Liver, Gallbladder, Spleen

Question 1

What vitamins and minerals are stored in the liver

Answer 1

Vitamins: A, D, E, K, B12

Minerals: Fe and Cu

Question 2

True/False most clotting factors are synthesized in the liver

Answer 2

True

Question 3

What is another name for Kuppfer cells and what do they do

Answer 3

Aka=Stellate reticuloendothelial cells

Fx= phagocytize aged RBC’s, WBC’s and bacteria

Question 4

Besides digestion of lipids what else does the bile do

Answer 4

used to deposit endogenous and exogenous waste products

Question 5

The liver receives blood from what 2 sources

Answer 5

• Hepatic artery: 25% of blood

- Portal vein: 75% of blood

Question 6

What is the function of hepatocytes

Answer 6

Makes 80% of liver

Cell layer that separates sinusoidal blood from canalicular bile

Location of synthesis of

• transport proteins like albumin
• lipoproteins, FAs, TAGs, cholesterol
• Bile

Question 7

What are the hepatic sinusoids

Answer 7

Highly permeable blood capillaries between rows of hepatocytes that receive blood from both the hepatic artery and the portal vein

Question 8

What is the major functional unit of the liver

Answer 8

hepatic lobules, hexagonal in shape w/ a central canal

Question 9

What are the portal tirades

Answer 9

area found at the corners of the lobules that contain a bile duct, branch of hepatic artery, and branch of the portal vein

Question 10

Does bile flow towards or away from the central canal

Answer 10

away from the central canal

Question 11

Does blood (arterial and venous) flow towards or away from the central canal

Answer 11

towards the central canal

Question 12

What is the progression of alcoholic cirrhosis and what are the final signs/symptoms

Answer 12

Progression: fatty liver->fibrosis-> cirrhosis

Signs/symptoms: jaundice, nausea, malaise, ascites, hepatic encephalopathy, renal failure, then death

Question 13

Describe the biliary tree starting from the bile ducts inside the liver

Answer 13

Bile ducts inside the liver->common hepatic duct -> cystic duct and common hepatic duct merge to form common bile duct-> common bile duct merges with pancreatic duct (Wirsong duct) to form ampulla of Vater

Question 14

When are bile acids considered bile salts and why does this happen

Answer 14

When they conjugate with taurine or glycine in the liver

bile salts are more water soluble than bile acids

Question 15

What are bile acid sequestrants

Answer 15

Rx that work to sequester bile acids before they can be used to emulsify lipids, thought to lower cholesterol levels

examples: colestipol, cholestyramine, colesevelam

Question 16

Where is bilirubin produced

Answer 16

degradation of heme-containing proteins

-80% produced by RBC’s

Question 17

Can bilirubin cross the blood brain barrier

Answer 17

yes can cross the BBB and it can be deadly if left to accumulate

Question 18

Describe the synthetization of bilirubin in bile

Answer 18

Synthesized by Kuppfer cells of the liver and reticuloendothelial of the spleen

1. Heme oxygenase liberates iron from heme which produces biliverdin (green)
2. Biliverdin gets reduced to yellowish bilirubin (unconjugated bilirubin)
3. If in the spleen bilirubin attaches to albumin and once it gets to the liver it gets conjugated and released into the bile along with some unconjugated bile
4. In the small intestine conjugated bilirubin is converted by bacterial enzymes to urobiligen (yellow) which is either reabsorbed and sent to the kidneys to be excreted or it continues in the large intestine to be further oxidized to stercobilins (brown)

Question 19

Buildup of the mostly unconjugated bilirubin in extracellular space is called what

Answer 19

Jaundice

Question 20

How can you differentiate between hemolytic jaundice vs obstructive jaundice

Answer 20

hemolytic jaundice= high unconjugated bilirubin and increased urobilinogen

obstructive jaundice= conjugated bilirubin in the blood is high, low urobilinogen in urine

Question 21

How is physiologic jaundice treated

Answer 21

blue wave lengths of light

Question 22

What is the function of the gallbladder

Answer 22

store and concentrate bile

Question 23

What is the function of the spleen

Answer 23

Important part of immune system, tissue repair (reservoir of monocytes), hematopoiesis in fetal development (only in extreme cases of anemia does this happen after birth), RBC and platelet destruction