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Unit 8 > Histology of the liver > Flashcards

Histology of the liver Flashcards

1
Q

What is unique about the livers blood supply?

A

Has a dual blood supply
Supplied by the hepatic artery and the hepatic portal vein, therefore receives a mix or oxygenated and deoxygenated blood.

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2
Q

Where is the liver located?

A

In the upper right quadrant just below the diaphragm.

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3
Q

What is the largest internal organ?

A

The liver.

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4
Q

What is the exocrine function of the liver?

A

Secretes bile into the doudenum to help digest fat and eliminate waste prodcuts such as bilirubin and cholesterol

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5
Q

What are the endocrine functions of the liver?

A

Synthesise the majority of plama proteins such as albumin, fibrinogen, lipoporteins and prothrombin.

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6
Q

What are the metabolism and detoxificatoin functions of the liver?

A

Breakdwon of proteins and toxic substances and many drugs.
Will oxidse and conjugate toxine.
Eliminate via bile or urine

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7
Q

What is the storage role of the liver?

A

Blood
Glycogen
Tricyclerdie
Vitamin A
Iron

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8
Q

What makes up the portal triad?

A

The hepatic artery
The portal vein
The bile duct

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9
Q

What is the central structure is a classic hepatic lobe?

A

The central vein

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10
Q

Describe the structure of a classic liver lobule.

A

Hexagonal in shape
Contain a portal triad at each corner
Main content is hepatocytes
Sinusoids made from the hepatic artery and portal vein drain towards the central vein
The bile duct drain out of the lobule towards the common hepatic duct

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11
Q

What is a kupffer cell and where are they located?

A

Found on the walls of sinusoids in the hepatic lobules
Act as macrophages, will phagocytse pathogen absorbed from the gut, are an innate immune defence

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12
Q

What is a sinusoid in a hepatic lobule and how does this relate to the blood flow?

A

Sinusoid is made from the combination of the hepatic artery and the portal vein
This is a mixture of oxygenated and dexocygenated blood
Travels towards the centre of the hepatocyte to drain into the central vein.

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13
Q

What is the heirachy of structures that blood flows through in a hepatic lobule?

A

Portal triad
Sinusoidal channel
Central vein

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14
Q

The drainage from how many portal traids will drain into one central vein in a hepatocyte lobule?

A

Six

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15
Q

What are bile canaliculi in the liver?

A

Enlarged intracellular spaces between two adjacent hepatocytes
Hold scretions from the hepatocytes that contribute to bile, will eventually drain into the bile duct in the portal triad.

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16
Q

What is the space of disse in the liver?

A

THe space between the endothelial cells of the sinusoids
and the hepatocytes
Carriers oxygen rich and glucose rich blood from the sinusoids to the hepatocytes.

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17
Q

What are ito cells in the liver?

A

Found in the space of disse
Are support cells for hepatocytes
Will store vitamin A

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18
Q

What are the key identifying features of hepatocytes in histological images?

A

Eosinophilic cytoplasm and a basophilic nucleus
Circular nucleus - may be binucleate
Are large and polyhedral but have some variation in size
Form the cords/plates within the liver

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19
Q

How are sinusoids identifiable on histological sections of the liver?

A

Are white spaces between rows of hepatocytes, vary is size and shape.

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20
Q

The liver stores significant quantities of….

A

Glycogen

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21
Q

What structures does bile flow through in the liver?

A

Bile canaliculi
Bile canals of Hering
Bile ductules
Bile duct (portal triad)

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22
Q

What cells are associated with bile ducts?

A

Choloanglocytes - line the bile duct walls
Are simple cuboidal in shape
Modify bile as it passess down the billary tree

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23
Q

How are kupffer cells identifible on histological section of a hepatic lobule?

A

Are in the sinusoidal lining
Star shaped

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24
Q

What additional structures may be found in the portal traid but are not normally included?

A

Lymphatics

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25
Q

What are the tips for distinguishing between different structures in the portal triad?

A

Portal vein - tends to have the largest lumen
Hepatic artery - smaller, sqaoumous cells surrounded by a muscular ridge, may see rbcs in lumen, flat nucleu
Bile duct - similar size to artery but contains cuboidal cells to more prominent and a higher density of nucleuses. Round nucleus

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26
Q

What are the three different theoretical models to describe the structure of the liver?

A

Classic lobule
Portal lobule
Liver acinus

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27
Q

What is the shape of the classic lobule and how is it organised?

A

Is hexagonal in shape
Has a central vein
Drains the contents from six portal triads.

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28
Q

What are the features of a portal lobule?

A

Is triangular is shape
Central portal traid
Corners are made from three central veins, denotes the areas that fluid from the portal triad may drain into/out of.

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29
Q

What are the features of the liver acinus?

A

A diamond shape area consisting of three different epileptical zones, represent perfusion of blood perfusion, metabolic activity and pathology.
two opposite corners are marked by central veins (long axis)
Two opposite corners are marked by portal triads. (short axis)

30
Q

What is the clinical significant of the different zone of the liver acinus?

A

Zone 1 - highest amount of blood flow, closest to short axis
Zone 2 -
Zone 3 - lowest perfusion of blood, closest to central veins
Zone three is most likely to suffer patholigcal damage from ischemic conditions

31
Q

What makes the short and long axis of the liver acinus?

A

Short - terminal branches of the portal triad that lie on the border between two classic lobules.
Long - line between two central veins closest to the short axis.

32
Q

What fibres may be found in the hepatic lobules and how can these be identified on histological imagin?

A

Reticular fibres
Stain black

33
Q

What is the main function of the gall bladder?

