1. Hepatic artery 2. Portal vein 3. Bile duct

Anatomy Of The Liver Flashcards by Kyra Catedral

LIVER

The largest _____ of the body.
_____ kilograms in adults.
Located below the_____

internal organ

1.2 - 1.5 kilograms

diaphragm

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LIVER

• Divided into right and left lobes by______

• The right lobe is____ bigger than the left.

falciform ligament

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LIVER

Approximately_____ of blood passes through the liver per minute.

Chief_____ organ

1,500 mL or 1.5 L

metabolic

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Two (2) Main Blood Vessels supplying blood:

Hepatic Artery (25%)

Portal Vein (75%)

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Receiving well oxygenated blood from the systemic circulation via the hepatic artery with a direct branch of aorta.

Hepatic Arterv (25%)

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Larger volume of poorly oxygenated but nutrient-rich blood from the intestinal tract.

Portal Vein (75%)

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• The two blood supplies (hepatic artery and portal vein) eventually merge into the_______.

• From the sinusoid, blood flows to the_______.

• It is through the______ that blood leaves the liver.

hepatic sinusoid

central canal

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The excretory system of the liver begins at the______

The ______are small spaces between the hepatocytes that form intrahepatic ducts, where excretory products of the cell can drain.

bile canaliculi

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• The_____ ducts join to form the right and left hepatic ducts, which drain the secretions from the liver.

• The right and left hepatic ducts merge to form the______, which is eventually joined with the______ duct of the gallbladder to form the _____duct.

• Combined digestive secretions are then expelled into the______

intrahepatic ducts

common hepatic duct

cystic duct

common bile duct

duodenum

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*________ -> The space between two adiacent hepatocyte; responsible for the transport of bile and drainage of bile into the bile duct.

*________ -> The duct of the gallbladder.

Bile Canaliculi

Cystic Duct

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The liver is divided into microscopic units called_____.

functional units of the liver

responsible for all metabolic and excretory functions performed by the liver.

lobules

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Each lobule is roughly a six-sided structure with a centrally located vein (called the______) with_____ at each of the corners.

central vein

portal triads

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PORTAL TRIAD:

Hepatic artery
Portal vein
Bile duct

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Contains two major cell types:

Hepatocytes
Kupffer cells

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making up approximately
80% of the volume of the organ

• Perform the major functions associated with the liver and are responsible for the regenerative properties of the liver.

Hepatocytes

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• Macrophages that line the sinusoids of the liver and act as active phagocytes capable of engulfing bacteria, debris, toxins, and other substances flowing through the sinusoids

Kupffer cells

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Process of removing a portion of the liver

Lobectomy

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LIVER

Can regenerate by_____ and _____

Difficulty in regenerating if >_____% are lost

Cell Division & Hypertrophy

65%

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FUNCTIONS OF THE LIVER

EMDS

Excretion/Secretion
Metabolism
Detoxification
Storage

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SYNTHETIC FUNCTION
• Ability of liver to synthesize substances

Plasma Proteins
Carbohydrates
Lipids
Clotting Factors
Ketone Bodies
Enzymes Normal Liver

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The liver is capable of producing the most abundant protein in the blood “______”

Albumin

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FUNCTIONS OF THE LIVER

• Synthetic Function
• Conjugation Function
• Excretory and Secretory Functions
• Detoxification and Drug Metabolisms
• Storage Function

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CONJUGATION FUNCTION
•_____ metabolism
•_____mg/day = conjugated lipid

Bilirubin

200-300 mg/day

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Red Blood Cells (RBC)

• Average life span of 120 days
• Phagocytized by Spleen/Liver/Red Bone Marrow Macrophage
• Broken down into (2)

Heme & Globin

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_______-> Protein = further breakdown = amino acids -› Will be put in the amino acid pool

Globin

______-› Carries iron & porphyrin ring Iron -> Ferric ion (Fe3+) will be carried by transferrin (carrier protein) toward to liver -› Some will be stored in the liver = converted to ferritin (storage form of iron

