Liver and gall bladder

Question 1

Liver produces and participates in?

Answer 1

Production 
-Bile=fat digestion 
-Blood plasma prot. 
-Clotting factors
Participation 
-carbo./prot. metabolism 
-detox(toxin/drugs)

Question 2

Liver vasculature is similar to which organ?

Answer 2

Lung

Question 3

LIver vasculature-systemic and functional

Answer 3

Systemic=proper hepatic artery
-nut.
Functional=Portal vn
-from digestiv tract w/ sm. GIT to liver

Question 4

which vn does the proper hepatic artery and portal vn go into

Answer 4

central vn.

Question 5

liver vasculature order

Answer 5

hepatic arter and protain vn into central vn–>sublobular vn. –>collecting vn.–>hepatic vn. –>inf. vena cava

Question 6

Glisson’s capsule

Answer 6

Thick dense CT
~ serosa
Covered by smp. sq. epith.
Lays over liver parenchyma which is held by reticular fiber

Question 7

Hepatocytes

Answer 7

Org. in plates surrounded by sinusoid
Epith/grandular cells
W/in parenchyma
Polyhedral cells=lateral borders connecting diff. hepatocytes(hexagon)
Zona occlusion=bile caniculi (tight junction)
Lrg. cell w/ eosinophil cytop.
-lrg nuc. w/ binuc.

Question 8

Exocrin and endocrine of hepatocytes

Answer 8

Endocrine=secretes into blood

Exocrine=bile ducts

Question 9

Hepatocytes-mitochon.

Answer 9

A lot
Allows for metabolic activty
Perform gluconeogenic and urea production

Question 10

Hepatocytes-S/RER

Answer 10

SER=detox
-oxidation, methylation, conjug. B4 excretion
-toxin B4 secretion
RER=prot. production
-Synth. albumin (carrier prot.), lipoport/glycoprot. prot., prothrombin/fibrinogen(clot)
-Non immune alpha and beta globulin to maintain blood colloid P. and carrier prot.

Question 11

Hepatocyte-GA

Answer 11

Exocrine secretion of bile via bile caniculi

Endocrine=lipoprot. goes into SOD and blood

Question 12

hepatocyte-peroxisomes

Answer 12

Brkdwn FA, purine
Detox of peroxide, alcohol
Gluconeogen b/c purine brkdwn

Question 13

Hepatocyte-lysosome

Answer 13

Iron storage/degradation of cytoplasmic organle

Might contain lipofuscin

Question 14

Endoth. cells line what structure

Answer 14

Space of dise and sinusoid

Question 15

Kuphffer cell

Answer 15

Located in liver
MAC
ID by IHC w/ AntiBD
Dye(india ink)

Question 16

Ito Cell

Answer 16

W/in liver cell
Persinsouid cell 
b/w sinusoid and hepatocytes 
Hepatic stellate cells 
Contain lipid droplet w/ vit. A

Question 17

Liver damage and ito cells

Answer 17

Called epith. mesenchymal transition (EMT)
Ito–>myofibroblast like cells and produce collagen
-causes fibroblast
Ito cells contract and incre. vascular R w/in sinusoid
-contrib. to portal HTN

Question 18

Space of disse

Answer 18

B/w hepatocyte (microvilli and ito cell) and endoth. (sinusoid/kuppffer cell)
B/w hepatocyte=blood for absorp. and secretion

Question 19

Is bilirubin soluble and what is it made up of?

Answer 19

Not soluble
RBC brken dwn in spleen
-Heme–>bilirubin

Question 20

Bilirubin travel to the liver

Answer 20

Bilirubin binds to albumin and travel through the blood to the liver
Goes to hepatic sinus–>SOD–>hepatocyte
-albumin goes back to the blood
Bilirubin then goes to SER and becomes cong. bilirubin
-Exocrine protal
-bile–>sm. intestine and excreted into fecal mater (cn remove toxin)

Question 21

Bile flow

Answer 21

Bile acid goes to bile canaliculi–>intralobular duct(low cell lumne)–>canal of hearing–>bile duct

Question 22

Bile acid

Answer 22

90% reabsorb into intestine to portal vn–>sinusoid–>caniculi
10% secreted
-w/ cholic acid synth. of cholesterol w/ glycine and taurine by SER
-goes to ball bladder
-emulsification of fat
:degradation via duodenum and lipase
:absorb by enterocyte

Question 23

Bile canaliculi

Answer 23

B/w hepatocyte borders
-hepatocyte has incre. microvilli to incre. SA for absorb.
Not always visible
Tight junction around canaliculi

Question 24

Caholangiocytes are found where

Answer 24

Canal of hearing

Question 25

Type of epithelium in the bile duct

Answer 25

smp. cub./columnar

Question 26

Sinusoid vs. bile canaculi

Answer 26

``` Sinusoid -discont. cap lined w/ endoth. and kuppfer cells -Goes to central vn. Bile Canaculi -lat. hepatocytes memb. -connected to canal of hearing ```

Question 27

Portal of triad

Answer 27

Bile duct Portal Artery Portal vn.

Question 28

Hepatic lobules

Answer 28

``` Classic lobule =flow to cental vn. -Cental vn. surrounded by multiple portal triads Portal lobule=bile flow -along hepatocyte plates to bile ducts -1 portal triad surrouned by 3 central vn. Liver acinus=O2/toxin exposure -Zone 3=closest to central vn. :most O2 and toxin :cn receive ischema/zonal necrosis -Zone 2=okay O2 and toxin -Zone 1=not enough of O2 and toxin :most susceptable to coag. necrosis b/c not enough not enough of O2 ```

Question 29

Gall bladder flow of bile

Answer 29

Bile form in liver-->common hepatic duct-->cystic duct-->gall bladder -->cystic duct-->common bile duct -->pancreatic duct-->hepatopancreatic ampulla of vatter -->duod. -->anus

Question 30

Gall bladder function

Answer 30

Store/conc. bile

Question 31

Layers missing in the gall bladder

Answer 31

Submucosa and mucosa muscularis

Question 32

Gall bladder layers

Answer 32

``` 3 Layers Mucosa -spec. simp. column epith. w/ microvilli -allow for H2O absorb. -LP=loose CT Muscularis externa -sm. muscle -respond to dietary fat -induce by sm. intestine enteroendocrine cell CCK horm. -contraction and bile goes through the common bile duct Adventitia -next to the liver ```

Question 33

Pre-pathological change in the gall bladder?

Answer 33

Rokitansky-Aschoff Sinus

Question 34

Rokitansky-Aschoff Sinus

Answer 34

``` Proliferation of gall bladder epith. Clefts extend dwn into LP -into the muscularis externa Form sinus through the muscularis externa Indicates exposure to P. ```

Question 35

Form sinus throu