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BRS GASTROENTEROLOGY > Hepatobiliary System - Liver > Flashcards

Hepatobiliary System - Liver Flashcards

1
Q

Which ligament separates the right and left lobe of the liver?

A

The falciform ligament

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2
Q

What structure anatomically separates the right and the left liver?

A

The middle hepatic vein

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3
Q

How any different segments does the liver have?

A

8

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4
Q

What is the purpose of the blood delivered to the liver by the hepatic portal vein?

A

carriers venous blood drained from the spleen, GI tract and associated organs

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5
Q

What is the purpose of the hepatic artery?

A

To carry blood from the aorta to the liver

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6
Q

Which two blood vessel compose of the dual blood supply of the liver?

A
  1. Hepatic artery
  2. Portal Vein
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7
Q

What vessels are responsible for the outflow of the liver?

A

The hepatic veins and the bile ducts

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8
Q

How many hepatic veins are in the liver?

A

3 - Right middle and left hepatic veins

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9
Q

Which side of the liver are functional segments 1-4 found on?

A

The left side

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10
Q

Which side of the liver are functional segments 5-8 found on?

A

The right side

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11
Q

What is the teres ligament?

A

found emerging from the posterior side of the liver, reminants of the fetal umbilical cord

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12
Q

What is the sinusoid?

A

mixed arterial and venous blood which drain into the central veins

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13
Q

What are the two sides which all hepatocytes have?

A

They have a bile-canaliculi facing side and a sinusoid facing side

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14
Q

What is a hepatic lobule?

A

The hexagonal structual unit of liver tissue

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15
Q

What is found at each corner of a hepatocyte?

A

Portal triad

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16
Q

What is found at the center of each hepatic lobule?

A

central vein

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17
Q

What is the function of the central vein in the middle of the hepatic lobules?

A

collects blood from the hepatic sinusoids -> into the hepatic veins and into the systemic venous system

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18
Q

What is a portal triad?

A

Structure found at every corner of a hepatic lobule, consists of a hepatic artery, portal vein and a bile duct

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19
Q

What does the hepatic artery in the portal triad do?

A

Brings O2-rich blood into liver to support hepatocytes ↑ energy demands

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20
Q

What does the portal vein in the portal trial do?

A

bring Mixed venous blood from GIT (nutrients, bacteria & toxins) and spleen (waste products)

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21
Q

What do hepatocytes do with blood from the portal veins?

A

process nutrients, detoxify blood & excrete waste

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22
Q

What is the purpose of the bile duct in the portal triad?

A

Bile produced by hepatocytes drains into a bile canaliculi

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23
Q

What is a hepatic acinus?

A

Functional unit of the liver - consists of two adjacent 1/6th hepatic lobules, which share two portal triads and extend into the hepatic lobules as far as the central vein

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24
Q

Describe the three zone model ?

A

Zone 1 - closest to the edge of the hepatic lobules and near the portal triad

Zone 2 - middle

Zone 3 - closest to the central vein

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25
Q

Describe the blood which is recieved in zone 1?

A

Zone 1 is closest to the portal triad - therefore recieves the most oxygenated blood however has the highest risk of toxins

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26
Q

Describe the blood recieved in zone 3 of the hepatic acinus?

A

blood is low in oxygen, however also means the toxin risk is lower

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27
Q

Which zone of the hepatic acinus is usually affected by ischaemia?

A

Zone 1

28
Q

What type of endothelial cells are sinusoidal endothelial cells?

A

Fenestrated - discontinuous endothelium

29
Q

What do sinusoidal endothelial cells do?

A

Allow lipids & large molecule movement to and from hepatocytes

30
Q

Where are Kuppfer cells found?

A

In the sinosoid, attached to the sinusoidal endothelial cells

31
Q

What are Kuppfer cells?

A

sinsoidal macrophages

32
Q

What is the purpose of the Kuppfer cell?

A

Eliminate & detoxify substances arriving in liver from portal circulation via phagocytosis

33
Q

Where are the hepatic stellate cells found?

A

In the space of disse

34
Q

Where is the space of disse found?

A

In the gap between the hepatocytes and the sinosoid

35
Q

What is the purpose of hepatic stellate cells?

A

Store Vitamin A in liver cytosolic droplets

36
Q

What are the three roles of the hepatic stellate cells?

A
  1. Store Vitain A in the liver in cytosolic droplets
  2. Activated (fibroblasts) in response to liver damage
  3. Proliferate, chemotactic & deposit collagen in ECM
37
Q

What are hepatocytes responsible for synthesizing?

A

albumin, clotting factors and bile salts

38
Q

What are cholangiocytes and what are there functions?

