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Gastrointestinal > 10. functions of the Liver > Flashcards

10. functions of the Liver Flashcards

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1
Q

the LIVER is the LARGEST SOLID ORGAN in the body with what WEIGHT

A

1.5 KG
(rugby ball)

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2
Q

WHERE is the LIVER

A

RIGHT UPPER QUADRANT

under RIBS, Diaphragm ‘roof’

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3
Q

LIVER has how many SEGMENTS

A

8

  • each have their own blood supply and bile drainage
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4
Q

what SUPPLY BLOOD IN to the LIVER

A
  • HEPATIC ARTERY
    (heart)
  • PORTAL VEIN from Intestines and Spleen
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5
Q

LIVER takes about 75% (MOST) of its BLOOD SUPPLY FROM…

A

HEPATIC PORTAL VEIN

from INTESTINES and SPLEEN

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6
Q

VENOUS DRAINAGE of LIVER by..

A

HEPATIC VEIN
(to IVC, to HEART)

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7
Q

BILE DRAINAGE BILIARY TREE consists of:

A

RIGHT and LEFT HEPATIC DUCT from liver
- COMMON HEPATIC DUCT

joins with CYSTIC DUCT from GALLBLADDER

-> COMMON BILD DUCT

(joins with pancreatic duct and secretes into duodenum via Ampulla)

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8
Q

LIVER is ARRANGED in..

A

LOBULES

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9
Q

each LIVER LOBULE has a … that DRAINS it

A

CENTRAL VEIN

  • SURROUNDED by PORTAL TRIADS
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10
Q

what does a PORTAL TRIAD CONSIST of

A
  • PORTAL VEIN branch
  • HEPATIC ARTERY branch
  • BILE DUCT
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11
Q

LIVER CELLS:

A
  • 60% HEPATOCYTES
  • 30% KUPFFER CELLS
  • STELLATE CELLS
  • ENDOTHELIAL CELLS
  • BILIARY EPITHELIUM (in bile ducts)
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12
Q

what is the name of the PATH from the PORTAL TRIAD TO the CENTRAL VEIN (Portal Vein and Hepatic Artery blood travels through on the way to central vein)

A

SINUSOID

  • FENESTRATED DISCONTINUED CAPILLARIES
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13
Q

LIVER ACINUS is the FUNCTIONAL UNIT of MICROCIRCULATION
it has 3 ZONES:

A

ZONE 1 - closest to portal triad
O2 RICH, OXIDATIVE METABOLISM

ZONE 2
- TRANSITION zone

ZONE 3- closest to central vein
LOW O2, ANAEROBIC METABOLISM, DRUG METABOLISM

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14
Q

which ZONE of the ACINUS has the HIGHEST OXYGEN

A

ZONE 1

(zone 3 - low o2)

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15
Q

what takes place in ACINUS ZONE 1

A

OXIDATIVE METABOLISM

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16
Q

what takes place in ACINUS ZONE 3

A

ANAEROBIC METABOLISM,
DRUG METABOLISM CP450

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17
Q

what are the KUPFFER CELLS of the liver

A

Liver-Resident MACROPHAGES

  • EAT UP:
    ANTIGENIC MATERIAL,
    SENESCING (dying) RBC
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18
Q

LIVER KUPFFER CELLS are CRUCIAL FOR…

A

CLEARING BACTERIA / endotoxins
from PORTAL VEIN (blood from gut - rich in bacteria)

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19
Q

what do KUPFFER CELLS Eat up

A

ANTIGENIC MATERIAL
SENESCING (dying) RBC

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20
Q

WHERE are KUPFFER CELLS in the liver

A

in SINUSOIDS

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21
Q

what is the ROLE of STELLATE CELLS of the liver

Study These Flashcards
A
  • STORE FAT
  • STORE VITAMIN A (fat soluble)
  • REGULATE the TURNOVER of ECM (proteins holding cell together)
22
Q

what can STELLATE CELLS do UNDER STRESS (ie alcohol consumption, excess fat deposition)

Study These Flashcards
A

STIMULATE INFLAMMATORY CYTOKINES
- leading to FIBROSIS

(LAYER EXTRA ECM)

