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BMS 150 FINAL 2 > Liver and Gallbladder Phys and Path again > Flashcards

Liver and Gallbladder Phys and Path again Flashcards

1
Q

what receives portal blood that drains the stomach, small intestine, large intestine, pancreas, and spleen?

A

the liver

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2
Q

what is in the liver that represent up to 80% of the mononuclear phagocyte system?

A

Kupffer cells

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3
Q

what are the four lobes of the liver?

A

right, left, quadrate, and caudate

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4
Q

what are the important ligaments of the liver?

A
  • coronary ligaments
  • falciform ligament
  • round ligament
  • ligamentum venosum
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5
Q

what anchors the liver to the diaphragm

A

coronary ligaments

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6
Q

what ligament separates right and left lobe

A

falciform ligament

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7
Q

what is the ligament found on free border of falciform ligament separates quadrate and left lobe

A

round ligament (ligamentum teres)

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8
Q

what connects the liver to the umbilicus

A

round ligament (ligamentum teres)

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9
Q

what ligament separates the caudate and left lobe

A

ligamentum venosum

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10
Q

what separates the caudate and right lobe

A

gallbladder

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11
Q

the liver receives oxygenated blood from the ?

A

hepatic artery

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12
Q

the liver receives deoxygenated, nutrient-rich blood from the ?

A

hepatic portal vein

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13
Q

what is the opening for the 3 main things entering the liver called? (hepatic artery, portal vein, common hepatic duct)

A

Porta hepatis

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14
Q

what are the 3 main components of the liver

A
  • hepatocytes
  • bile canaliculi/cholangiocytes
  • hepatic sinusoids
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15
Q

what are the major functional cells in the liver

A

hepatocytes

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16
Q

what are hepatocytes arranged into ?

A

hepatic laminae

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17
Q

what are hepatic laminae

A

“Plates” of hepatocytes, bordered by endothelial-lined vascular spaces (hepatic sinusoids)

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18
Q

what are bile canaliculi

A

Small ducts found between hepatic laminae that collect bile

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19
Q

what is the central vein

A
  • drains hepatic sinusoids
  • empties into hepatic vein
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20
Q

what does the portal triad contain?

A
  • bile duct
  • arteriole branch of hepatic artery
  • venule branch of portal vein
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21
Q

what is the capillary system specific to the liver?

A

hepatic sinusoids

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22
Q

what separates the hepatocytes and sinusoids?

A

space of disse

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23
Q

what is the area where blood from the portal vein and hepatic artery mix and then converge and drain into central vein

A

hepatic sinusoids

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24
Q

where are hepatic stellate cells found?

A

space of disse

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25
Q

hepatic stellate cells are normally…

A

in a quiescent state

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26
Q

the hepatic stellate cells become active when…

A

there is damage

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27
Q

what does hepatic stellate cells do?

A

secrete collagen and extracellular matrix in response to damage -> scar tissue formation

28
Q

what is the resident macrophage of the liver

A

Kupffers cells

29
Q

what is the function of kupffers cells

A

phagocytose old RBC’s, hemoglobin, particulate matter, cellular debris, microorganisms

30
Q

Hepatocytes, bile duct system and hepatic sinusoids can be organized into functional units called

A

hepatic acinus

31
Q

hepatocytes are arranged in ? zones around short axis

A

3 zones
○ Zone 1 – most O2
○ Zone 2
○ Zone 3 – least O2

32
Q

Hepatocyte function differs based on ? within hepatic acinus

A

zones

33
Q

what is the liver functions

A
  • Biotransformation & degradation
  • Bilirubin conjugation
  • Storage & synthesis of nutrients
  • Bile production
34
Q

why does the liver process lipophilic chemicals into polar, water-soluble metabolites?

