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Apex Review > Liver > Flashcards

Liver Flashcards

1
Q

Which structure is responsible for eliminating bacteria from the liver?
a. Kupffer cell
b. canaliculus
c. sinusoid
d. acinus

A

a. Kuppfer cell

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2
Q

The largest internal organ is the

A

liver

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3
Q

the functional unit of the liver is

A

the lobule

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4
Q

__________- is another way to functionally classify liver tissue.

A

Acinus

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5
Q

The acinus encompasses the liver tissue that is served by

A

a single terminal branch of the hepatic artery

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6
Q

______________ in the acinus are organized into zones according to their proximity to the portal triad and central vein.

A

Hepatocytes

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7
Q

__________________ are the most susceptible to ischemic injury

A

Hepatocytes in zone 3

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8
Q

______________ remove bacteria from the portal blood before the blood enters the systemic circulation

A

Kuppfer cells

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9
Q

Bile is produced by the ________ and stored in the ________

A

hepatocytes; gallbladder

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10
Q

What is the specific path that bile follows?

A

canaliculi–> bile duct–> common hepatic duct–> common bile duct–> ampulla of Vater–> duodenum

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11
Q

Lymph and proteins drain into __________ before they empty into the lymphatic duct

A

space of Disse

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12
Q

___________ is a connective tissue covering that encapsulates the liver along with parts of the hepatic artery, portal vein, and bile ducts.

A

Glisson’s capsule

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13
Q

What ligaments attach to the anterior abdominal wall attachments?

A

falciform and round ligaments

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14
Q

What ligaments attach to the diaphragmatic attachments?

A

coronary ligament and triangular ligaments

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15
Q

The liver receives SNS innervation from

A

T3-T11

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16
Q

A lobule is hexagonal in cross section with (how many veins)?

A

a central vein at its center and portal veins at its six corners

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17
Q

Sinusoids can be compared to

A

capillaries (serve this function)

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18
Q

The arterioles of the liver are the

A

hepatic artery and portal vein

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19
Q

The acinus is divided into 3 zones that correspond to the

A

distance from the arterial oxygen supply (portal triad)

20
Q

The highest concentration of CYP450 enzymes is in

A

zone 3

21
Q

The _______ controls the flow of bile released from the common hepatic duct.

A

sphincter of Oddi

22
Q

What are the 3 functions of bile?

A
  1. absorption of fat and fat-soluble vitamins
  2. excretory pathway for bilirubin and products of metabolism
  3. alkalization of the duodenum
23
Q

Eating fat and protein increases release of ______________________; which stimulates _______ contraction & increases the flow of bile into the duodenum

A

Cholecystokinin; gallbladder

24
Q

Which statement MOST accurately describes hepatic perfusion?
a. the hepatic artery provides 75% of liver blood flow
b. the portal vein provides 50% of liver blood flow
c. the hepatic artery provides 75% of the liver’s oxygen content
d. the portal vein provides 50% of the liver’s oxygen content

A

d. the portal vein provides 50% of the liver’s oxygen content

25
Q

The liver receives about _______ of the cardiac output via a dual blood supply

A

30%

26
Q

The portal vein provides _______ of the total liver blood flow and provides ____ of the liver’s oxygen supply

A

75%; 50%

27
Q

The hepatic artery provides __ of the total liver blood flow and provides _____ of the liver’s oxygen supply.

A

25%; 50%

28
Q

Is portal blood flow autoregulated?

A

Nope

29
Q

Increased splanchnic vascular resistance ____________ portal vein flow

A

reduces

30
Q

When there’s a reduction in portal vein blood flow, the hepatic arterial buffer response compensates by

A

increasing flow through the hepatic artery

31
Q

_________________ impairs the response of the hepatic arterial compensation

A

severe liver disease; makes the diseased liver even more susceptible to hypoperfusion

32
Q

_________ and ____________- reduce MAP and cardiac output which can reduce liver blood flow in a dose-dependent fashion.

A

Both general and neuraxial

33
Q

The liver receives a dual blood supply from the

A

portal vein and hepatic artery

34
Q

The following can increase splanchnic vascular resistance and decrease portal vein blood flow

A

SNS stimulation
pain
hypoxia
hypercarbia

35
Q

Portal perfusion pressure is calculated by

A

Portal perfusion pressure= portal vein pressure- hepatic vein pressure

36
Q

Normal portal vein pressure is

A

7-10 mmHg

37
Q

Portal vein pressure of ____– is diagnostic for portal HTN

A

> 20-30 mmHg

38
Q

Normal sinusoid pressure is

A

0 mmHg

39
Q

Sinusoid pressure of __________ is diagnostic for portal HTN

A

> 5 mmHg

40
Q

Portal hypertension reduces blood flow through the liver which produces back pressure to the following splanchnic organs:

A

vascular engorgement–> splenomegaly, & varices of the esophagus, stomach, & intestine

41
Q

Additional physiologic consequences of portal hypertension include

A

ascites, spider angiomas, hemorrhoids, and encephalopathy

42
Q

Perioperative factors that reduce liver blood flow include:

A

increased splanchnic vascular resistance (SNS stimulation, pain, hypoxia)
things that increase CVP (PPV, excessive hydration, & CHF)
some beta-blockers (propranolol)
intraabdominal surgical procedures (surgical retraction and release of vasoactive substances)
laparoscopic surgery (pneumoperitoneum)

43
Q

The celiac artery provides blood flow to which 3 organs?

A

liver
spleen
stomach

44
Q

The superior mesenteric artery provides blood flow to which 3 organs?

A

pancreas
small intestine
colon

45
Q

Name 1 organ that receives blood flow from the inferior mesenteric artery.

A

colon

Apex Review (224 decks)

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