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Histo Exam 3 > Liver/Gallbladder/Pancreas > Flashcards

Liver/Gallbladder/Pancreas Flashcards

1
Q

what are the 6 main functions of bile?

A 
gluconeogenesis
detoxification
storage
plasma protein production
bile producion
transfer of IgA into bile canaliculi
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2
Q

in gluconeogenesis, what do you convert into glucose? (per Dr. Turek)

A

amino acids and lipids

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3
Q

in liver detox, what types of enzymes catalyze methylation, oxidation or conjugation of drugs/toxins/chemicals?

A

a system of microsomal mixed-function oxidase enzymes

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4
Q

what ends up getting stored in the liver?

A

glycogen, triglycerides, & vitamin A

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5
Q

what types of plasma proteins are produced from the liver?

A

fibrinogen, prothrombin, albumin, urea (which isn’t actually a protein), and acute phase proteins (proteins that increase in level during inflammation)

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6
Q

plasma proteins produced from the liver are (endocrine/exocrine) type secretions

A

endocrine

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7
Q

the production of bile from the liver is an example of (endocrine/exocrine) secretion from the (rER/sER/Golgi)

A

exocrin

sER

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8
Q

Afferent vessels to the liver include

A

hepatic artery (20-30%) & portal vein (70-80%)

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9
Q

what is the efferent vessel of the hepatocyte?

A

central vein

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10
Q

what is Glisson’s capsule and what is its function?

A

it’s a fibroconnective tissue capsule that subdivides the liver into lobes and lobules

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11
Q

liver is composed of parenchymal cells also called _______ that are arranged in anastamosing & branching plates

A

hepatocytes

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12
Q

hepatocytes have what abundant structures? (7)

A 
rER
sER
lysosomes
peroxisomes
mitochondria
glycogen deposits
lipid droplets
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13
Q

hepatocytes are arranged in a _________ arrangement around a ________ ____

A

hexagonal arrangement

central vein

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14
Q

hepatocytes can be (uni/bi/multi)nucleated with large nuclei

A

binucleated

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15
Q

hepatocyte nuclei normally (haploid/diploid) - but also some are (haploid/diploid/polyploid)

A

diploid, but also some are polyploid with several times the normal DNA amount

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16
Q

iver cells (will/won’t) divide if part of the liver is removed

A

will divide if part is removed

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17
Q

what key landmark of the liver is located around the lobules of liver?

A

portal canals/portal triads/portal area

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18
Q

what vessels are present in the portal canal?

A

branches of the portal vein, hepatic artery, & bile duct

lymph is only sometimes present

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19
Q

blood from vessels in the portal areas flow into what and empty into what?

A

flow in liver sinusoids and empty into central vein

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20
Q

sinusoids have (continuous/fenestrated/discontinuous) endothelial lined spaces located (in-between/within) plates of hepatocytes

A

sinusoids have discontinuous endothelial lined spaces located in-between plates of hepatocytes

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21
Q

liver sinusoid endothelial cells have large _____

A

fenestrations

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22
Q

where would Kuppfer cells be located and what are they?

A

sinusoids contain many Kupffer cells (phagocytic cells i monocyte lineage)

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23
Q

what is the space of Disse

A

subendothelial space between hepatocytes & sinusoid epithelium

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24
Q

a portal lobule is centered around what 3 adjacent structures?
this triangular area defines the flow of what

A

defined by 3 adjacent central veins

triangular area defines the flow of bile into bile duct

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25
Q

what the heck is the hepatic acinus of Rappaport

A

area centered around 2 adjacent central veins
defines metabolic gradient (remember Zones 1-3)
Zone 1 has most oxidative functions
Zone 2 intermediate
Zone 3 low O2 area, detox role, susceptible to hypoxia

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26
Q

what are intralobular cholangioles

A

intralobular cholangioles transport bile from portal lobules to bile ductules (of Hering) which go to Bile ducts

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27
Q

function of space of Disse?

A

functions in exchange of materials between the bloodstream and hepatocytes

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28
Q

what types of fibers and what types of cells does the space of Disse contain?

A

contains reticular fibers and possibly fat-storing cells (hepatic stellate cells/cells of Ito)

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29
Q

what is the role of hepatic stellate cells?

