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IUSM Histology > Liver and Pancreas > Flashcards

Liver and Pancreas Flashcards

1
Q

What is the direction of bile flow with respect to blood?

A

Opposite

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2
Q

Define bile flow in liver

A

Bile canaliculi -> canals of Herine (small bile ductules) -> bile duct ->hepatic ducts -> cystic duct ->intestines -> portal vein -> liver sinusoid -> hepatocytes -> bile canaliculi

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3
Q

What does bile contain?

A

Cholesterol, phospholipids, bile salts, conjugated bilirubin, electrolytes

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4
Q

How do we remove conjugated bilirubin from our systemsystem?

A

Secreted via bile

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5
Q

What is a silent killer that obstructs bile?

A

Pacreatic carcinoma

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6
Q

What is obstructed blood flow in the liver leading to fluid accumulation in peritoneal cavity (ascites)

A

Portal Hypertension

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7
Q

Why is billirubin usually conjugated? What is a disease that leads to excess bilirubin

A

Free bilirubin is toxic to brain. Erythroblastosis fetalis, or blood group incompatibility between mother and fetus, can result in hyperbilirubinemia

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8
Q

Why does excess alcohol lead to liver injury?

A

In metabolizing alcohol, pathways can produce acetate, excess hydrogen ions, and free radicles, leading to liver stress

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9
Q

What leads to fibrosis?

A

Anything that causes systemic inflamation (alcohol, viral, bacterial toxins)

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10
Q

Describe pathway of cirrhosis

A

Cytokines are released from Kupffer cells due to inflammation, in response hepatic stellate cells transform to myofibroblasts and produce collagen, leading to fibbrosis

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11
Q

What causes release of bile from gallbladder

A

Cholecystokinin

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12
Q

What is the key feature of the gallbladder?

A

Diverticula of the epithelium - outpocketings of mucosa that form epithelial lined cysts in the lamina propria (Rokitansky-Aschoff sinuses)

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13
Q

What is the epithelium of gallbladder mucosa?

A

Simple columnar epithelium with microvilli on apical surface

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14
Q

What do we mean when we say that gallbladder has no true submucosa

A

Lamina propria loose connective tissue blends with epithelium basement membrane

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15
Q

What is the muscularis externa of the gallbladder

A
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16
Q

Is the pancrease an endocrine or exocrine secretor?

A

Both!

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17
Q

What has considerable connective tissue in between lobules of septa?

A

Interlobular ducts for exocrine secretion

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18
Q

What is most abundant endocrine cell? What do alpha, beta, delta, and epsilon cells produce?

A

Beta cells.

Beta cells - insulin, alpha cells, glucagon, delta cells, somatostatin, epsilon cells, ghrelin

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19
Q

What do each of these hormones do?

A
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20
Q

Why do enzymes start in proenzyme form in the pancrease?

A

So that they do not digest pancreatic tissue

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21
Q

What does the pancrease secrete via exocrine secretion

A

Amylase, lipase, ribonuclease, deoxyribonuclease, trypsin, chymotrypsin, carboxypeptidase, elastase enzymes, enzyme poor alkaline fluid (bicarbonate)

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22
Q

What causes each secretion?

A
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23
Q

What is the flow of exocrine secretions?

A

Intercalated ducts (centroacinar cells), intralobular ducts (cuboidal epithelium), interlobular ducts (large amounts of pancreatic tissue), main pancreatic duct

24
Q

What is Type 1 Ddiabetes mellitus?

A

Low levels of plasma insulin, polydipsia, polyuria, polyphagia

25
Q

What causes Type II diabetes?

A

Faulty signalling due to impaird insulin release, decreased insulin receptors, faulty post-receptor signalling

26
Q

What are two characteristic resistances of insulin resistant diabetes?

A

Hepatic insulin resistance, muscle insulin resistance

27
Q

What causes Hepatic insulin resistance?

A

Faulty signalling through docking molecules (insulin receport substrate) proteins that connect insulin receptor activation to downstream kinase cascades such as P12K or MAPK

28
Q

What is pancreatitis and what commonly causes it?

A

Inflammation of pancreas - often due to gallstones

29
Q

What type of pancreatitis leads to digestion of pancreatic tissue? What can cause it?

