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(SALMA) Physiology > Liver > Flashcards

Liver Flashcards

1
Q

where does the falciform ligament attach the liver to

A

anterior abdominal wall

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2
Q

what does the falciform ligament contain

A

ligamentum teres

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3
Q

what is the ligamentum teres a remnant of

A

umbilical vein

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4
Q

what are the liver impressions (6)

A 
oesophageal
renal
colic
duodenal
gastric
gallbladder
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5
Q

what is the dominant blood supply to the liver

A

portal system

venous drainage from GI tract to liver via hepatic portal vein

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6
Q

what is the structural and functional unit of liver

A

structural - lobules

functional - acinus

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7
Q

what is a liver lobule

A

hexagonal shape with central vein

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8
Q

where does the portal triad lie in the lobule

A

at the corners

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9
Q

what is the portal triad

A

hepatic artery
hepatic portal vein
bile duct

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10
Q

what is an acinus

A

functional liver unit

localised collection of hepatocytes around portal triad

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11
Q

what are sinusoids

A

discontinuous capillary

- mixes oxygenated blood from hepatic artery w nutrient rich blood from hepatic portal vein

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12
Q

what is the gallbladder

A

peritoneal structure involved w storage and bile conc

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13
Q

where does the common bile duct empty into the duodenum

A

major duodenal papilla (controlled by sphincter of Oddi)

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14
Q

what are the fat soluble vitamims

A

A
D
E
K

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15
Q

discuss vit A

A

retinal light adaptation

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16
Q

what is vit A found in

A

carrots

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17
Q

discuss vit D

A

increase intestinal calcium uptake

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18
Q

what is vit D found in

A

milk

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19
Q

discuss vit E

A

prevents RBC destruction

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20
Q

what is vit E found in

A

veg oil

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21
Q

discuss vit K

A

normal blood clotting

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22
Q

what is vit K found in

A

spinach

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23
Q

how is vit A metabolised (5)

A
  1. retinol absorbed by enterocytes
  2. retinol is esterified and incorporated into chylomicrons
  3. chylomicrons travel through intestinal lymph to liver
  4. retinol de-esterified and bound to retinol binding protein
  5. retinol stored in lipid droplets of sinusoidal pericytes
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24
Q

what is vit A aka

A

retinol

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25
Q

what is vit B aka

A

folate

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26
Q

how is vit B metabolised (5)

A
  1. vit B binds to R protein released from salivary glands n stomach (protects vit B from HCl
  2. pancreatic proteases free vit B in duodenum
  3. vit B binds to intrinsic factors (released from parietal cells)
  4. vit B-IF complex absorbed in enterocytes of terminal ileum
  5. vit B transported in blood to liver, then back to duodenum in bile (enterohepatic circulation)
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27
Q

how is vit D metabolised

A
  1. D3 (synthesised from liver) transported to liver n converted to calcidiol (25hydroxyvitaminD)
  2. intermediate travels to kidney and converted to calcitriol (1,25dihydroxyvitaminD)
  3. calcitriol binds to vit D receptors in target tissues
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28
Q

how is iron metabolised (5)

A
  1. iron is absorbed into enterocytes
  2. some iron is bound in enterocytic ferritin, rest transported to blood via ferroportin
  3. iron in blood bound to transferrin travels to liver
  4. transferrin in hepatocytes n kupffer cells stores iron in ferritin
  5. when hepatic iron stores are full, hepatocytes release hepcidin which inhibits ferroportin iron transport across enterocyte basolateral membrane
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29
Q

what is calcidiol

A

25 hydroxy vitamin D

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30
Q

what is calcitriol

A

1,25dihydroxy vitamin D

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31
Q

what are xenobiotics

A

foreign substances that are absorbed (skin, lungs, intestine) and are not used for energy purpose

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32
Q

what does phase 1 reaction involve

A

microsomal enzymes found in smooth ER

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33
Q

what does phase 2 reaction involve

A

non-microsomal enzymes found in cytosol

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34
Q

which enzyme is involved in phase 1 reactions

A

cytochrome p450

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35
Q

what happens during phase 1

A

oxidation
hydrolysis
small hydrophilicity increase

36
Q

what happens during phase 2

A

glucoronidation - greatly increases hydrophilicity

37
Q

what does hydrophilicity result in

A

water soluble = able to excrete

38
Q

what is glucuronidation

A

conjugation of substance with glucuronic acid

39
Q

where is albumin produced

A

hepatocytes

40
Q

list 3 functions of albumin

A
  1. maintains oncotic pressure (fluid distribution)
  2. acts as a carrier for hormones and molecules
  3. mops up free radicals
41
Q

how do complement factors enhance immune system

A

by stimulating cytokine release

42
Q

what are the 2 types of protein degradation

A

lysosomal

non-lysosomal

43
Q

describe lysosomal protein degradation

A

kupffer cells phagocytose unnecessary proteins

44
Q

describe non-lysosomal protein degradation

A

ubiquitin binds to protein for destruction

proteasome encases protein and destroys (aa can be recycled)

45
Q

what are the 3 steps of the glucose/alanine cycle

A
  1. alanine aminotransferase removes amine from glutamate and adds it to pyruvate to form alanine (transamination) and an alpha keto acid (used in Krebs)
  2. alanine is transported in blood to liver and broken down into pyruvate and an ammonia group
  3. pyruvate is used for gluconeogenesis, an the ammonia group is incorporated into the urea cycle
46
Q

what removes Amine from glutamate n adds it to pyruvate to form alanine n alpha keto acid (and what is this called)