A

important for vit A storage/metabolism

produces collagen during disease (e.g. cirrhosis) in response to cytokines from Kupffer cells

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30
Q

bile flows in the (opposite/same) directino as blood

A

bile flows in opposite direction as blood

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31
Q

bile is an (exocrine/endocrine) secretion from hepatocytes

A

bile is an exocrine secretion

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32
Q

where are bile canaliculi

A

intercellular spaces between hepatocytes that receive bile -> travel towards portal lobules

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33
Q

general pathway of bile flow

A

hepatocytes > bile canaliculi > canals of Hering (small bile ductules) > bile ducts in portal areas > hepatic ducts > common hepatic duct > cystic duct > gallbladder

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34
Q

bile functions

A

excretion of cholesterol, phospholipids, bile salts, conjugated bilirubin, electrolytes
absorption of ft & fat soluble vitamins in intestine
IgA transport to intestine
excretion of drugs and heavy metals

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35
Q

where are bile acids resorbed? where do they go from there?

A

ileum; venous blood from ileum goes to portal vein & liver sinusoids and get picked up by hepatocytes => resecreted into canaliculi

36
Q

where are IgA antibodies made and where do they get complexed?

A

plasma cells in the intestinal mucosa make IgA > enters circulatory to go to liver > gets complexed with secretory components > secreted to bile (towards intestines)

37
Q

bile canaliculi are rich in what type of activity

A

ATPase activity

38
Q

what are:

MDR
MOAT
BAT

A

multidrug resistance transporters
multispecific organ anionic transporter
biliary acid transporter

ATP- dependent pumps that pump bile into the bile canaliculus

39
Q

genetic defect in MDR2 would cause

A

focal hepatic necrosis & bile ductule proliferation

40
Q

describe a method in which heme is excreted

A

splenic macrophages degrade RBCs
heme from RBCs converted to bilirubin -> blood
conjugated in blood with albumin (water soluble) to get to liver > in liver enters hepatocytes complexed to ligandin > (free bilirubin) in cytosol > conjugated bilirubin = glucuronic acid+free bilirubin > bile

41
Q

hepatitis

A

inflammmation of the liver

can be caused by viruses or toxic materials

42
Q

routes of hepatitis viruses

A

hep A - fecal/oral route
hep B - serum hepatitis through blood & blood products
hep C - also tansfusion related

43
Q

cirrhosis

A

degeneration & fibrosis of damaged hepatocytes

caused by poisoning, chronic alcohol use or bile duct obstruction; long term ETOH use => fatty liver

44
Q

what is steatosis

A

another name for fatty liver, associated with cirrhosis

45
Q

jaundice

A

excess bilirubin in blood, bile pigment in skin & sclera of eye (so yellowing of eyes & skin)
cause: liver dysfunction - obsructed bile passages, excess RBC destruction (hemolytic jaundice)

46
Q

congestive heart failure

A

increased central venous pressure causes liver to engorge with blood (hepatomegaly)

47
Q

obstructed blood flow (often associated with cirrhosis). leads to fluid accumulation in peritoneal cavity (ascites)

A

portal hypertension

48
Q

what frequently obstructs bile outflow from liver?

A

pancreatic carcinoma

49
Q

what type of bilirubin is toxic to brain

A

free bilirubin

50
Q

what is another way you can get hyperbilirubinemia

A

hemolytic disease such as erythroblastosis fetalis (blood group incompatibility between mom & fetus)

51
Q

relevant to the liver, how is alcohol metabolized?

A

alcohol dehyrdogenase or mixed-function oxidase (MFO) system

52
Q

alchohol dehydrgonase breaks down alcohol into what products (2)?

A

acetaldehyde & excess H+

53
Q

mixed-function oxidase systems break down alcohol into what products (2)?
what can one of these products induce?

A

acetaladehyde & reactive oxygen products

ROS can cause lipid peroxidation

54
Q

gallbladder functions in response to what hormone

A

cholecystokinin

55
Q

gallbladder mucosa is lined by what type of cells

A

simple columnar epithelium with numerous microvilli on apical surface

56
Q

below the gallbladder’s epithelium is a lamina propria. this lamina propria has what type of connective tissue?

A

loose CT

57
Q

the lamina propria of the gallbladder blends with what layer?

A

lamina propria blends with the “submucosa”

no true submucosa

58
Q

what layer is below the blend of lamina propria and submucosa in the gallbladder?

