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Digestion and Excretion > Liver Physiology Bile and Jaundice > Flashcards

Liver Physiology Bile and Jaundice Flashcards

1
Q

What are the functions of the liver?

A

Removal and detoxification and first pass metabolism of orally administered drugs
Storage
Synthesis eg. albumin, bile, transport proteins

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2
Q

What is the role of the Portal Vein?

A

Drains GIT from the lower esophagus to the rectum

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3
Q

What does capillary bed 1 do?

A

Drains contents from small intestine

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4
Q

Where is capillary bed two found?

A

Within the liver

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5
Q

What is the structural unit of the liver called?

A

The hepatic lobule

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6
Q

What three ducts make up the triad found on each apices?

A

hepatic portal vein, hepatic artery and the bile duct

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7
Q

How do we know it’s the bile duct in a histology image?

A

small lumen, presence of epithelium cells line duct systems

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8
Q

What are the white spaces in-between pink cells?

A

Hepatic sinusoids

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9
Q

What types of cells are found in the liver?

A

Hepatocytes
Reticuloendothelial cells - structure
Endothelial cells
Hepatic stellate cells
cholangiocytes - bile secretion and motility

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10
Q

What is the function of the hepatic lobule?

A

Drains blood from portal vein and hepatic artery to hepatic/central vein

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11
Q

What is the function of the portal lobule?

A

Drains bile from hepatocytes to the bile duct

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12
Q

What is the function of the Hepatic Acinus?

A

Supplies oxygenated blood to hepatocytes

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13
Q

What Zone is the most oxygenated and what zone is the least oxygenated

A

Zone 1 = most oxygenated
Zone 3 = least oxygenated

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14
Q

What are the functions of zone 1?

A

Gluconeogenesis
Oxidation of fatty acids

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15
Q

What are the functions of zone 3?

A

Glycolysis
Lipogenesis
P450 enzyme mediated detoxification

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16
Q

What causes portal vein oxygenation to decrease?

A

Increasing GIT activity and O2 demand

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17
Q

What does zone 1 create?

A

Local microenviroments/

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18
Q

What happens when we move further away from the shirt axis?

A

Nutrients start to deplete

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19
Q

Where is bile produced and stored?

A

Produced in the liver
Stored in the gall bladder

20
Q

What are the functions of bile?

A

Emulsification of lipids
Hormonal action
Elimination of waste products eg. bilirubin

21
Q

What are the main components of bile?

A

Water, bile acids, HCO3-, Bilirubin

22
Q

What synthesizes bile acids?

A

Hepatocytes

23
Q

What is the aqueous component contributed by?

A

Bile duct epithelial cells (cholangeocytes)

24
Q

What stimulates duct cells?

A

Secretin but does not affect bile salt synthesis

25
Q

What are examples of primary bile acids?

A

Cholic acid
Chenodeoxycholic acid
Synthesized by hepatocytes from cholesterol

26
Q

What are examples of secondary bile acids?

A

Deoxycholic acid
Lithocholic acid
Generated by de-hydroxylation of bile acids by intestinal bacteria

27
Q

How are conjugated bile acids formed?

A

Addition of glycine or taurine groups to primary or secondary acids in the liver

28
Q

How is conjugation beneficial?

A

Helps solubility of acids for emulsifying lipids

29
Q

How are lipids emulsified by bile?

A

Hydrophobic side of bile acid binds to lipid
Hydrophilic side has polar regions - lipid can’t reform - allows lipases to come in and aggregate lipid
Surface area for digestion increased
Fat droplets coated with bile salts are suspended in water

30
Q

What is urso-deoxycholic acid?

A

Bile acid used to treat liver and neurodegenerative disease
Inhibit apoptosis
Abundant in bear bile - only produced in small amounts in human colon

31
Q

What bile acid can act as a signaling molecule?

A

GPBA
control peristalsis, energy homeostasis and anti-inflammatory

32
Q

How does bile enter the duodenum?

A

Via the sphincter of Oddi
Common exit with pancreatic secretions - allows for mixing

33
Q

How are bile acids returned to the hepatocytes?

A

Via sodium dependent organic anion transporter

34
Q

What does conjugation do to bile acids in the entero-hepatic recirculation?

A

Increases water solubility of bile salts - renders them relatively impermeable to the duodenum
Accumulate in the lumen

35
Q

Where are bile acids reabsorbed?

A

In the terminal ileum

36
Q

What is the function of the gall bladder?

A

Storage and concentration of bile
Contract to release bile when required

37
Q

What are the three phases of for the gall bladder?

A

Cephalic, gastric and intestinal phase

38
Q

What is the cephalic phase triggered by?

A

Thought and taste -> GB emptying

39
Q

What is the gastric phase triggered by?

A

vagus stimulated by gastric distension -> GB emptying

40
Q

What is the intestinal phase stimulated by?

A

Presence of acid in the duodenum -> secretin & ductal epithelial cells produce bicarb rich secretion
Presence of fat in the duodenum -> CCK & stimulation of contraction of GB

41
Q

How are gall stones formed?

A

Disregulation or an imbalance of cholesterol, phospholipids and bile salts in bile

42
Q

What are the consequences of removing your gall bladder?

A

Bile won’t be as concentrated
Bile is more dilute - less effective at absorbing lipids

43
Q

How is bilirubin removed?

A

Conjugated to glucuronic acid in the liver
Enters biliary system in bile
Enters small intestine where bacterial proteases turn it into urobilinogen
Mostly emoved as faeces or enters portal vein
Goes back into the blood and is excreted in urine via kidneys

44
Q

What is bilirubin?

A

A breakdown product of heme from red blood cells

45
Q

What is jaundice?

A

Elevated unconjugated bilirubin in the blood

46
Q

How does jaundice occur?

A

High levels of Heme breakdown or incomplete conjugation

Digestion and Excretion (22 decks)

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