Liver and gall bladder Flashcards
Liver produces and participates in?
Production -Bile=fat digestion -Blood plasma prot. -Clotting factors Participation -carbo./prot. metabolism -detox(toxin/drugs)
Liver vasculature is similar to which organ?
Lung
LIver vasculature-systemic and functional
Systemic=proper hepatic artery
-nut.
Functional=Portal vn
-from digestiv tract w/ sm. GIT to liver
which vn does the proper hepatic artery and portal vn go into
central vn.
liver vasculature order
hepatic arter and protain vn into central vn–>sublobular vn. –>collecting vn.–>hepatic vn. –>inf. vena cava
Glisson’s capsule
Thick dense CT
~ serosa
Covered by smp. sq. epith.
Lays over liver parenchyma which is held by reticular fiber
Hepatocytes
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.
Exocrin and endocrine of hepatocytes
Endocrine=secretes into blood
Exocrine=bile ducts
Hepatocytes-mitochon.
A lot
Allows for metabolic activty
Perform gluconeogenic and urea production
Hepatocytes-S/RER
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.
Hepatocyte-GA
Exocrine secretion of bile via bile caniculi
Endocrine=lipoprot. goes into SOD and blood
hepatocyte-peroxisomes
Brkdwn FA, purine
Detox of peroxide, alcohol
Gluconeogen b/c purine brkdwn
Hepatocyte-lysosome
Iron storage/degradation of cytoplasmic organle
Might contain lipofuscin
Endoth. cells line what structure
Space of dise and sinusoid
Kuphffer cell
Located in liver
MAC
ID by IHC w/ AntiBD
Dye(india ink)
Ito Cell
W/in liver cell Persinsouid cell b/w sinusoid and hepatocytes Hepatic stellate cells Contain lipid droplet w/ vit. A
Liver damage and ito cells
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
Space of disse
B/w hepatocyte (microvilli and ito cell) and endoth. (sinusoid/kuppffer cell)
B/w hepatocyte=blood for absorp. and secretion
Is bilirubin soluble and what is it made up of?
Not soluble
RBC brken dwn in spleen
-Heme–>bilirubin
Bilirubin travel to the liver
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)
Bile flow
Bile acid goes to bile canaliculi–>intralobular duct(low cell lumne)–>canal of hearing–>bile duct
Bile acid
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
Bile canaliculi
B/w hepatocyte borders
-hepatocyte has incre. microvilli to incre. SA for absorb.
Not always visible
Tight junction around canaliculi
Caholangiocytes are found where
Canal of hearing
Type of epithelium in the bile duct
smp. cub./columnar
Sinusoid vs. bile canaculi
Sinusoid -discont. cap lined w/ endoth. and kuppfer cells -Goes to central vn. Bile Canaculi -lat. hepatocytes memb. -connected to canal of hearing
Portal of triad
Bile duct
Portal Artery
Portal vn.
Hepatic lobules
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
Gall bladder flow of bile
Bile form in liver–>common hepatic duct–>cystic duct–>gall bladder –>cystic duct–>common bile duct –>pancreatic duct–>hepatopancreatic ampulla of vatter –>duod. –>anus
Gall bladder function
Store/conc. bile
Layers missing in the gall bladder
Submucosa and mucosa muscularis
Gall bladder layers
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
Pre-pathological change in the gall bladder?
Rokitansky-Aschoff Sinus
Rokitansky-Aschoff Sinus
Proliferation of gall bladder epith. Clefts extend dwn into LP -into the muscularis externa Form sinus through the muscularis externa Indicates exposure to P.
Form sinus throu
