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HE Test 4 > HE 33-34 Liver Gall Bladder Pancreas > Flashcards

HE 33-34 Liver Gall Bladder Pancreas Flashcards

1
Q

Glissons Capsule (what and where, and surrounding lining)

A

Dense Irregular Connective Tissue

Over entire surface of liver except porta hepatis
-porta hepatis structures course between layers of hepatic duodenal ligament

Visceral peritoneum covers glissons capsul except at bare end

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2
Q

Septa of liver structure and components

A

connective tissue stroma- continuous with glissons capsule.

  • contains BV’s bile ducts, nerves, lymph vessels
  • reticular fibers are major support unit for heptic sinusoids
  • pigs;well defined septa, separate lobules
  • humans; hard to delineate, and hepatic sinusoids are continuous from one lobule to the next
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3
Q

parenchyma and stroma of liver

A

parenchyma: epithelial derived hepatocytes
stroma: CT support tissue (different from septa how?)

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4
Q

Portal Triad definition and location

A

portal triad present gross and microscopic

Portain Vien Hepatic Artery Bile Duct

Portal area/portal canal contains microscopic of all three (at edge of hexagon lobule)-blood drains to central vein

periportal space of mall???

Triad a misnomer since lymph vessels present as well

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5
Q

Hepatocytes origin and structure

A

Derived from endoderm

25% binucleate, some are polyploidy (more than two sets homologous chromosomes)

cube shape, with two sinusoidal ends and four lateral domains

20-30uM

MANY organelles

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6
Q

Three classifications of liver lobules

A

Classic, acinus of rapport, portal lobe

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7
Q

Classic lobule

A

central vein at center

hexagon

six portal areas in periphery

blood drains to center

bile drains to periphery

separated by septa

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8
Q

Hepatic acinus of Rapport

A

distributing arterioles at center

diamond or oval shaped

two central veins

two portal areas in periphery

easily displays zones of oxygenation 1-2-3

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9
Q

Portal Lobule

A

Portal area at center

triangle shaped

three central veins in periphery

bile drains to center

blood drains to periphery

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10
Q

hepatocyte function based on location:

A

perivenous hepatocytes: in region of central vein (low oxygen)
LOTS of SER but no MITO (bio pathways requiring less atp) ie glycolysis, chol synthesis, FA syth, drug met)

periportal hepatocytes: in region of portal area (high oxygen)
High GA, RER (pathways requiring ATP)- protein synthesis, AA catabolism, gluconeogenesis, urea cycle)

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11
Q

centralobular necrosis

A

as might occur with congestive heart failure
-or other causes of hyperfusion and hypoxia

alcohol or drug induced hepatitis also causes centrilobular necrosis

viral hepatitis causes necrosis THROUGHOUT liver lobule

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12
Q

Hepatic sinusoidal Capillaries

A

Sinusoidal caps (spleen and liver)

endothelial lining of hep, sinusoids

  • cells have gaps between them with no BL
  • clusters of fenestrae present known as SIEVE PLATES
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13
Q

Hepatocyte plate patterns

A

1 cell thick in adults

2 cells thick in children

hepatic sinusoids separate plates

blood drains from portal areas to central vein

hepatic sinusoids derived from vitelline veins

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14
Q

Sinusoids lumen to hepatocyte: layers and cell types

A

Kupffer cells within lumen are macrophages derived from monocytes. Form part of sinusoid lining, unique to hepatic sinusoids

Endothelial layer.

Space of Disse: Separates sinusoidal lining cells from hepatocytes

  • drains into lymph vessels at portal area
  • microvilli of the hepatocytes
  • intermediary space between blood and hepatocyte
  • contains ITO cells

ito cell

  • Hepatic stellate cell
  • store fat and vitamin H
  • located within perisinusoidal space
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15
Q

Lateral domains, including cell types and clinical correlation

A

Contain Bile canaliculi
-create hepatic ducts
cholangiocytes:epithelial cells of biliary system
-have microvilli and long primary cilium
-cholangiocarcinoma-cancer in biliary system
intrahepatic bile duct???

