hepatic, pancreatic, and biliary systems Flashcards
5 system functions of the liver
digestive
endocrine
excretory
hematologic
immune
where is albumin produced
Liver
the liver converts and excretes…
bilirubin
what makes the pancreas an exocrine gland?
digestion!
it releases digestive enzymes and pancreatic juices to help the GI system
what makes the pancreas an endocrine gland?
glucagon and insulin secretion for metabolism
what is the function of the gallbladder
reservoir for bile
releases bile in duodenum in response to food
what does bile do
alkalinizes the intestinal contents and plays arole in emulsification, absorption, and digestion of fat
dark urine and light stools occur in association with…
jaundice
3 indications of hepatic issues
skin changes
spider angiomas
palmar erythema (warm palms)
jaundice can be diagnosed when _________ levels increase
serum bilirubin
why is stool normally brown?
bile and bilirubin
what does light-colored stool and tea/cola colored urine indicate
bilirubin goes to urinary system rather than digestive system
hepatic encephalopathy (or portosystemic encephalopathy)
reversible neuro-psychological symptoms caused by liver failure and metabolic buildup of toxins
asterixis
inability to maintain wrist extension with forward flexion of the upper extremity
musculoskeletal symptoms with liver disease
thoracic pain between scaps, right shoulder, right upper traps, right interscap, right subscap
hepatic osteodystrophy
abnormal development of bone associated with liver malfunction
due to skin changes in liver disease, individuals are more susceptible to ________
pressure ulcers
coagulopathy
easy bruising and bleeding under the skin or into joints in response to the slightest taumas
liver __(increases/decreases)__ size, weight, and blood flow with age
decreases
lipophilic
strong affinity for lipids
why does the decrease of albumin production impact how drug dosages are given
drugs typically bind to albumin
what is the livers role in the immune system response
it produces proteins associated with acute inflammatory reactions
5 severe complications that result from liver damage/nonfunctioning
- jaundice
- cirrhosis
- portal hypertension
- hepatic encephalopathy
- ascites
characteristics of jaundice (icterus)
yellow discoloration of the skin/eyes
urine turns dark
stool turns light
4 common causes of jaundice
- increase bilirubin production
- decreased uptake in bilirubin metabolism
- hepatocyte dysfunction
- impaired bile flow
cirrhosis
fibrosis and nodular regeneration of the liver from chronic inflammation
jaundice of newborns is caused by
a decreased uptake in bilirubin metabolism
portal hypertension
higher portal vein pressure (entry) than inferior vena cava pressure (exit)
what usually causes portal hypertension
cirrhosis
Lab findings in cirrhosis
- decreased albumin
- increased prothrombin time (longer to form blood clots)
- anemia
- increased alanine aminotransferase, lactate dehydrogenase
clinical presentations of cirrhosis
Hepatomegaly
Spider angiomata
Splenomegaly
GI bleeding
Edema
Jaundice
Portal hypertension
Ascites
decreased plasma proteins results in what 2 symptoms
ascites and edema
what happens to the body when metabolism of proteins, carbs, and fats occurs
the body becomes hypoglycemic
3 direct symptoms of liver inflammation
pain, fever, GI symptoms
Ascites
abnormal accumulation of fluid within the peritoneal cavity
what is the most common cause of ascites
liver cirrhosis (85%)
spontaneous bacterial peritonitis
infection of ascitic fluid in the setting of portal hypertension
an increase of urobilinogen is an indication of
liver necrosis
a DECREASE in bilirubin metabolism, bile in GI tract, vitamin K absorption is an indication of
liver necrosis
what does a decreased hormone metabolism result in and what are the symptoms
increased androgens and estrogens in the body
spider angiomas
palmar erythema
loss of body hair
what is hepatitis
acute or chronic inflammation of the liver
what can cause hepatitis
virus (main)
chemical/drug/alcohol abuse
how long must a person have hepatitis for it to be considered CHRONIC
6 months
what liver disease can chronic hepatitis lead to
cirrhosis
