Liver, Bile, & Lipid DIgestion Flashcards

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0
Q

What suspends the liver between the stomach and anterior abdominal wall? What are the two ligaments?

A

Peritoneum - Lesser Omentum & Falciform ligament

Part 1 - Slide 2, 3

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1
Q

What is the largest gland (by weight) and where is it located?

A

Liver, upper right abdomen between ribs 5-10

Part 1 - Slide 2

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2
Q

Where is the less omentum located and what does it contain?

A

Btwn liver & stomach
Contains hepatic blood vessels & bile ducts

(Part 1 - Slide 2)

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3
Q

Where is the falciform ligament?

A

Btwn liver & anterior abdominal wall

Part 1 - Slide 3

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4
Q

What covers the liver except the bare area?

A

Visceral peritoneum

Part 1 - Slide 3

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5
Q

Where is the top of the liver attached to and what is it surrounded by?

A

Attached to diaphragm
Surrounded by coronal ligament

(Part 1 - Slide 3)

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6
Q

What are the lobes of the liver & what are they demarcated by?

A

Right, Left, Quadrate, Caudate
blood vessels & ligaments

(Part 1 - Slide 3)

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7
Q

What is the ligamentum teres?

A

Vestige of an umbilical vein carrying blood from placenta to fetus

(Part 1 - Slide 3)

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8
Q

What is the Porta Hepatis and what does it contain?

A

Hilum of the liver
Contains bile ducts, hepatic artery, & portal vein

(Part 1 - Slide 3)

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9
Q

How much of cardiac output does the liver receive?

A

29%

Part 1 - Slide 4

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10
Q

What are some functions of the liver?

A
  1. Macrophages consume colonic bacteria
  2. Metabolizes the 3 major components of food: carb, lipid, prot
  3. Stores vitamin & iron
  4. Detoxifies drugs, hormones, etc
  5. Secretes bile

(Part 1 - Slide 4)

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11
Q

What does the liver do with carbs?

A

Stores glucose by forming glycogen/secretes glucose into circulation through gluconeogenesis

(Part 1 - Slide 4)

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12
Q

What does the liver do with lipids?

A

synthesizes lipoproteins, cholesterol, & phospholipids
oxidizes FA
converts carbs & prot into fat

(Part 1 - Slide 4)

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13
Q

What does the liver do with proteins?

A

Synthesizes plasma proteins
Forms urea

(Part 1 - Slide 4)

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14
Q

Where does the hepatic artery bring blood from?

A

Oxygenated blood from the aorta via the celiac artery

Part 1 - Slide 5

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15
Q

What does the portal vein bring?

A

Nutrient filled deoxygenated blood from the gastric, splenic, & mesenteric veins

(Part 1 - Slide 5)

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16
Q

What are the sinusoids lined with? What do they do?

A

hepatocytes, detoxify, metabolize, store iron & vitamins

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17
Q

What does the hepatic vein bring blood from?

A

Out of the superior aspect of the liver into the Inferior Vena Cava

(Part 1 - Slide 5)

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18
Q

What is the classic lobule?

A

Hexagonal arrangement of hepatocytes

Part 1 - Slide 6

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19
Q

What do the portal areas (triads) at each corner contain?

A

Hepatic artery, portal vein, and bile canaliculus

Part 1 - Slide 6

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20
Q

Where does the central vein lie?

A

In the middle of the classic lobule

Part 1 - Slide 6

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21
Q

What is the more functional unit of the liver?

A

Liver Acinus

Part 1 - Slide 7

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22
Q

What does the hepatocyte efficiency depend on?

A

Proximity to blood supply

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23
Q

Of the three concentric zones incorporating portions of adjacent lobules, what does zone 1 & 3 receive?

A

1 - highest concentration of oxygen & nutrients

3 - least oxygen & nutrients, but is primary site of alcohol & drug detox (susceptible to hypoxia & toxic damage)

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24
Q

Where does plasma flow from?

A

Sinuosoids into space of Disse

25
Q

Where is the space of Disse located?

A

Btwn hepatocytes & endothelium of sinusoids

26
Q

Where is lymph sent to via channels?

A

Inferior vena cava or thoracic duct

27
Q

What is portal hypertension?

