Liver

Question 0

Location of liver

Answer 0

Not palpable on normal exam except on inspiration with inspiration deliver moves downward and is palpable below the right costal margin

Question 1

Liver specs

Answer 1

Weighs 1.4 kg 3 pounds for 1400 g largest gland of the body second largest organ in the body located in right upper quadrant behind right costal margin diaphragm superiorly adherent to liver

Question 2

Liver anatomy

Answer 2

Covered by connective tissue also known as glistens capsule it has four loves right left Caudate and quadrate the right and left lobes are divided by falciform ligament

Question 3

Portal system

Answer 3

Carries blood between two capillary network’s without going to the heart first G.I. capillaries go to the sinusoids of the liver with the deoxygenated blood full of nutrients liver metabolizes stores modifies before sending to general circulation

Question 4

Villi of gut

Answer 4

Food medications passed through liver prior to general circulation this is called first pass metabolism as a result medications can be activated or in activated in the liver before creating any systemic effects dosage should be adjusted

Question 5

Liver blood supply

Answer 5

Hepatic artery 30% and portal vein 70%

Question 6

Hepatic artery

Answer 6

Branches off the Celiac artery and contains high oxygen from aorta

Question 7

Portal vein

Answer 7

Formed by mesenteric and splenic vein contains poorly oxygenated blood and is high in nutrients from the gut

Question 8

Portal Triad

Answer 8

Portal vein hepatic artery common bile duct

Question 9

Common bile duct

Answer 9

Forward by cystic and common hepatic ducts empties into duodenum

Question 10

Lobule

Answer 10

Functional unit of the liver

Question 11

Hepatocytes

Answer 11

Each lobule made up of these

Question 12

Lobules are arranged around a

Answer 12

Central vein

Question 13

Sinusoids

Answer 13

Instead of capillaries these carry blood throughout the lobule they carry mixed blood

Question 14

Bloodflow through lobules

Answer 14

Blood flows into lobules via portal veins blood exit lobules via central vein the central veins drain into the hepatic veins hepatic veins drain into IVC

Question 15

Functions of liver

Answer 15

Produce bile detoxify chemicals or drugs storage of glycogen and blood pigment breakdown

Question 16

Liver transplants

Answer 16

Second most common transplant performed approximately 6000 done in the US every year

Question 17

Survival rates for liver transplants

Answer 17

First month 95% first year 86% 3rd year 79%.58% chance of surviving to 15 years failure rate approximately 10 to 15%

Question 18

Diseases lead into liver transplantation

Answer 18

Hepatitis with cirrhosis biliary cirrhosis biliary atresia hepatocellular carcinoma alcoholism Wilson’s disease and hemochromatosis

Question 19

Liver anastomosis sites

Answer 19

Superior vena cava inferior vina cava bile duct hepatic artery portal vein duodenum

Question 20

Test clamp

Answer 20

Done to see if patient has enough collateral flow to sustain hemodynamic stability without the use of Vino Vino bypass the inferior and superior Ivc is clamped and portal vein is clamped