Liver and Pancreas Flashcards by Brendan Knapp

What are the major functions of the liver? (6 listed)

gluconeogensis
detoxification
storage 
produce plasma proteins (endocrine secretions)
production of bile (exocrine secretion)
transfer of IgA into bile canaliculi

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Liver receives blood from the _____ ____ (20-30%) and the ___ ___ (70-80%).

hepatic artery

portal vein

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blood leaves the liver via a ___ ____

central vein

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a fibroconnective tissue capsule subdivides the liver into ___ and ____

lobes, lobules

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the liver is composed of parenchymal cells called ____ that are arranged in anastamosing and branching plates. They are ____-shaped cells

hepatocytes

hexagon

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Hepatocytes have abundant ____, ____ ____, ____ and mitochondria, glycogen deposits, and lipid droplets

rER, smooth ER, peroxisomes, lysosomes

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The classic liver lobule is a ____ arrangement of hepatocyte plates aroiund a central ____

hexagonal

vein

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Liver cells can/cannot divide if part of the liver is removed

can

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around the periphery of each liver louble are several _____ ____ called portal triads

portal canals

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a portal canal consistsof branches of the ___ ____, ___ ____, and a ____ ____

portal vein
hepatic artery
bile duct

lymph vessels may also be present

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blood from vessels in the portal areas flow into _____ _____ and empties into the central vein

liver sinusoids

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Liver ___ are discontinuous endothelial lined spaces located in-between plates of hepatocytes.

sinusoids

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liver sinusoid endothelial cells have large _____

fenestrations

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Sinusoids contain many ____ cells that are phagocytic cells in the monocyte lineage

kupffer

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between the hepatocytes and sinusoid epithelium is a subendothelial space called the space of ____

disse

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The classic liver lobule defines flow of ___ while the portal lobule defines flow of ____

blood

bile

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The portal lobule is centered on a portal area is defined by 3 adjacent ___ ____. The triangular area defines the flow of ____

central veins

bile (into the bile duct)

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The hepatic accinus of Rappaport (liver acinus) defines the ____ _____

metabolic gradient

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the liver acinus is centered on the portal area but is defined by 2 adjacent ____ ____

central veins

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Zone 1 of the liver acinus consists of _____ functions (Cholesterol synthesis, gluconeogenis). it is a high ___ area

oxidative

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Zone 2 of the liver acinus is an ____ region

intermediate

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Zone 3 of the liver acinus is a low ____ area. Hepatocytes in this area have a role in _____ and are succeptible to hypoxia

detoxification

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The space of disse functions to exchange material between the ____ and ____

bloodstream

hepatocytes

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The space of disse has reticular fibers and may also have fat storing cells called ____ ____ cells(Cells of Ito). These are important for Vitamin _ storage and metabolism

hepatic stellate

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Hepatic stellate cells produce ____ during disease such as cirhossis in response to cytokines from the ____ cells

collagen | kupffer

The hepatocyte surface in the space of disse region has many _____

microvilli

The space of disse is located underneath ____ ____ and is where exchange of blood takes place

fenestrated epithelium

Bile flows in the ____ direction of blood

opposite

bile is an ____ secretion from the hepatocytes and is secreted into bile _____ which are intracellular spaces between the hepatocytes

exocrine | canaliculi

bile flows to canals of hering that are small ____ ____ at the edge of liver lobules and then into bile ducts located in the ____ ___

bile ductules | portal areas

Bile ducts merge into ____ ____

hepatic ducts

The common hepatic duct leads to the ____ ___ on the gallbladder neck

cystic duct

Bile canuliculi contain a lot of ____

ATPase

The main bile function is excretion of _____, phospholipids, bile salts, conjugated ____ and electrolytes

cholesterol, bilirubin

Bile acids reabsorb in the ____. Veinous blood from here goes to the portal vein and then to ____, where hepatocytes extract bile acids from the blood.

illeum | sinusoids

Bile acids are transported across ____ from sinusoids and are resecreted into ____

hepatocytes | canaliculi

Most IgA is made by plasma cells in the intestinal mucosa and eventually goes to the ____

liver

Hepatocytes complex ___ with secretory component and release it into the bile

IgA

Bile components are transported into canaliculis via an ____ dependent pump in the plasma membrane

ATP

Bile canaliculi contain ____ ____ transporters that just pump cancer drugs out with ATPase

multi-drug

Splenic macrophages remove senescent RBC's. Heme is converted to ____ and released into blood where it is conjugated with _____.

