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Physio II Exam 3 > Physiology of Liver and Pancreas > Flashcards

Physiology of Liver and Pancreas Flashcards

1
Q

Blood flow through a lobule

A
  • Portal vein → sinusoids → central vein → hepatic veins

* Hepatic artery → sinusoids → central vein → hepatic veins

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2
Q

Liver cell plates are composed of

A

two layers of hepatocytes.

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3
Q

Bile canaliculi lie between

A

two layers of hepatocytes in each cell plate

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4
Q

Sinusoids are lined with

A

Endothelial Cells and Kupffer Cells

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5
Q

Space of Disse is found between

A

endothelial cells and hepatocytes

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6
Q

Liver has high blood flow and low vascular resistance:

A

•1050 ml from portal vein + 300 ml from hepatic artery flows into sinusoids each minute. •27% of resting cardiac output.

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7
Q

Portal Pressure into Liver

Pressure from Liver to Vena Cava

A

9 mmHg

0 mmHg

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8
Q

Effect of cirrhosis on blood flow

A

cirrhosis increases blood resistance to blood flow

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9
Q

Effect of clot blocking portal vein or a major branch:

A
  • Blockage of return blood from spleen and intestines

* Increase in capillary pressure in intestinal wall → loss of fluid → death

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10
Q

High pressure in right atrium → ?

When might this occur?

A

backpressure on liver → increased blood volume in liver up to 1.5 liters.

May occur during cardiac failure with peripheral congestion

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11
Q

liver can store blood in ___ and supply blood in times of ____.

A

liver can store blood in times of excess and supply blood in times of diminished volume

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12
Q

Hepatic sinusoids are ___ permeable to proteins

A

highly

Efferent lymph has a protein concentration of 6 g/dl (almost equivalent to plasma concentration).

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13
Q

Higher than normal pressure in hepatic veins:

A
  • Back pressure causes fluid to transude into lymph.
  • Fluid leaks through liver capsule into abdominal cavity.
  • Fluid is almost pure plasma.
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14
Q

Ascites

A

Large amount of fluid in abdominal cavity

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15
Q

Functions of the Liver (7)

A
  1. Carbohydrate Metabolism
  2. Fat Metabolism
  3. Protein Metabolism
  4. Vitamin Storage (A, D, B12)
  5. Immune function
  6. Formation of coagulation factors
  7. Removal or excretion of drugs, hormones, and other substances
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16
Q

Removal or excretion of drugs, hormones, and other substances:

A
  • Detoxifies or excretes into the bile: sulfonamides, penicillin, ampicillin, and erythromycin
  • Excretes excess calcium into the bile
  • Detoxification and removal of ammonia and ethanol
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17
Q

Formation of coagulation factors:

A
  • Fibrinogen
  • Prothrombin
  • Accelerator globulin
  • Factors VII, IX, X
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18
Q

Carbohydrate metabolism:

A
  • Stores glucose as glycogen
  • Converts galactose and fructose to glucose
  • Gluconeogenesis
  • Forms many intermediate products of carbohydrate metabolism
  • Releases stored glucose into the circulation
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19
Q

Fat metabolism:

A
  • Oxidation of fatty acids for energy
  • Synthesis of cholesterol, phospholipids, lipoproteins
  • Synthesis of fats from proteins and carbohydrates
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20
Q

Protein metabolism:

A
  • Deamination of amino acids
  • Formation of urea
  • Formation of plasma proteins
  • Interconversion of various amino acids and synthesis of other compounds from amino acids
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21
Q

What factors stimulate the release of bile from the gall bladder?

A

Presence of fatty food in duodenum

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22
Q

Note that bile is secreted continuously by ______ and stored in the ______ until needed.

A

hepatocytes in the liver

gall bladder

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23
Q

In the gallbladder, bile is concentrated by ____ followed by secondary absorption of ___, ___, and ___.

A

active transport of sodium

chloride ions, water, and other diffusible constituents

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24
Q

Bile acids are conjugated with ___ or___.

what is added to the bile?

A

glycine or taurine

Electrolytes and water are added to bile

25
Q

Bile is concentrated in the gallbladder as a result of absorption of ___ and ___.

A

solutes and water

26
Q

Hepatic bile is produced and secreted by the…

Bile from the gallbladder is ___ that has been ___ and ___

A

liver

hepatic bile
stored and concentrated

27
Q

What do damaged RBCs release?

Free bilirubin is transported in the ___, attached to ___ to ___.

A

Hemoglobin

blood stream, plasma albumin, liver hepatocytes

28
Q

Reticuloendothelial System

A
  • Hemoglobin is phagocytized by macrophages (reticuloendothelial system).
  • Split into globin and heme
  • Heme ring is opened to free iron.
  • Heme is transported in the blood by transferrin.
  • Straight chain of pyrrole nuclei is formed.
  • Heme is converted by hemeoxygenase into biliverdin.
  • Biliverdin is converted to free (unconjugated) bilirubin.
29
Q

Bilirubin Formation

A

Free bilirubin is released from plasma albumin within the liver cells and conjugated

Conjugated bilirubin is:
•Secreted (active transport) into the intestine OR
•Excreted into the urine

30
Q

Jaundice

A
  • Refers to a yellowish tint to the body tissues.

* Usually caused by quantities of bilirubin in the extracellular fluids.

