The Liver, The Gallbladder, and The Exocrine Pancreas Flashcards
The liver is the _____ gland (~1500g) and has both _____ (bile) and _____ (albumin, lipoproteins, globulins) functions.
- Largest
- Exocrine
- Endocrine
The liver has a strategic location enclosed in _______, which is located beneath the peritoneal mesothelium it forms a sheath around branches of blood and lymphatic vessels and bile ducts.
Glisson’s capsule
75% of blood to the liver comes from ______ carrying deoxygenated blood with nutrients and toxins from the intestine.
Hepatic portal vein
25% of blood to the liver comes from the _______ carrying oxygenated blood.
Hepatic artery
Blood is drained by ______ into ______ near heart.
- Hepatic vein
- Inferior vena cava
The liver receives all of the _____ absorbed in the GI.
Food
Materials received in the liver are either _____, _____, _____, or ______ to blood. Liver also receives ____ and _____ them.
- Metabolized, Stored, Transported, Returned
- Toxins
- Detoxifies
_____ is the chief secretion of liver that ______ and also a vehicle for excretion of waste products.
- Bile
- Facilitates digestion of fats
The liver has ____ principal lobes, left and right. It consists of _____ arranged in plates or laminae called _____ which form a lobule.
- Two
- Epithelial cells
- Hepatic cords
Hepatic cords are exposed to _____ with _____.
- Sinusoids
- Fenestrae
Bile is secreted by the hepatocytes into the _______.
Bile canaliculi
Lobules are surrounded by a connective tissue layer in many mammals but not in _____.
Humans
Typical lobules are _____ with all corners occupied by branches of ______.
- Hexagonal
- Portal canal
Each portal canal contains…
-Artery
-Vein
-Bile duct
-Lymphatic vessel
(Not visible in histological sections)
The ______ describes cells that radiate around a central vein.
Classical Lobule
The _____ by _____ describes cells that radiate around a portal vein.
Portal Lobule by Mall
The _____ by ______ describes a lobule as a mass of tissue adjacent to the branches of the portal vein, hepatic artery, and bile duct.
Liver Acinus Lobule by Rappaport et. al.
The descriptions of the hepatic lobules do not _____ each other, instead they are ______.
- Contradict
- Complimentary
Three concentric elliptical zones identified in the Acinus Lobule
- The Periportal Zone (Zone 1)
- The Mid Zone (Zone 2)
- The Centrolobular Zone (Zone 3)
The Periportal Zone (Zone 1) consists of hepatocytes ______ to the portal venule and the hepatic arteriole.
It ____ receives O2, hormones, and nutrients from the blood stream.
________ synthesis by the hepatocytes occurs here.
- Closest
- First
- Plasma proteins
The Centrolubular Zone (Zone 3) consists of hepatocytes surrounding the central vein, farthest from oxygenated blood.
Is the first to show ______, _______, and is the site of most ____and _____ ______.
- Ischemic necrosis
- Fat accumulation
- Drug and alcohol detoxification
The Mid Zone (Zone 2)
consists of hepatocytes between the ______ and _____ zones.
Centrolobular and periportal
Hepatic sinusoids are ____ than regular capillaries and irregular in shape. They are directly ______ to liver cells and have no connective tissue.
- Larger
- Apposed
Sinusoids consist of
_______ which are flat, non-phagocytic and fenestrated and _______ which are stellate (star shaped), processes traverse sinusoids, their cytoplasm contains abundant lysosomes, and they actively phagocytic.
- Endothelial cells
- Kupffer cells
The Perisinusoidal Space or Space of Disses the _____ between sinusoidal lining and the liver cells. Endothelial cells _________ of liver cells. Contains collagen and reticular fibers with no matrix.
- Space
- Rest on microvilli
The two kinds of cells identified in the Space of Disse are ______ that store exogenous vitamin A. They also secrete growth factors, cytokines and extracellular matrix.
_____ have numerous pseudopodia; they are modified lymphocytes, not found in _______.
- Fat-containing cells of Ito
- Pit cells
- Humans
Possible function of space of Disse is the formation of _______.
Liver lymph
Hepatocytes are _____ with three surfaces. One side is exposed to _______. A second side is exposed to _______. A third one in contact with the _______.
- Polyhedral
- Space of Disse
- Bile canaliculi
- Adjacent cell
Hepatocytes have a large single nuclei, most cells single nucleated; ~ 25 % are _______.
Binucleate
The hepatocytes has one or more nucleoli per nucleus, rich in rough ER, fat, glycogen, mitochondria and _________ with enzymes _________ and _______.
- Abundant peroxisomes
- D-amino oxidase
- Catalase
The smooth ER of hepatocytes contains enzymes for ________, _______, and ________.
- Detoxifying drugs
- Converting glycogen to glucose
- Cholesterol synthesis
The smallest hepatic bile ducts have _________. Their junctional complexes contain _____ and _____. Many _____ occupy cytoplasm. The luminal surface has regular ______.
- One layer of small cuboidal cells
- Tight junctions and desmosomes
- Tonofilaments
- Microvilli
Hepatic bile canaliculi are minute canals that run between the liver cells. As a rule, ______ between adjacent cells. Walls of canaliculi are rich in _______.
- One canaliculus
- ATPase activity
About ___ mL of bile is produced by hepatocytes each minute.
0.5
The liver _____ and ____ blood in which Kupffer cells are involved.
Filters and cleans
The liver is a ______ site - sinusoids have enormous volume ~ 400 ml. Resistance to blood flow in liver causes development of _____ and leads to ______.