bilirubin | albumin

Lipid soluble bilirubin enters a hepatocyte, is complexed to ligandin and is the released as ____ bilirubin into the cytosol. Glucouronic acid is added to this to form ____ bilirubin, which is secreted into bile

free | conjugated

Hepatitis is ____ of the liver. A=_____, via a fecal or oral route. B=_____ via blood and blood products. C=transfusion related and can cause ______ carcinoma

inflammation infectous serum related hepatocellular

_____ is degeneration and fibrosis of damaged hepatocytes. Long-term ETOH consumption is one cause. It is often accompanied by ___ deposits.

cirrhosis | lipid

____ is due to excessive bilirubin in blood. Bile pigment will be seen in the skin and sclera of the eye. It is due to liver dysfunction, obstructed ____ passages, or excessive ____ destruction

jaundice bile RBC

Congestive heart failure causes increased central venous pressure and can cause the liver to _____ with _____.

engorge, blood

____ ____ is due to obstructed blood flow and is often associated with cirrhosis. It leads to ascites

Portal hypertension

Free ____ is toxic to the brain. Hemolytic diseases such as erythroblastosis _____ can result in ____

bilirubin | fetalis, hyperbilirubinemia

Alcohol is metabolized via _____ ____. This proudces excess H+ and _____ which is toxic to the liver due to production of reactive oxygen species

alcohol dehydrogenase | acetaldehyde

Chronic liver disease causes proinflammatory ____ to be released from kupffer cells. Thiese induce the hepatic stellate cell to produce ____ which causes _____

cytokines collagen fibrosis

During liver cirhossis, stellate cells transform to _____ and produce collagen

myofibroblasts

The gallbladder stores bile and releases it to duodenum in response to _____

cholecystokinin

The gall bladder mucosa is lined by ____ ____ epithelium with numerous microvilli on the apical surface.

simple columnar

the key feature of the gallbladder is the _____ of the epithelium. These are outpockings that form what appear to be epithelial lined ____ in the lamina propria (aka rokitansky-aschoff sinuses)

diverticula | cysts

The gall bladder is attached to the liver via ____, but is covered by ____ for most of the organ

adventitia | serosa

The gallbladder does not contain any _____

glands

Gallstones are usually of _____ crystals and can be found in the gallbladder and bile duct

cholesterol

The ____ is both an exocrine and endocrine organ

pancreas

The ____ portion of the pancrease is the islets of langerhans, made of several different cell types

endocrine

Alpha cells produce ______

glucagon (Elevates blood glucose)

____ cells produce somatostatin that inhibits hormonal release by neighboring secretory cells

delta

____ cells produce ghrelin which stimulates appetite

epsilon

Beta cells produce _____

insulin (decreases blood glucose)

Pancreas cell types can be distinguished by the ______ stain

mallory-azan

PP (F) cells produce _____ ____ that inhibits release of exocrine pancreatic secretions

pancreatic polypeptide

Endocrine cells are surrounded by a reticular fiber network and are located among the _____ of exocrine pancrease

acini

The exocrine pancreas secretes ____, ____, ribonuclease, and deoxyribonuclease in response to _____ from intestinal enteroendocrine cells

lipase, amylase | cholecystokonin

The exocrine pancreas secretes trypsin, chymotrypsin, carboxypeptidase, and elastase enzymes in _____ form, which must be activated in the intestine

proenzyme

intercalated duct cells secrete large quantities of enzyme poor ____ fluid (bicarbonate) in response to _____ produced by intestinal enteroendocrine cells

alkaline | secretin

What is the pathway of fluid drainage to the main pancreatic duct? acinar cells-->_______ (centroacinar cells)-->_________ (cuboidal epithelium)-->__________ (hella connective tissue)-->main pancreatic duct

intercalated ducts intralobular duts interlobular ducts

The alkaline fluid produced by intercalated ducts keeps pancreatic enzymes _____

inactive

Type _ diabetes is insulin dependent and is usually sudden onset before 20 years old. Low levels of plasma insulin are seen, characterized by ____ (Excessive thirst), ____ (excessive urination), and ____ (insatiable hunger)

1 polydispia polyuria polyphagia

Type __ diabetes is non-insulin dependent and is usually in overweight individuals over age 40. Insulin levels may be normal, or there may be impaired insulin release or decreased ____ _____

2 | insulin receptors

____ insulin resistance is a significant component to insulin resistance diabetes

muscle

____ insulin resistance can be due to faulty signalling through docking molecules, which are proteins that connect insulin receptor activity to downstream kinase cascades

hepatic

in acute ____ pancreatitis, ____ may be activated, leading to digestion of pancreatic tissue

necrotizing | proenzymes