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UCLA GI Histology > Histology of the Liver, Gall Bladder and Pancreas > Flashcards

Histology of the Liver, Gall Bladder and Pancreas Flashcards

1
Q

List the three functions of the liver.

A
  1. Neutralize toxins and hormones found in blood that is drained from the pancreas, spleen and gut before it circulates throughout the body
  2. store glucose as glycogen for later usage
  3. make bile, which is required for dietary lipid processing in the gut
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2
Q

What is the name for the liver’s capsule?

A

Glisson’s capsule

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3
Q

What is the exocrine function of the liver?

A

Produce bile

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4
Q

What is the endocrine function of the liver?

A

produce cholesterol, serum albumin, fibrinogen and prothrombin

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5
Q

What is the name of the cells that comprise the functional tissue of the liver?

A

hepatocytes

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6
Q

What histological features characterize hepatocytes?

A
  • hexagonal shape
  • arranged in long branching cords
  • microvilli on their luminal surface
  • small holes between adjacent hepatocytes (bile canaliculi)
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7
Q

What is the name of the open spaces between the plates of hepatocytes one would find in liver tissue?

A

hepatic sinusoids

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8
Q

In life, what substance would you find within the hepatic sinusoid spaces?

A

Blood

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9
Q

Because the are filled with blood, would the epithelium of a hepatic sinusoid be referred to as: (A) mesothelium (B) epithelium (C) endothelium

A

C, endothelium. Vessles or structures filled with blood have epithelium that is referred to as endothelium

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10
Q

Where would you find the perisiusoidal space of Disse? What purpose does this space serve?

A
  1. Located in between the hepatocytes themselves and the simple squamous layer of the fenestrated endothelial cells.
  2. provides a protective barrier against the blood inside the hepatic sinusoids
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11
Q

What is the function of bile canaliculi?

A

Bile canaliculi serve as the path by which bile produced in the liver can flow away from the hepatocytes.

Think of them literally as bile canals.

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12
Q

Although both are difficult to see histologically, bile canaliculi merge into _______ before flowing into large bile ductules and eventually the bile ducts of the portal triad.

A

Canals of Hering

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13
Q

Which duct is the final duct in the pathway of bile flow from the liver? Where is this duct located?

A

bile ducts of the portal triad; portal triad is located in the hepatoduodenal ligament in between the duodenum and the liver

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14
Q

Name the three main cells found in the liver.

A
  1. Kupffer cells
  2. stellate cells (Ito cells)
  3. Hepatocytes
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15
Q

Name the cell.

  • located in the hepatic sinusoid
  • irregular oblong nuclear morphology
A

Kupffer cell

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16
Q

Name the cell.

-located in the perisinusoidal space of Disse

A

stellate cells

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17
Q

What is the name of the resident macrophage of the liver?

A

Kupffer cell

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18
Q

List the three function of Kupffer cells.

A
  1. clear particulate matter from the sinusoidal surfaces
  2. phagocytose effete RBCs
  3. Act as antigen presenting cells for the liver (APC)
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19
Q

What is the function of stellate cells?

A

Stellate cells (1) store and metabolize vitamin A, (2) store fat and (3) secrete type I collagen

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20
Q

The vascular, biliary and lymphatic vessels that comprise the portal triad lie within a shared connective tissue compartment. What is the name of this connective tissue?

A

the portal tract

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21
Q

What are the four true histological components of the portal triad?

A
  1. portal vein
  2. hepatic artery (proper)
  3. bile duct (common)
  4. lymphatic capillaries (not listed anatomically)

Note in anatomy we learn that the portal triad consists of: 1. proper hepatic artery 2. portal vein 3. common bile duct

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22
Q

Describe the characteristic epithelium of the bile ductules.

A

cuboidal epithelium, with prominent nucleus (sometimes the nucleus can give the bile ducts a “toothed” appearance)

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23
Q

What is the name of the hepatocytes immediately adjacent to the portal triad?

