the hepatic, pancreatic, and biliary systems Flashcards
what are four functions of the liver?
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
what protein is the liver the sole source of?
albumin
TRUE OR FALSE: the liver produces 600 ml of bile each day
true
what is the primary function of the exocrine gland of the pancreas?
secretion of digestive enzymes and pancreatic juices
neutralize the acidic substances passed from the stomach to the dueodenum
what is the function of the endocrine gland of the pancreas?
secretion of glucagon and insulin for the regulation of carbohydrate metabolism
what structures secrete glucagon and insulin in the endocrine gland of the pancreas?
islet of Langerhans cells
what organ is a reservoir for bile?
gallbladder
what helps in alkalinizing the intestinal contents and plays a role in the emulsification, absorption, and digestion of fat?
bile
where does the gallbladder expel the bile into in response to the arrive of food?
duodenum
what are primary signs and symptoms of liver diseases?
GI symptoms
edema/ascites
dark urine
light colored or clay feces
right upper abdominal pain
what causes hepatic failure?
cirrhosis, liver cancer, or infection/inflammation
the following clinical syndromes are signs of what organ failure?
hepatic encephalopathy
renal failure
endocrine changes
jaundice
hepatic failure
what do light colored stools and urine the color of tea or cola indicate?
liver necrosis
what are some skin changes associated with the hepatic system?
jaundice
pallor
orange or green skin
what condition may be vascular manifestations of increased estrogen levels?
spider angioma
what condition is the warm redness of the skin over the palms, also called liver palms?
palmar erythema
what is hepatic encephalopathy?
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.
is hepatic encephalopathy reversible?
yes
what is asterixis? and what population is it often seen in?
people with hepatic encephalopathy
the inability to maintain wrist extension with forward flexion of the upper extremities
where is liver referred pain occur on the body?
thoracic pain between scapulae, right shoulder, right upper trap, right interscapular, or right subscapular areas
what is hepatic osteodystrophy? and what type of liver disease is it common in?
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
where do people with long term liver disease experience bone weakness?
wrist and ankles
what should you do if a client presenting undiagnosed or untreated jaundice comes into the clinic?
refer them to a physician
what should be avoided when the liver is compromised? (what physical activity?)
active, intense exercise
what are some PT implications that we should be aware of with people with liver disease?
risk for pressure ulcers
risk of coagulopathy (easy bruising and bleeding under the skin or into the joint)
what happens with aging and the hepatic system?
liver decreases in size, weight, and blood flow
with aging, it requires ____ time to process substances, medication, and alcohol
more
true or false: you become more tolerant to damage and more able to repair and regenerate the liver
FALSE: you become less tolerant and less able to repair and regenerate
what happens to albumin production with aging?
decreases
TRUE OR FALSE: Because there is a decrease in albumin, drugs that typically bind to albumin become more active in the blood
true
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?
lipophilic
what are the four common causes of jaundice?
disease associated with overproduction of bilirubin
decreased uptake or conjugation in bilirubin metabolism
hepatocyte dysfunction
impaired bile flow
what is jaundice?
yellow discoloration of the skin, sclerae, and mucous membranes
what disease does the patient have if their skin is yellow, urine turns darker, and stool is light in color?
jaundice
what is the final common pathway of chronic, progressive inflammation of the liver?
cirrhosis
is cirrhosis reverisble?
no
what is cirrhosis?
occurs when inflammation causes liver tissue damage or necrosis
what is portal hypertension?
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
what increases resistance and forms mechanical barriers in portal hypertension?
fibrosis
nodularity
abnormal liver architecture
TRUE OR FALSE: blood backs up in the stomach, esophagus, umbilicus, and rectum causing dilation and expansion
true
what is a complex neuropsychiatric syndrome with symptoms ranging from subtle neuropsychiatric and motor disturbances to coma and death?
hepatic encephalopathy (HE)
what are common causes of hepatic encephalopathy?
GI bleeding, infection, hypovolemia, or electrolyte abnormalities
what is ascites?
abnormal accumulation of fluid within the peritoneal cavity
what other condition accompanies ascites that makes it hard to breath?
dyspnea (increased respiratory rate occurs when the fluid displaces the diaphragm)
what is spontaneous bacterial peritonitis? and what other condition does it accompany?
infection of ascitic fluid in the setting of portal hypertension
ascites
