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Organ Systems Exam 4 > Liver 1 SSL > Flashcards

Liver 1 SSL Flashcards

0
Q

What are the two peritoneal ligaments?

A

The Lesser Omentum and Falciform Ligament

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1
Q

The liver is the largest gland in the body, what is its percentage body weight?

A

20%

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2
Q

Where do the peritoneal ligaments hold the liver?

A

between the stomach and the anterior abdominal wall

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3
Q

Where is the Lesser Omentum found?

A

It is found between the liver and stomach

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4
Q

What structures does the Lesser Omentum contain?

A

It contains hepatic blood vessels and bile ducts.

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5
Q

Where is the Falciform ligament found?

A

The Falciform ligament is found between the liver and the anterior abdominal wall.

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6
Q

What does the visceral peritoneum cover and what are the exceptions?

A

It covers the liver except the bare area, top of the liver attached to the diaphragm, and is surrounded by the coronal ligament.

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7
Q

What are the 4 lobes of the liver?

A

Right, Left, Quadrate, and Caudate

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8
Q

What are the boundaries or factors that identify the lobes of the liver?

A

The are demarcated by blood vessels and ligaments and do not represent internal organization.

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9
Q

What is the Ligamentum Teres?

A

It is a vestige of an umbilical vein carrying blood from the placenta to the fetus.

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10
Q

What is the Porta Hepatis and what structures does it contain?

A

It is the “hilum” of the liver and contains bile ducts, the hepatic artery, and the portal vein.

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11
Q

How much cardiac output does the liver receive?

A

29%

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12
Q

What is the hepatic name of the macrophages and what is their function?

A

They are called Kupffer cells and they consume colonic bacteria.

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13
Q

What are the 3 major components of food that are metabolized by the liver?

A

Carbohydrates, lipids, and proteins

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14
Q

How does the liver metabolize carbohydrates?

A
  • Stores glucose by forming glycogen

- Secretes glucose into circulation through gluconeogenesis.

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15
Q

How does the liver metabolize lipids?

A
  • Synthesizes lipoproteins, cholesterol, and phospholipids
  • Oxidizes fatty acids
  • Converts carbohydrates and protein into fat.
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16
Q

How does the liver metabolize proteins?

A
  • Synthesizes plasma proteins (such as Albumin)
  • Forms urea
  • Produces clotting factors from Vit K.
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17
Q

What are other functions of the liver?

A
  • Stores vitamins (D,A,K,E, B-12) and iron
  • Detoxifies drugs and hormones
  • Secretes bile
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18
Q

What are the functions of bile?

A
  • Emulsifies fats
  • Excretes extra cholesterol
  • Is a detoxifying substance
  • Content can determine overdose of drugs or poisoning
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19
Q

What major synthesized features/products change levels in liver failure?

A

Blood tests can reveal:
INCREASE: in bilirubin
DECREASE: in albumin and clotting factor (vit K).

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20
Q

The Hepatic Artery delivers __________ blood from the ________ via the ___________ Artery

A

oxygenated; aorta; Celiac

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21
Q

The Portal Vein brings nutrient-filled ____________ blood from which veins?

A

deoxygenated; Gastric, Splenic, and Mesenteric

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22
Q

What lines sinusoids and what is their function?

A

hepatocytes; that detoxify, metabolize, and store iron and vitamins.

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23
Q

The Hepatic Vein brings blood out of which area of the liver and drains it into the _________ _______ _______.

A

superior aspect of the liver; Inferior Vena Cava

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24
Q

What is the Classic Lobule?

A

The hexagonal arrangement of hepatocytes.

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25
Q

Portal areas (triads) are found at each corner of a Classic Lobule, what do they contain?

A

Hepatic artery, Portal Vein, and bile duct

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26
Q

What structure lies in the middle of the Classic Lobules?

A

Central veins

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27
Q

What is the Liver Acinus?

A
  • It is the more functional unit of the liver

- Consists of 3 concentric zones that incorporate portions of adjacent lobules.

28
Q

Hepatocyte efficiency depends on proximity to what?

A

blood supply

29
Q

From the hepatic and portal vessels, what does Zone 1 of the Liver Acinus receive?

A

It receives the highest concentration of oxygen and nutrients.

30
Q

From hepatic and portal vessels, what does Zone 3 of the Liver Acinus receive?

A

It receives the least oxygen and nutrients.

31
Q

For what is Zone 3 of the Liver Ancinus a primary site?

A

It is the primary site of alcohol and drug detoxification.

32
Q

What is the consequence of Zone 3 of the Liver Ancinus being the primary detoxifier?

A

This makes it susceptible to hypoxia and toxic damage.

33
Q

Protein-rich plasma flows from sinusoids into this area

A

the Space of Disse

34
Q

Where is the Space of Disse located?

