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Digestive System > Liver Anatomy and Function > Flashcards

Liver Anatomy and Function Flashcards

1
Q

What is meant by the dual supply of the liver

A
  • Receives arterial blood via the hepatic artery
  • Receives nutrient-rich venous blood from intestine via the portal vein
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2
Q

What is the liver responsible for making and what is the role of this product

A
  • Detergent like solution called Bile
  • Helps emulsify lipids so that they can be absorbed
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3
Q

What is significant about the size of the liver

A
  • Largest organ
  • Grows to fit metabolic demand (rugby player vs ballerina)
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4
Q

How many lobes is the liver composed of and what separates these lobes

A
  • 2 lobes
  • Separated by falciform ligament
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5
Q

What is the hepatic hilum

A
  • Anatomical region where bile ducts, hepatic arterial branches, portal vein branches, lymphatics and nerves enter or leave the liver.
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6
Q

What protects the liver from injury due to trauma

A
  • Thick matrix rich capsule, gives the liver a shiny appearance
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7
Q

What are the types of variations that can happen to the liver

A
  • Genetic variation (usually no consequences)
  • Internal factors
  • External factors
  • Lobular atrophy
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8
Q

Give examples of genetic variation of the liver

A
  • Hereditary anatomical displacement (no consequence)
  • Accessory lobes (no consequence)
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9
Q

Give examples of internal factors that can cause variation in the liver

A
  • Portal thrombosis
  • Cardiac cirrhosis
  • Liver fibrosis
  • Liver atrophy
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10
Q

Give examples of external factors that can cause variation in the liver

A
  • Impression effects - from diaphragm, tight belts & corsets, coughing &emphysema
  • Riedels and accessory lobes, clefts or fissure
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11
Q

What is lobular atrophy

A
  • Portal thrombosis or cancer cause one area of the liver to loose function, the area then ‘dies and decreases in size’ - Google definition of atrophy cus im confused :)
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12
Q

Why do people will gall stones experience pain after eating

A
  • This is when the gall bladder contracts on the gall stones in the gall ladder due to detection of fat in the duodenum.
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13
Q

How many independent segments can the liver be divided into and what makes these segments independent

A
  • 8 segments
  • Each segment has its own blood supply (in and out) and independent bile drainage outwards.
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14
Q

Describe the unusual natures of blood supply to the liver

A
  • Venous blood from intestines via the portal vein (75%)
  • Arterial blood via hepatic artery (25%)
  • 25% of cardiac output enters liver due to high metabolic demand
  • Blood from both vessels enters the liver and mixes in the sinusoids then drains via hepatic veins into the IVC near the right atrium
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15
Q

Give some places in the liver that has connective tissue within it

A
  • Around the portal tract and blood vessels within the liver (collagenous matrix)
  • Reticular network - allows hepatocytes to grow in appropriate channel
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16
Q

What are all of the types of connective tissue in the liver made up of

A
  • Extracellular matrix (composed of collagen mainly and some glycoprotein)
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17
Q

Where is the collagen of the ECM made and what is its half life

A
  • Stellate cells
  • Half life of 30 days (can use the metabolite hydroxyproline to measure breakdown rate)
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18
Q

What is the functional unit of the liver and what is its shape

A
  • Liver lobule
  • hexagonal shape (diameter of 1mm)
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19
Q

What determines the exterior and interior of the hexagonal liver lobule

A
  • Exterior border - Blood supply and biliary drainage.
  • Interior: Blood drainage
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20
Q

What are the 3 zones a liver lobule is divided into

A
  • Zone 1 - Periportal area - where nutrient and O2 blood comes in
  • Zone 2 - Intermediate zone
  • Zone 3 - Near central vein (cells here are more hypoxic - lack oxygen)
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21
Q

21:46

A

Healthy hepatocytes - dont understand diagra,

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22
Q

How does fibrosis and cirrhosis lead to disruption of lobular architecture

A
  • Connective tissue builds up during injury and fills up the space that would be filled by hepatocytes
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23
Q

What is the system to grade severity of liver cirrhosis and what grade would a normal liver be on this system

A
  • F1-F4
  • Normal liver is F0
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24
Q

Describe what you would see in each of the grades F1-F4

A

F1 - Some degree of connective tissue expansion
- F2 - Connective tissue expands to normal areas of hepatocytes
- F3 - Connective tissue starts to join up
- F4 - Islands of hepatocytes separated from each other by connective tissue

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25
Q

What percentage of liver tissue do hepatocytes make up

A
  • 60%-65%
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26
Q

What is the histological classification of hepatocytes

A
  • Polarised polyhedral epithelial cells
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27
Q

What is the mitotic index of hepatocytes and why is this

A
  • Low mitotic index
  • Do not die and divide often as a lot of energy is required to recreate these complex cells
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28
Q

What percentage of liver tissue do cholangiocytes (biliary epithelium) make up

A
  • 1%-3%
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29
Q

What is the histological classification of cholangiocytes

A
  • Polarised cuboidal/columnar epithelial cells
30
Q

What is the function of cholangiocytes

A
  • They from the ducts of increasing size to collect canalicular bile and eventually transport it to the gall bladder.
  • Modify contents of bile and excrete waste mineral into it
31
Q

Give one adaptation of cholangiocytes

A
  • Dense basement and tight junctions between cells to keep bile in duct
32
Q

What histological type of cells is the endothelium of the liver made of

A
  • Simple squamous epithelial cells
33
Q

What histological type of cells is the endothelium of the liver made of

A
  • Simple squamous epithelial cells
34
Q

What is the function of the endothelium in the liver (4 functions)

A
  • Protect the parenchyma
  • Allow for selective transport of materials in and waste products out
  • Regulate leukocyte traffic
  • Regulate coagulation
35
Q

