Liver Histology Flashcards

1
Q

Name 5 functions of the liver

A

Secretes products that aid digestion of macromolecules and absorption of nutrients in small intestine
* Bile is produced in liver and released into duodenum via the common bile duct
* Helps solubilizes, digest and absorb lipids
* Contains waste products – bilirubin and cholesterol

Receives and processes nutrients from small intestines

Synthesises and degrades plasma proteins

Detoxifies drugs and toxins

Stores glycogen and release glucose

Conversion of T4 to T3

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2
Q

Describe the structural organisation of the liver

A

Hepatocytes are arranged in lobules (that appear hexagonal in X section)

At (6) points around of lobule: portal triad:
* Hepatic artery
* Portal vein
* Bile duct

Centre of lobule: central vein
* Blood flows from hepatic artery & portal vein into central vein

Hepatocytes are in sinusoids between the portal triads and central vein

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3
Q

What is the CT like in liver?

A
  • Very little
  • Sinusoids are supported by collagen type III
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4
Q

Liver lobule structure:

What are the 3 zones in a liver lobule? [3]

Where are the 3 zones located in relation ot the portal triAd?

Differences in appearance between the 3 zones? [3]

A

Liver lobule structure:

All have different metabolic activities

What are the 3 zones in a liver lobule? [3]
* Zone 1: oxygenated blood
* Zone 2: medium oxygenated blood
* Zone 3: less oxygenated blood

Where are the 3 zones located in relation ot the portal triAd?
Zone 1: closest to portal triad: lighter purple
Zone 3: futhest to portal triad: deeper purple

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5
Q

What are the different functions of zone 1 c.f. zone 3 hepatocytes?

A

Zone 1 = oxidative/phase II reactions, gluconeogenesis and glycogen synthesis and, proteosynthesis and bile salt formation

Zone 3 = anaerobic/phase I reactions, glycogen stores (glycolysis), fat stores (lipolysis) and pigment store and glutamine synthesis

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6
Q

Label A-C

A
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7
Q

What is the cell structure like of bile ducts?

Simple squamous
Simple cuboidal
Simple columnar
Stratified squamous
Stratified columnar

A

What is the cell structure like of bile ducts?

Simple squamous
Simple cuboidal
Simple columnar
Stratified squamous
Stratified columnar

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8
Q

Which is bigger: portal vein or hepatic artery?

A

Which is bigger: portal vein or hepatic artery?

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9
Q

Label A-C

A
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10
Q

Describe how blood reaches the central vein

A

Blood from hepatic artery and portal vein mix and flow toward central vein through sinusoids

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11
Q

Sinusoids have:

continuous endothelium
discontinuous endothelium
fenestrated endothelium

A

Sinusoids have:

continuous endothelium
discontinuous endothelium
fenestrated endothelium

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12
Q

What is secreted at the apical surface of hepatocytes? [1]

Which way does the basolateral surface of the hepatocytes face in relation to the sinusoids? [1]

A

What is secreted at the apical surface of hepatocytes? [1]
Bile secretion into lumen on bile canaliculi

Which way does the basolateral surface of the hepatocytes face in relation to the sinusoids? [1]
Basolateral membrane faces the sinusoid: where materals absorbed / excreted

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13
Q

Label A-C

A
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14
Q

What is the name of the resident macrophages in the liver? [1]

Where exactly do they live? [1]

A

What is the name of the resident macrophages in the liver? [1]
Kupffer cells

Where exactly do they live? [1]
Lumen of sinusoids

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15
Q
A
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16
Q

The gap between the endothelium and the hepatocytes is called WHAT? [1]

A

The gap between the endothelium and the hepatocytes = space of Disse

18
Q

Hepatocytes secrete bile into WHAT? [1]

A

Hepatocytes secrete bile into canaliculi

19
Q

Canaliculi are joined by which type of junctions between adjacent hepatocytes?

Gap junctions
Desmosomes
Fascia Adherens
Tight junctions

A

Canaliculi are joined by which type of junctions between adjacent hepatocytes?

