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ANATOMYY2S2 > histology of liver > Flashcards

histology of liver Flashcards

1
Q

what is gallbladder?

A

muscular sac that stores and concentrate bile

contains crypts/diverticuli

Small pearl-shaped organ

1- Fundus ( rounded widest part , visible during imaging and surgery )

2- Body ( Central, largest section = main storage area for bile )

3- Neck = Narrow tapered end that connects to cystic duct allow bile to flow in and out of gallbladder

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2
Q

what makes the walls of gallbladder?

A

Mucosa

NO SUBMUCOSA

Muscularis externa

Adventitia/serosa

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3
Q

describe mucosa of gall bladder?

A

Folded in empty bladder –> resemble crypts

-Epithelium =

SIMPLE columnar epithelium provided with short apical MICROVILLI ( columnar cuz absorb, store , concentrate )

-Lamina propria:

Contains loose CT, lymphatic tissue, capillaries and venules for draining the water ( capillaries for absorption )

Which is reabsorbed from bile during concentration process

  • NO muscularis mucosa
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4
Q

where are the mucous glands found?

A

lamina propria at the neck only

commonly found in inflamed gallbladder

but normally shouldnt be there if present = inflammation

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5
Q

describe submucosa of gallbladder?

A

NO SUBMUCOSA

NO MUSCUALRIS MUCOSA

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6
Q

describe muscularis externa of gallbladder?

A

Smooth muscles arranged in :

Longitudinal

Transverse

Oblique direction muscles

collagen and elastic fibers

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7
Q

describe adventitia/serosa of Gallbladder?

A

CT with large blood vessels

lymphatic plexus and autonomic nerves

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8
Q

what is rokitansky - aschoff sinuses ?

A

Deep diverticuli (pouches ) of mucosa extending through the muscularis externa —> pouches in mucosa go down deep to the muscularis externa n get entrapped in it

They are not of themselves considered abnormal but they can foretell pathological changes and develop as a result of :

Hyperplasia and Herniation of epithelial cells through muscularis externa

Bacteria may accumulate in these sinuses causing chronic inflammation which is a risk factor for the formation of GALLSTONES

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9
Q

what are major functions of liver?

A

Heaviest gland ( Exocrine and endocrine )

Detoxification of metabolic waste products , drugs, toxins

Synthesis and secretion ( exocrine ) of bile

Synthesis of plasma proteins and lipoproteins

Metabolic functions : glycogen synthesis, gluconeogensis, storage of glycogen, vitamin and lipids

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10
Q

blood source for liver?

A

Hepatic artery 25% : Brings oxygenated blood from aorta

Portal vein 75% –> Carries venous blood from the spleen, stomach, pancreas, small and large intestines contains :

Nutrients and toxic material that are absorbed by GI tract to go to the liver first for processing

Breakdown product of blood cells from spleen

the blood from both vessels flows through sinusoids —> Central vein —> Hepatic vein —> Inferior vena cava

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11
Q

how does capsule affect the liver?

A

completely invest the liver

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12
Q

what is septa trabeculae ?

A

Divides the parenchyma into incomplete lobules

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13
Q

what is the function of trabeculae ?

A

Carry branches of :

Hepatic artery

Portal vein

Hepatic duct

Lymphatics

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14
Q

describe portal veins?

A

portal veins large

Carries nutrient rich blood from GI

Lined by flat squamous epithelium ( endothelium )

Collapsed appearance due to their thins walls and lower pressure

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15
Q

describe hepatic artery?

A

Supplies oxygenated blood to the liver

Lined by flat squamous epithelium ( endothelium )

More rigid and round due to thicker muscular wall –> Xcollapse

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16
Q

describe bile duct?

A

Transport bile away from the lobule

Lined by cuboidal epithelium

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17
Q

describe lymphatic vessels?

A

Drains excess fluid not clearly seen but present

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18
Q

what is a hepatic plate?

A

sheets or rows of hepatocytes

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19
Q

what do you find between the sheets of hepatocyte?

A

Spaces called Sinusoids

specialized capillaries

Sinusoids are filled with blood which flow through them towards CENTRAL VEIN

contain blood from both portal vein and hepatic artery and mix it then take to central then whatever needs to be done will get done then they will be moved to hepatic vein then IVc

Cental has least oxygenated blood cuz it gets the deoxy blood from sinusoids

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20
Q

describe the sinusoids endothelium?

A

highly porous basement membrane for easy exchange

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21
Q

describe venous drainage?

A

Central veins

intralobular veins

Interlobar veins

Hepatic veins

IVF

Heart

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22
Q

bile flow to gallbladder?

A

Hepatocyte

Bile canaliculi

Bile ductules

Interlobular bile ducts

right and Left hepatic ducts

Common hepatic duct ( could go to duodenum from here if neeeded for fat absorption )

Cystic duct

gallbladder for storage

23
Q

what is a portal tract/triad/area/field of liver?

A

3 main structures in fibrous stroma

1- Terminal of portal vein ( largest structure,thin wall, endothelial cells )

2- Terminal branches of hepatic artery A ( smaller diameter, thick walled vessels with typical structure of arteiroles, lined by endothelial cells

3- Bile ductules B ( same size as arterioles, simple columnar or cuboidal )

4- lesseasily identified since their walls are dlicate and often collapsed

24
Q

what is space of disse?

