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Physiology II Exam III > Liver And Pancreas > Flashcards

Liver And Pancreas Flashcards

1
Q

Liver cell plates are composed of ____ layers of hepatocytes. Where does the bile canaliculi lie?

A
  • 2

- lies between two layers of hepatocytes in each cell plate

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2
Q

What are sinusoids lined with?

A
  • endothelial cells

- Kupffer cells

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3
Q

Where is the space of Disse found?

A

-between endothelial cells and hepatocytes

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4
Q

Liver has high blood flow and low vascular resistance, what is the percentage of blood received from resting cardiac output?

A
  • 27% of resting cardiac output

- 1050mL from portal vein + 300mL from hepatic artery flows into sinusoids each minute

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5
Q

What is the portal pressure? What is the pressure from liver to vena cava?

A

9 mm Hg

0 mm Hg

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6
Q

How does cirrhosis affect blood flow to the liver?

A

-increase blood resistance to blood flow

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7
Q

What is the effect of a clot blocking portal vein or a major branch?

A
  • blockage of return blood from spleen and intestines

- increase in capillary pressure in intestinal wall -> loss of fluid -> death

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8
Q

What will high pressure in the right atrium result in the blood flow to the liver?

A

-high pressure of right atrium -> back pressure on liver -> increased blood volume in liver up to 1.5L
+may occur during cardiac failure with peripheral congestion

-therefore liver can store blood in times of excess and supply blood in times of diminished volume

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9
Q

Hepatic sinusoids are ________ permeable to proteins.

A
  • highly

- efferent lymph has a protein concentration of 6g/dL (almost equivalent to plasma concentration)

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10
Q

What happens with there is higher than normal pressure in the hepatic veins?

A
  • back pressure causes fluid to transfuse into lymph
  • fluid leaks through liver capsule into abdominal cavity
  • fluid is almost pure plasma
  • large amounts of fluid in abdominal cavity -> ascites
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11
Q

What is the function of the liver in terms of carb metabolism?

A
  • stores glucose as glycogen
  • converts galactose and fructose to glucose
  • gluconeogenesis
  • forms many intermediate products of carb metabolism
  • releases stored glucose into the circulation
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12
Q

What are the functions of the liver in terms of fat metabolism?

A
  • oxidation of FAs for energy
  • synthesis of cholesterol, phospholipids, lipoproteins
  • synthesis of fats from proteins and carbs
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13
Q

What are the functions of the liver in terms of protein metabolism?

A
  • deamination of aas
  • formation of urea
  • formation of plasma proteins
  • inter conversion of various aas and synthesis of other compounds from aas
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14
Q

What vitamins does the liver store?

A
  • vitamin A
  • vitamin D
  • vitamin B12
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15
Q

What’s another liver function not yet mentioned?

A

-immune function

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16
Q

What coagulation factors does the liver form?

A
  • fibrinogen
  • prothrombin
  • accelerator globulin
  • factors VII, IX, X
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17
Q

What does the liver do in terms of waste removal?

A
  • detoxifies or excretes I tot he bile: sulfonamides, penicillin, ampicillin, and erythromycin
  • excretes excess Ca into the bile
  • detoxification and removal of ammonia and ethanol
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18
Q

Potentially toxic substances are presented to the liver via the __________.

A

Portal system

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19
Q

Phase I rxns are catalyzes by what?

A

P-450 enzymes

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20
Q

Phase II reactions conjugate products from Phase I reactions.

A

:)

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21
Q

What stores bile?

A

Gallbladder

22
Q

What are the components of bile?

A

-bile acids
+colic and chenodeoxycholic acids (synthesized by hepatocytes)
+deocxycholic acid and lithocholic acid (converted by bacteria)

  • water and electrolytes
  • cholesterol and phospholipids
  • pigments and organic molecules -> bilirubin
23
Q

What is hemoglobin released from?

A

Damaged RBCs

24
Q

What is the reticuloendothelial system?

