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AP0408 > Liver & Kidney > Flashcards

Liver & Kidney Flashcards

1
Q

List and describe the function of some of the main structures of he liver

A
  1. Hepatic artery- Blood supply
  2. Bile canaliculi- Bile from liver cells to bile duct
  3. Bile duct- Takesble to gall bladder
  4. Branch of hepatic artery- O2 supply of liver
  5. Hepatocyte- Liver cells
  6. Kupffer cells- Engulf bacteria
  7. Sinusoids- Capillaries
  8. Central vein- Joins hepatic vein, which joins the inferior vena cava
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2
Q

List the 3 component software the portal triad

A
  1. Hepatic artery
  2. Hepatic portal vein
  3. Bile duct
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3
Q

What organ des the liver have the same wight as?

A

Brain

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4
Q

Describe tissue remodelling in an adult liver

A

Only gland in the body that can regenerate itself
Peptide growth factors stimulate hepatic DNA synthesis which trigger liver cell growth and development

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5
Q

Describe how the liver volume can be decreased

A

Toxicity- From drug overdose and traumatic processes leading to necrosis
Apoptosis- Programmed cell death to preserve other cell membranes, occurs through tumour necrosis factor

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6
Q

How does blood flow through the liver and back to the heart?

A
  1. Oxygenated blood from hepatic artery and nutrient rich, deoxygenated blood from the hepatic portal vein
  2. Liver sinusoids
  3. Central vein
  4. Hepatic vein
  5. Inferior vena cava
  6. Right atrium of heart
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7
Q

Describe CHO metabolism and the maintenance of blood glucose levels in the liver

A

Prior to eating, gluconeogenesis occurs transfering glycogen, amino acids lactic acid etc to glucose
After eating a meal BGL inc to between 6.6-8.3 mmol/l
This triggers gylcogenesis which converts glucose to glycogen and trigylcerides for storage

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8
Q

What hormone trigger CHO storage?

A

Insulin

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9
Q

What triggers Gluconeogenesis?

A

Glucagon and Adrenaline

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10
Q

Describe lipid metabolism in the liver

A

Triglycerides are stored
Fatty acids are broken down into ATP
Lipoprotein synthesis occurs- LDL and HDL takes cholesterol from the liver to the tissue where its needed
Cholesterol is synthesised- For bile sal production

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11
Q

Describe protein metabolism is the liver

A

Hepatocytes remove NH2 from amino acids which is used form ATP production or CHO/ fat synthesis

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12
Q

What 3 nutrients does the liver store?

A

Glycogen
Some fats
Vitamins
Minerals- i.e Iron and Copper

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13
Q

What are the main functions of vitamins A, B, D, E and K

A

A- visions growth and epithelial maintenance
B12- production of RBC’s
D- calcium absorption in gastrointestinal tract
E- antioxidant
K- blood clotting

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14
Q

What synthesis processes is the liver involved in?

A

Bile salts- Used in small intestine for emulsification of fats
Vit D3- To partially active form of vit 25-hydroxyvitamin D3, which regulates Ca2+ levels
Plasma proteins- Globulins, albumin, fibrinogen

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15
Q

How is blood clotting synthesised in the hepatocytes?

A
  1. Amino acid arrives at rough ER
  2. Precursor of prothrombin uses CO2 and Vit K to become activated
  3. Prothrombin produced, which has to be converted to thrombin in the prescence of thromboplastin and Ca ions during blood clotting
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16
Q

Describe iron homeostasis at the kupfer cells and hepatocytes

A
  1. Damaged RBC arrives and moves inside cell
  2. Lysosome converts it to a heme
  3. Broken down into microsomal heme oxygenase
  4. Moved to free iron pool which stimulates ferritin synthesis
  5. Free iron goes to apotransferin
17
Q

How is the liver involved in detoxification?

A

Converting ammonia- urea
Converting Haem from aged RBC- Bilirubin- bile
Alcohol eventually detoxified into CO2 and H20
Drugs (inc penicilllin) excreted into bile
Thyroid and steroid hormones chemically altered so they can be water soluble

18
Q

Outline drug metabolism

A

Phase 1 occurs in the smooth endoplasmic reticulum of the liver
Starts wiht NADPH enzyme which encorporates drug an enzyme and O2
Eventually H2O is produced, with the other oxygen atom combining with the drug product to make it water soluble
Phase 2- drug is converted to a hydrophilic, non-toxic compound, which the kidney can excrete

19
Q

What are the 3 stages of alcohol induced liver disease?

A

Fatty liver- fat deposits cause liver enlargement
Liver fibrosis- scar tissue forms, recovery is still possible at the stage
Cirrhosis- Growth of connective tissue destroys liver cells and the damaged irreversible

20
Q

What is the main purpose of the gall bladder?

