the hepatic, pancreatic, and biliary systems

Question 1

what are four functions of the liver?

Answer 1

conversion and excretion of bilirubin

produce of clotting factors and storage of vitamins

metabolize drugs, chemicals, and toxins

filters all of the blood from the GI system

Question 2

what protein is the liver the sole source of?

Answer 2

albumin

Question 3

TRUE OR FALSE: the liver produces 600 ml of bile each day

Answer 3

true

Question 4

what is the primary function of the exocrine gland of the pancreas?

Answer 4

secretion of digestive enzymes and pancreatic juices

neutralize the acidic substances passed from the stomach to the dueodenum

Question 5

what is the function of the endocrine gland of the pancreas?

Answer 5

secretion of glucagon and insulin for the regulation of carbohydrate metabolism

Question 6

what structures secrete glucagon and insulin in the endocrine gland of the pancreas?

Answer 6

islet of Langerhans cells

Question 7

what organ is a reservoir for bile?

Answer 7

gallbladder

Question 8

what helps in alkalinizing the intestinal contents and plays a role in the emulsification, absorption, and digestion of fat?

Answer 8

bile

Question 9

where does the gallbladder expel the bile into in response to the arrive of food?

Answer 9

duodenum

Question 10

what are primary signs and symptoms of liver diseases?

Answer 10

GI symptoms
edema/ascites
dark urine
light colored or clay feces
right upper abdominal pain

Question 11

what causes hepatic failure?

Answer 11

cirrhosis, liver cancer, or infection/inflammation

Question 12

the following clinical syndromes are signs of what organ failure?

hepatic encephalopathy
renal failure
endocrine changes
jaundice

Answer 12

hepatic failure

Question 13

what do light colored stools and urine the color of tea or cola indicate?

Answer 13

liver necrosis

Question 14

what are some skin changes associated with the hepatic system?

Answer 14

jaundice
pallor
orange or green skin

Question 15

what condition may be vascular manifestations of increased estrogen levels?

Answer 15

spider angioma

Question 16

what condition is the warm redness of the skin over the palms, also called liver palms?

Answer 16

palmar erythema

Question 17

what is hepatic encephalopathy?

Answer 17

a condition where the liver fails to filter out toxins from the blood which causes toxins to build up and affect the brain.

As a result, people experience symptoms like confusion, modo changes, etc.

Question 18

is hepatic encephalopathy reversible?

Answer 18

yes

Question 19

what is asterixis? and what population is it often seen in?

Answer 19

people with hepatic encephalopathy

the inability to maintain wrist extension with forward flexion of the upper extremities

Question 20

where is liver referred pain occur on the body?

Answer 20

thoracic pain between scapulae, right shoulder, right upper trap, right interscapular, or right subscapular areas

Question 21

what is hepatic osteodystrophy? and what type of liver disease is it common in?

Answer 21

a condition where liver disease leads to problems with bone health.

It can happen in people with any type of liver disease that blocks or slows down bile flow

Question 22

where do people with long term liver disease experience bone weakness?

Answer 22

wrist and ankles

Question 23

what should you do if a client presenting undiagnosed or untreated jaundice comes into the clinic?

Answer 23

refer them to a physician

Question 24

what should be avoided when the liver is compromised? (what physical activity?)

Answer 24

active, intense exercise

Question 25

what are some PT implications that we should be aware of with people with liver disease?

Answer 25

risk for pressure ulcers risk of coagulopathy (easy bruising and bleeding under the skin or into the joint)

Question 26

what happens with aging and the hepatic system?

Answer 26

liver decreases in size, weight, and blood flow

Question 27

with aging, it requires ____ time to process substances, medication, and alcohol

Answer 27

more

Question 28

true or false: you become more tolerant to damage and more able to repair and regenerate the liver

Answer 28

FALSE: you become less tolerant and less able to repair and regenerate

Question 29

what happens to albumin production with aging?

Answer 29

decreases

Question 30

TRUE OR FALSE: Because there is a decrease in albumin, drugs that typically bind to albumin become more active in the blood

Answer 30

true

Question 31

what type of medications have an increased area of distribution in older people in proportion to an increase in fat mass and decrease of lean mass with aging?

Answer 31

lipophilic

Question 32

what are the four common causes of jaundice?

Answer 32

disease associated with overproduction of bilirubin decreased uptake or conjugation in bilirubin metabolism hepatocyte dysfunction impaired bile flow

Question 33

what is jaundice?

Answer 33

yellow discoloration of the skin, sclerae, and mucous membranes

Question 34

what disease does the patient have if their skin is yellow, urine turns darker, and stool is light in color?

Answer 34

jaundice

Question 35

what is the final common pathway of chronic, progressive inflammation of the liver?

Answer 35

cirrhosis

Question 36

is cirrhosis reverisble?

Answer 36

no

Question 37

what is cirrhosis?

Answer 37

occurs when inflammation causes liver tissue damage or necrosis

Question 38

what is portal hypertension?

Answer 38

an elevated portal pressure gradient occurs when the pressure of the blood entering the liver is higher than the pressure of the blood in the inferior vena cava

Question 39

what increases resistance and forms mechanical barriers in portal hypertension?

Answer 39

fibrosis nodularity abnormal liver architecture

Question 40

TRUE OR FALSE: blood backs up in the stomach, esophagus, umbilicus, and rectum causing dilation and expansion

Answer 40

true

Question 41

what is a complex neuropsychiatric syndrome with symptoms ranging from subtle neuropsychiatric and motor disturbances to coma and death?

Answer 41

hepatic encephalopathy (HE)

Question 42

what are common causes of hepatic encephalopathy?

Answer 42

GI bleeding, infection, hypovolemia, or electrolyte abnormalities

Question 43

what is ascites?

Answer 43

abnormal accumulation of fluid within the peritoneal cavity

Question 44

what other condition accompanies ascites that makes it hard to breath?

Answer 44

dyspnea (increased respiratory rate occurs when the fluid displaces the diaphragm)

Question 45

what is spontaneous bacterial peritonitis? and what other condition does it accompany?

Answer 45

infection of ascitic fluid in the setting of portal hypertension ascites