Liver and gall bladder function Flashcards

1
Q

What are the different functions of the liver

A

Bile production
Metabolism
Detoxification of the blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the blood supply of the liver

A

30% of the blood is oxygenated and comes from the hepatic artery which originates from the coeliac artery

70% of the blood is deoxygenated and comes from the superior and inferior mesenteric arteries which supply blood to the intestines and pancreas. The blood from pancreas and intestines then drain into portal vein and that goes to liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What vein drains the liver

A

Hepatic vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How are endothelial cells adapted in the liver

A

Spaces between endothelial cells that lie hepatic sinusoids are large so in liver, blood that comes into these cells come into contact more easily with liver cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Where are bile canals in the liver

A

On other side of hepatocytes there are bile canals and hepatocytes secrete stuff into bile canals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the major secretions of hepatocytes into bile ducts

A
Bile salts
Phospholipids (lecithin)
Bile pigment (bilirubin)
Cholesterol
Inorganic ions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is enterohepatic recycling

A

Bile salts get recycled

  • Some are stored in gallbladder
  • Bile salts come into duodenum to emulsify fat. They then pass into small intestine and we actively reabsorb the bile salts in the ilium.
  • Travels via portal venous system so it goes back to liver
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are major breakdowns of haemoglobin

A

Bile salts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How is bilirubin removed from the body

A

1) RBCs broken down.
2) haemoglobin broken down into bilirubin
3) Albumin transports it to liver where hepatocytes combine it with glucorinic acid to become bilirubin glucuronide
4) Goes into small intestine and ends up in faeces (pale stools indicate a lack of bilirubin)
5) Some bacteria break it back down into bilirubin and forms H2 and urobilinogen
6) Some excreted as urine but some delivered back to liver and goes into hepatic veins and kidney

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Under normal conditions, what is the flow to the duodenum prevented by and what does this mean

A

Closure of the Sphincter of Oddi. Bile enters gall bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What relaxes the Sphincter of Oddi

A

After a meal, CCK is released in response to presence of fat in duodenum. Neural influences also relax it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

metabolism role of liver

A

Liver converts fructose and galactose to glucose

  • Large portion of glucose is taken up into liver and converted to glycogen or TAG
  • Fats combine with protein fraction and released as lipoproteins
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What does the liver synthesise and so what tests can be done to test liver function

A
Plasma proteins (albumin)
Clotting factors 

–> protein conc of blood decreased and so can’t hold water and so this causes ascites

–> Bleeding time is also increased so can check the INR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the detoxification function of the liver

A

Generally increases water solubility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What endogenous things does the liver remove and therefore how does this present if they are unable to get removed

A

INsulin, glucagon, aldosterone, female sex hormones

–> therefore in males, the build up of female sex hormones means they start to display female characteristics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What exogenous things does the liver remove

A

Drugs

17
Q

What is a telltale sign of liver failure

A

Jaundice

18
Q

Why does jaundice occur and how to treat it

A

Bilirubin accumulation in plasma

-Treat with light which breaks down pigment

19
Q

Different causes of jaundice

A

Haemolytic jaundice
Intrahepatic jaundice
Obstructive jaundice
Physiological jaundice of the new born

20
Q

What is haemolytic jaundice

A

Excessive haemolysis of red red blood cells (overwhelms liver capacity for excretion of bilirubin)

21
Q

What is intrahepatic jaundice

A

Defect in uptake or conjugation or secretion of bilirubin by hepatic cells (common in acute hepatitis)

22
Q

What is obstructive jaundice

A

Blockage of bile ducts

23
Q

What is physiological jaundice of the newborn

A

Babies have a poor capacity for conjugating bilirubin

24
Q

What is hepatitis

A

Infection/inflammation of the liver

25
Q

What is the cause of acute hepatitis

A

Viral infections - Hepatitis A,B,C

Drugs eg paracetamol

26
Q

Cause of chronic hepatitis

A

Viral infections - Hepatitis B,C

27
Q

Cause of cirrhosis and treatment

A

Necrosis of liver cells
Major causes: alcohol, Hepatitis B,C

–>No reversing treatment. Stop causative effect. Otherwise transplantation