Hepatobiliary Foundations Flashcards
What is distinct about segement 1 of the liver?
it has a separate venous drainage into the IVC
Describe the pathophysiology of a biloma.
ischemia to the biliary system (which only has one source of blood) will cause infarction of bile duct and extravasation of bile (can lead to infection and abscess formation)
What is interface hepatitis?
portal triad inflammation that penetrates the limiting plate to the parenchymal tissue
Contrast the portal lobule and the portal acinus.
portal lobule are the hepatocytes that surround a give portal triad
portal acinus are adjacent hepatocytes served by the same terminal hepatic venule
What is metabolic zonation?
based on the different distribution of cells in a lobule, those with higher oxygenation and nutrition express distinct metabolic profiles (specific cytochromes or enzymes in zone 1, 2, and 3
Describe the path of lymph as it enters the lymphatics from the liver.
fluid from the space of Disse continues on to the space of Mall were most lymphatics take up excess fluid
Where do you find the following cells: Kupffer cell, Pit cell, astrocyte?
In the sinusoid: Kupffer cell (phagocytose) and the Pit Cell (large granular lymphocyte with natural killer capabilities)
within the space of Disse: astrocytes (store vit A and can be activated to produce collagen)
Constriction of the sinusoid by astrocytes can cause what?
portal HTN (occurs when astrocytes are activated by toxins)
Contrast the destruction of DNA in necrosis and apoptosis.
in apoptosis (shrinking of cell), endonucleuses degrade DNA, this is not a particularly organized process in necrosis (accompanied by inflammation, enlargement of the cell and organelles)
Contrast liver regeneration and compensatory hyperplasia.
resection of a lobe will stimulate compensatory hyperplasia in order to replace missing tissue
diffuse, acute damage leading to necrosis as in tylenol overdose, the liver relies on hepatic stem cells (of ductules) for regeneration
