Pathology of the Liver Flashcards
What ribs cover the liver
7-11
What is the normal appearance of the liver?
Red brown colour with a smooth outline and contour
What 3 terms are used to describe the patterns of liver injury
1) Periportal Zone
2) Mid Acinar
3) Pericentral
What is the zone that is closest to the vascular supply
Zone 1
Cells in which zone are most vulnerable to injury?
Why is this the case?
Zone 3
They are furthest from the vascular supply - it takes longer for oxygen to reach them
What 4 aspects can cause insult to hepatocytes
Viral
Drug
Toxin
Antibody
How can we measure the degree of injury to the liver?
Insult
Grading the degree of inflammation
Staging the degree of fibrosis
Cirrhosis
What is cirrhosis
A chronic disease of the liver marked by degeneration of cells, inflammation, and fibrous thickening of tissue. It is typically a result of alcoholism or hepatitis.
What are 4 causes of the acute onset of jaundice
Viruses
Alcohol
Drugs (paracetamol
Bile duct obstruction
What is the underlying cause of acute onset of jaundice
Hepatic necrosis
What is necrosis?
The death of most or all of the cells in an organ or tissue due to disease, injury, or failure of the blood supply.
What is the chemical name for Paracetamol
Acetoaminophen
Describe the structure of the liver which has been damaged by aracetamol
not a normal structure
Necrotic hepatocytes are more rounded and not polyhedral
Majority of cells have lost their nuclei
What 3 things can occur as a consequence of acute liver failure?
Complete recovery
Chronic liver disease
Death from liver failure
What is jaundice
Yellowing of the skin due to excess bilirubin
What are the 3 classifications of jaundice
Pre- hepatic
Hepatic and
Post-hepatic
What are the 2 types of jaundice
Conjugated or Unconjugated
What is the cause of pre-hepatic jaundice
Too much haem to break down
Describe pre-hepatic jaundice
Haemolysis of all causes
Haemolytic anaemias
Unconjugated bilirubin (uncombined)
What is hepatic jaundice
When the liver cells are injured or dead and so we have reduced hepatic function
Describe hepatic jaundice
Acute liver failure (virus, drugs, alcohol) Alcoholic hepatitis Cirrhosis (decompensated) Bile duct loss (atresia, PBC,PSC) Pregnancy
What is post hepatic jaundice
Bile cannot escape into the bowel
Describe post-hepatic jaunice
Congenital biliary atresia
Gallstones block CB Duct
Structures of CB duct
Tumours (head of the pancreas)
What does cirrhosis of the liver signify
The endpoint of liver disease
Define cirrhosis of the liver
Bands of fibrosis separating regenerative nodules of hepatocytes
What does cirrhosis result in
Loss of hepatic function
What is the main cause of cirrhosis of the liver
Alcohol
Describe the histological appearance of cirrhosis in the liver
Islands of hepatocytes have been cut off from eachother by bands of fibrous tissue has been deposited
What is the main complication of Cirrhosis
Portal hypertension
What are 2 other complications of cirrhosis
Ascites
Liver failure
What is the result of pre hepatic jaundice
Obstructive thrombosis and narrowing of the portal vein (
What is the result of hepatic jaundice
Cirrhosis
What is the result of post hepatic jaundice
Right sided Heart failure
Hepatic outflow obstruction