Liver Histology (digestive System) Flashcards

1
Q

Anatomy pills

A

-The liver is the largest organ of the body.

-Its structural and functional unit is the hepatic lobule

-Intraperitoneal organ: enveloped by 2 layers of peritoneum (visceral and parietal)
-The liver is also held in place by different types of
mesenteries: lesser omentum, falciform ligament…

-The liver has capsule: Glisson’s capsule
-It’s innervated by intercostal nerves
-In case of inflammation and distension of the liver, the nerves can sense it and inform us of possible damage

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2
Q

Portal tract

A

The portal tract includes all the structures entering and leaving the liver:

1)Hepatic artery proper: responsible for providing 25% of
the blood directed to the liver
-It carries highly oxygenated blood
2)Portal vein: responsible for providing 75% of the blood that enters the liver
-It comes from the GIT and it carries blood rich in nutrients, together with toxins, bacteria drugs, alcohol
3)Hepatic plexus: provides innervation to the liver
-Made of sympathetic and parasympathetic fibers from
the celiac ganglia and the Vagus nerve, respectively
4)Lymphatic vessels: drain excess of intracellular fluid
from the liver
-The lymphatic vessels eventually drain into the celiac lymph nodes
5)Bile duct: receives all the bile produced by the liver
-The bile is important in several metabolic processes,
such as the emulsification of fats
-The bile also contains the metabolites that need to be
excreted from the body

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3
Q

Hepatic lobule

A

Structural and functional unit of the liver.

-It’s composed of hepatocytes

-it has a hexagonal shape
-At each pole: hepatic triad, which is composed by 3 different structures:
1)Hepatic arteriole: branch of the hepatic artery
2)Portal venule: tributary of the portal vein
3)Bile duct
-The hepatic triad is visible under microscope
-In reality, also lymphatic vessels are present, but they’re not visible under microscope
-The triad + lymphatic vessels: portal
tetrad
-From each pole, the hepatic artery and the portal vein both open into sinusoidal capillaries
-They are fenestrated capillaries, found in the
liver, spleen and bone marrow
-They also contain Kupffer cells
-The sinusoidal capillaries eventually drain inside
the central vein
-Found at the center of the hepatic lobule
-The blood flow is centripetal
-Many central veins from different lobules can meet
and fuse, forming interlobular veins
-Many interlobular veins together will form the hepatic veins, that eventually leave the liver and drain inside the Inferior vena cava

  • Inside the lobule, there’s another cell population called stellate cells
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4
Q

Lobules are mostly composed of..

A

Hepatocytes

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5
Q

Between lobules aplical membrane there are…

A

Bile canalculi which collect bile produced by hepatocytes

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6
Q

Between sinusoidal capillaries and hepatocytes of lobules are…

A

Perisinusoidal space of Disse

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7
Q

Circulation inside the liver

A

Portal venule and hepatic arteriole
➡️sinusoidal capillaries➡️certain vein

-Hepatic arteriole: carries highly oxygenated
blood (95%)
-O2 is released from hemoglobin so it can diffuse to the hepatocytes located around the capillaries
-In exchange, the capillary blood receives the waste products of the hepatocytes: bicarbonate, protons and CO2

-Portal venule: carries blood rich in nutrients, but also containing bacteria and toxins
-They are eliminated by the Kupffer cells

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8
Q

Macrophages of lobules found inside…

A

Sinusoidal capillaries

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9
Q

Macrophages of lobules found inside…

A

Sinusoidal capillaries

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10
Q

Macrophages of lobules functions:

A

1) control immunointolerance-inhibition of CD8 cells and cytotonic cells
2) elimination of bacteria
3)eimination of paracytes
4) elimination of olderythrocytes

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11
Q

How do Macrophages (kupffer cells) of lobules eliminate bacteria?