What is 1 adaptation that allows the endothelium of the liver to carry out its function

A
  • Anti-thrombogenic surface - Prevents blood clotting
36
Q

What are kupffer cells

A
  • Hepatic macrophages that are found in the sinusoids
37
Q

What are the functions of Kupffer cells

A
  • Phagocytosis
  • Produce cytokines, present antigens and stimulate immune responses
  • Regulate microcirculation (release mediators)
  • Remove endotoxin
38
Q

What are the functions of Kupffer cells

A
  • Phagocytosis
  • Produce cytokines, present antigens and stimulate immune responses
  • Regulate microcirculation (release mediators)
  • Remove endotoxin
39
Q

What are the functions of Kupffer cells

A
  • Phagocytosis
  • Produce cytokines, present antigens and stimulate immune responses
  • Regulate microcirculation (release mediators)
  • Remove endotoxin
40
Q

Give 2 characteristics of kupffer cells

A
  • Very active receptor-mediated endocytosis
  • Very motile - move up and down sinusoids
41
Q

Where are stellate cells found and what are they also known as

A
  • Found in sinusoids (on the back of endothelial cells)
  • Also known as lipocytes
42
Q

What are the functions of a stellate cells

A
  • Regulate the diameter of the sinusoids
  • Transform to fibro-blast like form in disease and causes fibrosis in chronic injury
43
Q

What is significant about the morphology of stellate cells

A
  • Branching structure allows stellate cells to make contact with other cells
44
Q

What type of cells are stellate cells

A
  • Perisinusoidal fat/ retinoid storing cells
45
Q

List the 6 functions of the liver

A
  • Digestive function
  • Cholesterol synthesis
  • Production of Bile
  • Immune function
    -Elimination/ detoxification
  • Synthetic function
46
Q

How does the liver carry out its digestive function

A
  • Fat is stored and metabolised in the liver
  • Glycogen is stored in the liver and broken down into glucose when BS is low
  • Metabolises proteins and amino acids
  • Stores vitamins and proteins
47
Q

Why is cholesterol synthesis in the liver so important

A
  • Cholesterol is essential in cell membrane permeability and fluidity
  • Cholesterol is a component in production of bile acids, steroids hormones and vitamin D
48
Q

What are some roles of bile that make bile production in the liver so important

A
  • Emulsifies fat and allows taking up fat soluble vitamins
  • Excretion route for non-soluble molecules
  • ## Bile acid is recycled in portal circulation
49
Q

What are some of the immune mechanisms in the liver

A
  • Phagocytosis of old or dying cells
  • Induction of tolerance (what is okay and what is not)
  • Protection from blood entering the liver
50
Q

What is the first step in the liver eliminating/ detoxifying a substance

A
  • Metabolising it to turn it into a water soluble product (oxidation, conjugation)
51
Q

What are the 2 ways that water soluble products of liver metabolism are secreted

A
  • Urinary excretion
  • Biliary excretion
52
Q

What are CYPs and what determines their level

A
  • Major enzymes in drug metabolism and deactivation.
  • Levels depend on age, gender, individual and even organ
53
Q

Name some of the proteins produced by the synthetic function of the liver

A
  • Albumin - plasma protein
  • Fibronectin - coagulation cascade
  • Transferrin
  • Hepcidin
  • Plasminogen
  • Alpha-1-antitrypsin
54
Q

Histology

A

-

55
Q

Liver Cirrhosis

A
  • 3.57
56
Q

What is end stage liver disease also known as

A
  • Liver Cirhossis
57
Q

How does liver Cirrhosis cause portal hypertension

A
  • Vascular resistance is increased due to the cirrhotic liver, this increases BP in vessels draining from intestine
58
Q

What is an oesophageal varices and what can cause it

A
  • Enlarged blood vessels in the oesophagus which are prone to rupturing.
  • Liver Cirrhosis
59
Q

What is splenomegaly and what causes it

A
  • Enlargement of the spleen
  • Can be caused by liver Cirrhosis
60
Q

What is ascites and what can cause it

A
  • Abnormal build-up of fluid in the abdomen.
  • Caused by increase in BP in the abdomen due to liver cirrhosis
61
Q

What causes liver disease

A
  • HIC - Alcohol and obesity
  • LIC - Viral infection (hepatitis B and Hepatitis C)
  • EU - Viral infection, alcohol and metabolic syndrome.
62
Q

What is a risk factor for non-alcoholic fatty liver disease

A
  • Being overweight or obese
63
Q

How is non-alcoholic fatty liver disease diagnosed

A
  • The results of a biopsy shows a minimum of 5% of hepatocytes having fatty deposits on them.
64
Q

What is viral hepatitis

A
  • Inflammation of the liver caused by viral infection
65
Q

How does a virus cause damage in the liver in viral hepatitis

A
  • Virus infects hepatocytes
  • A strong immune response will destroy infected hepatocytes which causes the severe hepatitis
66
Q

What viral liver infections lead to hepatitis, fibrosis, cirrhosis and eventually liver failure

A
  • Viruses that cause chronic infection and immune responses
67
Q

What are the treatments for hepatitis B and hepatitis C

A
  • Hepatitis B - Vaccine (however still contributes to 30% of cirrhosis cases)
  • Hepatitis C - Anti-virus drugs (long disease course with no symptoms until severe symptom)
68
Q

How does alcohol cause liver disease

A
  • Can cause death of hepatocytes
  • Death of hepatocytes creates an inflammatory response, this combined with alcohol metabolites = chronic injury and inflammation
69
Q

State the common pathway for liver disease progression

A
  • Acute hepatitis
  • Chronic hepatitis
  • Liver fibrosis
  • Liver Cirrhosis
70
Q

TREATMENTS

A

Digestive System (7 decks)

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