Topic 4 part 2 - disorders of accessory organs of Digestive System Flashcards
What are the essential roles of the Liver?
- production of bile salts
- elimination of bilirubin
- metabolism of steroids hormones
- metabolism of drugs
- carbs / fat / protein metabolism
- storage of minerals & vitamins
- Filtration of blood & removal of bacteria
Define: Jaundice
accumulation of bilirubin in the blood. a symptom of a liver disorder. (bilirubin = the catabolic product of RBC breakdown after life span).
Define: Cholestasis:
disruption in bile flow due to Cholelithiasis (gallstones). Bile = yellowy/green secretion that breaks down fats in response to CCK ( a fatty meal).
Define: Cholelithiasis
Gallstones (within the gall bladder - the place that stores bile). 2 types:
- Cholesterol stones: not necessarily made from excess cholesterol in the blood circ.
- Bilirubin stones:
Define: Cholecystitis
Inflammation of the Gallbladder (acute or chronic) caused by cholelithiasis (gallstones)
What is the GallBladder?
the sac / place that stores bile.
What is bile?
Bile = yellowy/green secretion that breaks down fats in response to CCK ( a fatty meal).
Define: Steatosis
fat accumulation in the Liver / Hepatocytes (cells of the liver).
Define: Ascites
the accumulation of fluid in the peritoneal cavity. Late stage manifestation of cirrhosis / portal hypertension.
Contributing Factors: failure of liver to metabolise aldosterone (hormone that increases water reabsorption) therefore increses hydrostatic pressure.
What is the Peritoneum/Peritoneal?
the extensive serous membrane that lines the entire abdominal wall of the M/F body. It extends to suspend the small intestine.
How is Liver Function assessed?
- Biochemical:
- ALT (alanine aminotransferase) = indicates a breakdown of liver cells (hepatocytes)
- Serum Albumin = HyperAlbumin / increased albumin indicates the Liver is unable to breakdown of____.
- Serum Bilirubin = measures Liver excretory function. - Imaging: angiography, ultra-sound, CT scan
- Liver biopsy
What is intr-hepatic biliary disease?
caused by a disruption of the flow of bile through the liver (i.e. cholestasis), 3 types:
- Primary Biliary Cirrhosis: an autoimmune disease = that inflames / scar’s small intrahepatic biliary ducts.
- Primary Sclerosing Cholangitis: Chronic inflammation of hepatic bile ducts.
- Secondary Biliary Cirrhosis: prolonged obstruction due to “Cholelithiasis” (gall stones).
Define Hepatitis?
inflammation of the Liver.
Caused by: hepatotropic Viruses - Hep A,B,C,D,E. HepC is most common.
Describe Hepatitis - common clinical features
jaundice, nausea & vomiting, diarrhoea & constipation, fever & malaise, myalgia, fatigue & weakness, anaemia.
Outline Hepatitis - aetiologies
- Auto-immune disorders
- Reaction to toxins & drugs
- Infections: Bacteria or Viral
- Non-infectious causes: biliary obstruction / cirrhosis
What is Portal Hypertension?
the portal vein pressure of 22mmHg or more.
normal pressure of blood flow to the liver = 5-10mmHg
What is the Portal Blood Supply?
the loop of arteries & veins that supply blood to the intestines to transport nutrients absorbed from food in the stomach (i.e. digestion) to the liver.
Describe the effects Portal Hypertension has on fluid:
“Ascites”: increased pressurein the peritoneal capillaries leads to water movement out into the peritoneal cavity.
Describe the effects Portal Hypertension has on blood flow:
“hepatic encephalopathy”: a disease of the brain caused by reduced liver function = occurs as a result of accumulation of neuro-toxic metabolites: “Ammonia” - a waste product usually converted into urea & excreted: Ammonia accumulates in blood & causes neurological damage.
Describe the effects Portal Hypertension has on blood:
“Anaemia”: a decrease in haemoglobin in the blood to levels below normal range.
What is Cirrhosis of the liver?
end stage liver disease where functional hepatic tissue is replaced by fibrous tissue - which disrupts vascular & biliary flow leading to alteration of the liver.
A diverticulum is the term used to describe
an outpouching of the gastrointestinal wall
Oesophageal diverticulum is described best by which statement?
It is an outpouching of the oesophageal wall through the muscularis layer.
Which of the following statements is true of the CTZ?
D. Toxins in the CSF or blood will stimulate CTZ receptors causing a vomiting response
Which of the following is NOT a test of liver function:
C. Serum creatinine
Which of the following does NOT cause chronic gastritis:
D. Long term high protein diets
Achalasia is a disorder caused by which of the following?
B. Lower oesophageal sphincter fails to relax upon swallowing
Fatty liver is also called:
A. Steatosis
An inflammatory bowel disease primarily affecting the ileum and proximal colon is?
B. ulcerative colitis
Which of the following is not an effect of portal hypertension?
Steatosis
Which of the following mechanisms causing intrahepatic biliary disease describes primary sclerosing cholangitis?
Chronic inflammation of hepatic bile ducts.