A

the limiting plate

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24
Q

The portal triad carries blood (into/out of) the liver and bile (into/out of) the liver.

A

blood into the liver; bile out of the liver

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25
Q

How can one differentiate between the central vein and peripheral veins?

A

The central vein lacks to other layers associated with peripheral veins (adventitia, intima and media). Central veins only have an endothelial layer.

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26
Q

If prepared on a blue Lee Stain, what can you appreciate about the number of structures in the portal triad?

A

There are two hepatic arterioles, two bile ductile, but only one portal venule

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27
Q

What can you expect to notice about the portal venule on a histological slide prepared with blue Lee Stain?

A

The portal vein will be the largest profile and will be unpaired.

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28
Q

On a histological slide of the portal triad, prepared with blue Lee Stain, how can you differentiate the hepatic arterioles from the portal venule.

A
  1. The portal venule will be large and unpaired

2. The tunica media of the hepatic arterioles will be stained and give the arterioles a thick walled appearance.

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29
Q

On a slide prepared with blue Lee Stain, how can you differentiate the bile ductules from the hepatic arterioles?

A

The bile ductules have cuboidal epithelial cells and will display a more prominent nucleus in comparison to the hepatic arterioles.

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30
Q

How can you identify a lymphatic capillary in a slide of the portal triad prepared with blue Lee Stain?

A

Lymphatic capillaries will look like artifacts on the slide. They will have an irregular lumen and variable size.

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31
Q

How are disease processes of the liver, that involve leukocytes evaluated for spreading?

A

The diseases are evaluated based on evidence that inflammatory cells have spread from the portal tracts, past the limiting plate and into the parenchyma of the liver.

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32
Q

Do central veins represent venous (inflow/outflow)?

A

venous outflow; the portal vein is venous inflow

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33
Q

The central vein eventually merges into what other venous structure?

A

hepatic vein; central vein is venous outflow of the liver

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34
Q

Central veins join together to form larger (sublobular veins/hepatic veins) and eventually form two or more (sublobular veins/hepatic veins).

A

sublobular veins; hepatic veins

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35
Q

What structure is thought to be at the center of a liver lobule?

A

A central vein

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36
Q

What structures are thought to lie around the periphery of a liver lobule in a hexagonal arrangement?

A

portal triads

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37
Q

Describe the classic or lobular model of liver function.

A
  • in the center of the lobule is the central vein
  • portal triads surround the periphery of the lobule in a hexagonal arrangement
  • hepatocytes are arranged such that they appear to radiate outward from the central vein
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38
Q

Describe the flow of blood in the classic or lobular model of liver function.

A

Blood flows into the lobule via at the portal triad and travels centrally towards the central vein before exiting the liver.

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39
Q

Where can you find a higher density of hepatocytes? (A) Around the portal triad (B) around the central vein

A

A; around the portal triad you can find more hepatocytes

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40
Q

Why does there appear to be more hepatocytes around the portal triad than the central vein?

A

There is less sinusoidal space around the portal triads. Consequently, the hepatocytes appear to be more densely compacted.

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41
Q

The hepatic sinusoids have blood mixed from what two structures?

A
  1. portal vein (deoxygenated blood from the gut)

2. hepatic artery (oxygenated blood from the heart)

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42
Q

What is the name for the area of the liver where the blood structures enter and the hepatic duct exits?

A

portahepatis

43
Q

What large vein does the hepatic vein drain into?

A

Inferior vena cava (IVC)

44
Q

The hepatocytes of the liver has access to blood located in which blood filled structures?

A

hepatic sinusoids

45
Q

Deoxygenated venous blood from the gut flows into the liver via the ___________.

A

portal vein

46
Q

Oxygenated arterial blood flows into the liver via the _____________.

A

hepatic artery

47
Q

Which zone of hepatocytes is exposed to the “freshest” blood?

