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SL12102 - the science of medicines > L24 - liver anatomy & function > Flashcards

L24 - liver anatomy & function Flashcards

1
Q

can the liver regenerate?

A

yes

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2
Q

mass of liver

A

approx 1.5kg

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3
Q

describe liver structure

A
  1. 4 lobes (left, right, caudate, quadrate) NOTE: opposite way on diagrams
  2. diaphragmatic surface superior upper surface of the liver
  3. visceral surface faces abdominal organs (where gallbladder is located)
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4
Q

what is the liver made up of?

A
  • lobules
  • containing hepatocytes + kupffer cells
  • blood vessels (sinusoids)
  • bile caniculi
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5
Q

what is the portal triad?

A
  • bile duct
  • hepatic portal vein
  • hepatic artery
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6
Q

describe liver blood flow

A
  • liver receives blood from the heart & GI tract
  • hepatic portal VEIN delivers deoxygenated blood from GI tract
  • hepatic artery delivers oxygenated blood from heart
  • the artery + vein divide into 2 and supply the left + right side of the liver
  • blood flows from hepatic portal vein and hepatic artery through lobules into central vein
  • bile flows in opposite direction
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7
Q

what are the exocrine (digestive) functions of the liver?

A
  1. secretes bile salts and HCO3-
  2. involved in cholesterol metabolism
  3. organic and drug metabolism
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8
Q

endocrine functions of liver

A
  1. secretes peptides & hormoes
  2. clotting and produces plasma clotting factors
  3. secretes plasma proteins
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9
Q

where is bile synthesised and stored?

A

synthesised in liver by HMG-CoA, stored in gallbladder

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10
Q

hepatocytes and their function in bile (exocrine function)

A
  • create bile salts to solubilise fats
  • cholesterol
  • phospholipids (lectin)
  • bile pigments ( extracts billirubin from rbc)
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11
Q

epithelial cells and their function in bile (exocrine function)

A
  • HCO3- neutralises stomach acid
  • secretion is triggered by secretion from small intestine in response to fatty acids in diet
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12
Q

during a meal what does the gallbladder do?

A
  • contracts
  • release bile into duodenum (SI)
  • via Sphincter of Oddi
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13
Q

what is the contraction of gallbladder stimulated by during a meal?

A

cholecytoskinin from SI which is triggered by fatty acids

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14
Q

enterohepatic circulation

A
  • flow of bile / bile salts
  • release of bile. bile salts from gallbladder
  • during fatty meal, bile salts are absorbed in SI but Na+ coupled transporters
  • 95% is retired back to liver through hepatic portal vein: enterohepatic circulation
  • hepatocytes absorb bile salts from blood and secrete back into the bile
  • 5% lost in faeces and new bile salts synthesised from cholesterol
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15
Q

what are new bile salts synthesised from?

A

cholesterol

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16
Q

what does the liver do with cholesterol?

A
  • extracts cholesterol from blood and secretes it into the bile and faeces
  • can use to make more bile
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17
Q

describe cholesterol

A
  • insoluble
  • froms micelles
  • forms lipoproteins in plasma
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18
Q

what happens when we eat dietary fibre?

A
  • hides bile in SI preveting enterhepatic circulation (bile doesn’t return to liver through hepatic portal vein).
  • so it removes the bile from the body and the cholesterol it contains
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19
Q

can cholesterol lower drugs?

A

yes

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20
Q

why do we need cholestrol?

A
  • membrane + bile synthesis
  • precursor to steroid hormones
  • taken up by cells from blood for use
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21
Q

how does the liver use bile?

A

extracts cholesterol and secretes it into bile or metabolises it into bile salts

22
Q

how are levels of cholesterol balance maintained?

A

increased dietary cholesterol suppresses HMG-CoA

23
Q

bad cholesterol (LDL)

A

saturated fatty acids
- red meat
- cheese
- whole milk
increases plasma cholesterol

24
Q

good cholesterol (HDL)

A
  • polyunsaturated/ monounsaturated
  • olive / peanut oil
    decreases plasma conc
25
Q

what do low density cholesterol do? (LDL)

A

deliver cholesterol to cells as they need a certain amount to make plasma membranes

26
Q

what do high density cholesterol do? (HDL)

A

remove cholesterol from plasma and delivers to liver

27
Q

too much cholesterol in body?

A
  • causes deposition of cholesterol in artery walls (atherosclerotic disease)
  • increased risk of heart attack
28
Q

how to lower risk of athersosclerosis?

A

decrease LDL:HDL

29
Q

what decreases HDL levels?

A

smoking

30
Q

what increases HDL?

A

weight loss

30
Q

what lowers LDL and raises HDL?

A

oestrogen

31
Q

familial hypercholesterolaemia

A

decreased LDL receptors so increased circulating cholesterol

32
Q

what are gallstones?

A

crystallisation of cholesterol in gallbladder

33
Q

complications of gallstones

A
  • can block gallbladder or bile duct, preventing fat digestion/ absorption
  • decrease in absorption of fat soluble vitamins (A,D,E)
  • clotting issues (K) and calcium deficiency
  • bacteria acting on unabsorbed fat causes diarrhoea and fluid loss
  • blocks pancreatic secretions
  • causes build up of billirubin
  • causes jaundice due to excess bilirubin
34
Q

endocrine functions - synthesis of plasma proteins

A

most medicines are plasma protein bound

35
Q

most abundant plasma protein?

A
  • albumin
  • made in liver
  • circulate in plasma as too big to be take up into cells or filtered in kidney
  • function in osmolarity of plasma
  • carrier molecules for substances and drugs
36
Q

globulins

A

immunoglobulins (antibodies)

37
Q

fibrinogen

A

involved in blood clotting cascade

38
Q

endocrine functions - synthesis of clotting factors

A
  • liver makes them
  • bile made by liver absorbs lipid soluble vitamin K from diet in SI
39
Q

vitamin K

A

essential for production of prothrombin (precursor to thrombin) + other clotting factors

40
Q

why can liver disease cause bleeding?

A

not making clotting factors and bile

41
Q

endocrine function - liver makes peptides and hormones

A
  • liver secretes insulin growth factor -1 (1GF-1) in response to increased levels of growth hormone (GH) from anterior pituitary
  • liver hydroxylate enzymes metabolise dietary (D2) or sunlight derives (D3) vitamin D to active form
42
Q

insulin growth factor -1 (IGF -1)

A

acts with grown hormone to cause bone chondrocytes for cell divison

43
Q

what does calcitriol do?

A

stimulates SI absorption of calcium needed for bones

44
Q

homeostatic function (endocrine) - peptides and hormones - angiotensinogen

A
  • liver makes produces Angiotensinogen which is cleaved to form Angiotensin I by the action of
  • renin is secreted by kidneys in response to drop in bp
  • Activation of AngI to Ang II stimulates vasoconstriction and Na+/ H2O retention
45
Q

immune function of liver

A

key detector of pathogens entering through GI tract.
Liver filters blood entering from hepatic portal vein
Pathogens detected by macrophage –like (Kupffer) cells

46
Q

non-alcoholic liver disease

A

caused by obesity

47
Q

hepatitis

A

viral infection or caused by alcohol

48
Q

heaemochromatosis

A

genetic disease - build up of iron

49
Q

cirrhosis

A

liver scarring and failure

50
Q

hepatic medications

A

drug induced

51
Q

liver function tests

A

blood test

SL12102 - the science of medicines (26 decks)

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