Hepatobiliary basics

Question 1

The liver is sub-divided into segments. ______ has a separate venous drainage into the vena cava

Answer 1

segment 1 (caudate)

Question 2

The liver has a dual blood supply: the ______ and ______

Answer 2

portal vein

hepatic artery

Question 3

The portal vein is made up of:

Answer 3

splanchnic vein, SMA, IMA

Question 4

The bile ducts receive blood flow only through the ________

Answer 4

hepatic artery

Question 5

Thrombosis of the hepatic artery can lead to ________, infarction of the bile duct which can heal with scarring and desquamation of biliary epithelium and serve as a nidus for stone formation

Answer 5

ischemic cholangitis

Question 6

A _____ is formed by extravasation of bile and can become infected

Answer 6

biloma

Question 7

Inflammation of the portal tracts leads to _________

Answer 7

interface hepatitis

Question 8

What molecular features are responsible for the zonation of the portal acinus?

Answer 8

differential expression some genes- ex for ammonia metabolism, glutamine synthesase are preferentially expressed in zones 2-3.
gene expression seems to be determined by nutrient status

Question 9

______ vessels start blindly in the space of Disse and communicate freely with the space of Mall

Answer 9

Lymphatic

Question 10

What effects do alcohol and other toxins have on hepatic sinusoids?

Answer 10

Capilarization of sinusoids- cause fenestrae to close off in order to protect the hepatocytes, formation of a basement membrane over time

Question 11

Describe the function of ito cells/ lipocytes/ stellate cells

Answer 11

Normally stores vitamin A and form Type III and type IV collagen
When stimulated can discharge vitamin A and becomes a myofibroblast and secretes type I collagen.
Can squeeze the sinusoids and lead to portal hypertension.

Question 12

What is the role of stellate cells/ ito cels/ lipocytes in the pathology of portal hypertension?

Answer 12

Ito cell is responsible for contracting on the sinusoids, forms type I collagen scar leading portal hypertension

Question 13

Kupffer cells are located:

Answer 13

WITHIN the sinusoids

Question 14

What is the association beteween portal hypertension, cirrhosis, and bacteremia?

Answer 14

Portal hypertension- blood has problem passing through the liver and so portal systemic collateral blood vessels form (recognized as verices)
blood can get back to the heart but the problem is no passage through the liver, Kupffer cells can’t function to remove microbes when blood is diverted to go around the liver

Question 15

A large granular lymphocyte in the sinusioid is also known as a ________

Answer 15

pit cell

Question 16

Endonucleases cleave chromatin in _______

Answer 16

apoptosis

Question 17

Inflammation is a key feature of _________

Answer 17

necrosis

Question 18

List the two processes of liver regeneration

Answer 18

Compensatory hyperplasia and regenerative nodules

Question 19

__________ is characterized by fibrosis surrounding regenerative nodules

Answer 19

Cirrhosis

Question 20

In fulminant hepatic failure, what cells are responsible for regenerating liver tissue?

Answer 20

Stem cells- found within the bile ductules, differentiate into hepatocytes