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BDS1 BAMS: Alimentary System > Liver and Pancreas > Flashcards

Liver and Pancreas Flashcards

1
Q

What are the 2 portions of the pancreas?

A

Endocrine and exocrine

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2
Q

Why is the pancreas described as a dual purpose gland?

A

It has 2 portions with different functions: endocrine and exocrine

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3
Q

Describe the endocrine portion of the pancreas

A
  • Only 1% of the pancreas is endocrine
  • Islets of Langerhans
  • Produces hormones: beta cells produce insulin, alpha cells produce glucagon and delta cells produce somatostatin
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4
Q

Describe the exocrine portion of the pancreas

A
  • 99% of the pancreas is exocrine
  • Produces digestive enzymes (acinus)
  • Bicarbonate ions (ducts)
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5
Q

What are some of the digestive enzymes produced by the exocrine portion of the pancreas?

A

Amylase, lipase, trypsin, chymotrypsin, nucleases

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6
Q

Which portion of the pancreas secretes bicarbonate ions and what is the function of these ions?

A
  • Exocrine portion

- Bicarbonate neutralises gastric acid; it is a buffer, maintains optimum pH

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7
Q

What does insulin do?

A

Decreases blood sugar

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8
Q

What does glucagon do?

A

Increases blood sugar

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9
Q

What does somatostatin do?

A

Inhibits gastrin secretion and reduces muscle contraction

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10
Q

What are the 4 regions of the pancreas?

A

Head, neck, body, tail

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11
Q

Which organ is the pancreas posterior to?

A

The stomach

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12
Q

The pancreas starts as 2 organs which then fuse in utero. What can happen if they don’t fuse together?

A

End up with 2 openings into the duodenum e.g. the major papilla and the minor papilla

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13
Q

What do alpha cells, beta cells and delta cells release in the pancreas? (endocrine portion)

A

Alpha cells: glucagon (15%)
Beta cells: insulin (80%)
Delta cells: somatostatin (5%)

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14
Q

What do acinar cells in the pancreas do?

A

Produce and transport enzymes that are passed onto the duodenum where they assist in the digestion of food

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15
Q

Which part of the pancreas does cystic fibrosis affect?

A
  • Exocrine portion
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16
Q

What are the clinical features of cystic fibrosis?

A
  • Abnormal, thick secretions
  • Damage to lungs, liver and pancreas
  • Destruction of primarily exocrine pancreas (reduced digestive function, malabsorption, steatorrhea)
  • Can affect the salivary glands (thick secretions can cause dry mouth)
  • Can cause infertility
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17
Q

What is steatorrhea?

A

Excretion of abnormal quantities of fat

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18
Q

What can CF patients be given to help with impaired pancreas function?

A

Pancreatic supplements to provide the missing enzymes

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19
Q

Which parts of the pancreas does pancreatic cancer typically affect?

A

The head and neck

Blocks the duct and the sphincter

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20
Q

What is blockage of the bile duct termed?

A

Biliary obstruction

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21
Q

What can biliary obstruction cause?

A
  • Biliary obstruction is blockage of the bile duct

- Can cause obstructive jaundice - yellowness of the skin, bile is redirected to the blood

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22
Q

Why is pancreatic cancer a very dangerous form of cancer?

A
  • It can cause early metastasis

- It cannot be operated on (worst prognosis of all cancers) because the pancreas might start to self-digest

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23
Q

Define metastasis

A

Cancer cells break off from original tumour and migrate in the bloodstream or lymph and form a secondary tumour away from the original site

24
Q

What is the liver?

A

A large lobed glandular organ in the abdomen involved in metabolic processes

25
Q

Where is the liver located?

A

Under the rib cage - extends all the way from left to right

26
Q

What are the functions of the liver?

A
  • Involved in metabolism: material absorbed from G.I. tract, storage of glycogen, release of glucose
  • Protein synthesis
  • Inactivation of hormones, drugs
  • Excretion of waste
  • Produces bile
27
Q

Where is bile produced?

A

In the liver

28
Q

Where is bile stored and concentrated?

A

In the gallbladder

29
Q

What are the 4 lobes of the liver?

A

Right, left, quadrate and caudate

30
Q

What do liver cells (hepatocytes) produce?

A

Bile

31
Q

What does bile contain?

A
  • Lipid emulsifiers (bile salts)

- Waste products including bile pigments (bilirubin)

32
Q

What is the purpose of the ductus venosus in the foetus?

A

The ductus venosus shunts a portion of umbilical vein blood directly to the inferior vena cava. It allows oxygenated blood from the placenta to bypass the liver.

33
Q

Where does bile travel to after it is produced in the liver?

A

Travels down the left and right hepatic ducts, to the common hepatic duct and into the gallbladder

34
Q

What effect does cholecystokinin (CCK) on the gall bladder?

A

When CCK is released it will act on the gallbladder which will release bile into the bile duct that feeds into the duodenum

35
Q

Which technique can be used to visualise any blockages in the liver/gallbladder/duodenum pathway?

A

Endoscopic Retrograde Cholangiopancreatography (ERCP)

36
Q

What are the 2 sources of blood for the liver?

A

Hepatic artery and hepatic portal vein

37
Q

Where does the hepatic artery come from?

A

The coeliac trunk branched from the aorta

38
Q

Where does the hepatic portal vein come from?

A

Drains abdominal unpaired organs

Almost all material absorbed by the G.I.T. enters the HPV

39
Q

Which vein drains abdominal unpaired organs into the liver?

A

Hepatic portal vein

40
Q

Which veins drain the gut?

A

Superior and inferior mesenteric veins and splenic vein -> hepatic portal vein

41
Q

What is the portal triad?

A
  • Component of a hepatic lobule

- Consists of the hepatic portal vein, hepatic artery and bile canaliculus

42
Q

Which direction do efferents from the liver move?

A

Towards the central vein (hepatic artery and hepatic portal vein)
Exception is bile: drains to the bile duct through the bile canaliculus

43
Q

Where do sinusoids drain?

A

Hepatic vein/central vein

44
Q

What are sinusoids?

A
  • Channels/blood vessels that receive blood from the hepatic artery and the hepatic portal vein (blood from both sources - hepatic artery and hepatic portal vein - mingle in the sinusoids)
  • Sinusoids drain into the central vein
45
Q

What are Kupffer cells?

A
  • Phagocytic cells found within sinusoids endothelium

- Important filtering function, remove and process antigens that arrive from the G.I. tract or systemic circulation

46
Q

Which cells are phagocytic ells that are found within the sinusoids endothelium?

A

Kupffer cells

47
Q

What is the function of Kupffer cells?

A
  • Filtering function

- Remove and process antigens that arrive from the G.I. tract or the systemic circulation

48
Q

What is hepatomegaly?

A
  • Enlargement of the liver
49
Q

What is cirrhosis?

A
  • Chronic disease of the liver
  • Characterised by degeneration of cells, inflammation and thickening of tissue/scar tissue
  • Typically a result of alcoholism or hepititis infection
50
Q

What can cause liver cirrhosis?

A

Alcoholism

Hepititis

51
Q

What does viral hepititis cause?

A

Inflammation of the liver

52
Q

What is obstructive jaundice?

A

Jaundice resulting from blockage of the bile ducts or abnormal retention of bile in the liver

53
Q

What can blockage of bile ducts result in?

A

Obstructive jaundice

54
Q

What is hepatic carcinoma?

A
  • A cancer arising from liver cells (hepatocytes)
55
Q

What is a primary risk factor for liver cancer?

A

Liver damage manifested by cirrhosis (scarring)

BDS1 BAMS: Alimentary System (8 decks)

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