The Liver and Billary System Flashcards
The liver has 2 blood supplies via the ______________ and ___________
Hepatic Portal Vein and Hepatic Artery
The microscopic units of the liver are _________ that are centred around a __________ with radiating cords of ________ with ___________ at the periphery
Liver Lobules
Central Vein
Hepatocytes
Portal Tracts
What are the functions of the liver:
- Metabolism of ingested CHO’s, proteins and fats delivered from the portal vein
- Synthesis of plasma proteins and proteins involved in blood coagulation
- Storage of Iron, Vitamin B-12
- Detoxification and excretion through bile
Bile is an aqueous solution composed of:
Conjugated bilirubin Bile salts Lecithin Cholesterol Minerals
Bile flows in the ________ direction of the blood. It drains into ___________ and then into larger ducts that become the ______________. Bile is __________ and ________ in the gall bladder.
Opposite
Bile Canaliculi
Common Hepatic Duct
Concentrated and Stored
What causes Liver Injury?
Alcohol Drugs Chemicals/Toxins Infections especially viral ones Obstruction Autoimmune disorders
What are the major types of Liver cell injury?
Fatty Change
Necrosis
Cirrhosis
What is Fatty change?
Accumulation of fat in the hepatocyte, it is usually reversible
What is Necrosis of liver?
Death of liver cells, remaining liver cells can regrow if death is only focal
What is Cirrhosis?
Diffuse fibrosis with regeneration nodules, it is irreversible
What is Hepatic Steatosis and what causes it?
Fatty Liver disease, An injury which disrupts normal fat metabolism in the liver leading to the accumulation of fat globules in hepatocytes
What what are common causes of Hepatic Steatosis?
- Excess alcohol use
- Solvents like Carbon Tetrachloride
- Protein malnutrition
- Anoxia
- Reye’s Syndrome
Briefly describe Alcoholic liver disease:
- Reversible fatty liver disease if you stop drinking
- Progresses to Alcoholic Hepatitis which causes degenerative changes and inflammation
- Progresses to Alcoholic Cirrhosis which is irreversible due to diffuse scarring
Common viruses that affect the liver are:
Hep A
Hep B
Hep C
All hepatitis viruses cause liver cell _______ and/or _______ and __________.
Injury
Necrosis and Inflammation
Summarise Hep A:
- Transmitted person to person by water and faecal contaminated food
- Short incubation and infectivity period
- No carrier status
- Usually acute and short illness
- Vaccine is available
Summarise Hep B:
- Transmitted by blood and body fluids
- 10% become chronic carriers and are infectious
- Has a carrier status, they may develop liver disease
- Preventative Vaccine is available
- Treated with HBV Ig after exposure
Summarise Hep C:
- Transmitted by blood and body fluids
- Large proportion become chronic carriers and are infectious
- No vaccine available
- No HCV Ig treatment available
Cholelithiasis (Gallstones) occur in __ to __% of the population. They are composed of __________________ most often _________.
10-20%
Bile Constituents
Cholesterol
When do gallstones form?
When cholesterol content is present in a supersaturated solution
Who is most at risk for gallstones
Fair Fat Fertile Females in their Forties and Fifties
What are the symptoms of gallstones?
Usually assymptomatic unless they pass into the cystic or common bile ducts
What complications can arise from gallstones?
Inflammation of the gall bladder, Cholecystitis
Rupture of the gall bladder with perforation
Obstruction of the common bile duct which may cause pancreatitis
