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Wehbe, Physiology II Exam 3 > Liver and Pancreas > Flashcards

Liver and Pancreas Flashcards

1
Q

What is the blood flow from the portal vein through the lobule?

A

Portal vein –> sinusoids –> central vein –> hepatic veins

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2
Q

What is the blood flow from the hepatic artery through the lobule?

A

hepatic artery –> sinusoids –> central vein –> hepatic vein –> IVC

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3
Q

How many layers are the liver cell plates composed of?

A

two layers of hepatocytes

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4
Q

Where are the bile canaliculi located?

A

Between two layers of hepatocytes in each cell plate

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5
Q

What are sinusoids lined with?

A 
Endothelial cells
Kupffer cells (marophage derived)
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6
Q

Where is the Space of Disse located?

A

between endothelial cells and hepatocytes

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7
Q

What do the bile canaliculi secrete?

A

bile down into the bile duct

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8
Q

What is the blood flow and resistance like in the liver?

A

High blood flow and low vascular restistance

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9
Q

What percent of cardiac output is the liver vascular supply?

A

27%

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10
Q

What is the portal pressure into the liver?

A

9 mmHg

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11
Q

What is the pressure from the liver to the vena cava?

A

0 mmHg

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12
Q

What is the effect of cirrhosis on blood flow?

A

Cirrhosis increases liver resistance to blood flow

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13
Q

What is the effect of clot blocking potak vein or a major branch?

A

Blockage of return blood from spleen and intestine

Increase in capillary pressure in intestinal wall –> loss of fluid –> death

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14
Q

What is the normal volume of the liver?

A

450 ml (10% of body’s blood volume)

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15
Q

How will the liver vascular supply change during cardiac failure with peripheral congestion?

A

high pressure in right atrium –> backpressure of liver –> increased blood volume in liver up to 1.5 L

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16
Q

T/F Liver can store blood in times of excess and supply blood in times of diminished volume

A

True

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17
Q

What are hepatic sinusoids highly permeable to?

A

proteins – efferent lymph has a protein concentration of 6g/dl

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18
Q

What happens when there is higher than normal pressure in hepatic veins?

A
  • back pressure causes fluid to transude into lymph
  • fluid leaks through liver capsule into abdominal cavity
  • fluid is almost pure plasma
  • large amount of fluid in abdominal cavity = ascites
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19
Q

What are the functions of the liver concerning carbohydrate metabolism?

A
  • stores glycogen
  • converts galactose and fructose to glucose
  • gluconeogenesis
  • forms intermediate products of carb metabolism
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20
Q

What are the functions of the liver concerning fat metabolism?

A
  • oxidation of fatty acids for energy
  • synthesis of cholesterol, phospholipids, lipoproteins
  • synthesis of fats from proteins and carbs
21
Q

What are the functions of the liver concerning protein metabolism?

A
  • deamination of amino acids
  • formation of urea
  • formation of plasma proteins
  • interconversion of various amino acids and synthesis of other compounds from amino acids
22
Q

What are the functions of the liver concerning vitamin storage?

A
  • vitamin A
  • vitamin D
  • vitamin B12
23
Q

What are the functions of the liver concerning formation of coagulation factors?

A
  • fibrinogen
  • prothrombin
  • accelerator globulin
  • Factors VII, IX, X
24
Q

What are the functions of the liver concerning removal or excretion of drugs, hormones, and other substances?

A
  • detoxify or excrete into bile (sulfonamides, penicillin, ampicillin, erythromycin)
  • excretes excess calcium into bile
  • detoxification and removal of ammonia and ethanol
25
Q

Where is hepatic bile produced and secrete?

A

the liver

26
Q

Where is hepatic bile stored?

A

gallbladder

27
Q

What are the 4 components of bile?

A
  1. Bile acids
  2. Water and electrolytes
  3. Cholesterol and phospholipids
  4. Pigments and organic molecules
28
Q

What is the major pigment in bile?

A

bilirubin

29
Q

What are the 2 major bile acids synthesized by hepatocytes?

A

Cholic acid and chenodeoxycholic acid

30
Q

What are the 2 major bile acids converted by bacteria?

A

Deoxycholic acid and lithocholic acid

31
Q

What are the fates of Urobilinogen?

A
  • oxidized into excreted products

- reabsorbed into blood and carried back to the liver to be re-excreted by liver or excreted in urine

32
Q

What are the characteristics of jaundice?

A
  • yellowish tint to the body tissues

- caused by quantities of bilirubin in extracellular fluids

33
Q

What are the common causes of jaundice?

A
  • Increased hemolysis

- obstruction of bile ducts or damage to liver

34
Q

What are the three main types of inlet cells?

A

Alpha, Beta, Delta

35
Q

What are the characteristics of alpha cells?

A
  • secrete glucagon

- 25% of total cells

36
Q

What are the characteristics of beta cells?

A
  • secrete insulin and amyling

- 60% of total cells

37
Q

What is the function of insulin?

A

inhibits glucagon secretion

38
Q

What is the function of amylin?

A

inhibits insulin secretion

39
Q

What are the characteristics of delta cells?

A

-secrete somatostatin

40
Q

What is the function of somatostatin?

A

inhibit insulin and glucagon secretion

41
Q

How is insulin found in the blood?

A

unbound form

42
Q

What is the half-life of insulin?

A

6 minutes

43
Q

Where is insulin destroyed if not bound to receptor?

A

liver

44
Q

What are the four potential outcomes of insulin binding to a receptor?

A
  1. Increased uptake of glucose
  2. Increased permeability to amino acids, potassium and phosphate ions
  3. Increased activity for many enzymes
  4. Changes in rates of translation and transcription
45
Q

What is the structure of proinsulin?

A

a, b. and c chains are linked together

a and b chains are linked by sulfide bonds

46
Q

What are the insulin receptor substrates due to phosphorylation of enzymes

A
  1. glucose transport
  2. protein synthesis
  3. fat synthesis
  4. glycogen synthesis
  5. growth and gene expression
47
Q

Where is most glucose absorbed after a meal?

A

stored as glycogen in the liver

48
Q

What is the glucose uptake mechanism for the liver?

A

insulin inactivates liver phosphorylase –> insulin activates glucokinase and enhance uptake of glucose from blood –> insulin increases activities of enzymes needed for glycogensis

49
Q

What is the process that causes glucose to be released into the blood?

A
  • decreased blood glucose from decrease insulin
  • lack of insulin reverses glycogen synthesis pathway
  • lack of insulin activates phosphorylase which splits glycogen into glucose phosphate
  • glucose phosphatase remoces phosphate from glucose and allows it to diffuse into blood
  • insulin inhibits gluconeogenesis

Wehbe, Physiology II Exam 3 (6 decks)

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