L1: Liver Structure, Function and Dysfunction Flashcards
What is the normal weight of the liver?
1.5kg
What cell type makes up the majority of the liver?
Stable Cells - capable of regeneration
The liver has a dual blood supply. Which 2 vessels supply the liver and which one is the predominant/major source of blood?
[1] Portal Vein - 75%
[2] Hepatic Artery
What drains into the portal vein?
GIT, spleen, pancreas, gall bladder, stomach
What stain is used to stain the connective tissue in the liver?
Trichrome Stain
What is the main function of the gall bladder?
Bile Storage
How is the common bile duct made?
left + right hepatic duct = common hepatic duct
CHD + cystic duct = CBD
CBD + pancreatic duct = CBD
What is an acinus of the liver?
areas of the liver supplied by 1 portal tract
If there is chronic venous congestion of the liver, what will happen to the liver blood tests - ALT, AST?
mild elevation of AST + ALT
What is Budd Chiari syndrome?
blood clots partially or completely block blood flow out of the liver
Blood congestion in the liver is most obvious in which part of the liver?
around central hepatic vein - increase in blood in zone 3
Why does nutmeg liver occur?
due to venous congestion in the liver - blood backup
What are some of the functions of the liver?
- Synthesis
- Bile Formation
- Detoxification
- Intermediary Metabolism
- Immune
- Storage
What is spotty necrosis?
small groups of cells die (in liver)
What is bridging necrosis?
large confluent groups fo cells die (in liver)
What is massive hepatic necrosis?
huge amount of tissue injury and death (in liver)
What are the 2 factors that are used to assess liver damage?
- Grade
2. Stage
Grade is used in the assessment of liver damage. What does grade mean?
extent of inflammation ± necrosis
Stage is used in the assessment of liver damage. What does stage mean?
extent of fibrosis
What is piecemeal necrosis?
interface inflammation
What is cirrhosis? (definition)
- diffuse distortion of liver architecture
- fibrous bands/septa surrounding regenerative nodules
- distorted vascular relationships (e.g obliteration of veins w/in liver, shunts form, hepatic venous pressure gradient (HVPG) rises)
What may be the consequences of shunts in the liver where blood by-passes the liver?
- reduces liver function
- reduces perfusion of liver
What are the key complications of decompensated cirrhosis? [7]
- ascites
- hepatic encephalopathy
- variceal haemorrhage
- hepatorenal syndrome (HRS)
- jaundice
- infection (esp. SBP)
- hepatocellular carcinoma
What are Kupffer cells?
macrophages present in the liver
What is Budd Chiari Syndrome?
- is caused by blood clots that completely or partially block blood flow from the liver
- the blockage may occur anywhere from the small and large veins that carry blood from the liver (hepatic veins) to the inferior vena cava
Why may chronic (passive) venous congestion of the liver occur?
- right heart failure (e.g. cor pulmonale, mitral stenosis)
- rare tricuspid incompetence
