Liver and Biliary Tract Flashcards
Bile ducts exit the liver through the ______.
Hilus
The common bile duct joins the pancreatic duct AKA ______
Duct of Wirsung; contained exocrine-digestive enzymes and pH control
The hepatic _______ enter the liver carrying nutrients from the small intestine for processing
Portal vein
The blood then passes though the liver, and once processed is “dumped” into the __________ for a “trip” to the right side of the heart
Inferior vena cava
What are the major liver functions?
- Excretory: Bile = Bilirubin + Bile Acids
- Metabolic: Fats, Carbohydrates, Proteins
- Storage: Carbohydrates & Fats
- Synthetic: Clotting Proteins, Albumin, transport proteins
What is the main indication that the liver is involved with a pathology?
Jaundice
Derived from the macrophage destruction of red blood cells that have completed there life span in the liver, spleen, & red bone marrow
Bilirubin
Give bile a foamy trait, and are important for digestion of fats in the small intestine
Bile acids
Bile acids are reabsorbed from the intestines and transported back to the liver via the portal vein for reuse. This “reuse” circulation of bile acids is called
Enterohepatic circulation of bile
Includes abnormal formation, processing , or excretion of bilirubin; yellow discoloration of skin and mucosa; brown or foamy urine with viral hepatitis; itchiness
Jaundice syndromes
Inflammation of the liver caused by viruses, drugs, alcohol, and immune mechanisms; often asymptomatic
Hepatitis
Injury of liver cells by exogenous chemicals or endogenous metabolites
Toxic/metabolic hepatic injury
End-stage liver disease which may result from many different liver diseases
Cirrhosis
Diseases caused by gallstones
Extrahepatic Bile Ducts & Gallbladder Diseases
Occur in the liver and biliary tract, classified as benign, malignant, and primary or secondary (metastasis)
Tumors
Bilirubin end product of phagocytosis of senescent red blood cells in the _______ of the liver
Kupffer’s cells
Transmitted fecal – oral route, may occur in a sporadic or epidemic form; Symptoms of infection include a short lived mild-fever, vomiting, loss of appetite, and jaundice
Hepatitis A
Transmitted via blood transfusions, exposure to contaminated blood or blood products, saliva, semen, or sexual contact; Most prevalent among health care workers, and those working in or around blood products should be inoculated and screened (leads to cirrhosis!); most common form
Hepatitis B
What are signs and symptoms of Hep B?
- Symptoms are weakness, nausea, vomiting
- Some have enlarged & painful liver on palpation
- Darkening of urine which contains bilirubin
- Some have measles-like skin rash
2nd Major cause of cirrhosis in the U.S. after alcohol abuse
Hepatitis B
Transmitted by contaminated blood products, needle sticks, intravenous drug use, contaminated blood transfusions; no vaccine available
Hepatitis C
End-stage liver disease; irreversible; incurable except by liver transplant; common causes are alcoholism, Hep B, C, and D, drugs, toxins, bile duct obstruction and inherited abnormalities
Cirrhosis
What is the pathophysiology of cirrhosis?
- Death of liver cells
- Tissue repair with fibrosis and fibrous bands which obstruct blood flow
- Regenerative tissue nodules separated by gray scar tissue which restricts blood flow
What are the complications in cirrhosis?
- Ascites (fluid in abdominal cavity)
- Splenomegaly
- Thrombocytopenia
