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GI Physiology > Physiology (And pharmacology) of Liver > Flashcards

Physiology (And pharmacology) of Liver Flashcards

1
Q

Where does arterial and venous blood mix?

A

liver sinusoids

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2
Q

What are sinusoids?

A

fenestrated capillaries

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3
Q

What shape are liver lobules in cross sections?

A

hexagonals

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4
Q

What do liver lobules have a branch of at their centre?

A

hepatic vein

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5
Q

What do liver lobules have at each 6 corners?

A

portal triad

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6
Q

How are cords of hepatocytes in the liver lobules arranged?

A

as hepatic plates

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7
Q

What direction does blood flow through sinusoids to the central vein?

A

inwardly

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8
Q

Where does bile secreted by hepatocytes flow?

A

outwardly through caniculi to the bile duct

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9
Q

How thick is the epithelium hepatocytes form and what does this separate?

A

1 cell thick, separates 2 fluid filled compartments

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10
Q

How are hepatocytes arranged?

A

in between sinusoids in plates 2 cells thick

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11
Q

What does the basolateral membrane face?

A

a pericellular space called the Space of Disse

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12
Q

What does the apical membrane form?

A

the caniculi

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13
Q

Which membrane is grooved?

A

apical

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14
Q

Which 3 cells do sinusoidal spaces contain?

A

endothelial cells, kuppfer cells and stellate cells

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15
Q

What structure do the endothelial cells form?

A

fenestrated

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16
Q

What do the endothelial cells in the sinusiodal spaces do?

A

allow for free movement of solutes but not cells

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17
Q

What do the Kuppfer cells do?

A

These are macrophages which remove particulate matter (eg bacteria) and senescent erythrocytes

18
Q

Where are the Stellate cells and what do they do?

A

In space of Disse, store vitamin A and play role in fibrosis and cirrhosis

19
Q

What may be used to dissolve non-calcified gall stones?

A

Ursodeoxycholic acid

20
Q

What is bile involved in the digestion and absorption of?

A

fats

21
Q

During a meal, what stimulates the gall bladder smooth muscle to contract?

A

chyme in duodenum via CCK and vagal impulses

22
Q

What does the sphincter of Oddi contract via?

A

CCK

23
Q

Via which ducts does bile spurt into the duodenum during a meal?

A

Cystic and common

24
Q

Is bile from the liver mixed in with the bile spurted into the duodenum during a meal?

A

Yes

25
Q

What soes primary juice secreated from hepatocytes into caniculi drain into?

A

biliary ductules

26
Q

What does hepatic bile consist of?

A

primary bile acids (mainly cholic and chenoeoxycholic acids) water and electrolytes, lipids and phospolipids, cholesterol, IgA and bilirubin

27
Q

What is bilirubin the breakdown product of?

A

breakdown product of the porphyrin component of haemoglobin

28
Q

When do bile duct secretions have an ionic composition similar to plasma?

A

between meals

29
Q

What happens to bile duct secretions during a meal?

A

During meals flow rate increases in response to secretin released from duodenal S cells

30
Q

Where does HCO3-/Cl- exchange occur and when is it reduced?

A

across the duct cell apical membrane – reduced at high flow rate - therefore HCO3- content increases

31
Q

What does the neutral/slightly alkaline pH of bile duct cell secretions contribute to?

A

micelle formation
neutralization of chyme
pH adjustment for digestive enzyme action
protection of the mucosa

32
Q

How are bile salts synthesised?

A

from cholesterol in a series of 14 reactions, first mediated by cholesterol 7a-hydroxylase (CYP7a1) to form the primary bile salts

33
Q

What is rate of synthesis of bile salts dependent on?

A

the hepatic portal blood concentration of the salts

  • Low concentrate stimulates synthesis
  • High concentration inhibits synthesis
34
Q

Is secretion across the apical membrane by diffusion or active transport?

A

is by active transport (MRP2 and BSEP)

35
Q

What causes aqueous alkaline bile secretion?

A

secretin

36
Q

In what phase of digestion does vagal activity produce a mild secretory response?

A

cephalic

37
Q

What are drug options for biliary colic?

A

For Analgesia

Morphine – but constricts the sphincter of Oddi; buprenorphine and pethidine are alternatives

For relief of biliary spasm

Atropine, or glyceryltrinitrate (GTN)

38
Q

How are gall stones actually treated?

A

surgery or ursodeoxycholic acid

39
Q

With what type of drugs do metabolites gain activity?

A

prodrugs

40
Q

Does drug metabolism make a drug more or less polar?

A

more polar (Adds an endogenous compound)

41
Q

Are some drugs excreted unchanged?

A

Yes

42
Q

What is aspirin changed to in the 2 phases of drug metabolism?

A 
Salicyclic acid (the derivative) and then Glucuronide
(conjugate)

GI Physiology (4 decks)

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