A

-The Kupffer cells will form pseudopods to phagocyte
the bacteria
-The bacteria is contained inside phagosomes
inside the cell
-Eventually the phagosome will fuse with lysosomes → phagolysosome
-Will breakdown the bacteria through its enzyme

-Gram- bacteria produce an endotoxin called lipopolysaccharide (LPS)
-Kupffer cells have TLR-4 receptor and CD14 on their surfaces: allows them to recognize LPS and bind to it
-The binding causes the activation of a cascade inside the Kupffer cell → release of cytokines (TNF-α, IL-1, IL-6, ROS, TGF-β, NO, prostaglandins) → promote inflammatory response

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12
Q

How does macrophages of lobules eliminate old erythrocytes?

A

Average lifespan: 100-120 days
-After, the red blood cells start losing flexibility and
pliability and has to be degraded
-Kupffer cells will recognize an old red blood cell and break into its 2 components:
-Globin: proteic portion, further degraded into Amino Acids by other enzymes
-Heme group: broken down into biliverdin and then bilirubin + iron
-Bilirubin will be conjugated inside the hepatocytes, so it can enter the biliary system and form the bile

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13
Q

Stellate cells of lobules

A

-Store vitamin A + fat

-Usually quiescent
-Can become active in case of damage to the liver tissue → become myofibroblasts
-Produce collage type I
→ causes liver vessels to become very fibrotic
→ narrows the blood vessel wall
→ flow is impeded
→ blood starts to backflow
→ leads to portal

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14
Q

Hepatocytes contain

A

-Bile salts: 70% of bile, include bile salts,
conjugated bile salts and bile acids
-Phospholipids
-Bilirubin: gives pigmentation
-Cholesterol

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15
Q

Hepatocytes of lobules

A

Makes of 80% of liver parenchyma

Responsible for producing bile

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16
Q

Hepatocytes contain

A

-Bile salts: 70% of bile, include bile salts,
conjugated bile salts and bile acids
-Phospholipids
-Bilirubin: gives pigmentation
-Cholesterol

17
Q

Hepatocytes contain

A

-Bile salts: 70% of bile, include bile salts,
conjugated bile salts and bile acids
-Phospholipids
-Bilirubin: gives pigmentation
-Cholesterol

18
Q

Hepatocytes have 2 faces

A

Basolateral membrane: presents microvilli to increase the surface area
-In contact with capillary system

Apical membrane: where the bile canaliculi are found

19
Q

Between basolateral membrane and apical membrane:

A

Between 2 juxtaposed cells there’s a point where the apical membranes fuse → creates a gap that forms the bile canaliculi
-Where the hepatocytes will released the
bile produced
-From the canaliculi, the bile continues in left and right bile ducts
➡️common hepatic bile duct
➡️fuses w/cyctic duct
➡️common bile duct

20
Q

Structures of hepatic lobule:

A

-classic lobule
-portal lobule
-acinus lobule

21
Q

Classic lobule

A

Centripetal 🩸 flow
-From the hepatic arteriole and the portal venule to central vein

22
Q

Portal lobule

A

Considers direction of bile flow
-Considering a triangle between 3 central veins of 3 different lobules → at the center of this triangle there will be a triad, with a bile duct
-Bile flows from each pole of the triangle (central vein) towards the bile duct at the center → centrifugal direction

23
Q

Acinus lobule

A

Considers flow of oxygen rich 🩸

-From portal triad to central vein: it creates zones
-Forms a rhomboid structure between 2 hepatocyte
-Zone 1: periportal, next to the triad
-Receives the blood richest in oxygen →most resistant to circulatory problems
-Zone 2
-Zone 3: perivenular
-Receives the blood with lowest partial pressure of O2 → will undergo necrosis and ischemia first in case of circulatory problems

24
Q

Zone heterogeneity of acinus lobule

A

-Zone 1: ↑O2 → oxidative pathways
- Amino acid metabolism, gluconeogenesis,
cholesterol synthesis, bile salt synthesis, urea genesis, beta-oxidation…
-Zone 2: intermediate zone, perform functions in- between zone 1 and zone -Zone 3: ↓O2 → non-oxidative pathways
-Glycolysis, fatty acid synthesis, ketogenesis, glutamine synthesis, xenobiotic metabolism…

These zones also present different mRNA, since they require different enzymes to carry out their functions