W3 D5 - Liver Failure Flashcards
Identify portions and functions of the liver
Left lobe
* smaller lobe
* removed for transplant, regrowth
Right lobe
* bigger portion, extends down
Gallbladder
* accessory organ
* releases/stores bile to digest fat
Glisson’s capsule
* connective tissue that covers liver w/nerves
Lobule
* working unit of the liver
hepatocytes
* major parenchymal cells
* many main functions
sinusoids
* blood vessels divided into capillaries, space between hepatocytes
* sponge like
Kupffer cells
* immune portion of the liver, destroys bacteria/detoxify
* inside sinusoids
bile canaliculi/channels
* channels within lobules
* collect bile and bring to common bile duct
Why is the livers blood supply unique?
Explain its blood flow
It has a dual blood supply
* hepatic artery supplies 25% of oxygenated blood
* portal vein supplies 75% deoxygenated blood
Bile duct
* transports from central vein to bile duct
Branch of portal vein
* transports deoxygenated blood to central vein
Branch of hepatic artery
* transports oxygenated blood to central vein
What are some of the livers functions?
Over 400 functions
Carbohydrate metabolism
* stores glucose as glucogen
* breaks down glycogen
* creates glucosde from proteins and fats
Protein metabolism
* synthesis of albumin to hold onto water, oncotic pressure
* breakdown of proteins into amino acids/urea
Fat metabolism
* synthesis of phospholipids, cholesterol
* breakdown of glycerol, fatty acids, ketones
Bile formation
* creates bile to stop fluid leakage ?
Vitamin & mineral storage
* storage of fat soluble vitamins A, D, E
* storage of minerals; iron, mag
Hematological functions
* synthesis of albumin, clotting factors; fibrinogen, K+
* removal of damaged RBCs
* filters blood to remove bacteria
Detoxification/drugs/hormones
* deactivates hormones
* conjugates steroids and hormones
Explain the patho of cirrhosis
Scarring between the cells
* blood and bile flow are restricted
* back up of fluid into liver
* portal hypertension / ascites
What are some common liver function tests?
Bilirubin - high
Albumin - low
* lack of proteins in blood
AST, ALT, ALP - high
* liver failure
Ammonia - high
* LOC is a concern
Could also affect:
* Hgb
* INR/PT/PTT
What is portal hypertension?
Blood backed up into the portal venous system increasing pressure in veins
Portal vein is distended through the esophagus, intestine, umbilicus, stomach, spleen, rectum
What is ascites?
What is esophageal varices?
What is gastrointestinal hemorrhage and hepatorenal syndrome?
What is hepatic encephalopathy and acute liver failure?
Explain clinical manifestations of liver failure
What is intra-abdominal hypertension?
causes, clinical, findings, grading, monitoring technique
What is abdominal compartment syndrome?
