liver microanatomy part 3 W4

Question 1

what ligaments support the liver

Answer 1

coronary ligament (superior)
ligamentum teres
falciform ligament (anterior)

Question 2

where does the portal vein supply blood from?

Answer 2

small intestine (superior mesenteric vein)
large intestine (inferior mesenteric vein)
spleen (splenic vein)

Question 3

what is the liver acinus

Answer 3

functional unit of the liver

Question 4

zones of the liver acinus?

Answer 4

1 - pericentral vein areas
2 - intermediate areas
3 - periportal areas

Question 5

glucose metabolism - high blood sugar?

Answer 5

high blood sugar
pancreas secretes insulin
insulin stimulates glycogen formation from glucose
glycogen stored in hepatocytes
decreased blood sugar

Question 6

glucose metabolism - low blood sugar?

Answer 6

low blood sugar
pancreas secretes glucagon
glucagon stimulates glycogen breakdown into glucose
increased blood sugar

Question 7

bilirubin metabolism -

Answer 7

haemoglobin broken down ultimately to bilirubin. high bilirubin influx to liver in some situations

Question 8

bilirubin metabolism?

Answer 8

unconjugated bilirubin transported to hepatocytes, conjugated to glucuronic acid, produces conjugated bilirubin.
-> small intestine
bacterial proteases break down conjugated bilirubin into urobilinogen -> mainly excreted in stool, some return to blood and excreted via kidneys

Question 9

detoxification pathway liver?

Answer 9

uptake mainly fat soluble toxins via portal vein circ.
using required nutrients, turns toxins into water soluble waste products.
eliminated from body via stool or urine

Question 10

what is measured in LFTs?

Answer 10

bilirubin
aminotransferases (alanine ALT and aspartate AST)
gamma glutamyl transferase (GGT)
alkaline phosphatase
albumin
prothrombin time ratio

Question 11

LFTs - what is bilirubin a measure of?

Answer 11

transport from hepatocytes into biliary system

Question 12

LFTs - what is aminotransferases a measure of

Answer 12

hepatocyte damage

Question 13

LFTs - what is gamma glutamyl transferase and alkaline phosphatase a measure of

Answer 13

cholestasis (impaired bile flow)
just GGT - may be increased by certain medications

Question 14

LFTs - what is albumin a measure of?

Answer 14

protein synthesis

Question 15

LFTs - what is prothrombin time ratio a measure of?

Answer 15

protein synthesis
good marker of the ability of the blood to clot

Question 16

what causes jaundice (yellow skin and eyes)

Answer 16

accumulation of bilirubin in the skin, caused by:
-gallstones
-tumours head of pancreas
-ampullary lesions
because they all cause blockage of bile ducts -> cholestasis -> jaundice!