physiology Flashcards
How does ETOH cirrhosis causes portal HTN?
Fibrous tissue and nodules distort the liver structure and increase resistance to portal blood flow.
Portosystemic shunts can lead to what complications; which are the most life threatening?
esophageal varicies-life threaatening if rupture
splenomegaly (increased portal vein resistance)
Umbilical vein enlargement: caput medusae
Hemorrhoids
You’re alcoholic patient presents to see if their cirrhosis is on the mend, as they’ve been sober for 3 months now. You decide to do a HVPG test and find that the difference between ______ and ________ is 4mm Hg. Which vessels are being used for this assesment, and is this value Hypertensive?
portal vein and IVC
This is not a hypertensive value; starts at 5mm Hg.
The intestinal circulation is regulated by what three components?
Neuro-sympathetic constriction of vessels
Metabolic autoregulation
Functional hyperemia-food ingestion which increases blood flow.
The portal vein is damaged and is leaking blood how will this be compensated for in the body?
A autoregulation of the portal vein will increase resistance
B autoregulation of the hepatic artery will increase resistance
C flow of blood will not be compensated
D hepatic arterioles will dilate leading to decreased flow, thus compenstating for the blood loss
B autoregulation of the hepatic artery will increase resistance as this artery and the portal vein are under reciprocal regulation, though the portal vein is not under autoregulation.
The mechanism is almost the one described by answer D except the dilation of the hepatic arteriole will increase blood flow through this area
what are some causes of pre and post-hepatic HTN?
obstruction due to cancer, thrombosis, LN
Budd-Chiari syndrome is pre or post hepatic? What is the pathology?
Occlusion of hepatic venules, portal vein and IVC or Right atrium due to: thrombosis, polycythemia, or hypercoagulability state
Your patient has asciteis which can be caused increased capillary hydrostatic pressure or decreased colloidal osmotic pressure secondary to what conditions related to what type of liver disorders?
Increased capillary hydrostatic pressure is secondary to increased aldosterone production (overfill issue) due to inability of the liver to metabolize it; secondary to liver failure.
Decreased capillary oncotic pressure is the result of hypoalbuminemia (decrease major serum protein) due to livers inability to synthesize the albumen due to liver failure.