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Gastrointestinal > Liver > Flashcards

Liver Flashcards

1
Q

Describe the gross anatomy of the liver.

A
  1. 4 lobes: left, quadrate, right and caudate; in dog/cat left and right split into medial and lateral; caudate love has caudate and papillary processes
  2. Gall bladder (absent in horses and rats)
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2
Q

Why is the liver lobated?

A

Allows movement of organ due to diaphragm.

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3
Q

What are the functional units of the liver?

A

Hepatic acinus

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4
Q

What cells make up the liver’s structure?

A

Hepatocytes and Kupffer cells

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5
Q

What are hepatocytes?

A
  • Chief functional cells of liver
  • Absorb ,molecules from ‘Space of Disse
  • Bile Canaliculus is dilated intercellular space between cells
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6
Q

What is the sphincter of Oddi?

A

A muscular valve controlling the flow of bile and pancreatic juice into the duodenum.

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7
Q

What are the two sources of blood to the liver?

A
  1. Hepatic portal vein
  2. Hepatic artery
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8
Q

What is a sinusoid in the liver?

A
  • A specialized, low-pressure blood vessel in the liver that allows the mixing of oxygen-rich blood from the hepatic artery and nutrient-rich blood from the portal vein.
  • Lined with fenestrated endothelial cells.
  • Surrounded by layers of hepatocytes.
  • Macrophages (Kupffer cells) patrol sinusoids.
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9
Q

Describe the transport of blood after the sinusoids.

A
  1. Blood from sinusoids empty into central veins
  2. Central veins coalesce into hepatic veins
  3. Hepatic veins empty into caudal vena cava
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10
Q

Describe the structure of a hepatic lobule.

A
  1. Hexagonal in shape
  2. Lobules made of plates of hepatocytes
  3. Hepatocytes radiate outwards from a central vein
  4. Between the lobules are portal tracts (triads): bile duct, hepatic artery, hepatic portal vein.
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11
Q

What are Kupffer cells, and what do they do?

A

Liver macrophages that phagocytose pathogens and old erythrocytes.

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12
Q

List some liver functions.

A
  • Synthesis of cholesterol and bile acids.
  • Synthesis of plasma proteins.
  • Breakdown of RBC.
  • Carb, lipid and amino acid metabolism.
  • Removal of bacterial
  • Production of clotting factors
  • Storage of glycogen, iron, copper and vitamins.
  • Detoxification of Body Wastes, Xenobiotics and Drugs.
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13
Q

What are the two phases of liver detoxification?

A

Phase I: Functionalization reactions (oxidation, reduction, hydrolysis).
Phase II: Conjugation reactions to make substances water-soluble.

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14
Q

What enzyme system is central to Phase I detoxification?

A

The cytochrome P450 enzyme family.

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15
Q

Where are detoxified substances excreted?

A

Into bile (via the bile canaliculi) or urine (via the bloodstream and kidneys).

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16
Q

How does the liver detoxify ammonia?

A

By converting it into urea through the urea cycle, which is then excreted in urine.

17
Q

Where are aged or damaged RBCs primarily degraded?

A

In the liver and spleen by macrophages (including Kupffer cells in the liver).

18
Q

How is heme processed during RBC degradation?

A

Into bile pigments -
1. Heme is converted into biliverdin by heme oxygenase.
2. Biliverdin is reduced to bilirubin by biliverdin reductase.

19
Q

What occurs to bilirubin in the liver?

A

It is conjugated with glucuronic acid to form conjugated bilirubin, making it water-soluble.

20
Q

How is conjugated bilirubin excreted?

A

It is secreted into bile and released into the small intestine.

21
Q

What happens to bilirubin in the intestine?

A
  • It is converted into urobilinogen by intestinal bacteria.
  • Urobilinogen can be reabsorbed, excreted in urine as urobilin, or oxidized to stercobilin and excreted in feces.
22
Q

What are the main functions of bile?

A
  1. Emulsification of dietary fats for digestion and absorption.
  2. Excretion of waste products like bilirubin and excess cholesterol.
23
Q

What is bile composed of?

A

Water, electrolytes, biliary proteins, bile pigments, cholesterol, phospholipids and bile acids/salts.

24
Q

Where is bile stored?

A

In the gallbladder, where it is concentrated until needed for digestion.

25
Q

How are bile acids synthesized?

A

From cholesterol in hepatocytes, involving enzymatic steps converting cholesterol into primary bile acids.

26
Q

What are the two primary bile acids and how are they made water soluble?

A
  • Cholic acid
  • Chenodeoxycholic acid
    Conjugated with glycine or taurine.
27
Q

What are secondary bile acids?

A
  • Following participation in lipid digestion and absorption primary bile acids move into ileum.
  • In terminal ileum some primary bile acids can be modified by bacteria.
28
Q

How are bile acids secreted?

A

Secreted into bile canaliculi (via active process) and flow into the bile duct, then stored in the gallbladder or released into the duodenum.

29
Q

What is enterohepatic circulation?

A

The recycling process where bile acids are reabsorbed in the ileum via active transport, returned to the liver via the portal vein, and reused for bile synthesis.

30
Q

What regulates bile secretion?

A
  1. Cholecystokinin (CCK): Stimulates bile release in response to fat in the duodenum.
  2. Secretin: Increases bile flow by stimulating bicarbonate secretion.
  3. Neural input: Parasympathetic stimulation enhances bile secretion.
31
Q

What are common consequences of liver disease?

A
  1. Jaundice (due to excess bilirubin).
  2. Coagulopathies (impaired clotting factor synthesis).
  3. Ascites (fluid accumulation in the abdomen).
  4. Hepatic encephalopathy (due to ammonia buildup).
32
Q

What are common diagnostic markers of liver disease?

A
  1. Elevated liver enzymes (ALT, AST).
  2. High bilirubin levels.
  3. Low albumin.
  4. Prolonged clotting times.
  5. High levels of bile acids in blood after meal.
33
Q

What is cholestasis?

A

A condition characterized by impaired bile flow, leading to accumulation of bile components in the blood.

34
Q

What is a porto-systemic shunt (PSS)?

A

An abnormal blood vessel that allows blood from the portal vein to bypass the liver and flow directly into systemic circulation.

35
Q

What are the two types of PSS?

A
  1. Congenital PSS (present at birth).
  2. Acquired PSS (secondary to chronic liver disease and portal hypertension).
36
Q

What are clinical signs of PSS?

A
  1. Poor growth or failure to thrive.
  2. Neurological signs (hepatic encephalopathy: seizures, head pressing, ataxia).
  3. Vomiting, diarrohea, or anorexia.
  4. Polyuria and polydipsia.
37
Q

Describe the route of bile production and secretion into duodenum.

A
  1. Synthesised in the hepatocytes.
  2. Travels from the hepatocytes via the intra-hepatic bile ducts.
  3. Then to the extra-hepatic bile ducts.
  4. Finally to common bile duct –> duodenum at the major duodenal papilla.
38
Q

Describe the route of bile production and secretion into gall bladder.

A

New bile travels to the gall bladder via the intra-hepatic bile ducts to the extra-hepatic bile ducts and finally the cystic duct into the gall bladder.

Gastrointestinal (12 decks)

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