Liver, Gallbladder and Biliary Apparatus Flashcards
What does the liver weigh roughly?
1.5 kg
What is the surface marking of the midline of the liver?
Xiphoid process.
What is Morison’s pouch and what is its clinical significance?
A potential space between the visceral surface of the liver and right kidney.
Fluid collects here in a bedridden patient.
What cells are found in liver lobules?
HELPK
- hepatocytes
- endothelial cells
- liver associated lymphocytes
- perisinusoidal cells (fat-storing)
- kupffer cells (phagocytic macrophages)
What are the functions of the liver?
DIPSAE
- detoxification
- immune functions - produces complement proteins
- production of plasma proteins, enzymes and bile
- storage of glycogen, iron, vitamins ADEK
- amino acid, lipid and carb metabolism
- excretion of bilirubin from dead RBCs
What is the space of Disse?
Between hepatocytes and sinusoids where exchange occurs.
Name the 3 surfaces of the hepatocyte.
Sinusoidal
- hepatocytes and sinusoids (fenestrated capillaries)
Intracellular
- functional complexes between adjacent hepatocytes
Canalicular
- bile canaliculi between adjacent hepatocytes
What is the blood supply of the liver?
Hepatic artery - 30% of blood and 2/3 of oxygen.
Portal vein - superior mesenteric and splenic join to form this. Supplies 70% of blood flow.
Hepatic vein - drains into IVC.
What are the main sites of porto-systemic anastomoses?
Lower 1/3 of the oesophagus
- oesophageal branches of left gastric vein and oesophageal tributaries to azygous system
Paraumbilical area
- portal veins of liver with veins of anterior abdominal wall
Anal canal
- superior rectal veins with middle and inferior rectal veins.
Retroperitoneal
- portal tributaries of mesenteric veins and retroperitoneal veins
What veins form the portal vein?
Superior mesenteric and splenic veins
- tributaries by inferior mesenteric, gastric and cystic veins.
Describe the branches of the common hepatic artery.
Firstly, branches into proper hepatic and gasproduodenal.
Proper hepatic splits into right and left hepatic, and gives off cystic and right gastric arteries.
Gasproduodenal gives off right gastroepiploic and the superior pancreaticoduodenal artery.
Describe the organisation of the acini.
Functional unit of the liver.
Zone 1 - aerobic zone found closest to central vein
Zone 2 - undefined intermediate zone
Zone 3 - anaerobic zone furthest away from central vein
What epithelium is found in the gallbladder?
Simple columnar with microvilli
What is the vascular supply of the gallbladder?
Cystic artery and vein
Where are gallstones most likely to become impacted in the gallbladder mucosa?
Hartmann’s Pouch - mucosal fold in gallbladder neck.