31
Q

Common Causes of Jaundice

A

Common causes:
•Increased hemolysis
•Obstruction of bile ducts or damage to liver

32
Q

Types of Islet Cells

A

Alpha, Beta, Delta

33
Q

Alpha Islet Cells

A
  • secrete glucagon

- 25% of total cells

34
Q

Beta Islet Cells

A
  • Secrete insulin and amylin
  • insulin inhibits glucagon secretion
  • amylin inhibits insulin secretion

-60% of total cells

35
Q

Delta Islet Cells

A
  • Secrete somatostatin

- inhibits insulin, glucagon, and gastrin secretion

36
Q

Communication Among Islet Cells

A

Via gap junctions:
•B cells to B cells
•A cells to A cells
•B cells to A cells

Via islet portal blood supply:
•B cells to A and D cells

37
Q

Pancreatic Secretions

Exocrine functions:

A

Digestive enzymes for proteins, carbohydrates or fats

38
Q

Digestive Enzymes for Proteins

A

Trypsin, chymotrypsin, and carboxypolypeptidase
•Trypsin inhibitor:
•Secreted by the glandular cells
•Necessary to prevent the action of trypsin on the pancreatic tissues themselves

39
Q

Digestive Enzymes for Carbohydrates

A

Pancreatic Amylase

40
Q

Digestive Enzymes for Fat

A

Pancreatic lipase, cholesterol esterase, phospholipase

41
Q

Characteristics of pancreatic secretions:

A
  • High volume
  • Isotonic
  • Same sodium and potassium ion concentrations as plasma
  • Higher bicarbonate concentration than plasma
  • Lower chloride ion concentration than plasma
  • Low flow rates: •Isotonic fluid composed mostly of sodium and chloride ions
  • High flow rates: •Isotonic fluid composed mostly of sodium and bicarbonate ions
42
Q

Acinar cells:

A

Produce small volume of pancreatic secretion composed mainly of sodium and chloride ions

43
Q

Ductal cells:

A
  • Secrete bicarbonate ion and reabsorb chloride ion via a chloride-bicarbonate exchange mechanism.
  • Ducts are permeable to water, so water moves into ducts to make secretion isotonic.
44
Q

Insulin

A

•Insulin circulates in unbound form in blood with half-life of 6 minutes. •Insulin not bound to receptors is destroyed in liver.

45
Q

Most of the glucose absorbed after a meal is stored as __ in the __.

A

glycogen, liver

46
Q

Glucose uptake mechanism for the liver

A
  1. Insulin inactivates liver phosphorylase
  2. Insulin activates glucokinase and enhances uptake of glucose from blood.
  3. Insulin increases activities of enzymes needed for glycogenesis.
47
Q

One of the most important functional roles of insulin in the body

A

to control from moment to moment whether fat (↓insulin) or carbohydrate (↑insulin) will be used by cells for energy

48
Q

Events that cause liver to release glucose into blood

A
  • Decreased blood glucose resulting in decreased insulin secretion.
  • Lack of insulin reverses glycogen synthesis pathway.
  • Lack of insulin activates phosphorylase which splits glycogen into glucose phosphate.
  • Glucose phosphatase removes phosphate from glucose and allows it to diffuse back into blood.
  • Insulin inhibits gluconeogenesis.
49
Q

Insulin promotes conversion of excess glucose into ___ and decreases ___. Previous effects are reversed and large amounts of ____ are released into the blood.

A

fatty acids

utilization of fats

glycerol and fatty acids

50
Q

Glucagon

A

Major effects: •Break down of liver glycogen •Increased gluconeogenesis

  • Glucagon cascade of events leading to ↑ Blood glucose
  • Increases lipolysis
  • Increases urea production (due to deamination of amino acids used for gluconeogenesis)
51
Q

•Glucagon cascade of events leading to ↑ Blood glucose:

A
  • Activates adenylcyclase in hepatic cell membrane
  • Which causes formation of cAMP
  • Which activates protein kinase
  • Which activates phosphorylase b kinase
  • Which converts phosphorylase b into phosphorylase a
  • Which promotes degradation of glycogen to glucose-1-phosphate.
52
Q

Increased blood amino acids stimulates ___ which does what?

A

Glucagon secretion which Prevents hypoglycemia due to unopposed insulin in response to high protein meal

53
Q

Somatostatin

A

Secreted by delta cells Major effects:
•Inhibits secretion of insulin, glucagon, and gastrin
•Decreases motility of stomach, duodenum, and gallbladder.
•Decreases secretion and absorption of GI tract

54
Q

Negative Effects of Increased Blood Glucose Levels

A
  • Increased osmotic pressure in extracellular fluid.
  • Loss of glucose in urine.
  • Osmotic diuresis (dehydration and loss of electrolytes)
  • Damage to tissues and blood vessels.
55
Q

Metabolic Syndrome:

A
  • Obesity (esp. abdominal fat)
  • Insulin resistance
  • Fasting hyperglycemia
  • Increased lipid triglycerides
  • Decreased HDL levels
  • Hypertension
56
Q

Type II (NIDDM):

A
  • Due to insulin resistance
  • Obesity is major risk factor
  • Preceded by metabolic syndrome
57
Q

Type I (IDDM):

A
  • Due to lack of insulin secretion
  • Injury to Beta cells:
  • Viral infections
  • Autoimmune disorders
58
Q

What does diabetes do to the curve of blood glucose level tolerance vs time?

A

increases it significantly (doubled or more in some places)

Physio II Exam 3 (9 decks)

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