A

Stores and concentrates bile released by the liver
Will aid the secretion of this bile via the billary tree into the duodenum.

34
Q

Explain the pattern of drainage of bile through the billliray tree?

A

From the liver - left and right bile ducts
Common hepatic duct
Joined by the cystic duct from the gall bladder to form the common bile duct
Joins with the pancreatic duct to form the
hepatopancreatic ampulla of vater
Enters the duodenum by the major duodenal papilla

35
Q

What is the difference in the secretory function of the minor and major duodenal papilla?

A

Minor - secretions from pancreas only as early branch from pancreatic duct
Major - secretions from the pancreatic duct and the common bile duct (joins with the pancreatic duct)

36
Q

What molecule is responsible for the release of bile?

A

Cholecystokinin

37
Q

What physiological changes must happen within the biliary tree for bile to be produced?

A

Relaxation of sphincters
Contraction of the gall bladder

38
Q

What structure is important between the gall bladder and the cystic duct?

A

The spiral valve - made from mucosal folds from the gall bladder help maintains the openeness of the passage to maintain patency of flow

39
Q

What are the important sphincter in the billiray tree?

A

The sphincter of the common bile duct (Boyden)
The sphincter of the main pancreatic duct
The sphincter of the hepatopancreatic ampulla of Oddi.
This controls the flow of bile and pancreatic juices into the doudenum.

40
Q

What are the consequences of a closed sphincter of the common bile duct?

A

Bile can not flow into the pancreatic duct
It backus up and is stored in the gall bladder, where it can be concentrated.

41
Q

What is the function of bile salts in the duodenum?

A

Emulsify fats

42
Q

What is included in the hepatocyte secretion into the canaliculi to form bile?

A

Bile acids (organic such a cholic acid)
Bile salts
Electrolytes
Cholesterole
Billirubin

43
Q

What are the key features to identify on a gall bladder histological section?

A

Simple columnar epithelium
Lamina propia
NO submucosa
Smooth muscle fibers in muscularis (indistinguishable types)
Connective tissue
Serosa

44
Q

What are the unique features of the gall bladder epithelium, what does this tell us?

A

Mucosal folds
Mucosal crypts
Indicates that the gall bladder is not full hence is not distended.

45
Q

What are the surface specialisation found in the gall bladder epithelium?

A

Simple columnar with microvilli

46
Q

What ‘white spaces’ may be found in the serosa of the gall bladder histological images?

A

Lymphatics

47
Q

What is cholelithiasis?

A

The presence of gall stones in the gall bladder or extrahepatic bile ducts.
Often deposits of cholesterol or calcified salts

48
Q

What are the common symptoms of choleitheasis?

A

Most patients have no symptoms
However is bile stones block the common bile duct then can result in jaundice and severe abdominal pain called biliary colic

49
Q

What is the most common bile stone treatment?

A

Laparoscopic surgery

50
Q

What is jaundice?

A

Yellow discoloration of tissue due to increased levels of bilirubin and associated deposits of bile pigment.

51
Q

What is hyper bilirubinaemia?

A

Raised levels of bilirubin

52
Q

What are the difference classifications of hyperbillirubaemia?

A

Prehaptic jaundice - due to increased preduction of bilirubin, such as in sickle cell aneamia
hepatic jaundice - acute or chronic liver damage means less break down of bilirubin
Post hepatic or obstructive jaundice - form of mechanical blockage which interrupts the flow of bile into digestive system e.g gall stones

53
Q

What are the borders between classical hepatic lobules?

A

Connective tissue

54
Q

What is the porta hepatis?

A

An invagination on the inferior surface of the liver where all the neurovascular elements and the and hepatic ducts enter or leave the liver.

55
Q

Identify the features in the blow histological image

A

B are binucleat hepatocytes
S are sinusoidal lining cells
Rest of cells are plates of hepatocytes

56
Q

Identify the features in the histological image

A

Shows the portal triad 1 is the portal vein
2 are branches of the hepatic artery
3 is the bile ducts
L is lymphatics which may also be found within the portal triad

57
Q

Draw a diagram to show the three different ways the liver can be separated into lobules

A

Classical lobule in red
Portal lobule in green
Hepatic acini

58
Q

What are the features of this histological image of the liver

A

Hepatocytes seperated by black reticular fibres

59
Q

What are the features of this histological image of the liver ?

A

Hepatocytes are the pinker cells with a clear round nucleus
Sinusoids as the surrounding pink space

60
Q

What are the key features of this histological image?

A

Hepatocytes and sinusoids
Arranged around a central vein

61
Q

Identify the key features in this hihstoligcal image

A

1 columnar epithelium
2 lamina propia
3 crypts
4 muscularis
5 serosa
6 connective tissue
7 mucosal folds

62
Q

Identify the key features of this histological image

A

1 mucosa
3 muscularis
4 serosa
5 lymphatic duct

63
Q

Idenity the organ from the slide
Epithelium is simple columnar

A

Gall bladder

64
Q

Describe what is shown in this image

A

Liver with central veins
Many lobules with portal triads at the corner
Made from hepatocytes and sinusoids

65
Q

Identify the portal vein, hepatic artery and bile duct

A
66
Q

Identify the portal vein, hepatic artery and bile duct

A
67
Q

Identify the key features of the below slide

A

Red hepatocytes
Green sinusoid
Yellow neutrophil
Blue Kupffer cells

68
Q

Where would bile canicular be located in this image?

A

The spaces between adjacent hepatocytes or the black lines showing contain bile

69
Q

This is a gall bladder identify the muscularis

A
70
Q

This is a gall bladder identify the mucosal infoldings

A

Unit 8 (22 decks)

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