liver Flashcards

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1
Q

what are the main facts about the liver ?

A

. second largest organ in the human body
. make up 2-3% body mass
. it accounts for 20-30% of the total oxygen consumption-very metabolically active
. filters 1.4L blood every minute

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2
Q

what are the main functions of the liver ?

A

. metabolism
. uptake of nutrients delivered from the digestive tract via portal vein
. temporary nutrient storage ( glucose-glycogen)
. vitamin storage ( Fe reserve )
. produces coagulation factors- these are proteins flowing in plasma of blood ready to form clots
. detoxification - removal of toxins from blood - excretion of substance with bile, urine, faeces
.bile production
. kupffer cells ( macrophages )

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3
Q

how many lobes does the liver contain ?

A

2

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4
Q

what are the 2 lobes in the liver separated by ?

A

falciform ligament- separates the lobes and holds liver in place suspended below diaphragm

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5
Q

what does each lobe contain ?

A

lobules

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6
Q

what are liver lobules ?

A

liver cells that have a hexagonal structure - they are composed of blood vessel , bile canaliculi , blood vessels come together to form sinusoid

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7
Q

what are lobules comprised of ?

A

hepatocytes which are surrounded by reticular fibre

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8
Q

what do hepatocytes secrete ?

A

connective tissue - which supports blood vessel and bile duct and contains collagen - which contains proteoglycan for flexibility

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9
Q

how does blood flow into the liver ?

A

blood comes in through the portal vein and hepatic artery

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10
Q

explain the dual blood supply to liver ?

A
  1. oxygen rich blood flows from the hepatic artery from the aorta
  2. nutrient rich blood from portal vein that has just been through gastrointestinal tract
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11
Q

where does blood from portal vein and hepatic artery mix?

A

in the hepatic sinusoids and blood flow past hepatocytes so they have both nutrient and oxygen rich blood

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12
Q

how does blood exit the liver ?

A

through central vein

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13
Q

who secretes bile ?

A

hepatocytes

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14
Q

how does bile exit the liver ?

A

through bile ducts

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15
Q

explain the structure hepatocytes ?

A

. hepatocytes have microvilli to increase surface area
. adjacent hepatocyte cells have tight junctions to prevent fluid flowing between hepatocytes
. bile canaliculi run between hepatocytes

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16
Q

explain the structure of hepatic sinusoid ?

A

.they are blood vessels made up of endothelial cells

.they are fenestrated - allow easy flow of plasma but not erythrocytes

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17
Q

what separates hepatocytes and hepatic sinusoids ?

A

they are separated by vasculature Disse’s space

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18
Q

what Disse’s space ?

A

separates hepatocytes and hepatic sinusoid and contain plasma and dendritic cells

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19
Q

function of dendritic cell ?

A

immune cells in Disse’s space which activate immune system

20
Q

what is the function of kupffer cells ?

A

.perform phagocytic function to remove protein complexes and small particles from the blood
. they also perform immune surveillance against toxic material from the gut and pathogens from the intestinal flora

21
Q

explain carbohydrate metabolism in the liver ?

A

. store excess glucose as glycogen ( glycogenesis )
. break down of glycogen to glucose ( glycogenolysis )
. convert galactose and fructose to useable glucose
. gluconeogenesis

22
Q

what is the glucose buffer ?

A
  1. high blood glucose level - liver - glycogen formation - normal blood glucose
  2. fall in blood glucose level - liver - glycogenolysis - normal blood glucose
23
Q

what is gluconeogensis ?

A

alternative pathway to produce glucose from carbon skeleton
e.g amino acid - keto acid - glucose
. helps maintain systemic glucose level in liver so brain and muscles have sufficient supply to meet demand

24
Q

why do we need glucose ?

A

. brain uses glucose as main energy source
. red blood cells rely on glucose as their only energy source
. glucose reserve of 190 g in glycogen store
. need 160 g glucose

25
Q

how does triglyceride broken down ?

A

triglyceride + water ———-> 3 fatty acid + glycerol
fatty acid - beta-oxidationto produce ATP
glycerol - gluconeogenesis to produce glucose

26
Q

how does lipid metabolism occur in the liver ?

A

. anabolism - synthesis of cholesterol and fatty acids
- synthesis of lipids from carbohydrates and amino acids ( lipogenesis )
. catabolism - beta oxidation of fatty acids to produce ATP

27
Q

how does protein metabolism occur in the liver ?

A

. liver is the primary site of deamination of amino acids
. ammonia is turned into urea through urea cycle
. interconversion of amino acids ( transamination )
. site of plasma protein synthesis

28
Q

what vitamins does the liver store ?

A
. vitamin A ( 10 month store )
. vitamin D  ( 4 month store )
. vitamin B12  ( 1 year store )
. vitamin E and K
. Folate
29
Q

what is the main ion stored in the liver ?

A

iron

30
Q

how is iron stored in the liver ?

A

. iron stored as part of the molecule ferritin in the liver

. iron in blood bound transferrin . binds with apoferritin in liver to form ferritin .

31
Q

when blood iron levels fall ?

A

when blood iron levels fall . ferritin releases free iron to bind to transferrin in blood

32
Q

what coagulation factors does the liver produce ?

A
  1. factor VII
  2. factor IX
  3. factor X
    first 3 are activation proteins that activate clotting
  4. fibrinogen
  5. prothrombin
    last 2 are essential in clotting process in wound heeling
33
Q

explain liver detoxification ?

A

hepatocytes convert toxins into non-toxic metabolites which can be excreted from the body

34
Q

what are examples of toxins our body deals with ?

A

. breakdown products from hormones and neurotransmitters
. drug
. pollutants
. insecticides and pesticides

35
Q

what are the two primary classes of chemical compound ( toxin)

A
  1. hydrophilic ( dissolves in water ) polar : can be excretes in bile or urine
  2. lipophilic ( dissolves in lipids ) non-polar : must be converted to hydrophilic to be excreted
36
Q

what are the two phases of converting lipophilic into hydrophilic ?

A

phase 1 : functionalisation

phase 2 : conjugation

37
Q

what happens in phase 1 functionalisation ?

A

enzymes : oxidoreductases e.g. cytochrome P450 and hydrolases introduce reactive/polar groups into toxins chemical structure
some become polar positive and are excreted through the kidney

38
Q

what happens in phase 2 conjugation ?

A

. more reactive molecules undergo conjugation reactions

. this makes the stable ( non-reactive ) but water soluble ( hydrophilic ) can be excreted via urine , bile and stool

39
Q

what does bile contain ?

A
. water
. cholesterol
. bile salts
. buffering ions ( bicarbonate )
. bile pigment ( bilirubin and biliverdin )
40
Q

what is the PH of bile ?

A

PH 8

greeny yellow in colour

41
Q

what is the main function of bile ?

A

. secreted into duodenum

. aids in digestion of fats

42
Q

how is bile secreted ?

A

. bile is secreted by hepatocytes

43
Q

where does bile flow through when made by hepatocytes ?

A

. flows through bile canaliculi between cells
. flows into common bile duct
. stored in gall bladder

44
Q

what is secretion of bile into duodenum controlled by ?

A

. hormones : secretin , gastrin and somatostatin

. vagus nerve

45
Q

where are kupffer cells found ?

A

. adherent to sinusoidal epithelial cells inside the sinusoid

46
Q

what kupffer cells ?

A

resident liver macrophages