Gap junctions
Desmosomes
Fascia Adherens
Tight junctions

20
Q

Describe the passage of bile into gallbladder

A
  • Hepatocytes secrete bile into canaliculi
  • The canaliculi are defined by tight junctions between adjacent hepatocytes
  • Bile flows through these narrow tubes towards the hepatic (bile) duct
  • From the bile duct it flows into the biliary tree out of the liver to the gallbladder or intestines
21
Q

Label A&B

22
Q

Describe the structure of gallbladder cells

A

Characteristic features:
* Irregular shaped villi
* Lined with very tall columnar epithelial cells
* Smooth muscle in the wall contracts under influence of hormone cholecystokinin
* Expels bile into duodenum

23
Q

Describe the structure of gallbladder cells

A

Characteristic features:
* Irregular shaped villi
* Lined with very tall columnar epithelial cells
* Smooth muscle in the wall contracts under influence of hormone cholecystokinin
* Expels bile into duodenum

24
Q

Smooth muscle in the gall bladder wall contracts under influence of which hormone? [1]

Where is it secreted from? [1]

A

Smooth muscle in the gall bladder wall contracts under influence of hormone cholecystokinin: from duodenum

25
Describe the histopathological changes that occur due to cirrhosis? What effect does this have?
Parts of the liver are repeatedly destroyed and **replaced with type 1 collagen and type 3 collagen from hepatic stellate cells** at the expense of the hepatic architecture This scarring disrupts the sinusoids and this results in the **backup of blood in the portal vein and portal hypertension**
26
Which pro-inflam makers are produced when cirrhosis occurs? [3]
Chronic inflammation (**TNF alpha, TGF beta, IL1** from Kupffer cells, endothelial cells, bile duct cells and hepatocytes)
27
Describe the histopathological changes that occur from steatosis (fatty liver disease)
Steatosis is the pathological retention **of lipid in hepatocytes** Lipids accumulate in lipid droplets that can eventually **displace the nucleus of hepatocytes**
28
Explain how alcoholism can induce steatosis?
Alcoholism can also induce steatosis because the metabolism of ethanol produces **NADH** which shifts the metabolism of **hepatocytes** toward **lipid synthesis** * Hepatocyte swelling and necrosis * If chronic then fibrosis
29
Describe the histopathological changes that occur from cholestasis and why they occur [2]
Cholestasis is a **pathological accumulation of bile within the liver parenchyma** It results from **blockage of bile ducts** or d**efects in bile secretion by hepatocytes** In this image, note the presence of bile in the ducts and cytoplasm of cells
30
What are cholelithiasis? [1]
Gall stones
31
What are cholelithiasis / gall stones made from: - 80% of time - 20% of time
What are cholelithiasis / gall stones made from: - 80% of time: **cholesterol stones** - 20% of time: **pigment stones**: bilirubin calcium salts
32
Where specifically do gallstones impact? [1]
Gallstones impact at **neck** just proximal to cystic duct
33
Describe the histopathological changes seen in: - chronic cholecystitis - acute cholecystitis
cholecystitis: inflammation of the gallbladder **Chronic**: * Inflammatory infiltrates (T-lymphocytes predominantly * Hypertrophy of muscularis * Metasplasia – intestinal types including goblet cells etc **Acute**: * Sudden gallstone physically blocking cystic duct
34
Which pathology is depicted here? Cholecystitis Cholestasis Steatosis Cirrhosis
Which pathology is depicted here? Cholecystitis Cholestasis **Steatosis** Cirrhosis
35
Which pathology is depicted here? Cholecystitis Cholestasis Steatosis Cirrhosis
Which pathology is depicted here? **Cholecystitis: chronic** Cholestasis Steatosis Cirrhosis
36
Which pathology is depicted here? Cholecystitis Cholestasis Steatosis Cirrhosis
Which pathology is depicted here? Cholecystitis **Cholestasis** Steatosis Cirrhosis