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GI > Histology: Liver and Gallbladder > Flashcards

Histology: Liver and Gallbladder Flashcards

1
Q

What is Glisson’s capsule? What is it covered by?

A

dense irregular CT that surrounds the liver’s 4 lobes

Covered by simple squamous epithelium from peritoneum

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2
Q

What do we mean when we say the liver has a dual blood supply?

What percent of cardiac output is bound for the liver?

A

The liver receives 75% of blood supply from the portal vein and the other 25% from the hepatic artery.

20 to 25% of cardiac output is to the liver.

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3
Q

What nutrients does the liver take up?

A

carbohydrates, amino acids, lipids, vitamins

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4
Q

What does the liver store and release? What does the liver synthesize?

A

Stores and releases: glucose, triglycerides, vitamins

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5
Q

What are some examples of products that are synthesized by the liver?

A

albumin, prothrombin & fibrinogen, a & b globulins,

glucose, fatty acids & triglycerides, cholesterol & phospholipids,

lipoproteins

Bile - secretes ~750 mL/day

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6
Q

What are examples of things the liver detoxifies?

A

metabolites, drugs, xenobiotics (foreign matter ingested w/ food)

bacteria, immunoglobulin complexes, “worn out” cells/proteins

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7
Q

What is the hepatic triad?

A
  1. Portal Vein
  2. Hepatic Artery
  3. Bile Ductule

(Slide also includes “lymph vessel” which would hose the whole “triad” thing, but whatev! (Kathleen asks if the lymph vessel is actually relevent to liver detoxor nutrient absorption, or just an artifact of blood flow?)

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8
Q

In the liver, what do the hepatocytes form?

A

A muralium (wall of cells) that radiate in a polyhedron from the central vein.

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9
Q

What is the path of blood through the lobule of the liver?

A
  • Enters at periphery
  • percolates via sinusoids
  • leaves by central vein
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10
Q

How does bile travel in the liver lobule?

A

Counter-current to blood, leaves at periphery of lobule

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11
Q

Describe the structure of a hepatocyte

A

Most cells are mononuclear but many may be binucleate

most cells polyploid (tetraploid)

80% of cells in liver

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12
Q

What are the 3 surfaces hepatocytes possess?

A
  • sinusoidal
  • baso-lateral
  • bile canalicular
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13
Q

What facilitates the access of blood to hepatocytes? What keeps blood cells out of the lymph?

A

Sinusoids with discontinuous wall and discontinuous basal lamina

supported by reticular fibers. Structure also keeps blood supply out of space of Disse (liver lymphatics).

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14
Q

What are Kupffer cells?

A

Liver macrophages

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15
Q

What is altered in diseases like hepatic fibrosis or hepatic cirrhosis?

A

The liver stroma - in disease, CT elements relate abnormally with parenchyma. Increase in CT alters normal fxn.

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16
Q

What are the three ways to describe liver lobules?

A
  • classic
  • portal
  • portal acinus (acinar lobule)
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17
Q

What are the following based on?

  • Classic lobule
  • portal lobule
  • portal acinus
A
  • Endocrine nature
  • exocrine nature
  • metabolic zonation
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18
Q

What is the shape of a classic lobule? What does it make?

A

polygonal in shape

peripheral central canals and center vein emphasize endocrine nature

Makes fibrinogen, albumin, glucose that are used elsewhere.

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19
Q

What lies at the center of a classic lobule? At the periphery?

What does this structure emphasize about the function of the gland?

A

Vein in center and portal canals at periphery

emphasizes the endocrine function of the gland

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20
Q

What is the shape of a portal lobule?

A

Triangular in concept

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21
Q

What is in the center of a portal lobule? At the periphery? Why does it have this arrangement?

A

Portal canal in center

Central vein in peripheral apices

Arrangement due to exocrine function - bile is secreted into a duct.

22
Q

What is the pictured lobulation?

A

portal acinus

23
Q

Where are the central veins located in a portal acinus?

A

at apices of the lobule

24
Q

The liver is zoned based on a gradient of metabolic activity. What are the zones?

A

Zone 1 - Periportal Zone

Zone 2 - mid-region

Zone 3 - centrolobular zone

25
Q

What does the periportal zone recieve?