A

Zone 1

48
Q

Which zone of hepatocytes contains the highest concentration of nutrients, including oxygen?

A

Zone 1

49
Q

Which zone of hepatocytes has the greatest concentration of toxic substances?

A

Zone 1

50
Q

Which zone of hepatocytes is LEAST susceptible to ischemic injury?

A

Zone 1

51
Q

Toxins such as (1) chloroform and (2) free radicals produced by acetaminophen breakdown especially target hepatocytes in which zone?

A

Zone 3

52
Q

Acetaminophen breakdown produces free radicals that preferentially target which zone of hepatocytes?

A

Zone 3

53
Q

Chloroform is a toxin that preferentially targets which zone of hepatocytes?

A

Zone 3

54
Q

Which zone of hepatocytes is exposed to blood that has the least amount of nutrition and oxygen?

A

Zone 3

55
Q

Which zone of hepatocytes has the least amount of toxic substances?

A

Zone 3

56
Q

Which zone of hepatocytes is the most susceptible to ischemic injury?

A

Zone 3

57
Q

What conclusions can you draw by using a silver stain section of the liver stroma?

A

The silver stain (reticular stain) can provide information about the regenerative state of the liver. A regenerating liver will have thicker plates of hepatocytes (3-4 cells thick as opposed to 1-2 cells thick).

58
Q

In a reticular stain, or silver stain, what are the open or unstained area of the slides?

A

hepatic sinusoids

59
Q

Describe the stroma of the liver.

A
  • reticular stroma

- loose mesh of reticular fibers made up of type III collagen fibers

60
Q

What pathology are trichrome stains generally used to diagnose?

A

the extent of fibrosis in liver tissue

This makes sense because trichrome preparations stain for collagen fibers (blue), tissues and muscles will appear as they would in an H&E stain.

61
Q

What is the difference between and H&E stain and a Trichrome stain?

A

A trichrome stain will collagen blue. Conversely, an H&E stain will have collagen stained in a pink/red color.

62
Q

The gallbladder has a shared adventitia where it borders the _____________ and a serosa that _____________.

A

liver; covers its free surface

63
Q

What are the two important functions of the gall bladder?

A
  1. Storage of bile and concentration of bile after its production in the liver
  2. Release of bile into the duodenum to emulsify dietary lipids
64
Q

Assuming the Sphincter of Oddi is closed, describe the pathway that bile takes from its production in the hepatocytes to its storage in the gall bladder.

A
  1. hepatocytes produce bile
  2. bile exits the liver via the bile canaliculi
  3. bile enters the canals of Hering
  4. bile enters bile ductules
  5. bile enters the right and left hepatic ducts
  6. bile enters the hepatic duct
  7. bile enters the cystic duct
  8. bile is stored in the gall bladder
65
Q

If you have a blockage in the middle of the bile duct, what will happen to your pancreatic secretions?

A

Nothing, the pancreatic duct does not join the common bile duct until right above the sphincter of Oddi. If the common bile duct is blocked in the middle, the pancreatic duct can still empty into the duodenum.

66
Q

Which two ducts have their opening into the duodenum controlled by the sphincter of Oddi?

A
  1. pancreatic duct

2. common bile duct

67
Q

What GI regulatory substance is responsible for both the contraction of the gall bladder and the relaxation of the Sphincter of Oddi?

A

CCK (bile bag mover)

68
Q

How many layers of muscularis propria does the gall bladder have?

A

1

69
Q

Do the gall bladder have a submucosa?

A

no

70
Q

List the simple histological architecture of the gall bladder starting from the epithelium to the serosa.

A
  1. epithelium
  2. lamina propria
  3. muscularis
  4. serosa
71
Q

Anatomically, the pancreas is posterior to what other GI organ in the abdominal cavity?

A

the stomach

72
Q

Is the pancreas and endocrine or exocrine organ?