A

To store bile produced by the liver

21
Q

List and describe the 4 functions of the gallbladder

A

Sodium glycocholate and taurochlorate- Emulsify fats in the small intestine
Bile salts make fatty acids soluble- The can then be reabsorbed through the intestinal wall
Bilirubin- converts microbes in small intestine to urobilinogen, then to stercobilin which is excreted in faeces
Stercoblin- colours and deodorises faeces

22
Q

How is bile secretion controlled?

A

Parasympathetic impulses along vagus nerves stimulate bile production by the liver
Fatty nd amino acids in chyme entering Duoderm stimulate the secretion in CCK into blood
CCK causes contraction of gallbladder

23
Q

What causes gall stones?

A

Insufficient idle salts or excessive cholesterol, that can obstruct bile flow to the Duoderm

24
Q

What are the 3 main functions of the urinary system?

A

Excretion
Elimination
Blood volume and pressure regulation

25
Q

What are the 8 important functions of the kidney?

A
  1. Eliminate metabolic waste products
  2. Regulation of blood plasma ion content
  3. Regulation of plasma osmotic pressure
  4. Acid base balance – excrete H+ when excess acid in plasma
  5. Regulate ECF volume by controlling Na+ and H2O excretion
  6. Regulate arterial blood pressure (Renin synthesis) 7. 7. Eliminate some drugs
  7. Degrade some hormones
26
Q

List the path of urine drainage

A

Papillary duct in renal pyramid
Minor calyx
Major calyx- where primary urine collects
Renal pelvis
Ureter
Urinary bladder

27
Q

What is the nephron?

A

Known as the functional unit of the kidney
Aprox 1 million per kidney

28
Q

List the components of the nephron and their functions

A

Spread across 3 parts of the kidney:
1. Cortex:
Juxtaglomerular apparatus
Connecting, Distal and proximal convoluted tubule
Renal corpuscle contains Bowman’s capsule (reduction of filtrate)
2. Outer medulla:
Outer medullary collecting duct
Thick ascending (Na+/ Cl- is reabsorbed) and descending thin limb (reabsorption of water)
3. Inner medulla:
Ascending limb
Papillary and inner medullary collecting duct (reabsorption of H2O and ion secretion

29
Q

List the flow of blood through the kidney

A

Renal artery
Segmental arteries
Interlobar arteries
Arcuate arteries
Interlobular arteries
Affront arteries
Glomerular capillaries
Efferent arterioles
Peritubular capillaries
Interlobular veins
Arcuate veins
Renal veins

30
Q

How is waste eliminated?

A

Glomerular filtration in the kidney tubules

31
Q

Outline glomerular filtration

A

Occurs in Renal corpuscle
Bowman’s capsule spirals round capillaries to form a filtration barrier
Blood pressure forces fluid and solutes out of the glomerular capillaries
Blood leaves via afferent arteriole so that it doesn’t end up in the urine

32
Q

What determines a molecules “filter ability”

A

Size and shape
Free filtration for H2O and small solutes up to 10kDa

33
Q

How is the glomerular filtrate rate regulated?

A
  1. Arterial blood pressure is elevated
  2. GFR inc
  3. Receptors inc delivery of Na+ Cl- and water
  4. Juxtaglomerular apparatus act as a control centre to dec secretion of nitric oxide
  5. Afferent arteriole constricts which dec blood flor through the glomerus, which dec GFR
  6. Returns to homeostasis when response brings GFR back to normal
34
Q

List some of the causes of reduced GFR

A

Heart failure- Dec renal blood flow
Massive blood loss- Hypoperfusion of kidneys
Hypertension arterioles- constriction of afferent
Glomerular inflammation- Acute glomerular nephritis

35
Q

Describe reabsorption and secretion along the renal tubule

A

In the PCT:
To regulate pH H+ is absorbed
Glucose, aa’s, 70%of Na, K, Ca and phosphate move out
In the Loop of Henle:
H2O moves is reabsorbed into blood
In the thick ascending limb:
Na+, Cl- and Ca2+ are reabsorbed
In the DCT:
Reabsorption of H2O, Na+ and Ca2+ 7 P-, Ned r the influence of ADH
K+ and H+ moves in
In the collecting duct:
NA, CL, H2O, HCO3 is reabsorbed
K,H and NH3 moves in

36
Q

How does glucose affect reabsorption?

A

Blood con go glucose above 200m/l= Diabetes
Renal symptorter cannot operate quickly enough o r absorb all glucose entering the glomerular filtrate
Excessive glucose in filtrate inhibit water reabsorption
This results in polyuria, dec blood volume and dehydration

37
Q

Describe water balance and the production of urine in the kidney

A

ADH (produced in the hypothalamus) stimulates reabsorption of water in the ascending loop of henle
If you drink lots ADH is inhibited
If dehydrated- hyper osmotic urine is produced

AP0408 (8 decks)

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