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Liver Physiology Flashcards

1
Q

The liver is considered the “_____” organ in charge of several

A

Powerhouse organ
In charge of several important functions required for survival

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2
Q

The liver has how many functions

A

500

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3
Q

How does bile formation occur

A

Hepatocytes secrete bile material into bile canalciuli

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4
Q

What is in the secreted bile material

A

Cholesterol
Bile salts
Mucin
Bilirubin

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5
Q

What are the 4 metabolic functions

A

Building up, breaking down, altering molecules to produce needed substances
Storage of unneeded substances
Release of energy
Neutralize toxic substances

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6
Q

What is carbohydrate metabolism and what are the processes that do this

A

Process that maintains blood sugar equilibrium
Glycogenesis, Glycogenolysis, Gluconeogenesis

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7
Q

What are is the reason for glycogenesis and how does the liver respond

A

Prevent hyperglycemia
Liver stores extra sugars as glycogen

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8
Q

What are is the reason for glycogenolysis and how does the liver respond

A

Prevent hypoglycemia
Liver converts glycogen into glucose and releases into general circulation

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9
Q

What is the stored form of sugar called

A

Glycogen

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10
Q

What is gluconeogenesis

A

Creation of sugars from fats and proteins when there isn’t enough sugars in storage

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11
Q

3 ways of fat metabolism
Liver converts ___ into more ___ form ____
Liver converts __% of ____ into ___ ___ and secretes into ___ ___
Remaining __% of ____ is carried into the ____ to other cells by ____

A

Converts fats into more “usable” form - lipoproteins
Liver converts 80% of cholesterol into bile salts and secretes into bile ducts
Remaining 20% of cholesterol is carried into blood stream to other cells by lipoproteins

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12
Q

Amino acids are the

A

Building blocks of proteins

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13
Q

What is amino acid synthesis and what is it accomplished by

A

Liver makes/alters amino acids to provide needed proteins
Accomplished by enzymes