A

muscularis externa made up of thin fascicles of smooth muscle fibers

59
Q

key feature of the gall bladder?

A

diverticula of the epithelium = outpocketings of mucosa that form what appear to be epithelial lined cysts in the lamina propria

60
Q

what is another name for the diverticula of the epithelium?

A

Rokitansky-Aschoff sinuses

61
Q

the layer of the gallbladder that is attached to the tissue is the _____
the rest of the gallbladder that isn’t attached to the liver is instead covered by _____

A

adventitia

serosa

62
Q

what is another name for biliary calculi

A

gallstones

63
Q 
gallstone concretions (compact mass formed by mineral precipitation) is usually composed of what 
where are they usually found?
A

cholesterol crystals or also from calcium salts of bile (calcium bilirubinate)
found in gallbladder and bile duct

64
Q

the pancreas is an (exocrine/endocrine) organ

A

the pancreas is both. HAH

65
Q

how are the glands of the pancreas organized

A

gland enclosed in CT capsule that subdivides into lobules via septa

66
Q

the islets of Langerhans of the pancreas is the (exocrine/endocrine) portion and it has many different cell types

A

endocrine

67
Q

can you distinguish endocrine pancreas cell types with H&E? If not, then what would you use?

A

H&E doesn’t work. use Mallory-Azan stain to differentiate the 3 cell types

68
Q

Alpha cells produce?

how abundant are these cells?

A

glucagon

15-20%

69
Q

Beta cells produce?

how abundant are these cells?

A

insulin

60-70%

70
Q

Gamma cells produce?

how abundant are these cells?

A

they don’t exist in the pancreas. so none

71
Q

Delta cells produce?

A

somatostatin

~5%

72
Q

what is somatostatin’s function

A

inhibits hormonal release by neighboring secretory cells

73
Q

Epsilon cells produce?

A

produce ghrelin

<1%

74
Q

what is the function of ghrelin?

A

stimulates appetite

75
Q

PP cells (F cells) produce?

A

pancreatic polypeptide

~10%

76
Q

what is the function of pancreatic polypeptide/

A

inhibits release of exocrine pancreatic secretions

77
Q

what are the secretions of the exocrine pancreas
which of these enzymes are secreted in response to cholecystokinin and which are secreted in a proenzyme form?

(note: cholecystokinied is secreted by enteroendcrine cells)

A 
* = in response to cholecystokinin; ` = proenzyme form
amylase*
lipase*
ribonuclease*
deoxyribonuclease*
trypsin`
chymotrypsin`
carboxypeptidase`
elastase`
78
Q

what happens if instead of being activated in the intestine, the proenzymes were activated in the pancreas?

A

pancreatitis

79
Q

intercalated duct cells secrete large quantities of what?

in response to what (which is produced by what?)?

A

intercalated duct cells secrete large quantities of enzyme poor alkaline fluid (bicarbonate)
in response to secretin (produced by intesetinal enteroendocrine cells)

80
Q

what’s the duct system for the pancreas?

A 
intercalated ducts (centroacinar cells) -> 
intralobar ducts (cuboidal epithelium) ->
interlobular ducts (surrounded by lots of CT)-> 
main pancreatic duct
81
Q

Type I diabetes mellitus is insulin (dependent/independent)

A

Type I diabetes is insulin dependent

82
Q

Type I diabetes is characterized by

A

low levels of plasma insulin,
polydipsia (excessive thirst),
polyuria (excessive urination),
polyphagia (instatiable hunger)

83
Q

Type II diabetes mellitus is non-insulin dependent and is characterized by

A

usually overweight individuals over 40
normal insulin levels or impaired insulin release,
decreased insulin receptors,
faulty post-receptor signaling

84
Q

what is a significant component to insulin resistant diabetes?

A

muscle insulin resistance

85
Q

what is HIS in relation to type 2 diabetes?

A

hepatic insulin resistance

due to faulty signaling through docking molecules that connects insulin to downstream cascades

86
Q

pancreatitis

most frequent cause?

A

inflammation of pancreas

often due to gallstones

87
Q

acute necrotizing pancreatitis

A

due to infection, gallstones, drugs, trauma

proenzymes may be activated - digest pancreatic tissues

Histo Exam 3 (6 decks)

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