
- It permits examination of __.
- Done to evaluate diffuse disorders of the parenchyma and to diagnose space-occupying __.
Liver biopsy
liver cells
lesions
__ are used to identify normal structures and abnormalities of the liver and biliary tree.
- __ is used to examine the liver and other pelvic structures.
Ultrasonography, computed tomography (CT) scans, and magnetic resonance imaging (MRI)
Laparoscopy
GIVE 9 MANIFESTATION OF HEPATIC DYSFUNCTION
- Jaundice
- Portal Hypertension
- Ascites
- Esophageal Varices
- Hepatic Encephalopathy and Coma
- Edema and Bleeding
- Vitamin Deficiency
- Metabolic Abnormalities
- Pruritus and Other Skin Changes
- the sclerae and the skin become __
- Jaundice becomes clinically evident when the serum bilirubin level exceeds __ mg/dL (__ mmol/L).
- The bilirubin concentration in the blood may be increased in the presence of liver disease.
tinged yellow or greenish-yellow.
2.0
34
Types of jaundice:
__ - result of an increased destruction of the red blood cells.
a. Hemolytic Jaundice
- increased pressure throughout the portal venous system.
- Manifests as __ (enlarged spleen), ascites and varices.
Portal Hypertension
splenomegaly
- movement of fluid into the peritoneal cavity.
- Marked by increased abdominal girth and rapid weight gain.
- Caused by the failure of the liver to metabolize __ and decreased synthesis of __
Ascites
aldosterone
albumin
is a procedure that involves inserting a stent (tube) to connect the portal veins to adjacent blood vessels that have lower pressure.
- Transjugular intrahepatic portosystemic shunt (TIPS)
- varicosities that develop from elevated pressure in the veins that drain into the portal system.
- They are prone to rupture and often are the source of massive hemorrhages from the upper GI tract and the rectum.
. Esophageal Varices
Injection of sclerosing agent into esophageal varices through an endoscope promotes thrombosis and eventual sclerosis, thereby obliterating the varices.
Endoscopic or injection sclerotherapy
A, A rubber band–like ligature is slipped over an esophageal varix via an endoscope.
B, Necrosis results, and the varix eventually sloughs off
Esophageal Banding Therapy (Variceal Band Ligation)