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Sustaining life > Microanatomy of the liver > Flashcards

Microanatomy of the liver Flashcards

1
Q

what is the liver?

A

large lobulated exocrine and blood-processing gland, with vessels and ducts entering and leaving at the porta

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2
Q

what is the liver enclosed by

A

thin collagen tissue capsule, mostly covered by mesothelium

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3
Q

what provides support to the liver?

A

collagen tissue of the branching vascular system provides gross support

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4
Q

what are parenchymal supported by?

A

fine reticular fibres

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5
Q

portal vein?

A

bringing food-rich bloodfrom the gut

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6
Q

hepatic artery?

A

bringing arterial blood

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7
Q

hepatic veins?

A

taking away processed blood into the vena cava

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8
Q

lymphatics?

A

taking away some lymph

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9
Q

hepatic ducts?

A

removing bile to the gallbladder and gut

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10
Q

blood supply of liver

A

dual, 25% from hepatic artery, 75% portal vein

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11
Q

nerve supply?

A

sympathetic and parasympathetic supply of perivascular structure, but very little at sinusoidal level

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12
Q

first impression of liver microanatomy

A

uniform mass of large glandular cells throughout the liver substance

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13
Q

how are cells in the liver arranged?

A

perforated plates, one cell wide
between the plates are sinusoidal blood channels 9-12um wide, lined by endothelial cells
scattered in the glandular mass are blood vessel, alone and accompanied by other vessels
the distribution defines or marks out the classic hepatic lobules

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14
Q

central vein/terminal hepatic venule

A

very thin wall
lies in the centre of a lobule
with sinusoids converging towards and opening into it

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15
Q

sublobular/ intercalated vein

A

thicker wall
lies alone at the periphery of the lobule

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16
Q

branch of portal vein

A

at the periphery ofd the lobule but accompanied by one or more small hepatic arteries/arterioles, one or more bileducts/ductules lined by cuboidal epithelium, and lymphatics

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17
Q

what forms the portal triad

A

portal vein, artery, and bile duct
the area in which they lie in is the portal area
(lymphatics are ignored for this naming)

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18
Q

hepatic lobular blood flow is…

A

from the branches of the portal vein and hepatic artery; from the periphery towards the centre
in the sinusoids, between the cell plates
blood collected in central veins goes to sublobular veins, then to collecting veins, and then hepatic veins leaving the liver

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19
Q

intralobular bile flow…

A

is from the lobules centre towards the peripheral bile duct and runs within any one cell plat, between the liver cells in bile canaliculi

20
Q

what is the liver acinus

A

functional unit comprising parts of three lobules or so

21
Q

what are sinusoids

A

low pressure vescular channels that receive blood from terminal branches of the hepatic artery and portal vein at the periphery of lobules and deliver it into central veins

22
Q

what are liver sinusoids lined by

A

fenestrated endothelial cells, loosely attached and hold phagocytic kupffer cells, they rest on microvilli of underlying hepatic cells, without a basal lamina intervening

23
Q

what are kupffer cells

A

larger, stellate with a pale oval nucleus

24
Q

what does plasma pass through?

A

seive plate, formed by the lning cells, out into the perisinusoidal space of disse to interact with the hepatocytes, some of this fluid may pass to the periphery of the lobule to be collected as lymph

25
Q

what does the space of disse contain

A

extracellular matrix materials, but not a visible base lamina

26
Q

what are stellate cells

A

scarce fat storing cells that lie outside the endothelial cells
store vitamin a
they responds to a variety of insults by making collagen and causing cirrhosis

27
Q

what does the sinusoidal wall provide for

A

blood cleansing - eg of gut toxins
haemopoiesis - blood cell component formation
bringing plasma into intimate contact with the hepatic cells for metabolic functions ( storage, transformations, syntheses, regulation of plasma concentrations, detoxification, the production of bile, assisting defence by producing acute-phase proteins)

28
Q

what are hepatocytes

A

main functional cells of the liver, 80% of the mass of the liver is hepatocytes

29
Q

how are hepatocyes arranged

A

plates that anastomose with one another
cells are polygonal in shape and their sides are in contact with other sinusoids (sinusoidal face) or neighbouring hepatocytes (lateral faces)

30
Q

what forms bile canaliculi

A

lateral faces of hepatocytes
microvilli are present abundantly on sinusoidal faces, but project sparsely into bile canaliculi

31
Q

what do hepatocyte nuclei look like

A

distinctly round, with one or two prominent nucleoli, a majority of cells have a single nucleus, but binucleate cells are common

32
Q

features of hepatocytes

A

ribosomes on outer membrane
extensive granular ER
smooth er for dteroid hormone and cholesterol metabolism, lipids taken in processed and secreted
many mitochondria
golgi body lying near the canaliculus
lysosomes to help form bile
lipofuscin, ageing pigment

33
Q

what can cause cirrhosis

A

too much alcohol
paracetamol overdose

34
Q

what is bilrubin

A

gives bile its green colour
breakdown product from old RBCs

35
Q

function of pancreas

A

secretes insulin to regulate blood sugar levels

36
Q

what is the function of the liver

A

toxins go into the liver and with help from nutrients they go through a number of processes to break them down, make toxins that are fat-soluble water-soluble, eliminated via the gall bladder, goes to kidneys or becomes bile and then becomes urine

37
Q

how do stellate cells cause cirrhosis

A

produce collagen that seal the fenestrate cells, causes pressure in the sinusoids to increase, this causes collagen to go back into the portal triangle, hepatocytes then start to die off

38
Q

what does bile do

A

assists in the breakdown of fat
emulsification of fat
secondary bile salts are formed from breaking down bacteria
primary bile salts are formed in the liver

39
Q

what is glucose metabolism

A

downregulates high blood sugar using insulin
upregulates low blood sugar using glucagon

40
Q

bilirubin metabolism

A

haemolysis causes breakdown of haemoglobin to bilirubin

41
Q

what happens when hepatocytes die

A

enzymes are released into the bloodstream

42
Q

what is albumin responsible for

A

bloods ability to clot

43
Q

what does blockage of bile ducts cause

A

leads to cholestasis which leads to jaundice

44
Q

what cause blockage of bile ducts

A

gallstones, tumours of the head of the pancreas, ampullary lesions

45
Q

what is jaundice

A

symptom when the skin and eyes become yellow, associated with the accumulation of bilirubin in the skin

46
Q

what do LFTs do

A

bilirubin assesses anion transport

Sustaining life (19 decks)

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