what is the most common cause of acute liver failure
acetaminophen hepatotoxicity (50% of cases)
fulminant hepatic failure
acute liver failure that is rare but can be fatal
t/f: viral hepatitis can be easily spread even if symptoms are not present
true
how is hepatitis A transmitted
fecal-oral route
(consuming contaminated water/food)
what two types of viral hepatitis are transmitted through the fecal-oral route
Hepatitis A and E
hepatitis A results ONLY this type of infection
acute infection
____ occurs in 90% of heavy drinkers
alcoholic steatosis (fatty liver)
how is hepatitis B transmitted
sexually transmitted disease
(percutaneous or mucosal contact)
how long can HBV survive on environmental surfaces
1 week
how is hepatitis C developed
injection drug use
what form of hepatitis is uncommon in the US
hepatitis D
how is hepatitis D transmitted
it is a coinfection or superinfection of hepatitis B
(it needs hep b to replicate)
what causes oxidative stress to the hepatocytes in the liver
metabolizing alcohol
how does the liver respond to inflammation and injury
by forming scars (fibroids)
nonalcoholic fatty liver disease (NAFLD) causes
related to diabetes and insulin resistance
genetic, environmental, and inflammatory factors
what quadrant is the pancreas located
left upper quadrant (near stomach)
what is the pancreas’s dual function
secrete insulin/glucagon
acts as endocrine gland
2/3rds of acute pancreatitis involve what
gallstones and chronic alcohol consumption
what type of pancreatitis makes up 80% of cases
interstitial pancreatitis
what type of pancreatitis makes up 20% of cases
necrotizing pancreatitis
is necrotizing pancreatitis or interstitial pancreatitis more severe
necrotizing pancreatitis
moderately severe acute pancreatitis is related to
the gallbladder
chronic pancreatitis
the development of irreversible changes in the pancreas secondary to chronic inflammation
what are the 3 risk factors of chronic pancreatitis
chronic alcohol consumption
smoking
genetic predisposition
the pancreas is able to work until more than __% of pancreatic function is lost
90%
what is the 3rd leading cause of cancer mortality in the US
pancreatic cancer
what cancer has the lowest 5-year survival rate after diagnosis
pancreatic cancer
95% of pancreatic cancers are _____.
Where is it located in the pancreas?
adenocarcinomas
head of pancreas
what disease can increase the risk of developing pancreatic cancer
type II diabetes
(glucose tolerance)
what are the 3 main clinical manifestations of pancreatic cancer
abdominal pain
weight loss
jaundice
t/f: tumors in the head of the pancreas are 2x as likely to metastasize to peritoneum than in the body or tail
false
the body/tail tumors are 2x more likely to metastasize
chole-
pertaining to bile
cholang-
pertaining to bile ducts
cholangiography
radiographic study of bile ducts
cholangitis
inflammation of bile duct
cholecyst-
pertaining to gallbladder
cholecystectomy
removal of gallbladder
cholecystitis
inflammation of gallbladder
cholecystostomy
incision and drainage of gallbladder
choledocho-
pertaining to common bile duct
choledocholithiasis
stones in common bile duct
choledochostomy
exploration of common bile duct
cholelith-
gallstones
cholelithiasis
presence of gallstones
cholescintigraphy
radionuclide imaging of biliary system
cholestasis
stoppage or suppression of bile flow
lith-
stone
what are gallstones made of
75% cholesterol
25% bilirubin salts (pigment stones)
cholelithiasis happens more in men or women
women
what does it mean to be litho-genic
to be more prone to stone formation
what causes cholelithiasis
changes in composition of bile salts, bilirubin, and cholesterol due to supersaturation
2 main complications of cholelithiasis
- cholecystitis (inflammation of gallbladder)
- cholangitis (inflammation of bile duct)
charcot triad
pain
fever
jaundice
peynolds pentad
pain
fever
jaundice
hypotension
mental confusion
___ may be the only presenting sign of acute cholangitis in the elderly
hypotension
acute cholangitis
obstruction and stasis of bile from choledocholithiasis (stones in common bile duct), biliary strictures, or malignancies
how long does acute cholecystitis abdominal pain last for
greater than 6 hours