A

It is located between the hepatocytes and the endothelium of the sinusoids.

35
Q

Where is lymph sent?

A

It is sent via channels to the Inferior Vena Cava or the Thoracic Duct.

36
Q

In instances of Portal Hypertension, what happens to blood?

A

There is a back pressure of blood into portal circulation due to flow obstruction.

37
Q

Varicosities in portal-caval anastomoses lead to…

A

hemorrhoids, caput medusae, and esophageal varices.

38
Q

What is ascites?

A

It is free fluid in the peritoneum. Portal hypertension increases lymph flow into the Space of Disse which increases lymph accumulation. The excess lymph seeps through the visceral layer of the peritoneum and creates fluid build-up in the peritoneal cavity.

39
Q

What does a drop in blood pressure stimulate (in relation to the kidney)?

A

It stimulates renal salt and water retention until blood volume is restored.

40
Q

Hepatocytes secrete bile through which structure?

A

They secrete bile through canaliculi towards the bile ducts.

41
Q

What are the major constituents of bile?

A

Bile acids, phospholipids, and cholesterol

Other constituents include: Bilirubin, HCO3, and Na+

42
Q

How is bicarbonate secreted and what is the purpose?

A

It is secreted from the bile ducts (via Secretin) and from hepatocytes to neutralize acids in chyme.

43
Q

What pigments bile?

A

Bilirubin

44
Q

Bile also contains melatonin, what is its function?

A

Melatonin functions as an antioxidant to protect the GI mucosa against the damaging effect of bile acids.

45
Q

What is the most important enzymes for converting bile salts from cholesterol?

A

7-a-hydroxylase

46
Q

What are 3 main ingredients of bile and what happens without them?

A

Bile salts, cholesterol vesicles, and lecithin. Without them there is a progression from sludge to gravel to actual stone/stones.

47
Q

Why is bile important?

A

It keeps cholesterol soluble which keeps from forming crystals (gallstones).

48
Q

What are the 8 biliary ducts?

A

Right and Left Hepatic Ducts, Common Hepatic Duct, Cystic Duct, Common Bile Duct, Hepatopancreatic Ampulla, Main Pancreatic Duct, and Major Duodenal Papilla

49
Q

Where do the Right and Left Hepatic Duct direct flow?

A

They direct bile outflow from the liver.

50
Q

Where is the Common Hepatic Duct located?

A

The junction of the R and L Hepatic Duct.

51
Q

Where does the Cystic Duct direct flow?

A

It directs outflow from the gall bladder.

52
Q

Where does the Common Bile Duct direct flow?

A

It directs outflow of bile from the gall bladder and liver.

53
Q

Where is the Hepatopancreatic Ampulla located?

A

It is located at the junction of the bile and pancreatic ducts.

54
Q

What does the Main Pancreatic Duct direct flow?

A

It directs outflow from the pancreas.

55
Q

Where does the Major Duodenal Papilla direct flow?

A

It directs bile and pancreatic secretion into the duodenum.

56
Q

What are the 3 main portions of the gallbladder?

A

The body, neck, and fundus

57
Q

What are the functions of the gall bladder?

A

Stores bile, concentrates bile, and releases bile.

58
Q

What creates backflow to fill the gallbladder?

A

Choledochal Spincter (of Oddi)

59
Q

How is bile concentrated?

A

Mucosa in the gallbladder absorbs water.

60
Q

Bile is released in the duodenum, what are other responses with release?

A

The Vagus nerve increases bile flow and contracts the gallbladder.
CCK is released in response to fats as the gallbladder wall is contracted.

61
Q

What percentages are included in the Triad of Biliary Lithogenicity?

A

% cholesterol, % phosphatidylcholine, and % bile salts

62
Q

Gall stones are precipitates of cholesterol due to what 5 factors?

A

1.) Excess absorption of water, 2.) excess absorption of bile salts and lecithin, 3.) excess secretion of cholesterol, 4.) inflammation of epithelium, and 5.) stasis of the gallbladder smooth muscle layer.

63
Q

Why does excess absorption of water lead to gall stones?

A

It over concentrates the bile.

64
Q

What does excess absorption of bile salts and lecithin lead to gallstones?

A

Cholesterol can not be dissolved

65
Q

Why does inflammation lead to production of gallstones?

A

It increases absorption of water and bile acids.

66
Q

Why does stasis of the gallbladder smooth muscle layer lead to formation of gallstones?

A

It increases the crystallization of cholesterol.

67
Q

What does CCK promote?

A

Gallbladder emptying, pancreatic secretion, gastric slowing, and intestinal peristalsis.

68
Q

Secretin promotes HCO3 secretion from which 3 areas?

A

Bile ducts, pancreatic ducts, and Brunner’s glands

Organ Systems Exam 4 (4 decks)

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