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SF3- EXAM 3 (Camelita) > Histology of Liver, Exocrine Pancreas and Gall Bladder > Flashcards

Histology of Liver, Exocrine Pancreas and Gall Bladder Flashcards

1
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2
Q

The ____________ serves as the point of entry into the liver for the hepatic arteries and the portal vein, and the exit point for the hepatic ducts.

A

porta hepatis

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3
Q

The whole surface of the liver except for the _________, is covered in a serous coat derived from the peritoneum, and this firmly adheres to the inner Glisson’s capsule.

A

bare area

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4
Q

Glisson’s capsule

A

A layer of connective tissue surrounding the liver and ensheathing the hepatic artery, portal vein and bile ducts within the liver.

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5
Q

At rest the liver normally receives about _______ of cardiac output.

A

25%

NOTE: The liver is unique amoung abdominal organs in having a dual blood supply, from the hepatic arteries and hepatic veins.

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6
Q

What are the two blood supplies of the liver?

A
  • Portal artery
    • 20-30%
    • Supplies oxygen rich blood
  • Portal vein
    • 70-80%
    • Supplies nutrient rich blood from the digestive tract

NOTE: The portal blood also contains breakdown products of hemoglobin from the spleen.

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7
Q

Where does blood from the head of the pancreas drain?

A

Superior mesenteric vein

NOTE: The tail of the pancreas drains into the splenic vein

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8
Q

What are the components of the portal triad?

A
  • Branches of the hepatic artery and vein
  • One or two bile ductules
  • Lymphatic vessels
  • Branch of vagus nerve
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9
Q

Explain the blood flow from the portal triads to the inferior vena cava.

A

Portal triads->central vein->sublobar vein->collecting vein->hepatic veins-> inferior vena cava

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10
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11
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12
Q

What are the 3 functional units of the liver? What’s the function of each?

A
  • Classic Hepatic Lobule
    • ​Drains blood from the portal vein and the hepatic artery to the hepatic or the central vein
  • Portal Lobule
    • ​Drains bile from hepatocytes to the bile duct
  • Hepatic Acinus
    • ​Supplies oxygenated blood to hepatocytes

NOTE: The hepatic acinus is the most funtional way to conceptualize the liver lobule based on blood flow.

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13
Q

What are the 3 metabolic zones of the hepatic acinus?

A

Zone I

  • Least oxygenated

Zone II

Zone III

  • Most oxygenated
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14
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15
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16
Q

Central veins coalesce into __________.

A

Hepatic veins

*Which leave the liver and empty into the vena cava

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17
Q

Purpose of the liver sinusoid

A

A liver sinusoid is a type of a capillary similar to a fenestrated capillary and serves as a location for mixing of oxygen rich blood from the hepatic artery and the nutrient rich blood from the portal vein

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18
Q

How does the liver sinusoids differ from other capillaries?

A
  • Larger
  • Lining of specialized endothelial cells, known as liver sinusoidal cells (LSEC)
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19
Q

Basolateral surface of the hepatocyte faces ______, and apical surfaces face ___________.

A

Sinusoids; bile canaliculi

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20
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21
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22
Q

Characteristics of the nucleus of hepatocytes

A
  • Prominent nucleolus
  • Dispersed chromatin
  • Polyploidy
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23
Q

Characteristics of the cytoplasm of hepatocytes

A
  • Glycogen lacey appearance
  • Fat spherical vacuoles
  • Ribosomes and RER basophilia
  • Mitochondira- eosinophilic
  • Lysosomes
  • Golgi complex
  • Peroxisomes
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24
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25
Q

Most of the glucose absorbed from a meal is stored as _________ in the liver.

A

Glycogen (5-6% of the liver’s fresh weight)

NOTE: Glucose is also stored in muscles

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26
Q

Blood glucose enters hepatocytes via which transporter?

A

GLUT2

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27
Q

The human body can store up to _____ grams of glycogen.

A

450

*A third of this is stored in the liver

28
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Label

A

Glycogen

29
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A
30
Q

Which structure of hepatocytes function to synthesize and secrete plasma proteins?

A

RER

Ex: Albumin, fibrinogen, thrombin

31
Q

Which structure of hepatocytes function to synthesize and secrete bile?

A

SER

  • Bile acids from cholesterol
  • Elimination of bilirubin
  • Secretion of secretory IgA
32
Q

Which structure of hepatocytes function to metabolize carbohydrates?

A

SER, cytosol

33
Q

Which structure of hepatocytes function to metabolize lipids?

A

RER

34
Q

Which structure of hepatocytes function to maintain normal levels of blood lipids?

A

VLDL

35
Q

Function of the smooth endoplasmic reticulum

A
  • Synthesis lipids, oils, phospholipids, steroids, and sex hormones
  • Hydrolysis of glycogen into glucose
  • Detoxification of drugs and poisons
  • Pumps calcium ions for muscle function
36
Q

___________ are spaces present between the plasma membrane of adjacent liver cells.

A

Bile canaliculi

37
Q

Flow of bile

A

Bile canaliculi-> Canals of Hering-> intrahepatic bile ductule (in portal triad)->Interlobular bile ducts-> left and right hepatic ducts-> Common hepatic duct

NOTE: The common hepatic duct joins with the cystic duct which becomes the bile duct, which enters the duodenum

38
Q

Function of Kupffer cells

A

Continuously sample the blood travelling through the sinusoids, phagocytosing antigens, microorganisms and damaged red blood cells.