Heme

(storage form of iron

ferritin

RBC Formation -> Breakdown of ferritin to iron -› Will be brought by_____ from the liver to the bone marrow

transferrin

Porphyrin Ring Oxidized by heme oxygenase = produces_____

biliverdin

biliverdin • Reduced by_______ = Unconjugated Bilirubin (B1)

biliverdin reductase

Unconjugated Bilirubin (B1) o Needs a carrier protein =____

Albumin

Albumin • Will go to______ through passive diffusion or receptor-mediated endocytosis Y & Z proteins will form a complex w/_____ bilirubin _____ will be attached to the complex Will go to the Hepatocyte____

hepatocytes unconjugated bilirubin Ligandin SER

= bilirubin conjugation takes place

Hepatocyte SER

Unconjugated Bilirubin to Conjugated Bilirubin (B2) • Catalyzed by the enzyme

Uridine Diphosphate Glucuronosyltransferase (UDPGT)

B2 Excreted by_____ Will go to the bile canal = intrahepatic duct = right/left duct = common hepatic duct = common bile duct =_____

hepatocytes small intestine duodenum

B2 in duodenum Will encounter intestinal bacteria • B2 becomes_____

mesobilirubin

mesobilirubin Converted into______ • 80% becomes______ = responsible for brown color of feces • 20% either absorbed by extrahepatic circulation or_____

urobilinogen stercobilin systemic circulation

(Stool color) if inadequate bilirubin/liver damage

Dark white

•_______ -› Goes back to the liver = undergoes same process •_______ -> Urobilinogen will go to the kidneys

Extrahepatic Circulation Systemic Circulation

Systemic Circulation -> Urobilinogen will go to the kidneys Will reach the urinary bladder Urobilinogen is oxidized into_____ = minor contributor for yellow color of urine ______= primary contributor for yellow urine

urobilin Urochrome

• Look for #1: Red blood cells that were ingested by the macrophage in the____. RBC will undergo lysis and they will release the____. • In #2: The hemoglobin is broken into____ and ____ • In #3: The amino acids will be reused by the body for____ synthesis. • In #4: The released iron will be reused by the body, some of it will be utilized to form hemoglobin in the bone marrow and some will be stored in the liver in the form of_____ • The remaining portions of the heme will be converted to the____. • Biliverdin will be acted upon by_____ converting it into yellow colored bilirubin. • In #9 and #10: The bilirubin formed from biliverdin should be transported towards the liver.

spleen hemoglobin heme and globin protein ferritin biliverdin biliverdin reductase

BILIRUBIN 1 • Water ______ -

insoluble

B1 requires_____ for it to be transported to the liver for excretion. So, for this to be eliminated in the body, it must be converted by the hepatocytes to a water-soluble form

albumin

• Unconjugated bilirubin • Indirect bilirubin

Cannot be removed from the body unless it is conjugated with______ in the liver, converting it to a water-soluble form and that is excretable form of bilirubin.

BILIRUBIN 1 glucuronic acid

• Bilirubin Monoglucuronide

• Non-polar bilirubin

• Conjugated bilirubin • Direct bilirubin

BILIRUBIN 2

• Water soluble • Polar bilirubin

• Bilirubin diglucuronide

• Secreted by the hepatocyte into the bile canaliculi then into the gallbladder or into the common bile duct.

DELTA BILIRUBIN

BILIRUBIN 2 + ALBUMIN

Total Bilirubin =

B1 + B2 + Delta Bilirubin

B1 =

Total Bilirubin - B2

DETOXIFICATION AND DRUG METABOLISM Every substance that is absorbed from the gastrointestinal tract (GIT) must first pass through the____ -› first pass effect.

liver

• It allows important substances to reach the systemic circulation and serves as a barrier to prevent toxic and harmful substances from reaching the systemic circulation.

