Normal Liver Structure and Function and Cirrhosis

Question 1

Name the 4 main aspects to liver function.

Answer 1

1. Blood Vessels
2. Parenchymal Liver Cells (cells that make up the bulk of the liver)
3. Biliary System
4. Connective Tissue Matrix

These are arranged as portal tracts (contains the portal triad) and parenchyma.

Question 2

What makes up the portal triad?

Answer 2

Hepatic artery, Portal vein and bile ducts.

Question 3

Where does the portal tract drain?

Answer 3

Sinusoids, which in turn drain into the hepatic vein.

Question 4

Describe a sinusoid.

Answer 4

Sinusoids are like capillaries but leakier. It is leakier by two adaptations; they have fenestrations and they lack a complete basement membrane below cells.

Question 5

Name the main cells of the liver

Answer 5

• Hepatocytes
• Endothelial Cells
• Kupffer Cells (Macrophages)
• Perisinusoidal Cells (Fat-Storing Cells, also store fat soluble vitamins)
• Liver-associaed lymphocytes

Question 6

What are the main types of collagen found in the portal tracts of the liver?

Answer 6

Collagen types 1 and 3.

Question 7

What does the biliary system include?

Answer 7

• Bile Canaliculi
• Bile Ductules
• Bile Ducts

Question 8

What 3 things do you need for it to be diagnosed with Cirrhosis

Answer 8

Nodules, Fibrosis and you need it to be Diffuse.

Question 9

List causes of Hepatitis, and therefore cirrhosis.

Answer 9

Alcohol
Metabolic Disease
Viral Infections e.g. Hepatitis
Auto-immune disease
Biliary Disease
Drugs or Toxins
Haemochromatosis
Cryptogenic

Question 10

What causes decreased liver cell function in Cirrhosis?

Answer 10

Less Normal Liver Tissue due to formation of nodules.
Shunting
More fibrous tissue and therefore less exchange between sinusoids and hepatocytes.

Question 11

What are the main complications of Cirrhosis?

Answer 11

Portal Hypertension - can lead to portal-systemic shunts and varices, ascites and splenomegaly. Splenomegaly can cause increased consumption of platelets thus lower platelet numbers.
Liver Failure
Hepatocellular Cancer
Hypoglycaemia - due to failure of storage of glycogen
Bleeding - due to liver not making coagulation factors