THE LIVER- SRUCTURE & FUNCTION Flashcards
Embryology-
The liver developed as _______ of the
________ (hepatic _______)
an outgrowth
primitive gut
diverticulum
________ is the largest organ in the body- (
Liver
Macroscopy of the liver
1.4-1.6kg =____% of body weight)
It lies in the ___________
2.5
right hypochondria.
Macroscopy of the liver
It has right and left lobes that are separated by the _________ anteriorly, ___________ inferiorly & that of ________ posteriorly
falciform ligament
fissure of ligamentum teres
ligamentum venosum
macroscopy of the liver
The (right or left?) lobe is larger
The _____lobe contain the caudate & quadrate lobes.
(Right or Left?) lobe is larger in infancy
Right
Right
Left
macroscopy of the liver
It is covered by ________ which has a deep fissure at the __________
Glisson’s capsule
portal hepatis.
macroscopy of liver
The _____,______,_________ and lymphatic enter the liver through the portal hepatis
portal vein, hepatic artery, common bile duct
macroscopy of liver
Blood flow-
portal vein :______% (derived from ____ and ———- ),
hepatic artery (branch of _______ artery): ________%(represent _____% of oxygen supply).
60-70
splenic & sup.mes. vein
coeliac
30-40
50
Microscopy of liver
Hepatic Lobule- ________ structure oriented around the ________ with portal tracts/triads at the ______
hexagonal
central vein
periphery
Microscopy of the liver
Portal triads each contain _______ branch, branch of ______ & a ______ , lymphatics with some scattered _______ and connective tissue in the triad
hepatic artery ; portal vein
small bile duct; lymphocytes
Microscopy of the liver
Hepatic acini (metabolic lobule)- ________ structure with _________ at the base and _________ at the apices.
triangular
portal tract
central vein
Zones of the liver
Zone 1-_________
Zone 2-__________
Zone 3- ___________
peri-portal
mid-zone
peri-venular
Central vein drains into the ______ vein
hepatic
Zones of the liver
Zone ___-closest to vascular supply
Zone ___-suffers toxic injury most
Zone ___- suffers hypoxic injury most
Zone ___- around the central vein
1
1
3
3
Total blood flow to the liver =____-____ mls/min.
This enter directly into the ______
Drainage occurs through the ______ Vein that drains into _________
1500 - 1900
sinusoids
hepatic
Inferior Vena Cava
Metabolic gradient of activity of enzymes exists
T/F
T
Many hepatic injuries do not exhibit zonal distribution
T/F
F
They do
_____________ are the principal parenchyma cells
Hepatocytes
Significance of the acini
Hepatocytes
Are organized into __________________ of ____ cell thick and disposed about the ________
cribriform anastomosing sheets or plates
one
central vein
Limiting plate refers to the plate of ______ that is ________/_______ the portal triad/ the portal tracts
hepatocytes
abutting
bordering
Each hepatocyte is a (small or large?) __________ cell with ( eosinophilic or basophilic?) cytoplasm containing _________
Large
polyhedral
eosinophilic; glycogen
The hepatocytes are uni-nucleate
T/F
T
Hepatocytes could be bi- nucleated with prominent nucleoli
T/F
T
Hepatocytes
______ stain showing cytoplasmic glycogen & __________ between hepatocyte plates draining into portal triad
PAS
bile canaliculli
Sinusoids- vascular channels which run between the _________, with (continuous or discontinuous?) / _______ endothelial cell.
They drain into the _________
hepatocyte plates
discontinuous
fenestrated
central vein
Kupfer cells are fixed _______, lie on the _______ surface of the ______ within the ___________.
macrophages
luminal
endothelium
sinusoids
Space of disse- space between the ________ and ____________
sinusoid and the plate of hepatocytes
Ito cells (_____________ cells) present in the _____________.
Hepatic stellate
perisinusoidal space
Ito cells
It is responsible for _________________ are present in this space. They also produce ________ in cirrhosis.
storage of fat containing vitamins (A,D,E,& K)
collagen
Bile canalliculi- are channels of _______________ size (into which numerous _______ protrude), are present between ____________________.