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14
Q

What are the 2 important enzymes for assessing liver function

A

AST - Aspartate Aminotransfersae
ALT - Alanine Aminotransfersae

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15
Q

AST is also known as

A

SGOT

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16
Q

ALT is also known as

A

SGPT

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17
Q

Where can liver enzymes be found

A

In liver cells and minimally detected in blood

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18
Q

With acute hepatocellcular disease blood levels in ALT & AST will

A

Both rise

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19
Q

Acute hepatocellular disease will cause

A

Destruction of liver cells releasing their contents into the blood

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20
Q

T or F
AST & ALT are not significantly affected by biliary obstruction

A

True

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21
Q

Protein synthesis have proteins related to

A

Blood coagulation

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22
Q

What are the 2 types of protein synthesis

A

Albumin Synthesis
Globulin synthesis

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23
Q

What are the proteins related to blood clotting

A

Fibrinogen
Prothrombin
Thrombin
Heparin

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24
Q

Which proteins are clotting proteins

A

Fibrinogen
Prothrombin
Thrombin

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25
Which protein is the anticoagulant protein
Heparin
26
The production of proteins requires
Vitamin K
27
Albumin synthesis is the large protein responisble for
Regulating fluid balance in the body
28
If the production of albumin synthesis is disrupted what will happen and what will the results be
Fluid accumulated outside the blood vessels Results: Acsites, pleural effusion, edema
29
What is globulin synthesis
Blood protein related to immune system
30
How does the detoxification of blood work
Both internally & externally produced toxins are absorbed from the environment can be metabolized by the liver
31
Ammonia is a toxic ___ of protein breakdown and is converted into
Toxic protein Converted into urea
32
What are some other functions of the liver
Storage site Phagocytosis Blood reservoir Source for body heat Formation of lymph fluid
33
Commonly you will hear these collectively referred to as LFT's
Liver function tests
34
What are the serum proteins
Total proteins Serum globulins Serum albumins
35
Total protein ____ with liver dysfunction but not specific to ___ ___
Decreases, not specific to liver disease
36
Analysis of specific proteins can ____ specificity
Increase
37
Elevated serum levels of AST/ALT can indicate
Hepatocytes are damaged
38
AST & ALT can also be found in
Muscle and brain cells
39
Max serum elevations occur within what acute conditions
Acute viral hepatitis Drug induced liver damage Severe liver congestion
40
Alkaline phosphate (ALP) is a liver enzyme which is normally
Excreted into bile
41
What other tissue produce ALP
Bone Teeth Kidneys Intestines
42
Serum levels will _____ with __-__ ___ obstruction
Increase Post-hepatic biliary obstruction
43
What is prothrombin time
Measurement of time it takes for sample of blood to clot when thromboplastin is added
44
What is the normal prothrombin time
12 seconds
45
Anything higher than 12 seconds of prothrombin time increases risk of
Uncontrolled bleeding
46
Any increased PT indicated ___ prothrombin producting in the liver which can be due to what 2 things
Decreased prothrombin Hepatocellular disease Vitamik K deficiency
47
Yellow bile pigment formed from the hemoglobin portion destroyed by RBC's
Bilirubin
48
Bilirubin usually happens in what 3 places in the body
Liver Spleen Bone marrow
49
Initially bilirubin is not ___ ___ and must be carried throughout the _____ by ____
Water soluble Carried throughout the blood stream By albumin
50
The inital non water-soluble bilirubin is called
indirect or unconjugated
51
Bilirubin is carried to the ___ and taken by the ____
Liver Taken by hepatocytes
52
What cells convert indirect bilirubin and what do they get converted into ___/___ which is ___ ___
Liver cells convert Converted into direct/conjugated which is water soluble
53
Hepatocytes secrete bilirubin into the
Bile canaliculi in the lobules
54
Jaundice can be shown by elevated levels of
Bilirubin in the blood and tissues
55
What are the 2 types of jaundice
Medial/non obstructive Surgical/obstructive
56
What are the 2 types of medial jaundice
Hemolytic jaundice Hepatocellular jaundice
57
What are the signs of hemolytic jaundice
Abnorally large # of RBC's being destroyed Indirect bilirubin is elevated Hepatocytes can't handle quantity
58
Hepatocellcular jaundice is caused by
Hepatocyte inflammation Fibrosis bile cannot be properly excreted into bile canaliculi
59
What is a sign of hepatocellular jaundice
Direct bilirubin is elevated
60
Surgical jaundice is the
Obstruction of bile out flow
61
Obstruction of bile out flow is caused by
Stone in CBD Mass in CBD, head of pancreas or duodenum Inflammatory stricture in CBD
62
What can be a sign of surgical jaundice
Direct bilirubin elevated
63
What is alpha-fetoprotein
Protein normally formed in the fetal liver and yolk sac
64
Alpha-fetoprotein can only be found in ____ amounts after ___
Trace amounts after birth
65
Alpha-fetoproteins are elevated in
Non pregnant adults by HCC
66
What is the process of sonographic liver evaluation
No prep Thorough and systematic Scan in both long and transverse planes Use landmarks to identitfy location
67
What is the normal sonographic appearance of the liver
Homogenous Echogenic margins Medium level echoes Easy visualization of vessels and diaphragm
68
What is the comparative echogenicity of the liver to the renal parenchyma
Liver is isoechoic or minimally hyperechoic to normal renal parenchyma
69
What is the comparative echogenicity of the liver to the pancreas
Liver is hypoechoic to pancreas
70
What is the comparative echogenicity of the liver to the spleen
Liver is isoechoic or hypoechoic to the spleen
71
What is the hepatic size measured in and what is the normal measurement
Sagittal plane at mid clavicular line 15 cm or less
72
What is the measurement of a hepatomegaly
More than 15 cm
73
In transverse you measure the caudate love from the
Edge of MPV to left lateral margin
74
In transverse you measure the right lobe from the
Right lateral margin to edge of MPV
75
What is the normal caudate lobe to right lobe ratio
0.65
76
The CL/RL ratio is increased by
Cirrhosis
77
What are the structures in the liver visible in the transverse plane
Diaphragm Dome of liver Hepativ cein confluence Ascending LPV MPV/RPV Falciform ligament GB
78
What are the structures in the liver visible in the longitudinal plane
Lateral top of left lobe Left liver/aorta/gastroesophageal junction RPV/GB/MLF Liver/Right kidney Lateral margin or right lobe

Abdomen (10 decks)

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