liver physiology Flashcards
what is the name of the process in which glucose is produced from amino acids?
gluconeogenesis
Where is HDL formed?
liver
Insulin, glucagon, ADH and steroid hormones. are they activated or inactivated by the liver?
de
What kind of things are stored in the liver?
fat soluble vitamins (ADEK), b12, iron, glycogen, copper
which proteins are synthesised?
Coagulation factors 2,7,9,10. Protein C and S. Albumin. Complement proteins. Apolipoproteins. Carrier Proteins
what are liver phagocytes called
kupffer cells
bile is produced continuously by the combined secretions of which two cell types?
hepatocytes and bile duct cells
what stimulates gallbladder smooth muscle to contract?
chyme in the duodenum (via CCK and vagal impulses)
HOW DOES THE SPHINCTER OF ODDI OPEN?
via CCK
Bile spurts into duodenum via?
sphincter of oddi
what are bile duct cells called?
cholangiocytes
what pH is bile?
neutral/slightly alkali
What does neutral/alkali ph assist?
micelle formation, neutralisation of chyme, ph adjustment for digestive enzyme action, protection of the mucosa
hepatocytes secrete primary juice into canaliculi which drain into biliary ductules and cuts. what does this juice contain?
primary bile acids water and electrolytes lipids and phopholipids cholesterol iga bilirubin metabolic waste and conjugated drug metabolites
causes of jaundice medical doctors aren’t very happy. surgeons are not much better
malignancy, drugs, antibiotics, viruses, haematological, stones, antibiotics, nodes, malignancy of pancreatic head
What is bilirubin formed from ?
Haemoglobin broken down into haem and globin. Globin is broken down into amino acids. Haem broken into iron and bilirubin. Iron reabsorbed into bone marrow. Bilirubin excreted in bile
what is cholelithiasis?
formation of gallstones
what could cause cholesterol to crystallize over time and form a gallstone?
concentration of bile in gallbladder produces super saturated solution
morphine is used to relieve pain of gallstones. why could his make it worse?
causes constriction of sphincter of oddi and increases intrabiliary pressure
which 2 drugs are used to relieve spasm of bile duct?
GTN and atropine
what happens to bile salts which enter duodenum?
only small amount (5%) are lost. Most are reabsorbed in the terminal ileum and undergo enterohepatic recycling
what happens to secondary bile acids?
they are recycled as bile salts after being conjugated in liver with glycine and taurine
In severe hepatic failure, the detoxification of what fails?
ammonia to ammonium
If ammonia levels rise in hepatic failure what happens
has a toxic effect on CNS causing drowsiness, come and death resulting from cerebral oedema.
