18 anatomy of the liver Flashcards

(71 cards)

1
Q

What are the functions of the liver?

A

Metabolism, excretion/secretion, detoxification, storage and immunologic

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2
Q

What does the liver metabolise?

A

Glycogen, glucose, triglycerides, phospholipids, cholesterol and proteins

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3
Q

What does the liver excrete?

A

Water, electrolytes, phospholipids, bile salts and pigments, cholesterol, bilirubin

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4
Q

What does the liver detoxify?

A

Drugs and poisons,

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5
Q

What does the liver store?

A

Glycogen, fat soluble vits, iron and blood

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6
Q

What is the immunologic function of the liver?

A

Phagocytosis of bacteria

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7
Q

How is the liver divided?

A

2 major lobes and 2 minor lobes

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8
Q

Which liver lobe is larger?

A

Right lobe

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9
Q

What is the Glisson’s capsule?

A

The connective tissue capsule surrounding the liver

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10
Q

What surrounds the lobules?

A

Connective tissue

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11
Q

What is the portal triad?

A

Heaptic vein, artery and duct

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12
Q

What are hepatocytes?

A

Epithelial cells with one or two nuclei and 5-12 surfaces

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13
Q

What occurs at the apical surface of hepatocytes?

A

Where bile is secreted from

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14
Q

What does the lateral surface of hepatocytes do?

A

Connect neighbouring hepatocytes

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15
Q

What separates hepatocytes?

A

Sinusoids

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16
Q

Where do immune cells reside?

A

Sinusoids

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17
Q

What is the rate of blood flow in the liver?

A

1500ml/min

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18
Q

What are the cons of the liver’s rich blood supply?

A

It is a prime site for metastasis of cancer

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19
Q

What does the hepatic portal vein do?

A

Take venous blood to liver

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20
Q

What does the hepatic artery do?

A

Take arterial blood to liver

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21
Q

What does the hepatic vein do?

A

Take processed blood to the vena cava

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22
Q

What is a sinusoid?

A

A small blood vessel found in liver that functions similarly to capillary

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23
Q

Compare sinusoids to capillaries

A

They have increased permeability compared to capillaries and allow larger molecules to leave the bloodstream.

they have no or discontinuous basement membrane but continuous in capillaries

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24
Q

Describe how sinusoids allow passage of large molecules

A

Their endothelial layer contains large intracellular gaps allowing for passage of large molecules and a further leak is allowed by fenestration that penetrate endothelial cells.

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25
How does blood enter the sinusoid?
From the portal vein and hepatic artery
26
What happens to plasma throughout the sinusoid?
It is filtered into the Space of Disse between the endothelium and hepatocytes
27
What are kupffer cells?
Macrophages of the sinusoid
28
What do kupffer cells do?
Remove particulate materials, including bacteria, from portal blood may be involved in final breakdown of of damages/aged RBCs
29
Where are Ito cells found?
In the space of Disse
30
What do Ito cells do?
They are the primary storage site for hepatic fat and vitamin A (released as retinol)
31
What happens to Ito cells?
They are transported from the liver to the retina to form rhodopsin. If the liver is injured, they become myofibroblasts and produce collagen. leads to fibrosis
32
What do dendritic cells do?
The play important roles in liver immunity, autoimmunity and regulation of hepatic allograft acceptance
33
What are dendritic cells?
Antigen presenting cells that capture, process and present antigens to immune effector cells
34
What is the biliary system?
a series of channels and ducts that convey bile from the liver into the small intestine
35
What are canaliculi?
The first channel in the biliary system
36
Describe the biliary system
Hepatocytes -> bile canaliculi -> canal of hering -> interloper bile duct -> bile duct
37
What is at the corners of tubules?
A portal triad of hepatic arteries, portal veins and bile duct
38
How does the bile duct leave the liver?
Via the common hepatic duct
39
Compare bile and blood flow
The flow in opposite directions
40
What are sinusoids?
Low pressure vascular channels that receive blood from the hepatic artery and portal
41
What is a liver acinus?
Oblong shaped, the smallest functional unit of the liver
42
What is the short axis?
The distance between portal triads at the border between neighbouring lobules
43
What is the long axis?
Line drawn between central veins closest to the short axis
44
What are the 3 zones of the long axis?
Zone 1 - periportal zone 2 - intermediate zone 3 - perivenous/pericentral
45
Describe zone 1
Closest to the short axis, first to receive oxygen,nutrients and toxins from blood last to die if circulation impaired, first to regenerate
46
Describe zone 3
most sensitive to hypoxia, closest to central vein, first to show ischaemic necrosis and fat accumulation, last to respond to toxins
47
What occurs at zone 1?
Oxidative metabolism, gluconeogenesis, urea genesis and bile formation
48
What occurs at zone 3?
Glycogen synthesis, glycolysis, xenobiotic metabolism
49
What occurs when kupffer cells are activated?
Various products, including cytokines, NOs and other products that regulate the phenotype of KC and neighbouring cells that traffic through liver activation is essential to response of the liver to infection or injury to protect from infections and limit cellular organ damage
50
What do kupffer cells produce?
Cytokines, chemokines, reactive nitrogen and oxygen species
51
Where are Kupffer cells found?
Localised in hepatic sinusoid
52
What is the M1 cell for?
Increased expression of pro-inflammatory
53
What is the M2 cell for?
Low expression of pro-inflammatory cytokines and increased expression of anti-inflammatory mediators
54
Where are large kupffer cells found?
In the periportal region of the liver acinus
55
How do periportal KC compare to smaller KC?
They have higher lysosomal enzyme activities and a greater phagocytic capacity
56
Describe the role of KC in haemoglobin clearance
They rapidly remove haemoglobin containing vesicles within the acinus
57
Describe the role of hepatocytes with bile
Secrete bile into canaliculi where it flows into bile duct
58
What is hepatic bile made of?
Bile acids, cholesterol and other organic materials
59
What happens to bile as it moves through the duct?
it is modified by addition of a watery, bicarb rich secretion from ductal epithelial cells
60
Describe bile acids
They are facial amphipathic and contain both hydrophobic and hydrophilic faces
61
What do bile salts do?
Convert large fat globules into smaller pieces with polar surfaces that inhibit re-aggregation
62
Describe emulsified fat globules
They are small enough that lipase enzymes gain access to degrade triglycerides to monoglycerides to fatty acids
63
Where do bile acids go?
They are extracted from sinusoidal blood and transported across the hepatocyte to be re-secreted into canaliculi
64
Where are coagulation factors synthesised?
In the liver
65
What are the vitamin-K dependent coagulation proteins?
Factors II, VII, IX, X, protein C, S and Z
66
How does the liver regulate coagulation and fibrinolysis?
By clearing coagulation factors fro the circulation
67
Describe the synthesis of albumin
Occurs in the liver by a fall in plasma oncotic pressure by hepatocytes
68
Where is albumin found?
In interstitial fluid
69
What does albumin do?
It acts as a transport protein for numerous substances
70
What causes hypoalbuminemia?
Increased loss of albumin
71
What causes hyperalbuminemia?
Dehydration due to loss of intravascular fluid due to depletion - same amount of albumin but ration of albumin to blood serum is higher