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Gastrointestinal > 10. functions of the Liver > Flashcards

10. functions of the Liver Flashcards

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

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)

A

STIMULATE INFLAMMATORY CYTOKINES
- leading to FIBROSIS

(LAYER EXTRA ECM)

23
Q

what do STELLATE CELLS STORE

A

FAT and VITAMIN A

24
Q

WHERE are STELLATE CELLS in the liver

A

PERISINUSOIDAL SPACE - end of SINUSOIDS

in SPACE OF DISSE

25
Q

what do STELLATE CELLS REGULATE the TURNOVER of and what can it cause

A

ECM

can cause FIBROSIS in stress/inflammation

26
Q

what do HEPATOCYTES DO

A

LIVER FUNCTIONS

  • PROTEIN, LIPID, CH20 (CARBOHYDRATE) METABOLISM
  • BILE, CHOLESTEROL, STEROID Hormones METABOLISM & SYNTHESIS
  • DRUG METABOLISM
  • PROTEIN SYNTHESIS
27
Q

HEPATOCYTES make up how much of LIVER CELLS

A

60 - 80 %

28
Q

which LIVER CELLS make up 30%

A

KUPFFER CELLS (macrophages)

29
Q

list some LIVER FUNCTIONS

A

-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
Q

what can LIVER do to DRUGS as they PASS

A

DETOXIFICATION

and Phase 1 METABOLISM

31
Q

how does LIVER have role in CARBOHYDRATE (CH20) METABOLISM
- by which PROCESSES:

A
  • 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
Q

ROLE of LIVER with LACTATE

A

MAIN ORGAN that CLEARS LACTATE

  • uses in GLUCONEOGENESIS to form glucose -> glycogen

if high lactate, indicates acute liver failure

33
Q

how does LIVER RECEIVE SUGARS

A

VIA PORTAL VEIN

  • Fructose, Galactose, Lactose, Glucose
    (GLYCOLYSIS)
34
Q

LIVER REGULATES..

A

BLOOD GLUCOSE

35
Q

where are GLYCOGEN STORES

A

MOSTLY LIVER

& MUSCLE CELLS

36
Q

what PROTEINS does LIVER SYNTHESIS

  • low levels can indicate liver problems
A
  • CLOTTING PROTEINS
  • AST/ALT (enzymes)
  • ALKALINE PHOSPHATASE
  • ALBUMIN
  • COMPLEMENT PROTEINS
  • CRP (inflammatory protein)
37
Q

what does LIVER do in PROTEIN METABOLISM

A
  • DETOXIFICATION of AMMONIA (lower levels)
    (urea metabolism)
  • DEAMINATION of AMINO ACIDS
38
Q

ORGANELLES that are important in LIVER FUNCTIONS

A
  • SMOOTH ER
  • ROUGH ER
  • MITOCHONDRIA
  • PEROXISOMES
39
Q

LIVER ENZYMES:

A
  • TRANSAMINASES
  • PHOSPHATASES
  • DEHYDROGENASES/HYDROXYLASES
  • CYTOCHROMES OXIDO-REDUCTASES
40
Q

in LIVER BLOOD TESTS, what proteins LEVELS would you look at

A
  • AST
  • ALT
  • ALBUMIN
  • PT / INR
  • BILIRUBIN
  • ALKALINE PHOSPHATASE
  • GAMMA GT
41
Q

ALT and AST are what types of ENZYMES

A

TRANSAMINASES

42
Q

AST and ALT LEVELS MARK /INDICATE what

A

INFLAMMATION

and Hepatocyte injury

  • RELEASED by DAMAGED HEPATOCYTES

(AST also from skeletal and cardiac muscles)

43
Q

what are ALBUMIN and PT / INR LEVELS MARKERS OF

A

LIVER FUNCTION

  • 1st blood test to go wrong with liver damage
    -> indicate some liver inflammation which stops liver functioning
44
Q

LOW ALBUMIN LEVELS are a GOOD MARKER of..

A

CHRONIC LIVER DAMAGE

45
Q

ALBUMIN HALF LIFE:

A

20 DAYS
(long)

stays normal for 20 days even if liver damage

46
Q

what does PT LEVELS MARK and what does it show

A

ACUTE AND CHRONIC LIVER DAMAGE

  • REFLECTS CLOTTING ENZYMES produced by liver
  • CLOTTING TIME
47
Q

what do BILIRUBIN, ALKALINE PHOSPHATASE and GAMMA GT LEVELS MARK

A

CHOLESTATIC LFTs

  • mark STASIS (STOPPING) of BILE FLOW
48
Q

what is BILIRUBIN

A

formed from BREAKDOWN of RBCS and EXCRETED AS BILE

so high levels mark bile flow stasis

49
Q

what can cause INCREASE in ALKALINE PHOSPHATASE LEVELS

A

BILIARY OBSTRUCTION

but also
PREGNANCY - released by PLACENTA
BONE DAMAGE - released

50
Q

GAMMA GT (enzyme) LEVELS can be ELEVATED due to..

A

ALCOHOL or CHOLESTASIS (BILE FLOW STASIS)

Gastrointestinal (19 decks)

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