Physiology - Liver Structure and Function Flashcards

1
Q

What are the two major and minor lobes of the liver?

A

Major Lobes: Left and Right

Minor Lobes: Caudate and quadrate

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2
Q

Where is the porta and what does it contain?

A

On the inferior surface of the liver

Blood vessels: Hepatic artery, hepatic portal vein
Lymphatic vessels
Nerves: hepatic nerve plexus
Bile ducts: left and right hepatic ducts from the common hepatic duct

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3
Q

The porta hepatic contains the portal triad.

What makes up the portal triad?

A

Hepatic artery
Hepatic portal vein
Hepatic ducts

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4
Q

Describe the biliary tree from the liver to the duodenum

A

Left and Right hepatic ducts join to form the common hepatic duct
The common hepatic duct joins the cystic duct from the gallbladder to form the common bile duct
The common bile duct joins the pancreatic duct.
These both flow out the major duodenum papilla (Sphincter of Oddi)

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5
Q

What is the function of the coronary ligament and what lies within its border?

A

Connects the liver to the inferior border of the diaphragm

The area inside the coronary ligament is the bare area of the liver.

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6
Q

What structures cover the liver?

A

The liver is covered by a connective tissue capsule.

Also mostly covered by peritoneum

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7
Q

What does the connective tissue capsule of the liver become on the inferior surface?

A

At the porta the connective tissue capsule becomes a branching network of septa which run through the liver providing support

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8
Q

How does the septa of the liver add to the histological shape of the parenchyma?

A

The septa divide the liver into hexagonal lobules

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9
Q

What structures follow the septa throughout the liver?

A

Vessels, ducts and nerves

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10
Q

What structures are located at the corners of each hexagonal lobule?

A

Portal triad:

  • Hepatic artery
  • Hepatic portal vein
  • Hepatic ducts
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11
Q

What exist in the centre of hexagonal lobules in the liver?

A

Central vein

These drain into hepatic veins and eventually into the inferior vena cava

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12
Q

Describe hepatic cords

A

Hepatic cords radiate out from central veins like spokes on a wheel.
They are lined by (composed of) hepatocytes.
Bile canuliculi (cleft like lumen) lie between cells in each cord.
Spaces between hepatic cords are hepatic sinusoids and contain blood channels.

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13
Q

What type of capillaries are in the hepatic sinusoids?

A

Discontinuous capillaries

This allows lots of exchange

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14
Q

How do blood and bile flow through the hepatic lobules?

A

Blood flows towards the central vein

Bile flows down bile canuliculi towards the hepatic bile ducts

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15
Q

Describe the flow of blood through the hepatic sinusoids

A

Blood comes from the alimentary canal through the hepatic portal vein. (Oxygen depleted but Nutrient rich)
Oxygenated blood that is nutrient deprived comes from the heart through the hepatic artery.

In the hepatic sinusoids these two sources mix giving both oxygen and nutrient rich blood.
As this blood travels through the hepatic sinusoids it exchanges with the hepatocytes and eventually drains into the central vein.

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16
Q

What are the functions of hepatocytes?

A

Bile synthesis: Main function (bile salts)
Nutrient storage
Nutrient interconversion
Detoxification

17
Q

What nutrients do the liver hepatocytes store?

A

We eat more food than we require so nutrients are stored in the liver for a rainy day.

Glucose: converted to glycogen. Enough stored to run maybe 18 miles. Then you hit “the wall”
Fat: once your liver can’t store any more glycogen you start storing fat. Theres no limit to this (steatosis)
Vitamin B12: Enough for 3 years
Vitamins ADEK: Plenty stored
Copper: stored here safely so that oxygen free radicals aren’t causing havoc
Iron: also stored

18
Q

How do hepatocytes play a role in detoxification?

A

Particularly metals

Conjugated so that they are rendered harmless
We can then pass them without damaging other parts of our body
This system works for most things but isn’t perfect

19
Q

What are the 6 components of bile?

A

Bile Acid
Lecithin
Cholesterol
(These three are synthesised in the liver and emulsify fat)

Bile pigments: bilirubin
Toxic metals: Detoxified in liver
Bicarbonate: Neutralise acid chyme (produced in duct cells not hepatocytes)

20
Q

What are bile pigments?

How does bilirubin colour bile, urine and faeces?

A

Breakdown products of old/damaged erythrocytes

Bilirubin (predominant bile pigment) extracted from blood by hepatocytes and secreted into bile = Yellow Bile

Bilirubin is modified by bacterial enzymes to give brown pigment = Brown faeces

Reabsorbed Bilirubin is excreted in urine = Yellow urine

21
Q

Describe the life cycle of bile acids

A

Synthesised in the liver from cholesterol.
Before secretion they are conjugated with glycine or taurine to produce bile salts. (Increased solubility)

Secreted bile salts are reabsorbed through the enterohepatic circulation.
Liver -> bile duct -> duodenum -> distal ileum -> hepatic portal vein -> liver
Absorbed near transporters for vitamin B12 complex

22
Q

Why do you need a gallbladder?

A

When your not eating no CCK is being produced
Duodenal papilla (Sphincter of Oddi) is closed
Bile is being produced all the time
This bile starts to back up in the biliary tree

Gallbladder exists as a storage vessel
It absorbs water so that the bile is concentrated

23
Q

Describe the histological layers of the gallbladder

A

Mucosa has ruggae much like the stomach
Muscularis externa has smooth muscle so that bile can be pushed out into the duodenum
Serosa is the connective tissue layer

24
Q

Describe the control of bile secretion

A

Sphincter of Oddi:

  • Controls release of bile and pancreatic secretion into duodenum
  • When no CCK sphincter closed
  • Bile builds up and backs into gallbladder
  • Storage and concentration by absorption of Na and H2O

Presence of fat in duodenum causes release of CCK:

  • Sphincter of oddi relaxes
  • Smooth muscle of gallbladder contracts
25
Q

How is H2O absorbed from bile by the gallbladder?

A

Sodium potassium pump moves sodium out of epithelial cell and potassium in.
Potassium allowed to flow back out through channel
Sodium concentration inside the cell is low.
Sodium channel on apical surface takes sodium into cell
Water follows the movement of sodium from apical surface to basolateral surface