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Physiology > Liver and Gallbladder > Flashcards

Liver and Gallbladder Flashcards

1
Q

What are the two metabolic functions of the liver?

A

Energy metabolism

Detox

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2
Q

What are the two excretory functions of the liver?

A

Lipid soluble waste products

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3
Q

What are the three major functions of the liver?

A
  1. Metabolic
  2. Excretory functions
  3. Storage and transport
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4
Q

What percent of blood going into the liver is from the portal vein?

A

70%

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5
Q

What is the “first pass effect”?

A

Concept that the first organ that a drug passes is the liver

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6
Q

What are at the apices of the hepatic lobule? (and what are its three contents)

A

Portal spaces (portal vein, hepatic artery, and bile duct)

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7
Q

What is the blood flow from through hepatocytes? Bile?

A

From the edges (branches of the portal vein), to the central vein

Bile is opposite

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8
Q

What type of cells are hepatocytes?

A

Polarized epithelial cell that interface with blood and bile

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9
Q

What are Kupffer cells?

A

Macrophages in the sinusoidal lumen that are exposed to portal blood

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10
Q

What is the significance of the endothelial cells in the liver?

A

Large pores between the cells and minimal basement membrane

this serves as a filter

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11
Q

What are the stellate cells of the liver?

A

Cells that fill the gaps in the BM of hepatic endothelial cells, and function to regulate the flow of blood

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12
Q

What are the four processes that occur in the liver?

A
  1. Uptake
  2. Transport intracellularly
  3. Biotransformation
  4. Secretion
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13
Q

Why is there specific intracellular transport in hepatocytes? What regulates this?

A

Chemical may be damaging to cells. Thus specific

Specific binding proteins regulate this

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14
Q

What is the goal of the biotransformation in the liver?

A

Make something more water soluble

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15
Q

Where do hepatocytes secrete chemicals?

A

Across the apical or basolateral membrane

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16
Q

What is the space between hepatocytes and the endothelium?

A

Space of Disse

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17
Q

How is intracellular movements effected?

A

binding proteins

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18
Q

What is phase I of biotransformation? (3 rxns)

A

Oxidation
Reduction
Hyrolysis

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19
Q

Do all chemical undergo phase I and II of biotransformation?

A

No, can go only to phase II or whatever

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20
Q

What is phase II of biotransformation? (3 conjugations)

A

Glucuronidation
Sulfation
Acetylation

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21
Q

What is the function of the oxidative transformations that the liver undergoes?

A

Make it more water soluble, and make the chemical more amenable to phase II transformations

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22
Q

What is the function of glucuronidation?

A

UDP-glucose added

23
Q

What are the two places that biotransformed molecules goes?

A

Bile cannuliculus

Blood

24
Q

What is the transporter for bile salts from the hepatocyte?

A

BSEP (bile salt export pump)

25
Q

What is the transporter for bulky, organic cations, (e.g. xenobiotics, cytotoxins, anti CA drugs etc) from the hepatocyte?

A

MDR1 (multidrug resistance associated protein)

26
Q

What is the transported for glucuronate, glutathione, and sulfate, from the hepatocyte?

A

MRP2 (multi-specific resistance associated protein)

27
Q

What is the transported for phosphatidylcholine, from the hepatocyte?

A

MDR3 (multidrug resistance associated protein)

28
Q

What are the two major components of bile?

A

Bile acids and salts

29
Q

How much bile does the liver secrete? Where does this go?

A

900 ml

  • Half to the gallbladder
  • Half to the duodenum
30
Q

Bile acids are synthesized from what precursor molecule?

A

Cholesterol

31
Q

What happens to bile acids?

A

Biotransformed to a bile salt (water soluble) and secreted into the duodenum

32
Q

What is the primary human bile acid?

A

Cholic acid

33
Q

What are secondary bile acids?

A

Bile salts that are modified by intestinal bacteria

34
Q

What is primary bile acid?

A

Secreted from the liver, untransformed by the gut microbiota

35
Q

The liver secretes 12-36 g/day, but synthesizes only 600 mg. How can this be?

A

There is reuptake of bile salts/acids in the intestines (Enterohepatic circulation)

36
Q

Where are bile salts absorbed in the intestines?

A

Ileum

37
Q

What is the function of somatostatin on the gallbladder? Ach?

A

Ach increased contraction

Somatostatin inhibits

38
Q

What is the MOA behind hepatic encephalopathy?

A

Toxins increase in [c] in the plasma, eventually crossing the BBB

39
Q

What is the function of somatostatin on the the sphincter of Oddi? Ach?

A

Ach induces relaxation

Somatostatin inhibits relaxation

40
Q

Obstruction of the pancreatic duct leads to what symptoms (besides pancreatitis symptoms)?

A

Pale stools d/t increased fat content

41
Q

What are the cells that regulate the flow of blood constituents between the fenestrae and across the Space of Disse to the hepatocytes?

A

Stellate cells

42
Q

Which phase of biotransformation includes oxidative, reductive and hydrolytic reactions?

A

Phase I

43
Q

What is the final result of phase I biotransformation by the liver?

A

the exposure of a functional group on the parent compound. This can render the compound a substrate for Phase II biotransformation

44
Q

What is the enterohepatic circulation?

A

The recycling of bile salts from the ileum back into the digestive system

45
Q

What are the two main promoters of bile secretion? What inhibits these?

A

CCK and ACh

Inhibitor = somatostatin

46
Q

What is the cause of hemolytic jaundice?

A

simply caused by excessive breakdown of red blood cells

47
Q

What is obstructive jaundice?

A

Extrahepatic obstructive jaundice (EOJ) is caused by an obstruction, such as in the bile duct, which impedes bilirubin excretion outside the liver

48
Q

What is intrahepatic jaundice?

A

caused by an obstruction in the liver, such as impaired hepatocyte function or blocked bile canaliculi

49
Q

What causes alcoholic cirrhosis?

A

Accumulation of acetaldehyde (breakdown product of EtOH)

50
Q

What is biliary cirrhosis?

A

Anything that chronically impedes the passage of bile through the bile duct, leading to fibrotic changes in the liver

51
Q

What are the two types of cholelithiasis?

A

Cholesterol or pigmented

52
Q

What causes cholesterol gallstones?

A

Overproduction of cholesterol, or impaired production of bile salts

53
Q

Where are pigmented stones from?

A

Pigmented stones are derived from calcium bilirubinate or other pigmented polymers

54
Q

What is the term for imparied bile flow?

A

Cholestasis

Physiology (75 decks)

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