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Medicine Unit 8 > Histology of the Liver > Flashcards

Histology of the Liver Flashcards

1
Q

liver location

A

largest internal organ/gland
upper right quadrant of abdomen
below the diaphragm

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2
Q

hepatic lobules, what are they

A

polygonal structures
basic functional units

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3
Q

blood supply to the liver

A

dual
hepatic artery and heptic portal vein
has supply of oxygenated and deoxygenated blood

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4
Q

liver lobes

A

major left and right
2 smaller inferior lobes

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5
Q

composition of blood supply to the liver

A

75% nutrient rich but O2 poor
25% supplies O2

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6
Q

Glissons capsule

A

Layer of connective tissue surrounding the liver
subdivides the parenchyma into lobules

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7
Q

main components of bile

A

water
bile salts
bilirubin
cholesterol
fatty acids
electrolytes

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8
Q

main functions of the liver

A

exocrine funciton
endocrine function
metabolism and detoxification
storage

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9
Q

exocrine function

A

secretion of bile into the duodenum
help digest fat
eliminate waste products: bilirubin and excess cholesterol

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10
Q

endocrine function

A

synthesis of majority of plasma proteins: fibrinogen, prothrombin, lipoproteins and albumins
and their release into the bloodstream

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11
Q

metabolism and detoxification

A

breakdown of proteins
toxic substances
many drugs
oxidation and conduction of toxins and other hormones
elimination via bile or urine

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12
Q

storage

A

iron
blood
glycogen
triglycerides
vitamin A

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13
Q

where does the hepatic portal triad enter

A

periphery of each lobule

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14
Q

where does the terminal hepatic venule enter

A

centre of the lobule
aka centralvein

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15
Q

corners of the polygonal classic lobule

A

portal triad

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16
Q

components of the portal triad

A

portal vein
hepatic artery
bile duct
(small lymphatic vessels)

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17
Q

label the image

A
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18
Q
A
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19
Q

bile flow VS blood flow

A

opposite directions

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20
Q

where does blood flow in the liver

A

branches of hepatic artery and vein empty into hepatic sinusoids
flows towards central vein

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21
Q

lining of the sinusoids

A

discontinuous
separated from radial plates of hepatocytes by space of Disse

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22
Q

bile canaliculi

A

receive bile from hepatocytes that border them
convey it to bile ducts in portal triads

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23
Q
A
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24
Q

hepatic microcirculation

A

portal triad
sinusoidal system
sinusoid lumina
terminal hepatic venule (central vein)

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25
Q

sinusoidal system

A

interconnecting system of capillary like channels
close contact with hepatocytes

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26
Q

central venues convergence

A

into larger veins
eventually form 2 or more large hepatic veins
empty into inferior vena cava

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27
Q

label the hepatic microcirculation

A
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28
Q

what are the bile canaliculi

A

enlarged intercellular spaces
between 2 adjacent hepatocytes

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29
Q

where do hepatic sinusoids carry blood to

A

glucose rich and oxygen rich
to hepatocytes
through space of Disse

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30
Q

what is the space of Disse

A

between endothelial cells of hepatic sinusoid and hepatocytes

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31
Q

label the image

A
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32
Q

hepatocytes

A

large
polyhedral
spherical nuclei, often binucleated
acidophilic cytoplasm
sER, rER
lots of mitochondria
peroxisomes
multiple small Golgi
form plates/cords in liver
store glycogen

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33
Q

what is in the image

A

hepatocyte
B- binucleate hepatocyte
S- sinusoid lining cell

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34
Q

what occurs at periphery of each hepatic lobule

A

many bile canaliculi join with bile canals of Hering

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35
Q

bile canals of Hering

A

cuboid epithelial cell lining
called cholangiocytes

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36
Q

cholangiocytes

A

allow bile modification

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37
Q

where do bile canals of herring join and drain

A

join bile ductules in portal areas
drain into biliary tree

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38
Q

cholecystokinin funciton

A

hormone
regulates bile release from liver and gall bladder
causes gall bladder contraction and expansion of bile

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39
Q

where does cholecystokinin come from

A

enteroendocrine cells in intestinal mucosa
releases as fats in chyme

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40
Q

bile ductules pathway

A

canaliculi
canals of herring
bile ductules
bile duct

41
Q

label bile ductule

A
42
Q

Ito cell funciton

A

vitamin A storage
supporting cells

43
Q

Kupffer cells

A

stellate macrophages
antigen presenting cells
remove worn out red blood cells
recycle iron molecules
remove bacteria/debris in portal blood

44
Q

cytoplasm in hepatocyte

A

acidophilic

45
Q

basal surface of hepatocytes

A

contact with perisinusoidal space of Disse

46
Q

apical surface of hepatocytes

A

connected to adjacted hepatocyte
form bile canaliculus

47
Q

what is in the image and label

A

PV - Portal vein
B - Bile ductules
A - Hepatic artery
L - lymphatics
H - Hepatocytes
S - Sinusoids

48
Q

lymphatics in histology

A

present in total traces
walls are delicate and often collapsed
less easily identified