A
  • hemoglobin is phagocytized by macrophages
  • split into globin and heme
  • heme ring is opened to free Fe
  • heme is transported in the blood by transferrin
  • straight chain of pyrrole nuclei is formed
  • heme is converted by heme oxygenase into biliverdin
  • biliverdin is converted to free bilirubin
25
How is free bilirubin transported?
-in the blood stream attached to plasma albumin to liver hepatocytes
26
How is conjugated bilirubin excreted?
- secreted into the intestine | - excreted into the urine
27
What is jaundice?
- refers to a yellowish tint to the body tissues - usually caused by quantities of bilirubin in the extracellular fluids -common causes: +increased hemolysis +obstruction of the bile ducts or damage to the liver
28
What are the major types of islet cells?
-alpha, beta, delta
29
What do alpha cells do?
- secrete glucagon | - 25% of total cells
30
What do beta cells do?
-secrete insulin and amylin +insulin inhibits glucagon secretion +amylin inhibits insulin secretion -60% of total cells
31
What do delta cells do?
-secrete somatostatin | +inhibits insulin, glucagon, and gastrin secretion
32
What are the two communication channels between the islet cells?
- gap junctions | - islet portal blood supply
33
What communicates with what via gap junctions?
- beta cells to beta cells - alpha cells to alpha cells - beta cells to alpha cells
34
What communicates via the islet portal blood supply?
-beta cells to alpha and delta cells
35
Insulin not bound to receptors are destroyed where?
Liver
36
What happens when insulin is bound to a receptor?
- increased uptake of glucose (decrease blood glucose) - increased permeability to aa, K, and P ions (decrease aa and K) - increase uptake of FAs - increased activity levels for many enzymes - changes in rates of translation and transcription
37
What is an insulin receptor?
- found on target tissues for insulin - intrinsic tyrosine kinase activity autophosphorylates the beta subunits, which then phosphorylate intracellular proteins -insulin down regulates its own receptor +increased in starvation +decreased in obesity
38
Most of the glucose absorbed after a meal is stored as glycogen where?
-in the liver
39
What is the glucose uptake mechanism for the liver?-I
- insulin inactivated liver phosphorylase - insulin activates glucokinase and enhances uptake of glucose from blood - insulin increases activities of enzymes needed for glycogenesis
40
Outline the events that causes the liver to release glucose into the blood.
- decreased blood glucose resulting in decreased insulin secretion - lack of insulin reverses glycogen synthesis pathway - lack of insulin activates phosphorylase which splits glycogen into glucose phosphate - glucose phosphatase removes phosphate from glucose and allows it to diffuse back into blood - insulin inhibits gluconeogenesis
41
How does blood flow through the liver lobule?
Portal vein -> sinusoids -> central vein -> hepatic veins -> hepatic artery -> sinusoids -> central vein -> hepatic veins
42
What does insulin promote excess glucose into?
-converted excess glucose into FAs and decrease utilization of fat
43
Explain how insulin works on fat storage physiologically.
- increases transport of glucose into liver creating excess - excess glucose in converted to acetyl CoA - FA synthesis is initiated - newly synthesized FAs are converted into triglycerides and transported from liver as lipoproteins - triglycerides are split into FAs in capillaries and taken up into fat cells - insulin promotes uptake of glycerol by fat cells
44
What happens when there are low amounts of insulin?
-large amounts of glycerol and FAs are released into the blood
45
Explain how lack of insulin effects fat storage physiologically.
- large amounts of acetoacetic acids are formed in the liver - carnation transport mechanism in the liver is activated - B-oxidation results in excess acetyl CoA - excess acetoacetic acids cause acidosis - increase of ketone bodies in blood
46
What are the major effects of glucagon? What does it work on?
- works on liver and adipose tissue - break down of liver glycogen - increased gluconeogenesis
47
Explain physiologically how glucagon works.
- activates adenyl cyclase in hepatic cell membrane which causes formation of cAMP - activates protein kinase - activates phosphorylase b kinase - converts phosphorylase b into phosphorylase a - promotes degradation of glycogen to glucose-1-phosphate - increases lipolysis -> increase in blood FAs -> increase blood keto acids -> increase in blood glucose - increases urea production (due to deamination of aas used for gluconeogenesis)
48
What does somatostatin do? What secretes this?
- secreted by delta cells - inhibits secretion of insulin, glucagon, and gastrin - decreases motility of stomach, duodenum, and gallbladder - decreases secretion and absorption of GI tract
49
What are the negative effects of increased blood glucose levels?
- increased osmotic pressure in extracellular fluid - loss of glucose in urine - osmotic diuresis (dehydration and loss of electrolytes) - damage to tissues and blood vessels
50
What causes Type I diabetes? What are some effects of it?
- caused by lack of insulin secretion | - injury to beta cells via viral infection and autoimmune disorders
51
What causes Type II diabetes? What are some risk factors?
- due to insulin resistance - obesity is a major risk factor - preceded by metabolic syndrome
52
What is metabolic syndrome?
- obesity (esp abdominal fat) - insulin resistance - fasting hyperglycemia - increased lipid triglycerides - decreased HDL levels - hypertension

Physiology II Exam III (9 decks)

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