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LSS Alimentary System > liver lecture > Flashcards

liver lecture Flashcards

1
Q

gross anatomy

A

present in upper right and left quadrants

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2
Q

what protects liver

A

thoracic ribcage

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3
Q

where does liver lie

A

very near diaphgram

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4
Q

4 lobed structure

A

right, left

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5
Q

what separates right and left lobe and attaches to diaphragm

A

falciform ligament

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6
Q

caudate lobe

A

in middle

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7
Q

quadrate lobe

A

bottom

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8
Q

blood delivery

A

hepatic portal vein, hepatic artery proper

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9
Q

blood removal

A

hepatic vein (into inferior vena cava)

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10
Q

couinaud classification

A

8 functionally independent segments - each can be resected without damaging those remaining

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11
Q

functional segments

A

centrally (portal vein, hepatic artery, bile duct), peripherally (hepatic vein)

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12
Q

blood supply

A

25% of resting cardiac output

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13
Q

dual blood supply

A

20% arterial blood from hepatic artery (left and right branches); 80% venous blood draining from gut through hepatic portal vein

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14
Q

where does blood from liver drain into

A

inferior vena cava via hepatic vein

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15
Q

purpose of dual blood supply

A

hepatic artery provides oxygenated blood to allow function as hepatic portal vein has low oxygen concentration - anything absorbed by gut must pass through liver before entering systemic circulation

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16
Q

micro-anatomy structures: morphological

A

lobules, portal tracts/triads

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17
Q

micro-anatomy structures: functional

A

acinis, blood flow, bile flow

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18
Q

lobule shape and structures on outer section

A

hexagonal, portal triad (hepatic portal vein branch, hepatic artery branch, bile duct)

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19
Q

where does blood from hepatic portal vein and artery mix

A

sinusoid - absorbed nutrients into hepatic cells, then to internal central canal; bile duct secretes bile to external

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20
Q

hepatocytes from external to internal

A

periportal to centilobular

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21
Q

where are portal tracts

A

around edges of adjoining lobules

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22
Q

4 key roles in liver

A

digestion, storage and biosynthesis, energy metabolism, degradation and detoxification

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23
Q

cell types of liver

A

hepatocytes (80% of mass), endothelial cells (line blood vessels and sinusoids), cholangiocytes (line biliary structures), Kupffer cells (fixed phagocytes), hepatic stellate cells (vitamin A storage cells, may be activated to fibrogenic myofibroblastic phenotype)

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24
Q

Kupffer cells or hepatic stellate cells

A

flattened, dense cell nuclei that appear to be in sinusoids

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25
Q

hepatocytes

A

large cells with pale and rounded nuclei

26
Q

hepatocytes

A

cords (sheets) of hepatocytes radiating from central vein

27
Q

acinus

A

functional unit less clearly defined - 2 adjacent 1/6ths of lobules

28
Q

acinus zones

A

1 (closest to portal triad), 2, 3 (closest to vein)

29
Q

acinus zone most susceptible to ischaemia

A

zone 3

30
Q

acinus zone most susceptible to viral hepatitis

A

zone 1

31
Q

what produces bile

A

hepatocytes

32
Q

where does bile flow

A

along canaliculus to bile duct (opposite direction to blood flow)

33
Q

non-parenchymal cells

A

Kuppfer cells, endothelial cells, hepatic stellate cells

34
Q

hepatic stellate cell

A

vitamin A storage, when activated produce ECM (fibrogenesis); respond to pro-inflammatory environments, laying down excessive ECM, promoting fibrosis and cirrhosis (loss of functional liver tissue replaced by fibrotic tissue)

35
Q

sinusoidal endothelial cell

A

fenestrated to allow lipid and other large molecule movement to and from hepatocytes

36
Q

Kupffer cell

A

phagocytosis including erythrocyte breakdown, secretion of cytokines promoting hepatic stellate cell activation, causing proliferation, contraction and fibrogenesis

37
Q

glucose metabolism

A

increase after meal, taken up by liver and muscle to be stored as glycogen (24 hours) then gluconeogenesis

38
Q

hepatocyte glucose metabolism: muscle and liver

A

glucose uptaken, glycolysis to pyruvate, TCA cycle/fermentation/lactate (if lactate uptaken by liver, converted to pyruvate, then to glucose (gluconeogenesis - energy dependent) and released again

39
Q

hitting the wall when running a marathon

A

when muscle and liver glycogen store exhausted, as must switch to metabolism of other substrates (e.g. fat - not as much energy per mole oxygen, and also slower process)

40
Q

amino acid source

A

diet or, in fasted state, from muscle

41
Q

amino acids in liver

A

generates secreted proteins (plasma proteins, clotting factors, lipoproteins)

42
Q

transamination purpose

A

some don’t come from diet - body must produce others from diet amino acids

43
Q

reversible transamination by transaminases

A

amino acid 1 (essential) + keto acid 1 - amino acid 2 (non-essential) + keto acid 2

44
Q

amino acids from a-keto glutarate

A

glutamate, proline, arginine

45
Q

amino acids from pyruvate

A

alanine, valine, leucine

46
Q

amino acids from oxaloacetate

A

aspartate, methionine, lysine

47
Q

muscle deamination - energy dependent

A

removal of amino group, converting pyruvate to glucose, removing nitrogen as urea

48
Q

glucose-alanine cycle in liver

A

pyruvate and glutamate (from amino acid breakdown) converted to alanine in muscle, then adding to a-ketoglutarate in liver to form pyruvate and glutamate

49
Q

fate of glutamate in liver

A

removal of amine group (4 ATP) to form urea, pyruvate converted to glucose (6 ATP) then secreted so muscle cells can uptake glucose

50
Q

fat storage

A

contains more energy, stored in adipose and liver

51
Q

when glycogen stores full

A

excess glucose and amino acids converted to fats in liver for storage

52
Q

production of acetyl CoA from fat in liver

A

triglyceride broken down into fatty acids (and glycerol) in adipose tissue - sent to liver - B-oxidation to acetyl CoA for use in TCA

53
Q

other outcome of acetyl CoA

A

2 produced and combined to produce acetoacetate (ketone - mobile method of acetyl CoA transfer) - used by tissues to liberate acetyl CoA

54
Q

lipoprotein synthesis in liver

A

glucose converted to pyruvate (and glycerol) - converted to acetyl CoA - converted to fatty acids or cholesterol

55
Q

glycerol fate

A

tri-acyl glycerol, then add apoproteins and phospholipids, which then combine with fatty acids and cholesterol from acetyl CoA, producing lipoproteins including VLDL (transport fatty acids to tissues)

56
Q

outcome of VLDL

A

become tri-glycerides in adipose tissue, or become LDL (transport cholesterol to tissues - bad)

57
Q

other outcome of lipoproteins

A

HDL (empty so pick up excess cholesterol - good)

58
Q

cholesterol functions

A

membrane integrity, hormones

59
Q

liver function as storage

A

store fat soluble vitamins (A (to vitamin B12), D, E, K), iron as ferritin (for erythropoiesis), copper

60
Q

liver function as detoxification

A

phase 1: attempts to make more hydrophilic (easier to excrete) by P450 enzymes; phase 2: attach water soluble side chain to make less reactive and leave blood until reaches kidney for excretion in urine

LSS Alimentary System (40 decks)

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