Wk 4 Liver Flashcards
The liver is the __ organ in the body
Largest
How much does the liver weigh?
Around 3 pounds
Takes up how much cardiac output?
7%
Where is the liver located?
Right epigastric region
The liver has a __ capsule that is divided into right and left lobes
fibrous
What is the functional unit of the liver?
Lobules
Lobules are made up of what type of cell?
Hepatocytes
Hepatocytes are arranges around a __ __
central vein
What type of cell is one of the only ones that can regrow and regenerate?
Hepatocytes
The liver can be regrown if…
the remaining liver is healthy
Where are Kupffer cells?
Line the inner liver capillaries and sinusoids
What type of cells line the inner liver capillaries and sinusoids?
Kupffer
What are Kupffer cells responsible for?
removing the bacteria and toxins from the blood
What does the liver store and metabolize?
Fat, carbs, proteins
Vitamins, minerals
The liver is a __ __ reservoir
blood volume
How does the liver alter circulating blood volume?
Distends/compresses
How does the liver filter our blood?
Removes bilirubin
What is bilirubin?
A byproduct of hemoglobin breakdown
What blood clotting factors does the liver make?
Prothrombin and fibrinogen
How does the liver affect drugs?
Works on metabolization and detoxification
List 5 major functions of the liver
Metabolism of micro/macro nutrients Blood volume reservoir Blood filter Blood clotting factors Drug metabolism and detoxification
The portal circulatory system brings blood from where to the liver?
Stomach
Intestines
Spleen
Pancreas
Basically the lower body
What vein brings blood to the liver, from the other organs?
portal vein
The blood in the portal vein is __
deoxygenated
The blood that is in the portal vein is rich in nutrients from…
the intestinal tract
Where do the absorbed products of digestion go?
Directly to the liver and are sent to the lobules
Where does the first pass effect come from?
The digested products from the small intestines go directly to the liver to be metabolized
Because of the first pass effect, oral drugs typically have…
higher doses
What 3 tests typically make up what is known as liver function tests?
ALT
AST
Alkaline phosphorous
What are the labs that we look at concerning the liver? (6)
LFTs Bilirubin Serum ammonia Serum protein Serum albumin PT (prothrombin time)
LFTs are not a great indicator of…
disease severity
Conjugated bilirubin is __
direct
Unconjugated bilirubin is __
indirect
The liver is responsible for __ __ ammonia, so if it is not functioning…
breaking down, we’ll see really high ammonia levels
The liver is responsible for __ protein. If the liver is not function we will see…
creating, low protein levels
Why does PT elevate?
Liver is responsible for making clotting factors
What is another name for jaundice?
Icterus
What causes jaundice?
Increased levels of bilirubin in the bloodstream
When is jaundice noticeable?
Total bilirubin great than 2-2.5 mg/dl
What are the 3 classifications of jaundice?
Hemolytic
Hepatocellular
Obstructive
This type of jaundice is caused by an increased breakdown of RBCs
Hemolytic
What is hepatocellular jaundice caused by?
liver unable to take up bilirubin from blood or unable to conjugate it
What causes obstructive jaundice?
Decreased or obstructed flow of bile
Why does hemolysis cause jaundice?
Because bilirubin is a product of RBC breakdown
Bilirubin is also a by product of __ breakdown
heme
Direct/conjugated bilirubin makes up what percentage?
30%
Indirect/unconjugated bilirubin makes up what percentage?
70%
When does an elevation of indirect (unconjugated) bilirubin occur?
Bilirubin overproduction OR impaired liver functioning
What does an elevation of direct (conjugated) bilirubin occur?
Liver is working but can’t get the bilirubin out such as bile duct obstruction
If a patient is jaundice, what lab would the provider order?
Bilirubin
Where do you look for jaundice in dark skinned people?
Sclera of the eyes, palms of hands and soles of the feet
If someone has jaundice their urine will be…
Dark
If someone has jaundice their liver enzymes will be…
Elevated
If someone has jaundice their stools will be…
Normal or clay colored
What other symptom might someone present with if they have jaundice?
pruritus
What gives our poop the brown color that it normally is?
Our liver releases bile salts into the stool
If stool is clay colored you could have…
liver infection that reduces bile production or the flow of bile out of the liver is blocked