A

alanine aminotransferase

- transamination

47
Q

where is the alpha keto acid from transamination used

A

krebs

48
Q

where is alanine transported to, where it is broken down

A

liver

49
Q

when alanine is broken down in the liver, what is broken into

A

pyruvate - used in gluconeogeesis

ammonia group - incorporated in urea cycle

50
Q

what are the functions of the glucose alanine cycle (2)

A
  1. provides liver w necessary ingredients for gluconeogenesis and urea cycle
  2. muscles don’t have to use energy to make glucose - all energy can go to muscle contraction
51
Q

what are the 4 steps of the urea cycle

A
  1. ammonia n carbon dioxide –> carbomyl phosphate
  2. carbomyl phosphate + ornithine –> citrulline
  3. citrulline –> arginine & another ammonia group added
  4. arginine cleaved by arginase –> urea and ornithine
52
Q

how many ATP does the urea cycle require

A

3

53
Q

how many ammonia molecules are secreted during urea cycle

A

2

54
Q

where are chylomicrons synthesised

A

enterocytes

55
Q

where are VLDL’s synthesised

A

hepatocytes

56
Q

what is the function of chylomicrons/VLDL

A

transport of triglycerides from liver to tissues

57
Q

what does lipoprotein lipase do to VLDL

A

strips triglyceride from VLDL

degrades the to glycerol and 3 fatty acids

58
Q

what are chylomicrons

A

lipoprotein particles that consist of triglycerides, phospholipids, cholesterol, and proteins

59
Q

what is the diff btwn VLDL and chylomicrons

A

VLDL transports endogenous products, whereas chylomicrons transport exogenous (dietary) products

60
Q

what is LDL produced by

A

hepatic lipase in hepatocytes

61
Q

what do LDL do

A

transport cholesterol from liver to tissue cell membranes (taken up by endocytosis)

62
Q

what does HDL do

A

removes excess cholesterol from cells and returns to liver

63
Q

what happens to excess cholesterol (HDL)

A

converted into bile salts n excreted

or involved in fat emulsification

64
Q

what happens during beta oxidation

A
  1. fatty acids diffuse across cell membranes
  2. fatty acid combine with coenzyme A to form acyl coenzyme A (catalyst by acyl CoA synthase)
  3. acyl coA transported across mitochondrial membrane via cartinine shuttle
  4. beta oxidation - 2 carbons are removed from fatty acid –> acetyl CoA, NADH and FADH (krebs/oxidative phosphorylation)
65
Q

what does high levels of fatty acid oxidation result in

A

excess acetyl CoA (too much for Krebs) –> increased ketogenesis

66
Q

what are the 3 products of hepatic lipid metabolism

A

acetoacetate (converted immediately to acetone)
acetone
hydroxybutyrate

67
Q

how is fatty acid oxidation regulated

A

high concentration of glycerol-3-phosphate = high levels of fatty acid oxidation

  • insulin inhibits fatty acid oxidation
  • glucagon activates fatty acid oxidation
68
Q

how does insulin affect fatty acid oxidation

A

inhibits

69
Q

how does glucagon affect fatty acid oxidation

A

activates

70
Q

what is ketoacidosis

A

diabetic - low insulin
alcoholic - high glucagon

ketones = strong acids –> lower blood pH –> oxygen can’t bind to Hb effectively

71
Q

what is insulin like in a diabetic

A

low

72
Q

what is glucagon like in an alcoholic

A

high

73
Q

how do ketones impact pH

A

lower

74
Q

what are bile salts

A

primarily cholesterol n waste products that need to be excreted

75
Q

where is bile produced

A

hepatocytes

76
Q

what is bile transported in

A

miceles

77
Q

bile is transported in micelles through what?

A

canaliculi

78
Q

why is bile transported in canaliculi

A

bc bile damages cell membranes

79
Q

what helps bile move to hepatic ducts

A

actin filaments that contract around canaliculi

80
Q

what is the path of bile to the gallbladder

A

liver - canaliculi - hepatic ducts - cystic duct - gallbladder (Sphincter of odd closed)

81
Q

how is bile released (4)

A
  1. food enters duodenum, CCK released
  2. gallbladder contracts and sphincter of Oddi opens
  3. bile enters the duodenum and emulsifies fats
  4. bile salts are reabsorbed in the terminal ileum - enterohepatic circulation
82
Q

how is bilirubin metabolised (6)

A
  1. kupffer cells break down haem to biliverdin
  2. biliverdin converted to bilirubin (catalysed by biliverdin reductase)
  3. bilirubin released from kupffer cells and travels in blood bound to albumin
  4. hepatocytes conjugate bilirubin with glucuronic acid (catalysed by glucuronyl transferase)
  5. water soluble conjugated bilirubin is excreted in bile and unconjugated in duodenum
  6. majority of bilirubin secreted as stercobilin (makes poo brown) or urobilin (makes pee yellow), some is recycled via enterohepatic circulation
83
Q

what breaks down haem to biliverdin

A

kupffer cells

84
Q

which enzyme catalyses biliverdin –> bilirubin

A

biliverdin reductase

85
Q

when bilirubin is conjugated with glucuronic acid, which enzyme catalyses it

A

glucuronyl transferase

(SALMA) Physiology (12 decks)

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