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GI II > Ketchum- Liver and gallbladder > Flashcards

Ketchum- Liver and gallbladder Flashcards

1
Q

What surrounds all four lobes of the liver

A

Glisson’s capsule- dense irregular CT

simple squamous epithelium

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2
Q

What runs through the porta hepatis

A

hepatic ducts, portal vein,hepatic artery

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3
Q

What is the distribution of blood supply to liver

A

20-25% of CO
75% from portal vein
25% from hepatic a

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4
Q

Where does blood exit liver

A

hepatic veins and enters IVC

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5
Q

What are the generalized functions of the liver

A 
take up digested nutrients
store and release compounds
synthesize
detox
bile formation and secretion
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6
Q

What nutrients does the liver take up

A

carbs, aa, lipids and vitamins

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7
Q

What does the liver store and release

A

glucose, triglycerids and vitamins

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8
Q

what does the liver synthesize

A

albumin, prothrombin, fibrinogen, a&b globulins, glucose, FA, triglycerides, cholesterol, phospholipids and lipoproteins

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9
Q

What does the liver detoxify

A

metabolites, drugs, xenobiotics, bacteria, immunoglobulin complexes, worn out cells and proteins

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10
Q

how much bile does the liver produce each day

A

750 ml/day

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11
Q

what extra functions does the liver have

A

sequesters IgA into bile, converts T4–>T3, embryonic hematopoesis, somatomedin production

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12
Q

What runs in the hepatic or portal triad

A

portal vein, hepatic a, bile ductule, lymph vessel

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13
Q

The lymph vessel in the hepatic triad comes from and goes wehre

A

derived from space of Disse and goes to periportal tissue space of mall

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14
Q

describe the protein content of lymph capillaries compaired to plasma

A

30%

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15
Q

Describe blood flow from portal vein

A

interlobar v-> interlobular v-> distributing (perilobular v)-> inlet venule –> sinusoids –> central v –>sublobular –>collecting v –>hepatic v–>IVC

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16
Q

describe blood flow from hepatic a

A

interlobar a –> interlobular a–>distributing a–> inlet a–> sinusoids–>central v–>sublobular v–>collecting v–>hepatic v–>IVC

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17
Q

What is a liver lobule

A

the polyhedral structure of hepatocytes

blood enters at periphery and percolates via sinusoids, leaves via central vein in the middle

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18
Q

describe the bile course in a liver lobule

A

bile travels counter-current and leaves at periphery of lobule

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19
Q

What is a muralium

A

the wall of cells(hepatocytes) that form liver lobule

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20
Q

What is the lifespan of a hepatocyte

A

150 days

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21
Q

describe the structure of hepatocytes

A

most cells mononuclear, many bi-nucleate cells, most 80% are polyploid (tetraploid, 4N)

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22
Q

how thick is the muralium in adults? infants?

A

2 cells thick in infants

1 cell thick by age 2

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23
Q

what are the 3 surfaces of a hepatocyte

A

sinusoidal, baso-lateral, bile canalicular

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24
Q

Describe the structure of sinusoids

A

the wall is discontinuous with supporting reticular fibers to facilitate blood access and no cells into space of Disse

