Liver and Biliary system - Exam 1 Flashcards
How many lobes of the liver are they?
6
- Right lateral
- Right medial
- Quadrate
- Left medial
- Left Lateral
- Caudate
- caudate process
- Papillary process
What are the afferent blood vessles to the liver
- Portal vein carries 80% of th ehepatic blood supply and has 50% of th eoxygen
- Arterial system- Aorta supplies 20% of the total hepatic blood supply and supplies 50% of the oxyten to the liver
What are the top 3 consequences of Liver Dysfunction
Coagulopathy Hypoproteinemia - delayed wound healing - ascites - Hypoalbuminemia Anemia
What is the route of bile in the liver
R/L hepatic ducts -> Cystic duct -> common bile duct -> major duodenal papilla
What are approaches to obtain a liver biopsy?
Percutaneous (FNA)
Laparoscopic cup biopsy
Open (wedge)
What is a guillotine technique of a liver biopsy
This is where loop of suture is placed around protrudign margin. Suture is pulled tight cutting through the liver parenchyma but ligates the vessel
What is an issue with a partial liver lobectomy
Hemorrhage
What to do with the liver biopsy?
Histopathology
Copper analysis
Culture
How do you know if a sample is a bad sample
too small
Crushed sample
Not representative of diseas
What is a complication of liver biopsy
hemorrhage- most common problem
What type of portosystemic shunts are surgically repairable?
single extrahepatic
What type of shunts do small breed dogs tend to have
extrahepatic
What types of shunts do large breed dogs tend to get
intrahepatic
what do you use for diagnostics of a portosystemic shunt
CBC, Chem
- evaluate liver enzymes, decreased albumin, glucose, urea, and cholesterol.
- Imaging essential for definitive diagnosis (CT ANGIOGRAM)
Medical treatment for PVH-MVD (portal vein hypoplasia- Microvascular dysplasia)
Doen in preparation for surgery
- Goal is to minimize signs of and risk for hepatic encephalopathy
1) low protein diet
decrease protein = decreased ammonia
2) Oral antibiotic
3) Lactulose (traps ammonium ion)
4) anti-seizure
5) Hepatoprotective- for conditions that cannot be fixed
6) GI protectants
