Physio: Liver Function

Question 1

What is found in a hepatic triad?

Answer 1

A portal vein, hepatic artery, and bile duct

Question 2

Portion of the hepatocyte associated with the space of Disse and the bloodstream.

Answer 2

Basolateral side

Question 3

Portion of the hepatocyte associated with the bile ducts.

Answer 3

Apical side

Question 4

Function of Kupfer cells

Answer 4

Liver macrophages

Question 5

Function and location of Stellate Cells

Answer 5

Located in the Space of Disse

Store Fat and vitamin A and are very active in secreting collagen that forms fibrotic tissue during liver disease

Question 6

Function of cholangiocytes.

Answer 6

Bile duct cells that regulate electrolytes in the bile

Question 7

The functional unit of the liver is the liver lobule. Which group of hepatocytes function mainly in oxidative metabolism and which group functions mainly in detoxification?

Answer 7

Periportal hepatocytes are closest to the triad and conduct oxidative phosphorylation.

Pericentral hepatocytes are closest to the central vein of the lobule and function in detox

Question 8

What are the 3 classifications of portal hypertension?

Answer 8

Pre-hepatic: caused by portal or splenic vein thrombosis usually causing splenomegaly

Intrahepatic (most common): caused by cirrhosis, hepatits or alcohol abuse

Post-hepatic: right heart failure, vena cava clot

Question 9

What are general symptoms of portal hypertension?

Answer 9

Ascites, Jaundice, GI bleed, vomiting, diarrhea

Question 10

How does portal hypertension cause ascites?

Answer 10

Increased pressure in the sinusoids causes leakage from the venous and lymphatic vessels into the peritoneal cavity. The body senses this as HYPOvolemia and the Renin-AgII-Aldosterone system reacts by reabsorbing sodium and water in the kidneys.

Question 11

Cells that produce bile.

Answer 11

Hepatocytes

Question 12

Bile is conjugated in the liver into two bile salts. Name them.

Answer 12

Taurine

Glycine

Question 13

What is the purpose of conjugating bile into bile salts?

Answer 13

Makes bile more water soluble as it prepares to enter the aqueous environment of the duodenal lumen.

Question 14

Bilirubin that is reabsorbed from the ileum is no longer conjugated. How does it travel thru the blood stream back to the liver?

Answer 14

Bound to plasma albumins

Question 15

Form of bilirubin excreted by the kidneys

Answer 15

Conjugated (must be water soluble)

Question 16

Bilirubin metabolite that is more lipid soluble so that it can be reabsorbed by the ileum and travel back to the liver bound to albumins.

Answer 16

Urobiligen

-still water soluble enough to pass through the glomerulus in the kidneys

Question 17

What is Gilbert Syndrome

Answer 17

Mutation of glucuronyltransferase enzyme resulting in a failure to transport bile into hepatocytes and a failure to conjugate bilirubin.

Question 18

What would serum tests reveal in a patient with hemolytic jaundice?

Answer 18

High levels of unconjugated bilirubin

Question 19

What is Crigler Najjar Syndrome?

Answer 19

Mutation in the UGT enzyme that conjugates bilirubin.

Question 20

What is Dubin Johnson syndrome?

Answer 20

Mutation in transport protein that transport conjugated bile from hepatocytes into the biliary ducts. Results in high levels of conjugated bilirubin in the serum.

Question 21

Characteristic of urine containing lots of conjugated bilirubin.

Answer 21

Foamy yellow appearance when disturbed

Question 22

What is the difference in location of brown vs. black gall stones.

Answer 22

Brown: ducts, more common with bacterial and helminth infections

Black: found in gallbladder