Liver and pancreas Flashcards

1
Q

What are the two broad functions of the pancreas

A

Hormonal (endocrine, secretions pass into blood)
Digestive (exocrine)

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2
Q

What is the main portion of the pancreas

A

Exocrine
(Endocrine 1%)

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3
Q

What is the function of insulin

A

Promotes glucose absorption from blood into thee liver, skeletal muscle and fat cells. This enables the conversion of glucose to glycogen to be stored.

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4
Q

What is a function of somatostatin

A

Helps to reduce acid secretion and helps to slow down the digestive process

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5
Q

What are produced within the islets of Langerhans (endocrine)

A

Insulin
Glucagon
Somatostatin

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6
Q

What can be found in exocrine gland

A

Many digestive enzymes
Bicarbonate ions

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7
Q

What converts glycogen to glucose

A

Glucagon

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8
Q

What enzymes are released from acinus within the pancreas

A

Amylase - starch-sugar
Lipase - Fats - fatty acids
Trypsin, Chymotrypsin - proteins
Nucleases - break down nucleotide

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9
Q

What is the function of chymotrypsin

A

Breaks down proteins and polypeptides

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10
Q

What do the ducts in the pancreas produce

A

Bicarbonate
-neutralises gastric acid

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11
Q

What are the five main sections of the pancreas

A

Head
Uncinate process
Neck
Body
Tail

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12
Q

Where is the head of the pancreas attached to

A

Duodenum by connective tissue
-Lies within C shaped curve

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13
Q

What is the uncinate process and where is it

A

A projection arising from the lower part of the head and extending medially to lie beneath the body of the pancreas. It lies posterior to the superior mesenteric vessels

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14
Q

What part of the pancreas is intraperitoneal

A

The tail

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15
Q

Where are bile and pancreatic secretions released

A

Major duodenal papilla which is surrounded by the sphincter of Oddi

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16
Q

What is the minor duodenal papilla

A

The opening of the accessory pancreatic duct typically present in 10% of people

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17
Q

What cells are found within islet of Langerhan’s

A

Alpha cells - secrete glucagon
Beta cells - secrete insulin
Delta cells - secrete somatostatin

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18
Q

What percentage of alpha cells are found within islet of Langerhans

A

15%

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19
Q

How are acini connected

A

Intercalated ducts which are then linked to intralobular ducts which drain to the pancreatic duct

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20
Q

What are Centroacinar cells

A

Spindle shaped cells which are extensions of intercalated ducts into each pancreatic acinus

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21
Q

What do centroacinar cells usually produce

A

Bicarbonate and mucin

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22
Q

How does cystic fibrosis affect the pancreas

A

Destruction of the pancreas and affects on the ability to secrete digestive enzymes can lead to malabsorption

