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Physiology II > Physiology of Liver and Pancreas (Lec 14) > Flashcards

Physiology of Liver and Pancreas (Lec 14) Flashcards

1
Q

What are the two pathways of blood flow through the liver 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 two layers of what?

A

hepatocytes

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3
Q

___ ___ lie between two layers of hepatocytes in each cell plate

A

bile canaliculi

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4
Q

Sinusoids are lined with what two types of cells?

A

endothelial cells and Kupffer cells

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5
Q

Where is space of Disse found?

A

between endothelial cells and hepatocytes

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6
Q

True or false?

Liver has low blood flow and high vascular resistance

A

false; high blood flow and low vascular resistance

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7
Q

In regards to liver vascular supply, 1050ml from portal vein + 300 ml from hepatic artery flows into ___ every minute

A

sinusoids

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8
Q

In regards to liver vascular supply, __% is resting cardiac output

A

27

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9
Q

Portal pressure into the liver = ___ mm Hg

A

9

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10
Q

Pressure form liver to vena cava = ___ mm Hg

A

0

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11
Q

What is the effect of cirrhosis on blood flow?

A

increases blood resistance to blood flow

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12
Q

What is the effect of clot blocking portal vein or a major branch of the liver?

A

blockage of return blood from spleen and intestines; increase in capillary pressure in intestinal wall -> loss of fluid -> death

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13
Q

In regards to liver vascular supply, what is the normal volume of the liver?

A

450 ml (10% of body’s blood volume)

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14
Q

High pressure in right atrium -> back pressure on liver -> increased blood volume in liver up to ___ liters

A
  1. 5

note: may occur during cardiac failure with peripheral congestion

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15
Q

True or false?

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

A

true

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16
Q

Hepatic sinusoids are highly permeable to what?

A

proteins

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17
Q

Efferent lymph has a protein concentration of __ g/dl

A

6 (almost equivalent to plasma concentration)

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18
Q

True or false?

There is a lower than normal pressure in hepatic veins

A

false; higher

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19
Q

Back pressure in the hepatic veins causes fluid to transude into ___

A

lymph

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20
Q

Fluid from the hepatic veins leaks through ___ __ into abdominal cavity

A

liver capsule

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21
Q

In regards to higher than normal pressure in hepatic veins, fluid is almost pure __

A

plasma

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22
Q

Large amount of fluid in abdominal cavity = ?

A

ascites

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23
Q

Carbohydrate metabolism is a function of the liver. Describe what carbohydrate metabolism does

A

stores glycogen; converts galactose and fructose to glucose; gluconeogenesis; forms many intermediate products

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24
Q

Oxidation of FAs for energy; synthesis of cholesterol, phospholipids, and lipoproteins; synthesis of fats from proteins and carbs are all aspects of what function of the liver?