1-2 micrometer
microvilli
adjacent hepatocytes plates
Connective tissue of the liver
The cells and sinusoids are supported by fine meshwork of _______, which radiate from ________ of each lobule.
reticulin fibers
central vein
Connective tissue of the liver
Reticulin fibers contains type ____ collagen and is continuous with the ________
IV
Glisson’s capsule.
Special stains used in liver histopathology
_________ stain-to demonstrate the framework to assess extent of liver cell necrosis
_____-demonstrate glycogen
__________ -to demonstrate copper in
Wilson’s disease or HBsAg in hepatocytes
_____ stain-to demonstrate iron in haemochromatosis
______-to demostrate collagen/fibrous tissue
Reticulin
PAS
Shikatta orcein
Perl’s
Trichome
Special stains used in liver histopathology
Reticulin stain-to demonstrate the _____ to assess extent of __________
PAS-demonstrate _______
Shikatta orcein-to demonstrate _____ in _____ disease or HBsAg in hepatocytes
Perl’s stain-to demonstrate ____ in ______
Trichome-to demostrate _______/________ tissue
framework; liver cell necrosis
glycogen
copper; Wilson’s
iron; haemochromatosis
collagen; fibrous
LIVER FUNCTION
Carbohydrate metabolism-
-maintains normal _____ level,
-stores ______ &
-provides energy for the body during _____ (through _______ and _________ )
glucose
glycogen
fasting
glygenolysis & gluconeogenesis
LIVER FUNCTION
Protein metabolism-
1) Form _________ from amino acids
2) synthesis of __________ including albumin, globulins such as; clotting factors 1,2,5,7,9 & 10), complement components, transferrin, haptoglobin, caeruloplasmin,alpha- feto protein, alpha1-anti-trypsin, alpha-2 macroglobulin
endogenous hepatic protein
serum proteins
LIVER FUNCTION
Protein metabolism-
3)______ formation from amino acids
4) Amino acid ________________
All except synthesis of serum proteins, vary with _________; suppressed in ______
Urea
release to other tissues.
dietary intake
fasting
LIVER FUNCTION
Liver functions
Fat metabolism-
_________ of cholesterol, PL, TG
_________ of fat
Synthesis of ____-proteins which combine with cholesterol, PL, TG to form ______
Synthesis of _____ which is excreted in ____ and some converted to _____
hydrolysis
Storage
apo; lipoproteins
cholesterol; bile; bile acids
Liver functions
Formation & Excretion of bile acids.
Primary bile acids (_____ and _________ acid) from cholesterol. Conjugated with ________ or _______ & secreted into bile
Cholic& chenodeoxycholic
taurine or glycine
Liver functions
Formation & Excretion of bile acids.
Secondary bile acids (_________ and __________) are formed from ____________ of primary bile acids after reabsoption, then excreted in stool
deoxycholic & lithocholic
deconjugation
Liver Also stores Cu
T/F
T
Bile acids aid absorption of fat soluble vitamins
T/F
T
Liver Functions
Detoxification/bio-transformation of substances such as:
Drugs- ____ soluble drugs becomes ——- soluble that ends up ___________
Metabolism of alcohol (__________ to ________ that leads to CO2
fat; H2O; excreted in bile
acetaldehyde; acetate
Liver helps in Detoxification/bio-transformation of hormones
T/F
T
Liver Functions
sinusoid provides _______ for blood
Kupffer cells provides _______ action removing ________ from blood
depot
phagocytic
bacteria
LIVER FUNCTION TESTS
Alpha feto protein level- ____eased in PLCC
Caeruloplasmin- _______ in Wilson’s disease
Serum Fe & ferritin- high serum Fe with high saturated iron-binding capacity suggests __________. Serum ferritin is also greatly increased.
incr
low or undetectable
haemochromatosis
LIVER FUNCTION TESTS
Alcoholic liver disease leads to ____eased serum Fe
Alpha 1 anti-trypsin- not detectable in ________ due to alpha 1-anti-trypsin deficiency which can also be associated with ________ and ________
Incr
Chronic liver disease
cirrhosis & emphysema
.
.
