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GIGU Exam 1 > Hepatobiliary Function > Flashcards

Hepatobiliary Function Flashcards

1
Q

Dual blood supply to liver:

A
  • Hepatic Artery (20-30%)
  • Portal Vein (70-80%)
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2
Q

Main Functions of Liver:

A
  • Bile production and secretion
  • Metabolism of carbs, proteins and lipids
  • Bilirubin production and excretion
  • Detoxification of substances
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3
Q

Metabolic Functions of Liver: Protein Synthesis

A
  • Synthesis of non-essential AAs
  • Modification of AA for use in biosynthetic pathways for carbs
  • Synthesis of almost all plasma proteins (ex. albumin, clotting factors)
  • Conversion of ammonia (byproduct of protein catabolism) to urea
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4
Q

Liver failure can result in ______ which may lead to edema

A

Hypoalbuminemia

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5
Q

Bile Composition:

A
  • Bile Salts (50%)
  • Bile Pigments (2%) – ex. Bilirubin
  • Cholesterol (4%)
  • Phospholipids (40%) – ex. lecithin
  • Ions
  • Water
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6
Q

Bile Function:

A
  • Vehicle for the elimination of substances from the body
  • Solves the insolubility problem of lipids
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7
Q

Location of Bile Synthesis:

A

Hepatocytes (Liver)

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8
Q

Location of Dehyroxylation of Primary Bile Acids to Secondary Bile Acids:

A

Lumen of Intestines

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9
Q

Location of Conjugation of Secodary Bile Acids:

A

Liver

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10
Q

Newly synthesized bile acids and returning bile acids (recycled from enterohepatic circulation) are secreted into the ___ ___

A

Bile Canaliculi

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11
Q

Bile Canaliculi

A
  • Located between Hepatocytes
  • Move bile away from the center of the lobule and out to the bile duct
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12
Q

What occurs in the Duodenum?

A

Emulsification and digestion of fats

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13
Q

What occurs in the Jejunum?

A

Micelle formation and fat absorption

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14
Q

What occurs in the Ileum?

A
  • Active absorption of conjugated form of bile acid (>90% of bile acids is absorbed into Portal blood here)
  • Involved in recycling conjugated bile acids back to liver
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15
Q

Recycled bile acids return to liver in ___ circulation

A

Portal

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16
Q

What occurs in the Gallbladder?

A

Storage and concentration of bile between meals

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17
Q

Almost all bile formation is driven by:

A

Bile Acids (bile acid-dependent)

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18
Q

A small portion of bile is stimulated by ___ and is secreted from the ducts – known as ____ ___-___ or ___ ___

A
  • Secretin
  • Bile Acid-Independent
  • Ductular Secretion
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19
Q

During the Interdigestive period, Gallbladder fills with bile:

A
  • Gallbladder is relaxed
  • Sphincter of Oddi is closed
20
Q

On Eating, CCK-mediated:

A
  • Contraction of the Gallbladder
  • Relaxation of the Sphincter of Oddi
21
Q

Uptake of Bile Salts across the Basolateral membrane of the hepatocytes is mediated by two types of systems:

A

(1) Na+-dependent transport protein, Sodium Taurocholate Co-Transporting Polypeptide (NTCP)
(2) Na+-independent transport protein, Organic Anion Transport Proteins

22
Q

Rate of Bile Acid Synthesis & Secretion: Ileal Resection

A
  • Do not have enough Bile Acid because it is not being reabsorbed in the Ileum
  • Increased rate of bile acid synthesis
  • Decreased rate of bile acid secretion
23
Q

Rate of Bile Acid Synthesis & Secretion: Bile Acid Feeding/Excess

A
  • Decreased rate of bile acid synthesis
  • Increased rate of bile acid secretion
24
Q

Cholesterol 7alpha Hydroxylase is inhibited by:

A

Bile Acids/Salts

25
Q

Unconjugated bilirubin toxicity in the CNS damages:

A
  • Neurons
  • Astrocytes (increased release of inflammatory factors)
  • Microglia (increased release of inflammatory factors)
  • Oligodendrocytes (decreased myelin synthesis)
26
Q

Biochemical Liver Function Tests: ALT

A
  • Type of serum aminotransferase
  • Very specific to the liver
27
Q

Biochemical Liver Function Tests: AST

A
  • Type of serum aminotransferase
  • Nonspecific – found in other tissue besides the liver
28
Q

What 3 Liver enzymes are commonly measured in the serum?

A

(1) ALT
(2) AST
(3) Alkaline Phosphatase

29
Q

Elevated aminotransferases (ALT and AST) are primarily the result of:

A

Hepatocyte injury

30
Q

Elevated Alkaline Phosphatase are primarily the result of:

A

Bile Duct injury (ex. Cholestasis)

31
Q

Liver Function Tests: Albumin

A
  • Synthesized exclusively in the liver
  • Levels of this protein fall as the synthetic function of the liver declines with worsening cirrhosis
  • Severe impairment of hepatocyte function is likely to reduce the level of this protein in the plasma
32
Q

_____ is not specific to liver disease; it may also be seen in Kidney Glomerular Disease

A

Hypoalbuminemia

33
Q

Liver Function Tests: Prothrombin Time (PT)

A
  • Reflects the degree of hepatic synthetic dysfunction
  • PT increases when hepatic synthesis of clotting factors is impaired
  • PT increases as the ability of a cirrhotic liver to synthesize clotting factors diminishes
34
Q

Saliva Secretion: Characteristics

A
  • High [HCO3-]
  • High [K+]
  • Hypotonic
  • Alpha amylase and lingual lipase
35
Q

Saliva Secretion: Factors that Increase Secretion

A

PNS

36
Q

Saliva Secretion: Factors that Decrease Secretion

A
  • Sleep
  • Dehydration
  • Atropine
37
Q

Gastric Secretion: Characteristics

A
  • HCl
  • Pepsinogen
  • Intrinsic Factor (IF)
38
Q

Gastrin Secretion: Factors that Increase Secretion

A
  • HCl is increased by Gastrin, ACh and Histamine
  • Pepsinogen is increased by PNS
39
Q

Gastric Secretion: Factors that Decrease Secretion

A
  • H+ in the stomach
  • Chyme in the duodenum
  • Somatostatin
  • Atropine
  • Cimetidine
  • Omeprazole
40
Q

Pancreatic Secretion: Characteristics of Aqueous Secretion

A
  • High [HCO3-]
  • Isotonic
41
Q

Pancreatic Secretion: Characteristics of Enzyme Secretion

A

Pancreatic Lipase, Amylase and Proteases

42
Q

Pancreatic Secretion: Factors that Increase Aqueous Secretion

A
  • Secretin
  • PNS
43
Q

Pancreatic Secretion: Factors that Increase Enzyme Secretion

A
  • CCK
  • PNS
44
Q

Bile Secretion: Characteristics

A
  • Bile salts
  • Bilirubin
  • Phospholipids
  • Cholesterol
45
Q

Bile Secretion: Factors that Increase Secretion

A
  • CCK – causes contraction of gallbladder and relaxation of sphincter of Oddi
  • PNS
46
Q

Bile Secretion: Factors that Decrease Secretion

A

Ileal Resection

GIGU Exam 1 (14 decks)

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