LVR Flashcards
the remnant of the obliterated umbilical V and enters the left liver hilum at the front edge of Falciform Ligament
a. round ligament
b. triangular ligaments
c. coronary ligament
d. hepatoduodenal ligament
A
separates L lateral and L medial segments along the UMBILICAL FISSURE and anchors the liver to anterior abdominal wall.
a. falciform ligament
b. triangular ligaments
c. coronary ligament
d. hepatoduodenal ligament
A
secures the two side of the liver to the diaphragm
a. falciform ligament
b. triangular ligaments
c. coronary ligament
d. hepatoduodenal ligament
e. round ligament
B
the anterior extensions from triangular ligaments. The R CL anchors the liver to R retroperitoneum
a. falciform ligament
b. triangular ligaments
c. coronary ligament
d. hepatoduodenal ligament
e. round ligament
C
contains porta hepatis
a. falciform ligament
b. triangular ligaments
c. coronary ligament
d. hepatoduodenal ligament
e. round ligament
D
What percent of the liver is the right lobe?
60-70%
R anterior lobe
a. Segment I
b. Segment IV
c. Segment V and VIII
d. Segment VI and VII
C
R posterior lobe
a. Segment I
b. Segment IV
c. Segment V and VIII
d. Segment VI and VII
D
Quadrate lobe
a. Segment I
b. Segment IV
c. Segment V and VIII
d. Segment VI and VII
B
Caudate lobe
a. Segment I
b. Segment IV
c. Segment V and VIII
d. Segment VI and VII
A
Major blood supply of liver
a. Hepatic artery
b. Portal vein
c. celiac artery
d. Gastroduodenal artery
B
2 blood vessels that form the portal vein
Splenic v and SMV
Where does IMV drain to?
Splenic v
Normal pressure inside the portal v.
3-5mmHg
The portal vein
a. has valves
b. has no valves
B
The portal vein decompress to which vein during portal hpn?
Coronary (L Gastric V)
What vein directly cause esophageal and gastric varices?
L gastric V
R hepatic vein drains
a. Right anterior segment
b. Segment I
c. Quadrate lobe
d. Segment VI and VII
A. Segments V-VIII
Caudate lobe is drained by
a. IMV
b. SMV
c. L hepatic v
d. IVC
D
Parasympathetic innervation of the liver is from the
L vagus
Sympathetic innervation of the liver
Greater thoracic nerves and celiac ganglia
This is a location in the liver between a hepatocyte and a sinusoid.
Presinusoidal space of Disse
The space between the stroma of the portal canal and the outermost hepatocytes in the hepatic lobule, and is thought to be one of the sites where lymph originates in the liver.
Periportal clefts of Mall
hilar cystic duct LN is also known as
Lund’s node or Mascagni’s lymph node, or erroneously called Calot’s Triangle
Enzyome responsible for conjugation of bilirubin
glucoronly transferase
Excreted in feces, minimally dissolved in the blood then excreted in urine
a. Conjugated bilirubin
b. Unconjugated bilirubin
A
Rate of bile production by hepatocytes
1L/day
components of bile (6)
BBLECh Bile pigments Bile salts lecithin Electrolytes Cholesterol
Functions of bile
a. aid in digestion and absorption of lipids and lipid soluble vitamins
b. eliminate waste products
c. both
d. neither
C
The mixture of primary and secondary bile salts and bile acids is primarily absorbed in _______
terminal ileum
conjugation reactions- glucoronate, acetate, glutathione, glycine, sulfate and methyl group additions – Smooth ER
a. PHASE I
b. PHASE II
B
PHASE I: oxidation, reduction and hydrolysis by Cytochrome P450
Predominantly liver specific
a. AST
b. ALT
c. Alk Phos
d. LDH
B
What tests to evaluate synthetic function of the liver
Albumin and PT
The following causes prolonged PT EXCEPT
a. Vit K
b. Warfarin
c. liver cirrhosis
d. NOTA
D
Impaired bile flow from liver to duodenum either intra or extrahepatic etiology
a. cholecystitis
b. cholangitis
c. cholelithiasis
d. cholestasis
D
Extrahepatic
a. indirect bilirubin elevation
b. direct bilirubin elevation
A
direct bilirubin elevation = intrahepatic
found in liver, bile duct epithelium and bones
a. AST
b. ALT
c. LDH
d. ALk Phos
D
hepatocytes and biliary epithelium, sensitive to biliary disease if Alk Phos is elevated
GGT
Bilirubin levels when jaundice becomes apparent
2.5-3 mg/dL
A mild liver disorder in which the liver does not properly process bilirubin. This disease is due to a mutation in the UGT1A1 gene which results in decreased activity of the bilirubin uridine diphosphate glucuronosyltransferase enzyme.
Gilbert’s Syndrome
This is a rare inherited disorder affecting the metabolism of bilirubin, a chemical formed from the breakdown of the heme in red blood cells. The disorder results in a form of nonhemolytic jaundice, which results in high levels of unconjugated bilirubin and often leads to brain damage in infants.
Crigler-Najar Syndrome
defect in transport protein of bilirubin, no pigmentation of liver
a. Gilbert’s syndrome
b. Crigler-Najar Syndrome
c. Rotor’s Syndrome
d. Dubin Johnson Syndrome
C
defect in secretion of bilirubin by hepatocytes into the bile
a. Gilbert’s syndrome
b. Crigler-Najar Syndrome
c. Rotor’s Syndrome
d. Dubin Johnson Syndrome
D
The following are causes of post hepatic jaundice except
a. cholelithiasis
b. benign biliary strictures
c. pancreatitis
d. Rotor’s syndrome
D
The following are prehepatic EXCEPT
a. immune mediated hemolytic anemia, + direct Coomb’s test
b. malnutrition
c. severe burns
d. pancreatitis
D. post hepatic
Prehepatic cause of jaundice EXCEPT
a. malaria
b. septicimia
c. Carcinoma of the head of pancreas
d. Any haemolytic anemia
C - post hepatic
Intrahepatic cause of jaundice
a. Gilbert’s syndrome
b. Crigler-Najar syndrome
c. Viral hepatitis
d. Paracetamol poisoning
AOTA