A

Both, its endocrine functions are related to carbohydrate metabolism and its functions related to dietary digestion are exocrine.

73
Q

Endocrine or Exocrine: Secretory products destined fro release inside the body.

A

endocrine

74
Q

Endocrine or Exocrine: secretory products destined for release outside the body.

A

exocrine

75
Q

Which secretions are ductless? Endocrine or exocrine?

A

Endocrine

76
Q

If substance enters the blood and is distributed widely throughout the body is it and endocrine or exocrine substance?

A

endocrine

77
Q

Endocrine or Exocrine: Secretory products are emitted through ducts

A

exocrine

78
Q

Endocrine or Exocrine: Substances that are intended to be released outside of the body (i.e. on top of the skin, into the GI lumen, into the respiratory tract)

A

exocrine

79
Q

If a substance is intended to end up in the respiratory tract is it an endocrine or exocrine substance?

A

exocrine

80
Q

What structures are the defining characteristics of a pancreas specimen?

A

Islets of Langerhans; small light patches distributed amongst the dark serous acini of the pancreas.

81
Q

Are the Islets of Langerhans and endocrine or exocrine portion of the pancreas?

A

endocrine

82
Q

What is the function of the serous (non-islet) acinar tissue of the pancreas? Is this endocrine or exocrine tissue?

A

synthesize digestive enzymes destined for release into the pancreatic duct; exocrine

83
Q

Does the pancreas have mucus secreting cells?

A

No

84
Q

Does the pancreas have striated ducts?

A

No

85
Q

What three types of cells are the Islets of Langerhans comprised of?

A

Alpha islet cells, beta islet cells and delta islet cells

86
Q

Which pancreatic islet cells secrete somatostatin?

A

Delta islet cells

87
Q

Which pancreatic islet cells secrete insulin?

A

Beta islet cells

88
Q

Which pancreatic islet cells secrete glucagon?

A

alpha islet cells

89
Q

Which hormone from the pancreatic islet cells raises blood glucose?

A

glucagon

90
Q

What is the function of glucagon?

A

stimulates the liver to release glycogen

91
Q

Which hormone from the pancreatic islet cells decreases blood glucose?

A

insulin

92
Q

Which tissues will be stimulated, by the release of insulin to take in and store glucose?

A
  1. adiopocytes
  2. liver
  3. muscle
93
Q

Which hormone secreted from the pancreatic islet cells has opposite effects to human growth hormone?

A

somatostatin

94
Q

The delta islet cells secrete this hormone, whose function is to inhibit hormone release from pancreas.

A

somatostatin

95
Q

How does the pancreas protect itself from the proteolytic enzymes it synthesizes?

A

It synthesizes its proteolytic enzymes as inactive zymogens

96
Q

Where does the final modification of zymogens to active enzymes take place?

A

in the duodenum

97
Q

What is the ampulla of Vater?

A

It is the shared entrance to the duodenum for both the pancreatic duct and common bile duct.

98
Q

CCK will cause the release of digestive substances from two organs in the abdomen. Name these two organs.

A
  1. gall bladder: secretes bile

2. Pancreas: secretes digestive enzymes

99
Q

What is the function of enteropeptidases (enterokinases)?

A

These enzymes cleave the zymogen, trypsinogen into trypsin.

100
Q

Where are enteropeptidases (enterokinases) synthesized?

A

In the duodenum

101
Q

What is the function of trypsin?

A

It converts trypsinogen into trypsin and also converts other proenzymes into their active forms.

102
Q

List the proteases secreted by the pancreas.

A

Trypsinogens, proteolastases, chymotrypsinogens

103
Q

List the non-proteases secreted by the pancreas.

A

Amylases, lipases, ribo and deoxyribonucleases

104
Q

What suffix and prefix imply that a substance is a proenzyme?

A

suffix: -gen
prefix: pro-

UCLA GI Histology (3 decks)

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