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Block One > The Liver In The Abdoinal Body > Flashcards

The Liver In The Abdoinal Body Flashcards

1
Q

General functions of the liver

A

Production, storage, excretion, biotransformation, metabolism

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2
Q

Physical exam of the liver

A

Should not be palpable with occasional exception of l lateral lobe at left cranial and ventral area of abdomen at costal arch, edges should feel sharp not round

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3
Q

Radiograph of the liver

A

Contained with in ribcage spans cranial abdomen d v and l to r; soft tissue or fluid opacity between stomach and diaphragm

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4
Q

Liver location in abdomen

A

Caudal to diaphragm, cranial to stomach intestine and other abdominal organs; mass spands width of body w/ slightly ore mass to R side of median

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5
Q

Cranial surface of liver

A

Curved or domed conforming to caudal surface of diaphragm

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6
Q

Caudal surface of the liver

A

Faces viscera, conforms to shape of organs it comes into contact with (ex stomach, duodenum, kidneys)

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7
Q

Connection of liver to adjacent structures

A

Coronary ligament, left and right triangular ligaments, falciform ligament, lesser omentum

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8
Q

Coronary ligament

A

Surrounds vessels that leave or bypass the liver, ie hepatic veins and casual vena cava, and it connects liver to diaphragm

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9
Q

Right and left triangular ligaments

A

Folds of peritoneum reinforced with connective tissu; extend from coronary ligament
Right triangular ligament extends from diaphragm to along dorsal margin of right lateral lobe
Left triangular ligament attaches from diaphragm along dorsal margin of left lateral loss

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10
Q

Falciform ligament

A

Remnant of ventral mesentery, connects liver, diaphragm, ventral body wall to umbilicus; found between two medial liver lobes

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11
Q

Umbilical vein fetus and adult remnant

A

In fetus this courses in ventral mesentery, remnants of umbilical vein may be ween as round ligament of liver

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12
Q

Lesser omentum liver attachment

A

Remnant of ventral mesentery, extends from lesser curvature of the stomach to visceral surface of the liver; bile duct, hepatic arteries, and hepatic portal vein course through the lesser omentum

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13
Q

Liver lobes

A

Two left lobes, two right lobes, a quadrate lobe, and a caudate lobe

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14
Q

Left lateral lobe

A

Largest lobe, contacts the diaphragm cranially and lat thoracic body wall and costal arch laterally; height extends from floor of body cavity to just under crura of diaphragm. Visceral surface is concave conforming to shape of stomach leaving gastric impression

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15
Q

Left medial lobe of liver

A

Smaller, can be found at cranial edge of left lateral lobe

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16
Q

Right medial liver lobe

A

Forms apex of the liver with left medial lobe; laterally and ventrally there is a fossa where gall bladder is situated;

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17
Q

Quadrate lobe

A

Forms other half of fossa for gallbladder with in it

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18
Q

Gallbladder is situated between

A

Right medial liver lobe and quadrate lobe

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19
Q

Right lateral liver lobe

A

Relatively small, located just caudal to right medial lobe

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20
Q

Caudate lobe

A

Located caudal to rest of the liver lobes; two processes, a papillary process lying on lesser curvature of the stomach and caudate process in which a recess has been formed around the curvature of the cranial pole of the right kidney

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21
Q

Gall bladder

A

Situated in a fossa between right medial and quadrate lobes of the liver; storage organ for bile

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22
Q

Bile ductules

A

Bile produced by liver cells reach bile ductules via bile canuculi; bile ductules are found at portal triads

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23
Q

Portal triad

A

Portal venule, portal arteriole, bile ductule

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24
Q

Hepatic ducts

A

Bile ductules are tributaries of hepatic ducts which carry bile toward gallbladder and marks the intersection of cystic duct and bile duct

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25
Q

Cystic duct

A

Two way passage of bile to and from gallbladder

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26
Q

Bile duct

A

Carries bile from the gall bladder to the duodenum (poems into major duodenal papilla)

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27
Q

Equine gallbladder

A

THEY DO NOT HAVE ONE

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28
Q

Structural blood supply

A

Supplies the cells of the specified organ itself

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29
Q

Functional blood supply

A

Blood that the organ works on for further use by the body

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30
Q

Structural blood supply of the liver

A

Hepatic artery; the arterial blood derived from the heart

31
Q

Functional blood supply to the liver

A

Portal vein; blood drained from digestive tract to the liver

32
Q

Structural blood supply to the liver

A

Branches of celiac artery hepatic arteries branch to become hepatic arterioles which supply cells of the liver via sinusoids

33
Q

structural blood supply blood flow within the liver

A

sinusoids are spaces between rows of liver cells in which blood flows from portal triads toward central veins

34
Q

structural blood flow from the liver

A

central veins are tributaries to hepatic veins which carry venous and filtered blood from liver to caudal vena cava back to right atrium of heart

35
Q

functional blood supply to the liver

A

venous blood from areas of digestive system such as cranial and caudal mesenteric veins, gastroduodenal vein, splenic veins, and tributaries draining into hepatic portal vein which divides into vessels draining into L and R sides of the liver

36
Q

portal veins drain into

A

portal venues, which can be seen at portal triads and portal tracts as they supply units of the liver

37
Q

portal blood flows through

A

sinusoids similar to arterial blood where they come into contact with hepatocytes for processing

38
Q

venous blood return functional blood supply of liver

A

venous blood returned via central veins, and eventually the draining vessels become larger leading to hepatic veins which flow to caudal vena cava and right atrium of the heart

39
Q

how much of blood suppled to the liver comes from the portal system?