- Blood storage
- Ascites
- Cirrhosis
The liver ______ and ______ nutrients, maintains normal blood sugar level by ________ and _______, and maintains normal lipid levels by transporting or transforming.
- Processes and transfers
- Glycogenesis and glycogenolysis
The liver is the site of synthesis of ______, substantial rate of production of albumin, alpha and beta globulins, glycoproteins, lipoproteins, prothrombin, fibrinogen etc.
Plasma proteins
It is the site of _______ of lipid soluble drugs such as barbiturates (sleep inducers). Enzymes in the smooth endoplasmic reticulum (_______) called ___________ are responsible. Administration of drugs such as barbiturates stimulates activities of microsomal enzymes
- Detoxication
- Microsomes
- Microsomal enzymes
The liver has _____ fuction as well. _______ from the breakdown of red blood cells is eliminated by Kupffer cells. (Bilirubin –> urobilinogen –> feces)
- Excretory
- Bilirubin
Accumulation of bilirubin –> hyperbilirubinemia –> ______. Causes include increased production of bilirubin, decreased uptake of blood by liver, disturbance in conjugation of bilirubin with other substances and interference with its secretion.
Jaundice
Major function of liver concerned with the digestive system is the secretion of _____.
Bile
Bile consists of…
And ______ fat molecules.
- Cholesterol
- Lecithin
- Fatty acids
- Electrolytes
- Bile salts
- Emulsify
The Gallbladder is a ______ hollow organ attached to posterior surface of liver. It has a fundus, a body and a neck region which continues into the ______.
- Pear shaped
- Cystic duct
The gall bladder has rich blood supply through ________, has rich lymph supply and is innervated by both sympathetic and parasympathetic autonomic nervous system.
Cystic artery
The _______ of the gallbladder wall consists of dense connective tissue, the ______ is all smooth muscles, the ______ and _______ are loose connective tissue.
- Submucosa
- Muscularis
- Subserosa and serosa
The _______ of the gallbladder wall consists of dense connective tissue, the ______ is all smooth muscles, the ______ and _______ are loose connective tissue.
- Submucosa
- Muscularis
- Subserosa and Serosa
The epithelium of the mucosa of the gall bladder is tall ________ with microvilli and is thrown into folds called ______.
- Simple columnar
- Rugae
The mucosa of the gall bladder has outpouchings called ________ which cross lamina propria and muscles - this is a ________.
- Rockitansky-Aschoff sinuses
- Pathological condition
In the mucosa of the gall bladder, ______ has loose connective tissue with mucosal glands. Smooth muscles are longitudinal, transverse and oblique.
Lamina propria
In the mucosa of the gall bladder, there is frequently dense connective tissue with _______ that are found among smooth muscles.
Luschka ducts are ________ which never established connection with lumen – a ______ feature.
- Luschka ducts
- Embryonic bile ducts
- Histological
The junction of the gallbladder with pancreas and duodenum consists of a portion of ______ wall, the common ______ duct, the _____ duct, the _______, and the ________.
- Duodenum
- Bile
- Pancreatic
- Ampulla of Vater
- Sphincter of Oddi
The function of the gallbladder is to _____, ______, and _____ bile.
-Store, concentrate, and release
Bile normally does not enter small intestine until gallbladder is stimulated. Ingestion of ____ stimulates gallbladder. Stimulation is by the secretion of ________ from small intestinal mucosa.
- Fat
- Cholecystokinin
Concentration of bile is through absorption of ____ followed by water.
Na++
The pancreas is the _______ gland. It is pinkish white in color and is _______.
- Second largest
- Retroperitoneal
The pancreas’s ________ constitute approximately 1,200 ml of digestive juices.
Exocrine secretions
The pancreas’s ________ (hormones) regulate carbohydrate metabolism.
Endocrine secretions
The exocrine pancreas is a ________ gland that is divided into ______ with connective tissue.
- Compound acinar
- Lobules
The exocrine pancreas has rich _____, _____, and _____ supply and single rows of _______ resting on basement membrane.
- Blood, lymph, and nerve
- Pyramidal cells
Cells of the exocrine pancreas have apical ______ and are rich in rough ER and polyribosomes.
Zymogen granules
In the exocrine pancreas duct system, the lumen of each acinus is continuous with a duct bounded by _________.
Centroacinar cells
Lumen intralobular duct –>
Interlobar duct –>
A larger ________ that opens into ampulla of Vater or a smaller _________ that opens into the larger duct – the opening of the _________ is controlled by _________.
- Duct of Wirsung
- Duct of Santorini
- Ampulla of Vater
- Sphincter of Oddi
The exocrine secretion of the pancreas is ______ and is controlled by nervous (minor) or hormonal (major) stimuli.
Rhythmic
________ of the pancreas are through the release of neurotransmitter acetylcholine.
Nervous stimuli
Hormonal stimuli are through the release of two hormones both from _____________.
______– causes release of large volumes of alkaline bicarbonates solution to neutralize acidic chyme
_________ – causes release of large volumes of enzyme solution and activates gallbladder for bile release
- Small intestinal mucosa
- Secretin
- Cholecystokinin
The Pancreatic Secretion is composed of _______ for starch and glycogen digestion, ________ for digestion of lipids, ________, _______, ________, and _______ inhibitor for protein digestion, and _____ and ______.
- Pancreatic amylase
- Pancreatic lipase
- Trypsinogen, chymotrypsinogen, procarboxypeptidases and trypsin
- DNAse and RNAse