A

space found betweeen hepatocytes and the sinusoidal endothelium

aka perisinusoidal spaces

25
function of space of disse?
Allows for exchange of nutrients, gases and waste products between the blood and liver cells
26
what happens in liver disease to space of disse?
in cirrhosis or inflammation fluid leakage will lead to fluid leaking into this space causing liver fibrosis or ascitis lead to portal hypertension
27
describe hepatocytes ?
Large polygonal cells constitute 80% of cell population 1 or 2 large spherical nuclei ( BINULCEATED ) = IMP Great regeneration capacity Eosinophilic cytoplasm due to numerous mitochondria ( need energy ) Basophilic granulity due to extensive ribosomes and rough endoplasmic reticulum ( protein synthesis of proteins and albumin )
28
in well nourished people ?
Cytoplasm stores significant quantities of glycogen and lipid Both metabolites are partially removed during routine histological preparation , leaving irregular unstained areas within cytoplasm
29
what increases with age?
Fine brown granules of wear and treat pigment LIPOSUCIN
30
why is peroxisome numerous ?
Generate hydrogen peroxide which is involved in the detoxification process occuring in the liver like alcohol detoxificaiton
31
what lines sinusoids ?
discontinuous , fenestrated endothelium no basement membrane
32
what extends from hepatocyte ?
Numerous irregular microvilli Extend from hepatocyte surface into the space greatly increasing the surface area for metabolic exchange
33
describe endothelial cells in sinusoid lining ?
The majority with flat nuclei
34
describe kupffer cells in sinusoid lining?
Scattered among the endothelial cells Large cells with ovoid nuclei Phagocytic : Form part of monocyte macrophage defense system Participate in the removal of senile erythrocyte and other particulate debris from circulation
35
describe stellate cells?
Found in space of disse ( perisinuoidal space ) Cannot be easily distinguished by light microscopy Have lipid droplet containing VITAMIN A VITAMIN A storage
36
what happens in stellate cells in injury?
They differentiate into myofibroblasts Produce collagen fibers in perisinusoidal space CAUSING FIBROSIS contain contractile elements that increase vascular resistance within the sinus leading to PORTAL HYPERTENSION
37
describe reticular meshwork?
Hepatocytes and sinusoid lining cells supported by fine meshwork of reticulin fibers COLLAGEN TYPE 3 which merge with the collagenous supporting tissue of portal tracts and terminal hepatic venules AT PERIPHERY : the reticulin becomes continuous with a thin but tough collagenous capsule ---> GLISSON CAPSULE which invests the external surface of liver
38
what happens to reticular meshwork in increased toxin substances?
increased amount of perisinusoidal fibrous stroma is an early sign of liver response to toxic substances
39
what is space of mall?
Space between the stroma of portal tract and the outermost hepatocyte
40
FUNCTION OF SPACE OF MALL?
Plasma that remains in perisinusoidal space drains to the space of mall From which the fluid then enter LYMPHATIC CAPILLARIES that travel with the other components with portal triad help maintain the liver the ability to maintain fluid homeostasis
41
what is bile canaliculi ?
bile is made by hepatocytes and secreted into a system of minute canaliculi which from an anastomosing network within the plates of hepatocytes
42
Describes canal of hering/ interhepatic ductules?
Short intra hepatic ductules formed by merging of bile canaliculi of adjacent hepatocyte plates Drain into bile ductules of portal tracts Lined with cuboidal non hepatic cells
43
bile pathway?
Hepatocyte bile canaliculi ( tiny channels between hepatocyte ) Canal of hering ( short intrahepatic ductules formed by merging with bile canaliculi ) Bile ductules Interlobular bile duct Right and hepatic ducts Common hepatic duct Cystic duct Gallbladder ( store ) NOTE common bile duct = cystic + common hepatic = duodenum
44
charactistics of classic liver lobule ?
Hexagonal shape Central vein as its center PORTAL TRIAD AT EACH CORNER : hepatic arterioles portal venule Bile ductule Lymphatic vessels
45
describe classic lobule ?
central vein at center Hexagonal in shape PORTAL TRIAD AT CORNERS COMMON VENOUS DRAINAGE
46
describe portal lobule ?
Portal triad at center Triangular in shape CENTRAL VEIN AT CORNERS EMPHAIZE THE EXOCRINE FUNCTION OF LIVER = COMMON BILE DRAINAGE
47
what are 2 liver acinus ?
Short axis -- branches of portal triad between 2 classic lobules Longaxis --> Between 2 central veins
48
function of liver acinus ?
Provide best correlation between blood perfusion and liver pathology Best functional units since mirors pattern of liver degeneration , regeneration or toxic effects due to quality of vascular perfusion BEST FUNCTIONAL UNIT FOR UNDERSTANDING LIVER VASCULAR PERFUSIONS AND ITS ROLE IN DEGENERATION AND REGEN
49
Describe liver/hepatic acinus?
More accurate representation of liver function More difficult to define histologically Centered on PORTAL TRACT LIES BETWEEN 2 CENTRILOBULAR VENULES Blood flows from the portal tracts through the sinusoids to the VENULES Blood from portal tracts ---> through the sinusoids ---> Venules ----> oxygenated blood ---> zone 1 to zone 2 to zone 3
50
Zone of liver acinus ?
Closest to the portal tract Receives most oxygenated blood Coreresponds to peripheray of classic lobule
51
Zone 2?
Lies between zones 1 and 3 it has no sharp boundaries
52
Zone 3?
Surrounds the central vein ( least oxygenated vessel ) Being fathest from portal tract Recieves least oxygen thus most SUSCIPTBLE TO ISCHEMIC INJURY CORERESPONDS TO MOST CENTRAL PART OF THE CLASSIC LOBULE
53
describe zones of hepatic acinus ?
Distribution of liver damage as result of ischemic and exposure to toxin substances can be explained using the zonation of liver acini Cells in zone 1 are the first to receive toxins Cells in zone 3 are the first to show ischemic necrosis ( CENTRILOBULAR NECROSIS )

ANATOMYY2S2 (19 decks)

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