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Liver Anatomy and Function Flashcards

1
Q

Divisions of functional units in each segment of the liver

A
  • Lobule
  • Acinus
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2
Q

What are functional units of the liver composed of?

A
  • Plates of hepatocytes
  • Sinusoidal channels
  • Inlet + exit blood vessels
  • Bile canaliculi
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3
Q

Which vessels supply the liver with blood?

A
  • Hepatic artery
  • Portal vein
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4
Q

Course of blood through the liver

A
  • Enters
  • Mixes in sinusoids
  • Drains via hepatic veins into IVC
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5
Q

Lobule vs acinus

A
  • Acinus centred on portal tracts
  • Lobule centred on central veins
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6
Q

Types of cell in the liver

A
  • Hepatocyte
  • Biliary epithelium
  • Endothelium
  • Kupffer cells
  • Stellate cells
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7
Q

What type of cells are hepatocytes?

A

Polarised polyhedral epithelial cells

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8
Q

What type of cells are biliary epithelium?

A

Polarised cuboidal/columnar epithelial cells

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9
Q

What type of cell are liver endothelial cells?

A

Squamous epithelial cells

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10
Q

What do endothelial cells do in the liver?

A
  • Line hepatic vasculature
  • Protect parenchyma from blood cells, bacteria + viruses
  • Filter fluids
  • Anti-thrombogenic
  • Regulation of coagulation
  • Regulation of leukocyte traffic
  • Selective uptake of solutes + particles
  • Scavenging of waste products
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11
Q

What are Kupffer cells?

A

Hepatic microphages located within the sinusoids

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12
Q

Function of Kupffer cells

A
  • Phagocytosis
  • Regulation of microcirculation
  • Removal of endotoxin
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13
Q

What are stellate cells?

A

Perisinusoidal fat/retinoid storing cells

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14
Q

Digestive functions of the liver

A
  • Carb + fat metabolism
  • Protein metabolism
  • Storage of vitamins + minerals
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15
Q

What does cholesterol do?

A
  • Establishes proper membrane permeability + fluidity
  • Important for production of bile acids, steroid hormones + vitamin D
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16
Q

What is phase 1 metabolism?

A

Oxidation by P450 enzymes

17
Q

What is phase 2 metabolism?

A

Conjugation

18
Q

What are the main enzymes involved in drug metabolism and deactivation?

19
Q

Which useful proteins are produced in the liver?

A
  • Albumin
  • Fibronectin
  • Plasminogen
  • Alpha-1 antitrypsin
  • Transferrin
  • Hepcidin
20
Q

Immune functions of the liver

A
  • Protection against pathogen arriving in blood
  • Phagocytosis of older/dying cells
  • Innate immune functions
  • Introduction of tolerance
21
Q

What is bile important for?

A
  • Emulsification of fat
  • Fat-soluble vitamin uptake (A, D, E, K)
  • Excretion of some substances
22
Q

What causes jaundice?

A

Build-up of bilirubin in tissue fluids + bloodstream

23
Q

How is bilirubin produced?

A

Product of haem metabolism

24
Q

How is bilirubin removed from the body?

A
  • Transported to the liver by albumin
  • Conjugated with glucuronic acid by UDP glucoronyltransferase –> makes water soluble
  • Excreted into bile
  • Metabolised by beta-glucuronidase in the gut to form urobilinogens
25
What is pre-hepatic jaundice?
Bilirubin is produced faster than the liver is able to conjugate it
26
What is Gilbert's syndrome, and what does it cause?
- Mutation in bilirubin UDP-glucuronyl transferase 1 gene --> elevated unconjugated bilirubin - Pre-hepatic jaundice
27
AST/ATL and ALP/gGT levels in pre-hepatic jaundice
- AST/ATL = normal - ALP/gGT = normal
28
What is intra-hepatic jaundice?
Damage to/disease of the liver impedes its ability to conjugate bilirubin at the required rate
29
Causes of intra-hepatic jaundice
- Failure of cellular mechanisms of excretion of conjugated bilirubin - Acute hepatitis - Chronic hepatitis + cirrhosis - Cholestasis - Interruption of bile flow as result of liver damage
30
AST/ATL and ALP/gGT levels in intra-hepatic jaundice
- AST/ATL = raised (2-20x) - ALP/gGT = mild increase
31
What is extra-hepatic jaundice?
Excretory block outside of the liver prevents conjugated bilirubin being excreted out
32
Causes of extra-hepatic jaundice
- Obstruction of bile ducts: > Gallstones > Disease of ducts (cancer, inflammation) > Compression of ducts (lymph nodes, pancreatic cancer)
33
AST/ALT and ALP/gGT levels in extra-hepatic jaundice
- AST/ALT = modest increase (5x) - ALP/gGT = raised (>3x)
34
What happens in viral hepatitis?
- Very strong immune response to virus causes severe hepatitis - Immune system kills infected hepatocytes - Some virus cause chronic ongoing infection --> development of fibrosis + end stage liver failure
35
What can gallstones causes if they migrate to bile ducts?
- Obstruction - Jaundice - Cholangitis
36
Complications of cirrhosis
- Portal hypertension - Renal failure - Varices in oesophagus - Ascites
37
How does non-alcoholic fatty liver disease occur?
- Fat accumulation in >5% hepatocytes - Ranges from just fat to hepatitis + fibrosis

DIG (19 decks)

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