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23
Q

What does destruction of primarily exocrine pancreas lead to

A

-Reduced digestive function
-Malabsorption
-Steatorrhea

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24
Q

What is steatorrhea

A

No breakdown of fats lead to fatty stool/faeces

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25
What exocrine does cystic fibrosis affect
Lungs Liver Pancreas Salivary glands - secretions are more mucosal in nature
26
How does cystic fibrosis affect the airway
Thick, sticky mucus blocks the airway making it much harder for air to pass through, negatively affecting the breathing
27
How does cystic fibrosis affect the liver
Blocked billiary ducts
28
Why can digestion become reduced with cystic fibrosis
Blocked pancreatic ducts in the pancreas which leads to malabsorption and less nutrients absorbed in the intestines due to lack of enzymes released in pancreas for breakdown of food
29
What is nail clubbing
A deformity of the fingers and toe nails associated with a number of conditions of the heart and lungs -loss of the angle of the nail bed, increased convexity
30
What tissue layer is affected with cystic fibrosis
Inflammation of lamina propria
31
Where does pancreatic cancer affect
Head of the pancreas, Cases blockages in bile duct and pancreatic duct which results in biliary obstruction Bile cant pass into duodenum
32
Symptoms of pancreatic cancer
Loss of apatite Unexpected weight loss Lethargy and exhaustion Abdominal pain
33
What is obstructive jaundice
Yellowing of skin and sclera. Symptom of a build up of bilirubin which is not excreted and typically with experience steatorrhea
34
Why is pancreatic cancer often fatal within a year of diagnosis
It frequently has early metastasis (spreads to other sites) e.g. liver
35
Functions of the liver
Metabolism -material absorbed from G.I.T. (detoxifies and processes) -storage of glycogen -release of glucose(regulates levels) Protein synthesis (clotting factors) Inactivation of hormones, drugs Excretion of waste Produces Bile
36
Why is paracetamol toxic
Bi product of metabolism in liver is extremely toxic
37
What are the lobes of the liver
Right Left Caudate Quadrate
38
Where in the abdomen does the liver lie
Right hypochondrium, extending to the epigastric region and then to the left hypochondrium
39
What is the largest gland in the body
Liver
40
What is the heaviest internal organ
Liver
41
What is the ductus venosus
Directs blood in foetal life
42
What embryological remnants are found on the liver
Falciform ligament - attaches intestines to posterior abdominal wall Round ligament - remnant of the umbilical vein.
43
What is the ligamentum venosum
The fibrous remnant of the ductus venosus, sometimes continuous with the round ligament
44
What supplies the liver
The hepatic portal vein 75% and the hepatic artery 25% (oxygenated) (coeliac trunk)
45
What carries bile to the gallbladder
Left and right hepatic ducts
46
What forms the hepatic duct
Left and right hepatic ducts. Intrahepatic ducts unite to form the left and right extrahepatic ducts which link to the common hepatic duct
47
What are liver cells called and what do they do
Hepatocytes - produce bile
48
What does bile contain
Lipid emulsifiers (bile salts) Waste products including bile pigments (bilirubin-breakdown product of RBCs)
49
Where is bile stored
Gallbladder
50
What are the purpose of bile salts
Help cholesterol metabolism and aid absorption of fat soluble vitamins (A,D,E,K)
51
What does sphincter of Oddi do
Helps control secretions from pancreas and biliary secretions into duodenum
52
What does ERCP stand for
Endoscopic Retrograde Cholangiopancreatography
53
What route does almost all absorbed material from the G.I.T. take
Enters the HPV Passes through liver Processed
54
What is the function of the hepatic portal vein
Drains unpaired abdominal organs Carries blood from Gut, pancreas, spleen etc. to the liver
55
Why is the HPV not a normal vein
Takes blood to liver instead of heart
56
What veins make up the HPV
Superior mesenteric and splenic veins Also contains blood from inferior mesenteric vein, stomach and gallbladder
57
What are sinusoids
Larger diameter capillaries which drain to the hepatic vein from the liver. Has specialised lining endothelial cells (main role in clearing blood waste) and Kupffer cells, specialised macrophages
58
What does the portal triad consist of
Portal vein (blue) Hepatic artery (red) Bile canaliculus (green)
59
Where does the portal triad drain to
Central vein (middle of hexagon)
60
How is the liver used in oxygen transport
Liver is involved in storing and mobilisation of iron which is used by RBCs for oxygen transport proteins like haemoglobin
61
What are some diseases of the liver
Hepatomegaly Cirrhosis Viral hepatitis Obstructive jaundice Hepatic carcinoma
62
What is hepatomegaly and its symptoms
Enlarged liver- sign of underlying problems with liver or cardiac failure. Can be caused by many conditions Symptoms: Abdominal pain Fatigue Nausea Vomiting Jaundice
63
What is cirrhosis
Scarring or fibrosis of liver, inflammation like hepatitis or chronic alcoholism
64
What can cause obstructive jaundice
Pancreatic cancer Gall stones
65
What is the primary liver cancer
Hepatic carcinoma (most common) -linked to chronic liver disease and cirrhosis
66
What is the duct called that comes from the gall bladder
Cystic duct
67
What is a gall stone
Crystalline bodies made of cholesterol or bilirubin and calcium salts
68
What is the blood supply for the pancreas
Superior and inferior pancreaticoduodenal arteries
69
What vessels unite to form the hepatic portal vein
Superior mesenteric and splenic veins
70
Where does anastomoses occur
oesophagus and stomach
71
Why is portal hypertension so dangerous
An increase in pressure in the liver which can result in raised pressure in the oesophageal and gastric vessels which may rupture resulting in haematemesis
72
What division of the gut does the superior mesenteric artery supply
Midgut
73
What division of the gut does the coeliac trunk supply
Foregut
74
Where does the bile produced in the liver open into the intestinal tract
Via the major duodenal papilla, through sphincter of Oddi, into the second part of the duodenum
75
What is the arterial supply of the liver
Hepatic artery
76
Where does the hepatic artery arise from
Coeliac trunk
77
What is the region called where the hepatic portal vein, bile ducts and hepatic artery enter the liver
Porta hepatis
78
What is the round ligament of the liver
Remnant of the umbilical vein which lies in the free edge of the falciform ligament
79
What was the purpose of the round ligament in foetal life
To bypass the liver to allow nutrients to reach the foetus directly rather than being processed in the liver
80
What does the portal triad contain
Portal vein Hepatic artery Bile canaliculus
81
What cell types are present in islets of Langerhans's
Alpha Beta Delta