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16
Q

Flow of bile system in liver

A

Bile Canaliculi: spaces between hepatocytes, secreted directly here, walls formed by cell membrane (plasmellum) of hepatocyte

Flows to

intralobular bile ducts: simple cuboidal epithelium
-located at portal are an collect bile from liver lobules via intra hepatic bile ductules

flows to

R & L Hepatic ducts, exit right and left liver lobe

17
Q

Fxns of liver

A

Production of Bile : 100ml a day
-digestion and absorbtion (emulsification) of fats and elimination of cholesgterol

-bilirubin: breakdown product of hemoglobin from dead RBC
bilirubin
-bilirubin and bile pigments make up 2% of organic components of bile

-bile acid salts are 50% of the organic composition of bile

90% of bile acids are recycled
10% produced de NOVO from SER in hepatocytes

LOOK AT IMAGES ON SLIDES FOR SECRETION

18
Q

Jaundice

A

Yellow discoloration of the skin due to abnormally high amounts of bilirubin in blood
-glucuronyltransferase (conjugates H2O insoluble bilirubin forming H2O soluble bilirubin glucoronide

??

19
Q

Regulatino of blood glucose by liver

A

storage of glycogen , release of glucose in response to glucagon from pancreas (rat liver picture of glycogen being stored at 2 hour fast and then gone at 21 hr fast)

synthesis of glucose: 90% liver 10% kidney, however during acidosis or prolonged starvation gluconeogenesis shifts to kindeys: 50/50

20
Q

Gall Bladder Epithelium

A

simple columnar with microvilli

  • oval shaped nuclei at base
  • abundant mitochondria
  • mucosal folds in empty gall bladder (full GB no folds)
21
Q

Gall bladder LP, muscularis, adventitia, and serosa

A

LP: vascular loose CT, elastic and collagen fibers
-neck of gall bladder contains glands for mucus

muscularis externa: randomly oriented muscle fibers (SMOOTH? SKELETAL?)

adventitia: LCT, attaches to flissons capsule
serosa: visceral peritoneum: over non attached surface of GB

NO MUSCULARIS MUCOSA or SUBMUCOSA

22
Q

Function of GB

A

Store/concentrate/release Bile

23
Q

path of Bile

A

hepatocyte secrete

  • canaliculi
  • hepatic bile ducts
  • interlobular bile ducts
  • common hepatic duct joins cystic duct to form bile duct
  • joins main panc duct at ampulla of vater @ major duodenal papilla
24
Q

how does bile get to gall bladder

A

constriction of sphincter of bile duct prevents bile from entering duodenum and instead backs up cystic duct to GB for conc and storage

25
Q

concentration of bile

A

active transport of sodium ions and H2O follows passively (into intracellular and basally to blood stream)
-inactive vs active (spaces open) states

26
Q

release of bile

A

in response to CCK (cholecystokinin)

  • from DNES cells of duodenum after fatty foods enter duodenum
  • causes simultaneous constriction of smooth muscle of gall bladder and relaxation of smooth muscle of sphincters

sphincter of oddi refers to a collection of sphincters in one area…????

27
Q

Pancreas- two main cells

A

pancreatic acini: exocrine pancrease

islet of Langerhans : endocrine pancreas

septa derived from CT capsule and subdivides glands into lobules. septa contains Vessels, interlobular ducts and nerve fibers

28
Q

Pancreatic acini

A 
two cells: 
acinar cells:
-compound tubuloacinar serous glands
-40-50 acinar cells per acinus
-BL separates acinar cells from septa
-pyramidal shape
-round nucleus at base 
-basal cytoplasm basophilic (lots RER)
-basal membranes bave receptor for CCK 
-apex full of secretory granules with zymogen of digestive enzymes and proenzymes (lipase, amylase, trypsin, chymotrypsin, carboxypeptidase

centroacinar cells:

  • 3-4 within the bottom, rest in intercalated duct
  • cuboid shape, pale nucleus
  • receptors for secretin from SI
  • alkaline fluid producers to keep enzyme inactive
  • intercalated ducts join the form interlobular ducts then main accessory panc ducts
  • cuboidal epithelium becomes columnar api in duct system
29
Q

Islets of Langerhans:

A

endocrine pancreas

  • one islet can contain 100’s of cells , 1 million islets in the pancreas
  • pale staining cells, each islet HEAVILY vascularized
  • Mallory azan method??
  • shows how reticular fibers surround each islet and the fenestrated caplillaries in the islet
30
Q

islets of Langerhans cell types

A

alpha cell: 20% of islet-periphery, produce glucagon

beta cell: 70% of ilst, center, produce insulin

delta cell: 5% of islet-periphery, produce somatostatin
-membrane bound granules with relatively low densities

31
Q

Diabetes types

A

Type I DM: low insulin prod
-formerly insulin dependent or juvenile

Type II DML inability to respond to insulin
-formerly non insulin dependant or adult onset

Diabetes (to pass) mellitus (sweet)

32
Q

Acini vs Lang

A

acini: secretion of dig enzymes (exocrine)
lang: secretion of hor from islets (endocrine )

HE Test 4 (5 decks)

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