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2 - Form & Function > Lecture 41 - Liver and Bile Acids > Flashcards

Lecture 41 - Liver and Bile Acids Flashcards

1
Q

what are the 3 main functions of the liver

A
  1. biotransformation
  2. storage
  3. synthesis
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2
Q

what are liver macrophages called

A

Kupffer cells

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3
Q

what are the additional functions of the liver

A
  1. bile production and secretion
  2. metabolism of protein, lipids, and carbs
  3. storage of glycogen, triglycerides, iron, copper, vitamins
  4. detoxification
  5. conversion of ammonia
  6. immune filter
  7. clotting factor production
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4
Q

T/F: the liver has a dual blood supply

A

TRUE

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5
Q

where does the liver receive blood from

A
  1. portal v. (75%)
  2. hepatic a. (25%)
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6
Q

describe the structure of the liver lobes

A
  • hexagonal shape
  • hepatocytes form cords radiating from central vein
  • sinusoids lined with Kupffer cells
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7
Q

what composes the portal triad

A
  1. hepatic venule
  2. bile duct
  3. hepatic arteriole
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8
Q

what is the gall bladder

A

organ that stores bile

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9
Q

gallbladder contraction is stimulated by

A

CCK

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10
Q

T/F: horses don’t have gallbladders

A

TRUE

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11
Q

what is the limiting plate

A

ring of hepatocytes abutting the portal

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12
Q

Describe a classic hepatic lobule

A

based on blood flow
central vein and portal tracts at periphery

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13
Q

Describe portal lobules

A

based on bile flow; opposite to blood flow
organized as “triangle” with Portal tract at center

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14
Q

describe the route of bile through a portal lobule

A
  1. bile canaliculi
  2. canals
  3. bile ductules
  4. interlobular bile ducts
  5. intrahepatic ducts
  6. right/left ducts
  7. common hepatic duct
  8. common bile duct
  9. duodenum
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15
Q

what zones can the liver be divided into (name innermost to outermost)

A
  1. periportal (oxygenated blood)
  2. midzonal
  3. centrilobular (deoxygenated central v.)
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16
Q

hepatocytes in the periportal zone do what

A
  1. Cholesterol synthesis
  2. Fatty acid oxidation
  3. bile acid production
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17
Q

hepatocytes in the centrilobular zone do what

A
  1. glycolysis
  2. lipogenesis
  3. xenobiotic transformation
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18
Q

acinus

A

triangle-shaped unit containing a small portal tract (1) at the center and terminal hepatic venules (3) at the periphery

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19
Q

what amino acid is essential to cats

A

taurine

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20
Q

create a flowchart of the conversion of cholesterol to bile acid

A

cholesterol –[7a-hydroxylase]–> cholic acid –[taurine/glycine]–> taurocholic acid

21
Q

T/F: bile acids are synthesized by Kuppfer cells

A

FALSE - hepatocytes

22
Q

bile is an excretory route for what

A

fat-soluble metabolic waste (bilirubin, cholesterol, drugs, etc.)

23
Q

T/F: the rate-limiting step of bile acid synthesis is 7a hydroxylation

24
Q

what drives bile acid transporation? what locations do they start and end in?

A

Bile Salt Export Pump (BSEP)
hepatocyte –> canalicular bile

25
Q

the closure of ________ causes bile to back up into the cystic duct/gallbladder

A

sphincter of Oddi

26
Q

what signals for secretion of bile acid in the duodenum

A

fat in duodenum and CCK

27
Q

what is the significance of urodexycholic acid

A

hydrophilic synthetic bile acid administered to dogs/cats to increase the circulating bile acid “pool” to combat biliary disease

28
Q

when returned to the liver, bile acid will be bound to

29
Q

the entire bile acid pool recirculates ___ per meal

30
Q

bile salts escaping ileal reabsorption pass into the colon where they become

A
  1. deoxycholic acid
  2. lithocolic acid
31
Q

Summarize the assimilation of fats in 6 steps

A
  1. pnacreas makes lipase delivered into lume of GI tract and hydrolyzes FA
  2. results in hydrophilic head and hydrophobic tail of TG
  3. Micelle forms
  4. micelle disassembles
  5. FA and BG are assembled into TG to make chylomicron
  6. chylomicron travels through intestinal lymphatics
32
Q

T/F: milky white lymph and plasma lipemia is normal 1-2 hours after meals

33
Q

enterohepatic circulation

A

circulation of biliary acids, bilirubin, drugs or other substances from liver through the digestive tract and returning to the liver

34
Q

Summarize bile salt recycling in enterhepatic circulation in 4 steps

A
  1. bile salts pass to ileum
  2. reabsorbed into circulation
  3. travel through hepatic protal v. to liver for recycling
  4. small amount of bile salts continue through GI tract and are eliminated
35
Q

If liver function isimpaired, serum concentration of bile acid ____ after a meal

36
Q

what test is more sensitive to detecting bile-related disease

A

“challenge” test with pre- and post-prandial blood collection

37
Q

cholecystokinin (CCK)

A

released in response to intraluminal fat
results in gallbladder contraction

38
Q

secretin

A

released in response to intraluminal acid
results in bicarbonate secretion and neutralization of bile acids

39
Q

what is the source of bilirubin

A

Breakdown of RBC hemoglobin

40
Q

unconjugated bilirubin

A

bound to albumin; insoluble

41
Q

conjugated bilirubin

A

unbound; soluble; passes through glomerulus

42
Q

what converts heme to biliverdin

A

heme oidase

43
Q

what converts biliverdin to bilirubin

A

biliverdin reductase

44
Q

what enzyme makes bilirubin conjugated

A

uridine glucuronyl transferase

45
Q

what makes feces brown

A

stercobilin

46
Q

what are the 5 steps to bilirubin metabolism

A
  1. production
  2. hepatic uptake
  3. conjugation
  4. bile duct excretion
  5. intestinal delivery
47
Q

causes of pre-hepatic icterus

A
  1. Rate of bilirubin production exceeds clearance
  2. RBCs are destroyed rapidly
48
Q

causes of hepatic icterus

A
  1. liver function compromised so clearance cannot occur
  2. Acute and chronic liver conditions
49
Q

causes of post-hepatic icterus

A
  1. Biliary system is unable to excrete via GI tract
  2. Biliary obstruction

2 - Form & Function (44 decks)

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