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25
What are examples of sinusoidal cells
Kupffer cells, endothelial cells, fibroblasts, lipocytes, hemtopoetic cells during fetal life
26
What stroma in the liver is altered in disease
the sinusoidal stroma in hepatic fibrosis, hepatic cirrhosis | Increase CT alters normal function
27
What are the 3 types of liver lobules
``` classic lobule (endocrine nature) portal lobule (exocrine nature) portal acinus (based on metabolic donation) ```
28
Why is the structure of the classic liver lobule important for function
emphasizes endocrine function to secrete synthesized products into blood
29
Describe differences in the general shapes of liver lobules
classic- polygonal | portal - triangular
30
Why is the structure of the portal lobule important for function
triangular shape with portal canal in center and central v at peripheries exocrine function to secrete synthesized products into duct (bile)
31
Describe structure of the portal acinus lobule
portal triads and central vv at periphery metabolic activity (peripheral->central and central-->peripheral) hepatic regeneration, development cirrhosis, centrolobular necrosis
32
Describe zone 1 in the portal acinus lobule
zone 1- periportal zone, receives blood with highest [ ] of nutrients/oxygen last to die first to regenerate
33
Describe zone 2 of the portal acinus lobule
mid region, receives blood of intermediate "quality"
34
Describe zone 3 of the portal acinus lobule
centrolobular receives blood with lowest nutrient/oxygen content from zone 2 first cells to die in centrolobular necrosis
35
The zonal differences of the portal acinus lobule reflect differences in what
carb metabolism, protein metabolism, lipid metabolism, drug metabolism
36
In a partial hepatectomy what areas regenerate
hepatocytes of all zones regenerate
37
how does the liver regenerate in hepatic cirrhosis
abnormal regeneration, cT elements don't cooperate in regeneration results in altered hepatic structure and compromised parenchymal function
38
What is half life of mitochondria in hepatocytes
10.5 days
39
How to mitochondria replicate and what is the function
``` form by budding function in oxidative phosphorylation, urea cycel, TCA cycle, lipid oxidation ```
40
What is the function of lysosomes in hepatocytes
autophagy (internal structures) | heterophagy (external structures)
41
Describe the internal environment of a lysosome
low pH 4-5 need for lysosomal enzymes maintained by ATP H pump 40-50 catabolic enzymes present
42
What endocrine R do lysosomes have in hepatocytes
``` growth hormone prolactin insulin glucagon norepinephrine ```
43
Examples of lysosomal diseases
``` Tay Sachs(sphingolipidosis) metachromatic leukodystrophy(sulfatidosis) Type II glycogenosis ```
44
What causes Tay Sachs
absence of B hexosaminidase A | degrades fatty gangliosides
45
What causes metachromatic leukodystrophy
absence of aryisulfatase to cause accumulation of sulfated cerebrosides
46
What causes type II glycogenosis
acid maltase is absent
47
What proteins are synthesized in the rER of hepatocytes
albumin, prothrombin, fibrinogen
48
Are the synthesized proteins in hepatocytes stored in secretion granules
no, secreted in small clear vesicles
49
Where do hepatocytes make VLDL
synthesize VLDL and completely formed in sER
50
What is the role of sER in hepatocytes
synthesis of cholesterol and phospholipids esterification of FFA to triglycerides dehaloginase converts T4-T3 biotransformation of durgs, metabolites and xenobiotics to detox synthesis of cholic acid (conjugation with glycine and taurine to form bile acids) Ca storage and release
51
How do hepatocytes store glucose
polymeric storage form of glucose-->glycogen | glycogen rosettes are seen near sER-- assoc with those enzymes
52
Where is glycogen derived from in liver
gluconeogenesis in periportal area | glucose in perivenous area
53
What are peroximsomes (microbodies) in hepatocytes
membrane bound bodies that produce uric acid and oxidize substrates using O2 and H2O2 also can do peroxisome biogenesis
54
What substrates are used for oxidases in peroxisomes
lactate, urate, D-AA, polyamines
55
What substances are used for per oxidation reaction in peroxisomes
alcohols, formate, nitrite, quinones
56
How to peroxisomes regenerate
bud from previous peroxisomes | bud from rER
57
What are the cytoskeletal elements of hepatocytes
microtubules, microfilaments, intermediate filaments
58
What is the role of microtubules in hepatocytes
involved in vesicular transport
59
What is the function of microfilaments in heptocytes
submembranous and pericanalicular location important for bile flow
60
What is the function of intermediate filaments
submembranous and pericanalicular location found in mallory bodies and seen in hepatic diseases
61
describe the endothelial cells of liver
fenestrated without diaphragms no pericytes basal lamina is indistinct with type IV collagen and laminin detectable
62
What type of collagen is in a liver fibroblast
type III
63
What is the function of Kupfffer cells
Fc and C' R because phagocytose IC, bacteria and non-immune particulates bind and degrade Hb to bilirubin
64
How can Kupffer cells help spleen out
can assist in RBC degradation
65
What are the Ito cells in liver
hepatic lipocytes (fat cells)
66
What do Ito cells do
take up Vit A rapidly and store | take up lopiphylic and membranolytic molecules that damage lysosomes
67
What compunds are found in bile
``` electrolytes (Na, K, Ca, Mg, Cl, HCO3) biles acids cholesterol conjugates (cholic and deoxycholic) phopholipids bilirubin-glucuronide ```
68
What are the intraheptic ducts of biliary channels? | extrahepatic?
intrahepatic--> bile canaliculus, terminal ductules, interlobular bile ducts extrahepatic-->right & left hepatic ducts, proper hepatic duct, cystic duct, common bile duct
69
What seals the bile canaliculi
zonula occludens & desmosomes
70
where are the golgi and sER oriented to in biliary channel
towards bile canaliculus
71
what are the terminal ductules of the biliary channels and describe them
transition from canaliculus to interlobular bile ducts basal surface is attached to hepatocytes have flat cuboidal epithelium HCO3 secreting pinocytotic vesicles modify bile
72
Describe characteristics of interlobular bile ducts
cuboidal to columnar epithelium surrounded by elastic and collagen CT surrounded by sm m at porta hepatis seen in cholangiograms because narrow
73
Where are the extrahepatic ducts and describe them
right, left, proper hepatic ducts tall columnar cells with occasional mucous cells mucosa, submucosa, muscularis, adventitia
74
Describe structure of cystic duct
neck twists, throwing spiral fold into mucosa
75
What is different about the common bile duct when compared to hepatic ducts
circumferential sm m sphincter present (sphincter of Boyden or choledochus)
76
When the gallbladder is full what does it look like, empty?
full has even surface | empty has decussating folds or rugae
77
Describe mucosa of gallbladder
simple columnar epithelium with microvilli desmosomes Rokintansky-Aschoff crypts (invaginations of surface epithelium) mucus glands near neck
78
Describe the lamina propria of gall bladder
thin layer dense irregular CT numerous small blood vessels numerous small lymph vessels no muscularis mucosa
79
Describe submucosa of gallbladder
no submucosa
80
Describe the muscularis externa of gallbladder
tunica muscularis | smooth m layer with some collagen and elastic fibers
81
describe serosa of gallbladder
thick layer dense irregular CT abundant aa, vv and lymph mesothelium covers underlying CT
82
What are the secretory stimuli for gall bladder
from enteroendocrine cells: secretin(HCO3 and H2O) and CCK(contraction)

GI II (12 decks)

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