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Pelvis and Abdomen A&P > Liver > Flashcards

Liver Flashcards

1
Q

regions

A

right hypochondriac, epigastric and left hypochondriac

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2
Q

where does the base lie

A

at the right costal margin, apex of the wedge extends into the left hyporchondrium

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3
Q

superior and inferior

A

diaphragm and ant abdominal wall

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4
Q

posterior

A

IVC, aorta, GB, vertebral column, diaphragm and oesophagus

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5
Q

lateral

A

lower ribs and diaphragm

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6
Q

inferior

A

stomach, bile ducts, duodenum, hepatic flexure of the colon, right kidney and adrenal gland

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7
Q

impressions

A

colic: hepatic flexure of the colon
tuber: lesser curvature of stomach
gastric
renal: right kidney
duodenal

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8
Q

what are the types of ligaments

A

falciform
round
coronary
triangular

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9
Q

ligaments role

A

anchors liver to diaphragm

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10
Q

falciform

A

fold from the peritoneum which extends from the liver to the diaphragm to the anterior abdominal wall, other small fold extend to the superior and posterior surfaces of the liver to diaphragm

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11
Q

round

A

hangs below the falciform ligament, below the liver and runs towards the umbilicus

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12
Q

coronary

A

attaches liver to diaphragm

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13
Q

triangular

A

attaches liver to the diaphragm laterally

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14
Q

portal fissure

A

region on the posterior surface where several structures enter and exit the gland, portal vein enters carrying blood from the stomach, spleen, pancreas, SI and LI
hepatic artery enters carrying arterial blood
branch from the coeliac artery which branches from the abdominal aorta

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15
Q

porta heaptis

A

lies on the inf surface between the quadrate anteriorly and caudate posteriorly
portal vein, hepatic artery and neves enter the L & R hepatic ducts , lymph vessels leave the liver
bile leaves to go to the GB via the hepatic ducts

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16
Q

where does the lymph drain into

A

abdominal and thoracic nodes

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17
Q

four lobes:

A

right
left
quadrate (subdivision of the right)
caudate (subdivision of the left)

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18
Q

anterior

A

filiform ligament separates left and right
teres ligament holds the round ligament

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19
Q

superior

A

upper portion

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20
Q

inferior

A

lower edge

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21
Q

visceral

A

slopes from the posterior border to the tip of the anterior border

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22
Q

peritoneum of the liver

A

enclosed by a thin fibrous capsule and is an retroperitoneal organ
folds of the peritoneum form ligaments which support and hold the liver in place, attaching to the inferior surface of the diaphragm

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23
Q

weight and size

A

1.4kg and 20cm long

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24
Q

where does it lie

A

below the diaphragm to the right and overlaps part of the stomach

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25
Q

what type of blood supply does it have

A

double

26
Q

describe the arterial supply

A

heart -> aorta -> coeliac trunk -> common hepatic artery (25%)
nutrient rich venous blood is brought to the liver from the GI tract from the portal vein (75%)

27
Q

venous supply

A

posterior surface into the IVC from the hepatic veins

28
Q

where does anterior lymph drainage go

A

hepatic lymph nodes at the hilum -> coeliac nodes -> cisterns chyli -> thoracic duct

29
Q

where does posterior lymph drainage go

A

drains into the phrenic and posterior mediastinal nodes -> right lymphatic and thoracic duct

30
Q

describe the nerve supply in the parenchyma

A

innervated by the hepatic plexus containing
- sympathetic coeliac plexus
- parasympathetic vagus nerve
fibres enter at the portages hepatis and follow the path of the hepatic artery and portal vein

31
Q

describe the structure of the lobules

A

many make up the lobes
composed of hepatocytes which are lined up in rows
columns of cuboidal epithelium which contain glycogen and fat
consist of sheets of hepatic cells which single layer hexagonal arrangements, these are stacked on each other, but are separated by sinusoids
small blood vessels diffuse oxygen and nutrients across into the capillaries

32
Q

what is the role of the hepatocytes

A

remove substances and metabolise them

33
Q

what is the central vein

A

it is found in the centre of the lobule which is the tributary for the hepatic vein

