Liver Flashcards
Porta hepatis
Where and what inc directions
L and r hepatic duct (exit)
L and r hepatic arteries (enter)
Portal vein (enter)
Hepatic branch of vagus
Runs into liver middle/back/bottom , between caudate quadrate left and right lobes
NOT hepatic vein - runs behind and up into ivc
2 surfaces of liver
Visceral- inferior/posterior, visceral peritoneum
Diaphragmatic- anterior superior posterior
Bare area where
Between anterior and posterior fold of coronary ligament
Superior of liver, around ivc and along
Reticuloendothelial system
Immune system in reticular fibres
Kidney liver spleen lymph
Inc Kupfer cells
Ligament that attaches liver to stomach
Hepatogastric
Ligament that attaches liver to duodenum
Hepatoduodenal
Ligament that attaches liver to diaphragm
Right and left triangular ligaments
Anterior and posterior coronary ligaments
Portal triad
Bile cannaliculae
Hepatic portal vein (from gut)
Hepatic artery
Blood drains from portal triad to what
Bile drainage?
Central vein- joins into hepatic vein
Bile goes other way from vein into portal triad
acinus vs classic lobule vs portal lobule (way of drainage between portal triad and hepatic vein)
zones??
functional/structural
classic lobule = hexagon kinda format, in centre= hepatic vein, corners = portal triads ==structural
portal lobule = triangle. in centre = portal triad, corners= hepatic veins
acinus = oval shape type thang. long way points= hepatic veins, near points= portal triads ===functional
zone 1- most blood supply, nearest to portal triads
zone 3- least, nearest to hepatic vein. zone 3 recieves blood last and so dies first.
Blood supply
2/3- 75% portal vein . Rest is hepatic artery
How much of co goes to liver
25%
What bile related reaction happens in liver
Billirubin (yellow) Unconjugated. —> conjugated so now soluble
Conjugated with glucuronic transferase, (glucoronyl transferase )
What is secretes in bile
conj billirubin
What becomes billirubin.
And where
Heme from rbc breaks down to Billiverdin and iron (heme oxygenase)
Billiverdin to billirubin
This happens: spleen bone marrow and liver reticuloendothelial cells
Billirubin concerted by gut bacteria to…
10% urobilinogen
—- some reabsorbed to kidney (enterohepatic circulation) . Rest excreted in urine - makes light and yellow
90% stercobillinogen
—faeces - brown
Symptoms of prehepatic jaundice
Normal faeces normal urine
Yellow skin sclera
High unconj in boood
Intraheparic jaundice
Yellow skin sclera
High conj and unconj in blood
Maybe darker urine (decreased urinobillinogwn )
Posthepatic jaundice symptoms
High conj in blood
Yellow skin sclera
Pale faeces (less sterco)
Dark urine (less urobillinogen)
Newborn jaundice
Excess breakdown of fetal haemoglobin
Immaturity of conjugation enzymes in liver
Premature babies esp
Gone in 2 weeks
targeted protein removal
ubiquitin signals proteasomes kill (amino acids recycled)
no targeted protein removal
lysosomal– kupfer cells phagocytosis
urea cycle
are orangutans citrus
arginine —> ornithine —> citrulline —> arginine
arginine –> ornithine AND UREA
ornithine AND CO2 AND AMMONIA–> citrulline
citrulline AND AMMONIA –> arginine
phase 1 reaction detoxification
non-synthetic
microsomal enzymes - (SER of hepatocytes, CY450)functionalisation– expose functional groups like OH, SH, NH2, COOH
small increase in hydrophilicity
phase 2 reaction detoxification
synthetic
non microsomal enxymes (cytoplasm/ mitochondria of heaptocytes)
conjugation/ glucuronidation - add glucuronic acid
large increase in hydrophilicity
vitamins stored
a d e k b12
metals stored
iron (ferritin)
copper
where are rbc broken down
bone marrow , spleen, liver reticuloendothelial cells