A

easier to excrete into bile when hydrophilic

35
Q

what are the 4 major steps of biotransformation and degradation of the liver

A
  1. Hepatocyte imports the compounds from blood across it’s basolateral membrane
  2. Hepatocyte transport material within the cell
  3. Hepatocyte may chemically modify/ degrade products intracellularly
  4. Hepatocyte excretes the molecule into bile across its apical membrane
36
Q

what are the 2 phases of hepatocyte chemically modifying and degrading products intracellularly

A
  • Phase I – oxidation or reduction reactions typically catalyzed by P-450 cytochromes enzymes (aka CYP450)
  • Phase II – conjugation
37
Q

what is an inducer of many CYP450 enzymes

A

Hypericum perforatum (St. John’s Wort)

38
Q

what can transport a wide variety of conjugated drugs and bilirubin either into bile or blood

A

ATP-binding Casette

39
Q

Senescent erythrocytes are phagocytosed by macrophages & heme will be degraded into ? & released into the blood
○ Unconjugated ? will be carried to the liver bound to ?

A

Bilirubin
bilirubin
albumin

40
Q

Bacteria in the terminal ileum and colon converts some of the conjugated bilirubin back into bilirubin. Then, this bilirubin will be converted to ? and some will then be converted to ?

A

urobilinogen
stercobilin

41
Q

what is the main pigment of feces

A

stercobilin

42
Q

bile production by the liver serves 2 functions:

A
  1. elimination of exogenous and endogenous waste products
  2. promotes digestion and absorption of lipids from the intestines
43
Q

Bile is synthesized initial from ? in the liver

A

cholesterol

44
Q

what is the process called when ileum and colon bile can be dehydroxylated by bacteria and reabsorbed

A

Enterohepatic circulation

45
Q

what is the bile flow pathway

A

hepatocyte -> bile canaliculi -> bile ductules -> bile ducts -> common hepatic duct -> cystic duct -> common bile duct -> duodenum

46
Q

what is the small, pear shaped organ on inferior aspect of liver

A

gallbladder

47
Q

what is continuous with the cystic duct?

A

gallbladder

48
Q

what are the layers of the gallbladder

A
  • mucosa
  • muscularis
  • serosa
49
Q

what is the function of the gallbladder

A

Storage of bile that is secreted continuously by hepatocytes until it’s needed in the duodenum

50
Q

When food digestion begins in upper GI tract, the gallbladder begins to ?

A

empty

51
Q

Emptying occurs with ?

A

rhythmical contractions of gallbladder wall also requires simultaneous relaxation of the sphincter of Oddi

52
Q

what is cirrhosis

A

Diffuse remodeling of the liver into parenchymal nodules surrounded by fibrous bands and variable degree of vascular shunting

53
Q

what are the leading causes of cirrhosis

A
  • Chronic hepatitis B,
  • chronic hepatitis C,
  • Nonalcoholic fatty liver disease
  • Alcoholic liver disease
54
Q

what are the symptoms of cirrhosis

A
  • Many are asymptomatic until most advanced stages of disease
  • Symptoms are often non-specific:
    ○ Anorexia, weight loss, weakness
55
Q

cirrhosis is reversible but will often progress to ?

A

liver failure

56
Q

what is the most common biliary tract disease

A

cholelithiasis (gallstones)

57
Q

what are the 2 main types of gallstones

A
  • cholesterol stones
  • pigment stones
58
Q

what is the pathogenesis of cholesterol stones

A

Cholesterol concentrations exceed the solubilizing capacity of bile (supersaturation)
-> cholesterol can no longer remain dispersed and nucleates into solid cholesterol monohydrate crystals

59
Q

cholelithiasis can progression into?

A

acute cholecystitis

60
Q

what results in jaundice and icterus?

A

elevated bilirubin

61
Q

what is jaundice

A

yellow discolouration of the skin

62
Q

what is icterus

A

yellow discolouration of the sclera

63
Q

the etiology of jaundice can be divided into :

A
  • Pre-hepatic causes
  • Intra-hepatic causes
  • Post-hepatic causes
64
Q

pre-hepatic causes mean

A

excessive extrahepatic production of bilirubin

65
Q

intra-hepatic causes mean

A

reduced hepatocute uptake, impaired conjugation, decreased heptocellular excretion

66
Q

post-hepatic causes mean

A

impaired bile flow

BMS 150 FINAL 2 (26 decks)

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