A

They are cells found lining the bile ducts, secrete bicarbonate and water into the bile

39
Q

What are the metabolic and catabolic functions of the hepatocyte?

A

synthesis & utilization of carbohydrates, lipids and proteins.

40
Q

What are the secretory and excretory functions of the hepatocyte?

A

synthesis & secretion of proteins, bile and waste products.

41
Q

What are the Detoxification & immunological functions of the hepatocyte?

A

breakdown of ingested pathogens & processing of drugs

42
Q

Describe how the liver participates in the cori cycle?

A
  1. Muscle cell takes up glucose - undergoes glycolysis
  2. This produces pyruvate
  3. One of the fates of pyruvate is lactate
  4. Lactate is taken up by liver and converted into pyruvate using lactate dehydrogenase
  5. Gluconeogenesis occurs in the liver, producing glucose from pyruvate
43
Q

How many ATP molecules does gluconeogenesis require?

A

needs 4 ATP and 2 GTP

44
Q

Describe the process of protein synthesis in the hepatocyte?

A

Amino acids are transported into the liver (in the fed state from the diet, in the fasting state from the muscle cells) where they are converted into secreted proteins like plasma proteins, clotting factors and lipoproteins which are then secreted out the liver

45
Q

Describe how non-essential amino acids are produced?

A

Through different transamination reactions which involve different transaminase enzymes

46
Q

When alpha-keto glutarate undergoes transamination, which amino acids are produced?

A

glutamate and proline

47
Q

How is alanine (a non essential amino acid) produced?

A

through the transamination of pyruvate

48
Q

How is aspartate produced?

A

Through the transamination of oxaloacetate

49
Q

Muscle can potentially utilise amino acids to produce glucose for energy; but converting pyruvate to glucose requires energy. how is this problem overcome?

A

By transferring the problem to the liver -

  1. Pyruvate from glycolysis and glutamate from amino acid breakdown undergo deamination to produce ALANINE
  2. The alanine is transferred to the liver - here it undergoes another deamination reaction to produce GLUTAMATE AND PYRUVATE
  3. The glutamate is then converted into urea using 4 ATP which is then excreted
  4. The pyruvate is the converted into Glucose using 6ATP which is then taken up by the muscle cells
50
Q

What is the main energy store in the body?

A

Fat

51
Q

Where is fat stores?

A

In adipose tissue and the liver

52
Q

What happens to excess glucose when glycogen stores in the liver are full?

A

When glycogen stores full, liver converts excess glucose & amino acids to fat for storage

53
Q

Describe what happens to fatty acids in the liver?

A

fatty acids are converted into Acetyl CoA through beta oxidation which the enters into the TCA cycle

54
Q

How is acetoacetate formed from 2 x Acetyl CoA?

A

2 x Acetyl CoA makes aceto Acetyl Coa

Adding another CoA makes HMG CoA

HMG CoA is then cleaved to form acetoacetate which is a ketone body and is used as a tissue energy source

55
Q

Which two enzymes are involved in lipogenesis or fatty acid synthesis?

A

fatty acid synthase and Acetyl CoA Carboxylase

56
Q

How are the hepatocytes involved in lipoprotein synthesis?

A

Glycerol and fatty acids combine to form tri-acyl glycerol in the liver

These tri-acyl glycerol molecules combine with apoproteins to make lipoproteins

57
Q

What is one of the major roles for cholesterol in cells?

A

Maintenance of Cell membrane integrity

58
Q

what is the purpose of LDL?

A

To transport cholesterol to tissues

59
Q

What is the purpose of VLDL?

A

To transport fatty acids to tissues

60
Q

What is the purpose of HDL?

A

They are empty - they are important fo picking up excess cholesterol

61
Q

What is the hepatocyte responsible for storing?

A

Vitamin B12, A, D, E and K

Iron

Copper

62
Q

What are the four fat soluble vitamins?

A

A, D, E and K

63
Q

What process is vitamin K responsible for?

A

Blood clotting

64
Q

How does the hepatocyte store iron?

A

As ferritin - ensures it is available for erythropoesis

65
Q

Describe how the hepatocytes are involved in detoxification?

A

1) Xenobiotics

2) P450 enzymes:
-Phase 1 (modification)
– more hydrophilic
-Phase 2 (conjugation)
– attach water soluble side chain
to make less reactive

66
Q

What are the uses of bile?

A

Cholesterol homeostasis

Absorption of lipids & lipid soluble vitamins (A, D, E, & K)

67
Q

What is bile involved in the excretion of

A

Xenobiotics / drugs
cholesterol metabolites
adrenocortical and other steroid hormones
Alkaline phosphatase

BRS GASTROENTEROLOGY (25 decks)

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