49
Q

what surrounds the portal tract

A

anastomosing plates of hepatocytes
called hepatic sinusoids

50
Q

3 ways to describe structure of the liver as a functional unit

A

classic lobule
portal lobule
liver acinus

51
Q

classic lobule shape

A

polygonal

52
Q

portal lobule shape

A

triangular

53
Q

liver acinus she

A

diamond
3 zones and correlates to blood perfusion, metabolic activity and liver pathology

54
Q

label the image of liver organisation

A
55
Q

short axis of the acinus

A

defined by the terminal branches of portal triad
lie along border between 2 classic lobules

56
Q

long axis of acinus

A

line drawn between 2 central veins closest to the short axis

57
Q

hepatocyte arrangement in liver acinus

A

3 concentric elliptical zones

58
Q

zone 1 acinus

A

periphery of classic lobules
closest to short axis and blood supply from penetrating branches of portal vein and hepatic artery

59
Q

zone 2 acinus

A

between zones 1 and 3
no sharp boundaries

60
Q

zone 3 acinus

A

most central part of classic lobule
surrounds terminal hepatic vein
furthest from short axis

61
Q

describe images

A

a. hepatocytes
b. reticulin along plates of hepatocytes
c. central vein, more collagen than smaller sinusoids
d. peripheral portal areas with more connective tissue, site of portal triad

62
Q

what is the gall bladder

A

hollow organ
inferior to the liver

63
Q

function of gall bladder

A

store and concentrate bile

64
Q

where is bile produced

A

liver hepatocytes

65
Q

connections of gall bladder

A

to liver and duodenum
by biliary duct system
organ drains through cystic duct
joins common hepatic duct
forms common bile duct

66
Q

how is bile released

A

in response to fats in duodenum
due to cholecystokinin

67
Q

how does bile enter the duodenum

A

sphincter muscles relax
gallbladder contacts
forces bile in

68
Q
A
69
Q

function of bile acids and salts

A

emulsify lipids in duodenum
promote digestion and absorption

70
Q

bile flow

A

leaves liver in left and right ducts
merge to common hepatic
connects to cystic duct that serves gall bladder
these ducts merge to form common bile duct

71
Q

where does the main pancreatic duct merge with common bile duct

A

hepatopancreatic ampulla

72
Q

where does the hepatopancreatic ampulla enter duodenum

A

at major papilla of Vater

73
Q

where does the hepatopancreatic ampulla enter duodenum

A

at major papilla of Vater

74
Q

where does the accessory pancreatic duct enter the duodenum

A

minor papilla

75
Q

what mixes before releasing into the duodenal lumen

A

bile and pancreatic juices

76
Q

layers of the wall of the gall bladder

A

mucosa
muscularis propria
serosa

77
Q

label the image of the gall bladder

A
78
Q

what reduces the volume of the gall bladder

A

contractions of the muscularis externa
forces bile out through the cystic duct and common bile duct

79
Q

lining of hepatic, cystic and common bile duct

A

mucous membrane
simple columnar epithelium of cholangiocytes

80
Q

apical histological surface of the gall bladder

A

simple columnar epithelial cells
many microvilli

81
Q

lamina propria gall bladder

A

highly cellular
connective tissue
scattered smooth muscle cells from musculris

82
Q

muscularis gall bladder

A

circular smooth muscle bundles, longitudinal and oblique random orientation
intervening connective tissue and blood vessels

83
Q

outer layer gall bladder

A

thick fibrous connective tissue
contains nerves, blood and lymphatic plexus
externally covered by peritoneum so called srrosa

84
Q

extra hepatic bile ducts

A

contain all layers of gall bladder wall
lined by epithelium similar to gall bladder

85
Q

name of gall stones

A

cholelithiasis

86
Q

components of gall stones

A

often solid deposits of cholesterol or calcium salts

87
Q

symptoms and treatment of gall stones

A

no symptoms
can cause jaundice due to blocked bile flow

laparoscopic surgery

88
Q

biliary colic

A

severe abdominal pain

89
Q

gallstones risk factors

A

female
obesity
oral contraceptives

90
Q

complications of gallstones

A

acute or chronic cholecystitis
blockage of ampulla of Vater so may lead to acute pancreatitis

91
Q

cholecystitis

A

gall bladder contracts more strongly to try overcome obstruction
musculature thickens consequently
high pressure in gall bladder lumen
pushes pouches of mucosa into muscle layers

92
Q

jaundice

A

yellow discolouration of tissues due to increased levels of bilirubin and associated deposition of bile pigments

93
Q

bilirubin

A

Bilirubin is yellowish pigment that is made during the normal breakdown of red blood cells. Bilirubin passes through the liver and is eventually excreted out of the body.

94
Q

hyperbilirubinaemia

A

(raised blood level of bilirubin)

95
Q

classifications of hyperbilirubinaemia

A

prehaptic jaundice
hepatic jaundice
post hepatic jaundice/ obstructive jaundice

96
Q

prehapetic jaundice

A

occurs due to increased production of bilirubin, such as when there is excessive red cell breakdown in sickle cell anaemia.

97
Q

hepatic jaundice

A

occurs when there is acute or chronic damage to the liver, reducing its ability to metabolise and excrete bilirubin.

98
Q

Posthepatic jaundice AKA obstructive jaundice

A

when there is some form of mechanical blockage which interrupts the flow of bile into the biliary system, such as gallstones.

Medicine Unit 8 (24 decks)

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