39
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Label

A
40
Q

Which component of hepatocytes is being described below?

  • A subendothelial space
  • Space between hepatocytes and sinusoidal lining cells
  • Microvilli of hepatocytes project into the space
  • Fat storing stellate cells that store Vitamin A found here
  • Space continuous with sinusoids
  • Space drains to lymphatics of portal triad
A

Space of Disse

41
Q

Which component of hepatocytes is being described below?

  • Lie in perisinusoidal space
  • Have long cytoplasmic processes that extend below the endothelial cells
  • Contain actin and myosin and contract in response to endothelin and substance P
  • Contribute to regulate the diameter of the sinusoid
    • Store fat and Vitamin A
A

Ito (stellate cells)

42
Q

Ito cells can proliferate when activated by _____ and ________.

A

Kupffer cells; hepatocytes

43
Q

What happens to Ito cells in pathological conditions?

A
  • They change into collagen producing cells
  • They secrete type I collagen leading to fibrosis of the liver
  • As the fibrotic process advances, ito cells change into myofibroblasts which contrict the lumen of the sinusoids and increase vascular resistance
    • An increase in resistance to the flow of blood in the hepatic sinusoids leads to portal hypertension
44
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45
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46
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47
Q

Which portion of the pancrease makes and secretes digestive enzymes into the duodenum?

A

Exocrine

NOTE: This includes secretory acinar and duct cells with associated connective tissue, vessels, and nerves.

48
Q

Components of exocrine pancreas

A

NOTE: Most pancreatic enzymes are produced as zymogens, which help minimize the risk of self digestion within the pancreas

49
Q

Label

A
50
Q

What are the two portions of the cytoplasm of each acinar cell?

A
  • Apical
    • ​Filled with eosinophilic protein secretory granules
  • Basal
    • ​Strongly basophilic
    • Replet with RER
51
Q

What accounts for the dark appearance of secretory ganules?

A

High concentration of proteins (enzymes) and other macromolecules

NOTE: Secretory granules are primarily found in the apical side of the cell. Fusion with the plasma membrane releases the contents of the granules into the extracellular space.

52
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Label

A
53
Q

What are the two secretory products of pancreatic juice?

A
  • Digestive enzymes
    • Synthesized and secreted from the exocrine acinar cells
  • Bicarbonate
    • Secreted from the epithelial cells lining small pancreatic ducts
54
Q

When is secretin secreted?

A

In response to acid in the duodenum which stimulates duct cells to produce water and bicarbonate

55
Q

How is merocine secretion of proenzymes by acinar cells regulated?

A
  • Secretin
  • Cholecystokinin
  • Nerve stimulation from the vagus nerve
56
Q

Components of acinar cells of the pancreas

A
  • Trypsin
  • Chymotrypsin
  • Elastase
  • Sodium bicarbonate
57
Q

How is trypsinogen activated?

A
  • By enterokinase, which is embedded in the mucus membrane of the duodenal mucosa

NOTE: Trypsin is autocatalytic which means that trypsin, once activated, forms more trypsinogen, which is then activated to trypsin

58
Q

Chymotrypsinogen and procarboxypeptidase are converted to an active form by ______ in the duodenal lumen.

A

Trypsin

59
Q

Bile empties to the common bile duct under ________ stimulation.

A

Hormonal

NOTE: Cholecystokinin stimulates the gallbladder. Cholecystokinin (CKK) is secreted by the I cells of the intestinal mucosa.

60
Q

Once stimulated by CCK, how does the gallbladder respond?

A

By contracting and delivering more bile to the duodenum through the Sphincter of Oddi, which relaxes (opens) in response to CCK.

61
Q

Function of bile

A
  • Excretion of cholesterol, phospholipids, bile salts, conjugated bilirubin and electrolytes
  • Contributes to fat absorption in the intestinal lumen
  • Transports IgA to the intestinal mucosa by enterohepatic circulation
  • Excretion of metabolic products of drugs and heavy metals processed in the hepatocyte
  • Conjugated bile acids inhibit the growth of bacteria in the small intestine
62
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63
Q

What are the 4 layers of the gall bladder?

A
  • Lining epithelium (simple columnar)
  • Lamina propria
    • Rich in elastic fibers and blood vessels
  • Muscularis
    • Consists of circularly arranged smooth muscle fibers intermixed with connective tissue rich in elastic fibers
  • Serosa/ adventitia
64
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65
Q

Cholecystitis

A
  • Inflammation of the gall bladder
  • Rokitansky-Aschoff sinuses- herniation of mucosa into muscular wall

SF3- EXAM 3 (Camelita) (23 decks)

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