A

4/5

40
Q

smallest units of the liver

A

hepatocytes

41
Q

hepatocyte shape

A

polyhedral

42
Q

hepatocyte nucleus

A

euchromatic, centrally positioned, contains prominent nucleoli indicating activity

43
Q

hepatocyte cytoplasm

A

appears acidophilic containing basophilic material such as rough ER or ribosomes; mitochondria or Golgi apparatus may be apparent; may have foamy appearance bc of glucose and glycogen production as well as lipid inclusions

44
Q

hepatocyte arrangment

A

arranged in plates, between cells within a plate bile caniculi drain bile salts that are produced within the cell and drain towards bile ductules

45
Q

sinusoids

A

spaces that separate plates of hepatocytes; blood flows from portal venues through sinusoids toward central veins; arterial blood from hepatic arterioles supply hepatocytes via sinusoids

46
Q

perisinusoidal space

A

smaller space lying between sinusoid and hepatocytes; helps permit free movement of material between plasma and hepatocytes

47
Q

Kuppfer cells

A

macrophages that reside on top of sinusoid endothelial cells and help remove foreign particles

48
Q

central vein

A

plate of sinusoids are radially arranged around a central vein, sinusoids drain toward a central vein which drain other central veins to drain blood towards hepatic veins

49
Q

portal traids

A

situated in corners of hepatic lobule with in connective tissue septa; portal venules, hepatic arterioles, and bile ductules

50
Q

portal venules bring ____ to blood supply from ____ system to sinusoids and hepatocytes

A

functional blood supply from portal system

51
Q

hepatic arterioles bring ____ blood supply to sinusoids and hepatocytes

A

structural

52
Q

bile ductules drain bile from ____ to eventually be stored in ____

A

hepatocytes to eventually be stored in gall bladder

53
Q

bile ductule epithelium

A

simple cuboidal (typical of other ducts of exocrine glands)

54
Q

3 classifications of the liver

A

hepatic lobule, portal lobule, hepatic acinus

55
Q

hepatic lobule

A

morphological description of a liver unit; central vein in center, portal triads in connective tissue septa making up the peripheral borders (usually a hexagon)

56
Q

portal lobule

A

functional categorization; based on exocrine function of liver (flow of bile from hepatocytes); bile ductules in portal triad is in center of this unit; peripheral corners are central veins from 3 hepatic lobules

57
Q

blood flows ___ portal triad ____ center vein

A

from portal triad toward central vein

58
Q

hepatic acinus

A

based on blood flow in the liver; another functional classification of a unit of the liver; blood flows from portal triads and portal tracts toward central veins, this axis of blood vessels in a portal tract is the center of the hepatic acinus and blood flows from here toward central veins

59
Q

3 zones of hepatic acinus

A

inner zone (1), middle zone (2), outer zone (3)

60
Q

inner zone

A

zone 1; closest to portal tract and blood vessels; receives most oxygenated blood; general metabolism occurs most in zone 1

61
Q

middle zone

A

zone 2; between zones 1 and 3 receives oxygen and toxins in amount between other two zones

62
Q

outer zone

A

zone 3; furthest from portal tract and closest to central veins, receives least amount of oxygen and may be prone to ischemia; drug metabolism occurs here so prone to any harfmful metabolites of drug conjugation

63
Q

liver lobectomy

A

ventral midline incision made through linea alba from xiphoid caudally; may need to retract stomach, duodenum, pancreas, and spleen; careful blunt direction needed around caudal vena cava, portal vein, celiac artery, and cranial mesenteric artery; entire lobe can be removed by isolating and ligating blood vessels and biliary ducts at hilus

64
Q

percutaneous liver biopsies

A

can be performed blindly or via u/s

65
Q

liver regeneration

A

amazing regenerative capacity; adequate liver function may be possible with as much as 80% of liver removed; this is bc small amount of connective tissue stroma not limiting physical growth and changes in blood flow are rapid

66
Q

blood test for liver

A

ALT, AST, ALP, Albumin, coagulation factors, urea nitrogen, bilirubin, bile acids

67
Q

alt

A

alanine aminotransferase,hepatocelluar cytoplasmic enzyme; injury to liver cell membrane results in release of enzyme

68
Q

ast

A

aspartame aminotransferase; also found in muscle

69
Q

alp

A

alkaline phosphatase; located in liver and bone, in liver located on cell membranes hepatobiliary region; inflammation or obstruction of bile tract is associated with increased ALP glucocorticoids also increase levels of ALP

70
Q

albumin

A

produced by hepatocytes; low levels in plasma may mean decreased production and hepatic insufficiency

71
Q

coagulation factors

A

also present in the liver; when levels are low indicates hepatic insufficiency, hemorrhage or lack of hemostasis may occur; various test for clotting and coagulation

72
Q

urea nitrogen

A

conversion of intestinal derived ammonia to urea nitrogen occurs in liver. Increased levels blood ammonia or decreased levels of blood urea nitrogen may indicate hepatic insufficency

73
Q

bilirubin

A

pigment produced by degradation of RBC; bilirubin is Brough to liver by albumin liver conjugates it and excretes it not stool or urine; increase in bilirubin concentrations in blood may indicate hepatic insufficiency or increased red blood cell breakdown

74
Q

bile acid

A

bile acids are produced in the liver stored in gallbladder and secreted into duodenum where they aid in digestion and absorption of fat and fatty acids; bile acids are reabsorbed into the ileum and are transported back to the liver via the hepatic portal system; increase in bile acids above normal values indicates that bile acids are not being reabsorbed by live indicating liver insufficiency

Block One (31 decks)

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