A

receives blood with highest concentration of nutrients/oxygen last to die and first to regenerate.

26
Q

What does zone 2 (mid-region) recieve?

A

receives blood of intermediate “quality“ (from zone 1)

27
Q

What does the centrolobular zone (zone 3) recieve?

A

receives blood with lowest nutrient/oxygen content (from zone 2) first cells to die in centrolobular necrosis

28
Q

There are numerour differences in zones, what are four we covered?

A

carbohydrate metabolism

protein metabolism

lipid metabolism

drug metabolism

29
Q

How does regeneration of hepatocytes differ in a diseased liver compared to a healthy liver?

A

Zonal damage, selective regeneration of damaged zones as opposed to regeneration in all zones.

30
Q

What is different about hepatic regeneration in cirrhosis?

A

CT elements don’t cooperate, leading to

  1. Altered structure
  2. compromised parenchymal function
31
Q

What are some examples of hormones that target the liver?

A

growth hormone

  prolactin

    insulin

    glucagon

    norepinephrine
32
Q

What does Tay-Sachs disease result from?

A

A.K.A. Sphingolipidosis

-Absence of B-hexosaminidase (which degrades acidic fatty gangliosides)

33
Q

What causes metachromatic leukodystrophy?

A

The absence of aryisulfatase causes accumulation of sulfated cerebrosides.

34
Q

What causes type II glycogenolysis (not a good thing)?

A

acid maltase (acid alpha-glucosidase) is absent

35
Q

Where are VLDL’s made? What do they do?

A

Made in the rER from chylomicrons converted by the sER.

VLDL’s transport apoprotein for lipoproteins

36
Q

Where is glycogen preferentially laid down in gluconeogenesis?

A

The periportal area

37
Q

Where is glucose preferentially laid down in the liver?

A

Perivenous area

38
Q

What do we need to digest fats?

A

Lipase and bile

39
Q

What do peroxisomes do?

A
  • Oxidize substrates with O2 and H2O2, including lactate, D-amino acids and polyamines.
  • Peroxidize alcohols, formate, nitrite, quinones
  • Purine catabolism
40
Q

What is a stellate cell for?

A

Storage break down and storage of fats.

41
Q

What is being indicated here? When are these seen?

A

Mallory bodies.

Seen in a variety of hepatic diseases

Cholestatic conditions, cirrhosis

42
Q

What do hepatic sinusoids do for hepatocytes?

A
  • Allow easy access to blood
  • exclude cellular elements from the space of Disse
43
Q

What are Ito cells?

A

Another name for Stellate cells, which is another name for lipocyte

44
Q

What are the functions of Kupffer cells?

(4)

A
  1. phagocytose immune complexes, bacteria, non-immune particulates via Fc and C’ receptors.
  2. Bind and degrade hemoglobin to bilirubin
  3. Can assume RBC destruction responsibilities of the spleen
  4. Process and present antigen
45
Q

Identify cell type

A

Kuppfer cell

46
Q

What vitamin is rapidly taken up and stored in the lipid droplet of Ito cells?

A

Vitamin A

47
Q

What is bile necessary for?

A
  1. solubilization/absorption of intestinal fat
  2. provides main pathway for excretion of cholesterol
  3. eliminates many toxins, including bilirubin
48
Q

Describe the submucosa in the gall bladder.

A

There is none

49
Q

Describe the lamina propria of the gall bladder

A
  • thin layer of dense irregular CT
  • numerous small blood vessels
  • numerous small lymphatic vessels
  • no muscularis mucosa
50
Q

Describe the surface of the gallbladder when empty and full.

A
  • filled - surface is even
  • empty - decussating folds or rugae
51
Q

What is the secretory stimulus from the gut enteroendocrine cells for the gall bladder?

A
  • secretin - induces biliary bicarbonate and H20 secretion
  • cholecystokinin (CCK ) - induces gall bladder contraction
52
Q

Describe the serosa of the gall bladder

A
  • thick layer of dense irregular CT
  • abundant arteries, veins & lymphatics
  • mesothelium covers underlying CT

GI (26 decks)

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