A

Back pressure of blood into portal circulation due to flow obstruction

28
Q

What are ascites?

A

Portal hypertension increases lymph flow into space of Disse, excess lymph seeps through the visceral layer of peritoneum & creates fluid build-up in the peritoneal cavity, drop in blood volume stimulates renal salt & water retention until blood volume is restored

29
Q

Where does hepatocytes secrete bile through?

A

Canaliculi towards the bile ducts

30
Q

What are the constituents of bile?

A

Bile acids, Phospholipids, Cholesterol
Bicarb (bile ducts via secretion, hepatocytes)
Bile pigments (bilirubin)

31
Q

What are the biliary ducts?

A

R & L hepatic ducts, common hepatic duct, cystic duct, common bile duct, hepatopancreatic ampulla, main pancreatic duct, major duodenal papilla

32
Q

What does the R & L hepatic duct do?

A

Bile outflow from liver

33
Q

What does the common hepatic duct?

A

Junction of R & L hepatic ducts

34
Q

What does the cystic duct do?

A

Outflow from gall bladder

35
Q

What does the common bile duct do?

A

Outflow of bile from gall bladder & liver

36
Q

What does the hepatopancreatic ampulla do?

A

Junction of bile & pancreatic ducts

37
Q

What does the main pancreatic duct do?

A

outflow from pancreas

38
Q

What does the major duodenal papilla do?

A

bile & pancreatic secretion into duodenum

39
Q

What are the parts of the gall bladder?

A

body, neck, & fundus

40
Q

How is bile stored?

A

Choledochal sphincter (of Oddi) creates backflow to fill gall bladder

41
Q

How is bile concentrated?

A

mucosa absorbs water

42
Q

How is bile released back into the duodenum?

A

CCK (released in response to fats) contracts GB wall, vagus nerve increases bile flow & contracts gall bladder

43
Q

What does CCK promotes?

A

gall bladder emptying, pancreatic secretion, gastric slowing, intestinal peristalsis

44
Q

What does secretin promote?

A

bicarb secretion from bile ducts, pancreatic ducts, brunner’s gland

45
Q

What are gall stone precipitates of cholesterol due to?

A

Excess absorption of water, excess absorption of bile salts & lecithin, excess secretion of cholesterol, inflammation of epithelium, and stasis of the gall bladder smooth muscle later

46
Q

What is bile necessary for?

A

digestion & absorption of lipids, elimination of endogenous products & exogenous substances

47
Q

What is the sequence of fat digestion?

A

Lipases hydrolyze TG into FFA, digested fats transported to enterocytes via biliary micelles, FFA reconverted to TGs, converted to chylomicrons, transport to blood

48
Q

What does bile emulsify fat into?

A

1 um soluble droplets

49
Q

What does pancreatic lipases do?

A

Hydrolyze TGs to glycerides & FAs

50
Q

What does Phospholipase A2 do?

A

hydrolyzes phospholipids

51
Q

What does cholesterol esterase do?

A

hydrolyzes cholesterol

52
Q

What is the structure of a micelle?

A

bile acids, phospholipids & cholesterol form lipophilic center that emulsifies fats into a form digestible by lipases

53
Q

What do micelles do?

A

transport & facilitate absorption of glycerides & FAs through mucosa

54
Q

Long chain FAs can pass through aqueous layer to reach what?

A

enterocyte membrane

55
Q

Where do FAs, glycerides, & cholesterol go?

A

FA & glycerides - re-synthesized into TGs

Cholest - absorbed & processed in free form

56
Q

What is enterohepatic circulation?

A

bile acids & salts are recycled back to the liver, most reabsorption is active transport in the ileum (less passive transport from rest of intestine), bile acids & salts are returned to the liver & reconjugated to tuarine & glycine.

57
Q

What are the four types of lipoproteins?

A

chylomicrons, VLDL, LDL, HDL

58
Q

Where are the lipoproteins produced?

A

Chylo - SI, VLDL - liver, LDL/HDL - plasma

59
Q

What do the lipoproteins do?

A

Chylo - transport fat into blood, VLDL - transport TG from liver to organs, LDL - transport cholest. ester from liver to organs, HDL - transport cholest. from tissues to liver

60
Q

What is bilirubin derived from?

A

hemoglobin (converted by colonic bacteria)