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Gastrointestinal > Liver > Flashcards

Liver Flashcards

1
Q

What is the blood supply to the hepatocytes of the liver?

A

Dual blood supply:
Hepatic artery 20%
Hepatic portal vein 80%

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2
Q

Describe the structure of the liver

A
  • organised into lobules: each contain a hepatic portal triad at each of the 6 corners
  • made up of hepatocytes which have a dual blood supply from the heptaic portal vein + hepatic artery
  • venous + arterial blood mix in the hepatic sinusoids
  • bile canaliculli carry bile + merge to form bile ducts
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3
Q

What is the hepatic triad made of?

A

Hepatic portal vein
Hepatic artery
Bile duct

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4
Q

Difference between hepatic portal vein + hepatic vein

A
  • hepatic portal vein brings blood TO the liver
  • hepatic vein takes blood AWAY FROM the liver
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5
Q

What is the functional unit of the liver?

A

Acinus

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6
Q

Describe the acinus of the liver

A
  • diamond shape of adjoining liver lobules
  • contains three zones: zone 1 is closest to portal triad | zone 3 closest to central vein
  • toxins effect zone 1 most
  • ischemic damage effects zone 3 most
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7
Q

What part of the liver acinus do toxins effect the most?

A

Zone 1

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8
Q

What part of the liver acinus does ischemic damage effect the most?

A

Zone 3

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9
Q

What are the two components of bile?

A

Bile acid dependant
Bile acid independent

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10
Q

Outline the bile acid dependant component of bile

A
  • secreted into canaliculi by hepatocytes
  • contains bile acids + pigments
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11
Q

Outline the bile acid independent component of bile

A
  • secreted by duct cells
  • alkaline solution (like pancreatic duct cells)
  • stimulated by secretin
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12
Q

Function of bile acids

A

Important in digesting fats

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13
Q

What are the 2 primary bile acids?

A

Cholic acid
Chenodeoxychloic acid

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14
Q

Function of bile salts

A

Helps solubilise fats
Facilitate fat digestion - form micelles

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15
Q

What are bile salts?

A

Bile acids which are conjugated with amino acids e.g. glycine + turbine

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16
Q

Why do we need bile salts as well as bile acids?

A
  • bile acids are not always soluble at duodenal pH > bile salts generally are soluble
  • bile salts have amphipathic structure > can act at oil/water interface > crucial for emulsification of dietary lipids
17
Q

Describe the digestion of fats

A
  • bile acids emulsify fats into smaller units > increases SA
  • bile salts form micelles with lipid breakdown products
  • allows fats to diffuse to brush border of enterocyte
  • lipids diffuse down conc. gradient into cytosol of enterocyte
  • lipids are re-esterified back into tri-glycerides, phospholipids + cholesterol
  • reformed lipids packaged with apoproteins to form chylomicrons
  • chylomicrons exocytose + enter lymph capillaries > thoracic duct > left internal jugular vein
18
Q

What happens to bile salts after aiding fat digestion?

A
  • remain in gut lumen
  • reabsorbed in terminal ileum
  • return to liver in portal blood
  • liver extracts bile salts to reuse
19
Q

Where is bile stored?

A

Gallbladder

20
Q

Where is bile produced?

A

Hepatocytes

21
Q

What is steatorrhoea?

A

Excretion of excess amounts of fat in faeces

22
Q

Symptoms of steatorrhoea

A

Faeces are:
Foul smelling
Pale
Hard to flush
Float

23
Q

How many lobes does the liver have?
Name them

A

4 lobes
Left lobe
Right lobe
Caudate lobe - next to IVC
Quadrate lobe - next to gall bladder

24
Q

What peritoneal ligaments attach the liver to the diaphragm?

A

Falciform ligament
Coronal ligament
Triangular ligament - ‘at the corners/points’

25
Q

What is the bare area of the liver?

A

Part of the liver with no peritoneal covering on right lobe

26
Q

Where does the hepatic portal vein originate?

A

Behind the neck of the pancreas L1

27
Q

What drains into the hepatic portal vein?

A

Splenic vein
Superior mesenteric vein

28
Q

Describe the anatomical location of the portal triad in relation to the vessels

A
  • Bile duct lateral
  • Hepatic artery medial
  • Hepatic portal vein posterior

Portal - Posterior
biLe - Lateral

Gastrointestinal (28 decks)

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