A

Acute necrotizing pancreatitis

Can be caused by infection, gallstones, drugs, trauma

30
Q

What are the functions of the liver?

A

Gluconeogenesis, detoxification, storage, production of plasma proteins, production of bile, and transfer of IgA into canaliculi

31
Q

What mixes in the liver sinusoid?

A

Blood from hepatic artery and portal vein, portal vein major contributor

32
Q

Is the majority of pancreas exocrine or endocrine?

A

The MAJORITY is exocrine, does both

33
Q

Name the plasma proteins produced by the liver

A

fibrinogen, prothrombin, albumin, urea, acute phase proteins (endocrine secretions)

34
Q

What subdivides the liver into lobes and lobules?

A

A fibroconnective tissue capsule (Glisson’s capsule)

35
Q

What kind of cells are hepatocytes?

A

Parenchymal cells

36
Q

What organelles are particularly abundant in hepatocytes

A

rEr, sEr lysosomes, peroxisomes, mitochondria

37
Q

Describe the classical liver lobule

A

Defined division of liver as hexagonal hepatocyte plates organized around a central vein (not easy to see histologically)

38
Q

Where is bile secreted?

A

Space in between cells called canaliculi

39
Q

Describe the nuclei of the liver

A

Binculeate with large nuclei and 2x normal DNA - some are polyploid,. Liver cells therefore can divide if part of liver is lost

40
Q

What is the key identifying feature of the liver?

A

The portal canal

41
Q

What is the portal canal (triad, area)

A

Branches of portal vein, hepatic artery, and bile duct grouped together around lobule. Often lymph vessel is present

42
Q

Trace the flow of blood through the liver

A

Portal vein and hepatic artery -> sinusoids -> out endothelial fenestrations into Space of Disse -> back in through fenestrations -> central vein

43
Q

What kind of endothelium do sinusoids have?

A

Discontinuous endothelial lined spaces in-between plates of hepatocytes, large fenestration, and Kupffer cells

44
Q

What is a Kupffer cell?

A

Phagocytic cells of monocyte lineage

45
Q

Where is the space of Disse located? What is its purpose?

A

Space of Disse is located between the endothelium of the sinusoids and the microvilli of the hepatocytes

46
Q

What is a portal lobule?

A

Lobule defined by portal area and the flow of bile, includes three central veins centered around a bile duct.

47
Q

What is the hepatic acinus of Rappaport?

What are the zones in the hepatic acinus and what function does each zone perform?

A

Defined by metabolic gradient, region between two veins that defines oxygen gradients.

Zone 1is highly oxygenated and performs oxidative functions-cholesterol synthesis, gluconeogenesis, plasma proteins.

Zone 2 - intermediate region

Zone 3 - low O2 area - Hepatocytes serve role in detoxification and is susceptible to hypoxia

48
Q

What cells store fat in the Space of disse? What vitamin do they also store and metabolize? What happens when they are diseased?

A

Hepatic stellate cells/cells of Ito.

Important for Vit A storage and metabolism

Produce collagen in response to cytokines from Kupffer cells leading to cirrhosis

49
Q

What is the purpose of bile?

A

Facilitates absorbtion of fat and fat soluble vitamins

50
Q

How much bilic acid is reabsorbed in ileum?

A

90%

51
Q

What is the name for bile reuse and recirculation

A

Enterohepatic recirculation

52
Q

How does bile relate to IgA

A

Bile carries IgA complexed from hepatocytes

53
Q

What else can bile excrete?

A

Drugs and heavy metals

54
Q

What is Hepatitis? What is the difference of infection between A, B, C

A

Inflamation of liver. Virus A - infectious fecal, oral route, B - serum hepatitis-blood & blood products, C- transfusion related- hepatocellular carcinoma

55
Q

What is degeneration and fibrosis of liver?

A

Cirrhosis

56
Q

What causes cirrhosis

A

Poisoning, chronic alcohol use, bile duct obstruction, long term ETOH consumption with lipid deposits or steatosis

57
Q

How does the liver relate to jaundice?

A

Liver dysfunction obstructs bile passages yields excess bilirubin in blood and bile pigment in skin and sclera of eye. Can result in RBC destruction

IUSM Histology (15 decks)

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