34
Q

blood sinusoids

A

have a wider diameter than capillaries
lined with endothelial cells forming part of the recticoendothelial system
lined with knupffer cells which are specialised macrophages

35
Q

what does the portal canal contain a branch of

A

hepatic artery
portal vein (deoxygenated blood from organs)
hepatic duct

36
Q

describe the blood flow from the hepatic artery and portal vein

A

enters the blood sinusoids, passing between the cells to reach the central vein and back into the venous system.
blood drains from the sinusoids into the central vein which merges with veins from other lobules forming larger veins which form the hepatic vein which leave the liver into the IVC

37
Q

what is the reticuloendothelial system

A

protective system
knuppfer cells ingest and destroy worn out blood cells and any foreign particles present in the blood.
phagocytosis (rate depends on the blood flow and cell function)

38
Q

what do hepatocytes secrete

A

bile

39
Q

bile canalicular

A

run between the columns of the hepatocytes, each column has a blood sinusoid on one side and a bile canniulus on the other

these join yo form large bile canals, forming the right and left hepatic ducts which drain bile from the liver which lies in the portal canal

40
Q

what is found in each lobule

A

lymphoid tissue and a lymphatic network

41
Q

what are the functions of the liver

A

heat production
bile production
storage of vitamin A and D
Fe storage
formation of plasma proteins
formation of antibodies
deamination of AA
transamination
storage of anti-anaemic factor
formation of prothrombin and fibrinogen
formation of heparin
carb metabolism
breakdown of erythrocytes and defence
bile production and excretion
inactivation of hormones
fat metabolism
detoxification of drugs and toxic substances

42
Q

formation of plasma proteins

A

AA-> protein
absorbed in intestine

43
Q

transamination

A

nitrogenous portion attaches to another carb forming a new molecule/ non essential AA

44
Q

storage of anti-anaemic factor

A

vitamin 12 is absorbed from the stomach and stored until the liver needs it

45
Q

iron storage

A

absorbed in the intestine
released by Hb breakdown

46
Q

formation of prothrombin and fibrinogen

A

needed in blood clotting

47
Q

heparin

A

prevents intravascular clotting in the body

48
Q

formation of antibodies

A

recticoendothelial cells involved in the production

49
Q

carb metabolism

A

maintain plasma glucose levels
when levels are high glucose is converted to glycogen for storage under the influence of insulin
when levels are low glucagon converts glycogen into glucose

50
Q

bile production and excretion

A

hepatocytes synthesis the contents of bile from mixed arterial and venous blood in the sinusoids

51
Q

inactivation of which hormones

A

cortisol
sex hormones
aldostrone
insulin
glucagon
thyroid

52
Q

detoxification of drugs and toxic substances

A

ethanol, waste and microbial toxins are metabolised so once it leaves the liver it is at an inadequate level to achieve therapeutic effects

53
Q

what colours faeces

A

stereobilin, small amounts are reabsorbed and excreted in the urone as urinobilinogen

54
Q

what causes jaundice

A

excess of bilirubin

55
Q

what is a product of Hb breakdown

A

bile pigments

56
Q

what does bile facilitate

A

absorption of fatty acids, glycerol and fat soluble vitamins

57
Q

what happens when the sphincter of Oddi is shut

A

bile accumulates, removal of water concentrates bile

58
Q

where does bile flow

A

down from the hepatic ducts to the common bile duct

59
Q

functions of bile

A

fat digestion: bile acid is synthesised by hepatocytes from cholesterol then secreted into bile as Na and K
bile salts make cholesterol and fatty acids more soluble

excretion of bilirubin: product of haemolysis of erthyrocytes by hepatic macrophages in the live
insoluble in water so it is blood bound to albumin
it is conjugates with glucronic acid, becoming water soluble so can be excreted in bile

60
Q

enterohepatic circulation

A

large amount of bile salts water the SI from a small bile acid pool

61
Q

what is bilirubin converted into

A

stereorubin

Pelvis and Abdomen A&P (12 decks)

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