A

fat metabolism

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25
Protein metabolism is a function of the liver. Describe what occurs in protein metabolism
deamination of AAs; formation of urea; formation of plasma proteins; interconversion of various AAs and synthesis of other compounds from AAs
26
Vitamin storage is a function of the liver. What vitamins are stored in the liver?
Vitamin A; Vitamin D; Vitamin B12
27
True or false? | Immune function is a function of the liver
true
28
Fibrinogen; prothrombin; accelerator globulin; factors VII, IX, X are all aspects of what function of the liver?
formation of coagulation factors
29
Removal or excretion of drugs, hormones, and other substances is a function of the liver. Describe how the liver does this
detoxifies or excretes into the bile: sulfonamides, penicillin, ampicillin, and erythromycin; excretes calcium into the bile; detoxification and removal of ammonia and ethanol
30
Hepatic bile is ___ and ___ by the liver
produced; secreted
31
Bile from the ___ is hepatic bile that has been stored and concentrated
gallbladder
32
What are the components of bile?
bile acids, water and electrolytes, cholesterol and phospholipids, pigments and organic molecules
33
Cholic and chenodeoxycholic acids are bile acids. What are they synthesized by?
hepatocytes
34
Deoxycholic acid and lithocholic acid are bile acids. What are they converted by?
bacteria
35
What is the major pigment in bile?
bilirubin
36
In regards to bilirubin formation, first, hemoglobin is released by what?
damaged RBCs
37
In regards to bilirubin formation, hemoglobin is phagocytized by what?
macrophages
38
In regards to bilirubin formation, hemoglobin is split into ___ and ___
globin; heme
39
In regards to bilirubin formation, Heme ring is opened to free what?
iron
40
In regards to bilirubin formation, heme is transported in the blood by what?
transferrin
41
In regards to bilirubin formation, straight chain of ___ nuclei is formed
pyrrole
42
In regards to bilirubin formation, heme is converted by ____ _____ into biliverdin
heme oxygenase
43
In regards to bilirubin formation, biliverdin -> free ____
bilirubin
44
In regards to bilirubin formation, free bilirubin is transported attache to ____ ___ to liver ____
plasma albumin; hepatocytes
45
In regards to bilirubin formation, free bilirubin is released from plasma albumin within the liver cells and conjugated. Describe the break down of conjugation with glucoronic acid, sulfate, and other substances
glucuronic acid -> bilirubin glucuronids (80%) sulfate -> bilirubin sulfate (10%) variety of other substances (10%)
46
Conjugated bilirubin is secreted (active transport) into what?
intestine
47
Conjugated bilirubin in the intestine is converted by bacterial action into what?
urobilinogen
48
Urobilinogen is oxidized into excreted products or:
reabsorbed into the blood and carried back to the liver
49
If urobilinogen is carried back to the liver, what happens?
it can be re-excreted by the liver or excreted in the urine
50
___ refers to a yellowish tint to the body tissues
jaundice
51
What is jaundice caused by?
quantities of bilirubin in the extracellular fluids caused by increased hemolysis or obstruction of bile ducts or damage to liver
52
What are the types of islet cells and what do they secrete?
alpha: secretes glucagon, 25% of total cells beta: secretes insulin and amylin, 60% of total cells delta: secretes somatostatin
53
Insulin inhibits ___ secretion
glucagon
54
Amylin inhibits __ secretion
insulin
55
Somatostatin inhibits ___ and ___ secretion
insulin; glucagon
56
Insulin circulates in unbound form in blood with a half-life of __ minutes
6
57
What happens to Insulin not bounded to receptors?
destroyed by liver
58
The following occur when what happens? increased uptake of glucose; increased permeability to AAs, potassium, and phosphate ions; increased activity levels for many enzymes; changes in rates of translation and transcription
insulin binds to receptor
59
How is insulin secreted?
beta cells in the islets of langerhans release insulin in two phases - rapid and slow
60
Describe the structure of the insulin receptor
transmembrane receptor that belongs to the large class of tyrosine kinase receptors
61
What happens to most of the glucose that is absorbed after a meal?
stored as glycogen in the liver
62
In regards to the glucose uptake mechanism, insulin inactivated liver ____
phosphorylase
63
In regards to the glucose uptake mechanism, insulin activates ___ and enhances uptake of glucose from __
glucokinase; blood
64
In regards to the glucose uptake mechanism, insulin increases activities of enzymes needed for ___
glycogenesis
65
In regards to events that cause liver to release glucose into blood, decreased blood glucose results in decreased ___ secretion
insulin
66
In regards to events that cause liver to release glucose into blood, lack of insulin reverses what pathway?
glycogen synthesis
67
In regards to events that cause liver to release glucose into blood, lack of insulin activates phosphorylase which does what?
splits glycogen into glucose phosphate
68
In regards to events that cause liver to release glucose into blood, glucose phosphatase removes phosphate from glucose and allows it to what?
diffuse back into blood
69
In regards to events that cause liver to release glucose into blood, insulin inhibits what?
gluconeogenesis
70
What is insulin's effect on fat storage?
Insulin promotes conversion of excess glucose into FAs and decreases utilization of fat
71
In regards to effects on fat storage, insulin increases transport of ___ into liver creating excess
glucose
72
In regards to insulin's effect on fat storage, excess glucose is converted to what?
acetyl-CoA
73
In regards to insulin's effect on fat storage, FA synthesis is ___
initiated
74
In regards to insulin's effect on fat storage, newly synthesized FAs are converted into what?
Triglycerides and then transported form liver as lipoproteins
75
In regards to insulin's effect on fat storage, triglycerides split into fatty acids in ___ and are taken up into ___ cells
capillaries; fat
76
In regards to insulin's effect on fat storage, insulin promotes uptake of ___ by fat cells
glycerol
77
In regards to effects of lack of insulin on fat storage, previous effects are reversed and large amounts of ___ and ___ are released into blood
glycerol; FAs
78
Large amounts of acetoacetic acids are formed in the ___
liver
79
In regards to effects of lack of insulin on fat storage, ___ transport mechanism in the liver is activated
carnitine
80
In regards to effects of lack of insulin on fat storage, B-oxidation results in excess of ___
acetyl-CoA
81
In regards to effects of lack of insulin on fat storage, excess acetoacetic acid causes ___
acidosis
82
In regards to effects of lack of insulin on fat storage, increase of ___ bodies in blood
ketone
83
The is an increase in plasma insulin concentration after increase in what?
blood glucose
84
Break down of liver glycogen and increased gluconeogensis are the two major effects of what?
glucagon
85
Describe the cascade of events leading to the major effects of glucagon
activates adenyl cyclase in hepatic cell membrane; cases formation of cAMP; activates protein kinase; activates phosphorylase b kinase; converts phosphorylase b into phosphorylase a; promotes degradation of glycogen to glucose-1-phosphate
86
Somatostatin's major effects are?
inhibits secretion of insulin and glucagon; decreases motility of stomach, duodenum, and gallbladder; decreases secretion and absorption of GI tract
87
Increased osmotic pressure in extracellular fluid; loss of glucose in urine; osmotic diuresis; damage to tissues and blood vessels are effects of what?
negative effects of increased blood glucose levels
88
This type of diabetes is due to lack of insulin secretion and injury to beta cells
Type I
89
What causes Type II diabetes
insulin resistance, obesity, metabolic syndrome
90
Obesity, insulin resistance, fasting hyperglycemia, increased lipid triglycerides, decreased HDL levels, hypertension are all symptoms of what?
metabolic syndrome

Physiology II (19 decks)

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