Liver Flashcards
What are the four lobes of the liver?
left, right, caudate and quadrate
Where is a lap cholecyetectomy done?
In gallbladder in junction of segments 4 and 5 - safe removal of gallbladder from Calot’s triangle.
Where is Calot’s triangle
Triangle bound by the cystic duct, bile duct and cytic artery.
What supplies blood to the liver?
20% arterial blood from left and right hepatic arteries
80% from venous blood from hepatic portal vein
Where does the blood from the liver drain to and via what?
Drains to the inferior vena cava via the hepatic vein
How much of the resting cardiac output goes to liver?
25%
What are hepatic lobules
roughly hexagonal structural with a portal triad at each corner to link with adjacent lobules and a central vein in the middle to collect blood from hepatic sinusoids to return to venous system (w/ rows of hepatocytes, each with a sinusoid-facing and caniculi-facing side)
What does a branch of the hepatic portal vein contain?
mixed venous blood from GI organs and spllen, rich in raw nutrients, toxins and waste products - hepatocytes process nutrients and detoxify blood
What shape is the acinus?
elliptical or diamond shaped and divided into 3 zones
What are found around the edges of adjoining lobules?
Portal tracts
What are portal triads composed of?
An arteriole
A branch of the portal vein
A bile duct
Where does blood flow in the liver?
Deoxygenated blood nutrient rich from the portal vein and oxygenated blood from hepatic artery flow towards central vein
What functions does the liver have a key role in?
- digestion
- biosynthesis
- energy metabolism
- degradation
- detoxification
What are the 5 cell types in the liver?
Hepatocytes Endothelial cells Cholangiocytes Kupffer cells Hepatic stellate cells
What do hepatocytes look like?
Large cells with pale and rounded nuclei
What do kupffer cells or hepatic stellate cells look like?
Flattened dense cell nuclei that appear to be in the sinusoids
What are acinus
A cluster of cells - unit of hepatocytes divided into zones depending on proximity to arterial blood supply
What are the different zones in the acinus called?
1) periportal
2) transition zone
3) pericentral
Which zone of the acinus is the least susceptible to ischaemic injury and why? However it is most susceptible to what?
Zone 1, closest to entering vascular supply so gets most oxygenated blood, but most susceptible to viral hepatitis or hemosderin deposition in haemachromatosis
What is periportal zone 1 involved in?
Gluconeogenesis
oxidation of fatty acids
cholesterol synthesis
What is acinus zone 3 involved in?
glycolysis
lipogenesis
p450 based drug detoxification
Where is the terminal acinus found? And where is hepati acinus found?
Terminal - centred on portal tract
Hepati - centred on line connecting two portal triads
What produces bile and where does it flow?
Bile is produced by hepatocytes, and flows along canaliculus to bile duct
Liver function in metabolism of carbohydrates?
Control blood glucose as XS glucose taken up by tissues and stored as glycogen in muscle and liver and breakdown of liver glycogen maintains blood glucose conc between meals (MUSCLE CANNOT RELEASE GLUCOSE BACK INTO BLOOD)