23
Q

what do STELLATE CELLS STORE

Study These Flashcards
A

FAT and VITAMIN A

24
Q

WHERE are STELLATE CELLS in the liver

Study These Flashcards
A

PERISINUSOIDAL SPACE - end of SINUSOIDS

in SPACE OF DISSE

25
what do STELLATE CELLS REGULATE the TURNOVER of and what can it cause
ECM can cause FIBROSIS in stress/inflammation
26
what do HEPATOCYTES DO
LIVER FUNCTIONS - PROTEIN, LIPID, CH20 (CARBOHYDRATE) METABOLISM - BILE, CHOLESTEROL, STEROID Hormones METABOLISM & SYNTHESIS - DRUG METABOLISM - PROTEIN SYNTHESIS
27
HEPATOCYTES make up how much of LIVER CELLS
60 - 80 %
28
which LIVER CELLS make up 30%
KUPFFER CELLS (macrophages)
29
list some LIVER FUNCTIONS
-METABOLISM of NUTRIENTS, BILIRUBIN, DRUGS, HORMONES - DETOXIFICATION of DRUGS, TOXINS, Hormones - STORAGE of MINERALS and VITAMINS - ENDOCRINE functions activation VIT D, T4 -> T3 Conversion, Angiotensinogen, metabolism - IMMUNE FUNCTIONS Antigen Presentation, Phagocytosis (kupffer cells), filtering portal blood Bacteria - EXCRETION (BILE) - SYNTHESIS (PROTEINS)
30
what can LIVER do to DRUGS as they PASS
DETOXIFICATION and Phase 1 METABOLISM
31
how does LIVER have role in CARBOHYDRATE (CH20) METABOLISM - by which PROCESSES:
- GLYCOLYSIS BREAKING down glucose/sugars to release Energy - GLYCOGENESIS glucose uptake to STORE as Glycogen - GLYCOGENOLYSIS glycogen break down to RELEASE glucose - GLUCONEOGENESIS MAKING glucose from new sources ie. fatty acids, lactate
32
ROLE of LIVER with LACTATE
MAIN ORGAN that CLEARS LACTATE - uses in GLUCONEOGENESIS to form glucose -> glycogen if high lactate, indicates acute liver failure
33
how does LIVER RECEIVE SUGARS
VIA PORTAL VEIN - Fructose, Galactose, Lactose, Glucose (GLYCOLYSIS)
34
LIVER REGULATES..
BLOOD GLUCOSE
35
where are GLYCOGEN STORES
MOSTLY LIVER & MUSCLE CELLS
36
what PROTEINS does LIVER SYNTHESIS - low levels can indicate liver problems
- CLOTTING PROTEINS - AST/ALT (enzymes) - ALKALINE PHOSPHATASE - ALBUMIN - COMPLEMENT PROTEINS - CRP (inflammatory protein)
37
what does LIVER do in PROTEIN METABOLISM
- DETOXIFICATION of AMMONIA (lower levels) (urea metabolism) - DEAMINATION of AMINO ACIDS
38
ORGANELLES that are important in LIVER FUNCTIONS
- SMOOTH ER - ROUGH ER - MITOCHONDRIA - PEROXISOMES
39
LIVER ENZYMES:
- TRANSAMINASES - PHOSPHATASES - DEHYDROGENASES/HYDROXYLASES - CYTOCHROMES OXIDO-REDUCTASES
40
in LIVER BLOOD TESTS, what proteins LEVELS would you look at
- AST - ALT - ALBUMIN - PT / INR - BILIRUBIN - ALKALINE PHOSPHATASE - GAMMA GT
41
ALT and AST are what types of ENZYMES
TRANSAMINASES
42
AST and ALT LEVELS MARK /INDICATE what
INFLAMMATION and Hepatocyte injury - RELEASED by DAMAGED HEPATOCYTES (AST also from skeletal and cardiac muscles)
43
what are ALBUMIN and PT / INR LEVELS MARKERS OF
LIVER FUNCTION - 1st blood test to go wrong with liver damage -> indicate some liver inflammation which stops liver functioning
44
LOW ALBUMIN LEVELS are a GOOD MARKER of..
CHRONIC LIVER DAMAGE
45
ALBUMIN HALF LIFE:
20 DAYS (long) stays normal for 20 days even if liver damage
46
what does PT LEVELS MARK and what does it show
ACUTE AND CHRONIC LIVER DAMAGE - REFLECTS CLOTTING ENZYMES produced by liver - CLOTTING TIME
47
what do BILIRUBIN, ALKALINE PHOSPHATASE and GAMMA GT LEVELS MARK
CHOLESTATIC LFTs - mark STASIS (STOPPING) of BILE FLOW
48
what is BILIRUBIN
formed from BREAKDOWN of RBCS and EXCRETED AS BILE so high levels mark bile flow stasis
49
what can cause INCREASE in ALKALINE PHOSPHATASE LEVELS
BILIARY OBSTRUCTION but also PREGNANCY - released by PLACENTA BONE DAMAGE - released
50
GAMMA GT (enzyme) LEVELS can be ELEVATED due to..
ALCOHOL or CHOLESTASIS (BILE FLOW STASIS)

Gastrointestinal (19 decks)

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