LIVER

• Anything that is absorbed from the GIT will have to pass through the___\. • Important chemicals are allowed to reach the systemic circulation. • Anything that is toxic and harmful, should be detoxified by the_____.

liver hepatocytes

• Is the byproduct of protein metabolism. • It is converted by the liver into urea and urea is then excreted by the kidneys.

Ammonia

Liver diseases -› high ammonia levels in blood which can lead to____.

coma

_______is the major component of the bile pigment Derived from the breakdown of_____ in red cells.

Bilirubin hemoglobin

Bile Acids • Conjugated cholic acid -› cholate • Conjugated chenodeoxycholic acid -> chenodeoxycholate

Cholic Acid Chenodeoxycholic Acid

Glycine is conjugated with glycine and taurine forming_____

bile salts

STORAGE FUNCTION

• All fat-soluble vitamins • Water-soluble Vitamins • Glycogen

If the liver becomes completely nonfunctional for any reason, death will occur within approximately _____ due to______.

24 hours hypoglycemia

The excretory system of the liver begins at the

bile canaliculi

e bile canaliculi are small spaces between the hepatocytes that form______, where excretory products of the cells can drain.

intrahepatic ducts

The right and left hepatic ducts merge to form the common hepatic duct, which is eventually joined with the cystic duct of the gallbladder to form the_______

common bile duct

Combined digestive secretions are then expelled into the______

duodenum

The body produces approximately____ of bile per day and excretes____ of what is produced.

3 L 1 L

is the principal pigment in bile, and it is derived from the breakdown of red blood cells

Bilirubin

Approximately____ days after the emergence from the reticuloendothelial tissue, red blood cells are phagocytized and hemoglobin is released

126

Hemoglobin is degraded to

heme, globin, and iron

The iron is bound by______ and is returned to iron stores in the liver or bone marrow for reuse. The globin is degraded to its constituent______, which are reused by the body. The heme portion of hemoglobin is converted to______ in 2 to 3 hours.

transferrin amino acids bilirubin

Bilirubin is bound by______ and transported to the liver. This form of bilirubin is referred to as______

albumin unconjugated or indirect bilirubin

________ is insoluble in water and cannot be removed from the body until it has been conjugated by the liver. Once at the liver cell, unconjugated bilirubin flows into the sinusoidal spaces and is released from albumin so it can be picked up by a carrier protein called_____.

Unconjugated bilirubin ligandin

_______, which is located in the hepatocyte, is responsible for transporting unconjugated bilirubin to the_______, where it may be rapidly conjugated.

Ligandin endoplasmic reticulum

The conjugation (esterification) of bilirubin occurs in the presence of the enzyme_________, which transfers a glucuronic acid molecule to each of the two propionic acid side chains of bilirubin to form bilirubin______, also known as______

uridine diphosphate glucuronosyltransferase (UDPGT) diglucuronide conjugated bilirubin.

is water soluble and is able to be secreted from the hepatocyte into the bile canaliculi. Once in the hepatic duct, it combines with secretions from the gallbladder through the cystic duct and is expelled through the common bile duct to the intestines.

Conjugated bilirubin

Intestinal bacteria (especially the bacteria in the lower portion of the intestinal tract) work on conjugated bilirubin to produce_______, which is reduced to form______ and then_____ (a colorless product).

mesobilirubin mesobilirubinogen urobilinogen

Most of the urobilinogen formed (roughly 80%) is oxidized to an orange-colored product called______ (______) and is excreted in the feces. The urobilin or stercobilin is what gives stool its_____ color.

urobilin/ stercobilin brown

Approximately______ of bilirubin is produced per day, and it takes a normally functioning liver to process the bilirubin and eliminate it from the body

200 to 300 mg

Almost all the_____ formed is eliminated in the feces, and a small amount of the colorless product,_____, is excreted in the urine.

bilirubin urobilinogen

The healthy adult has very low levels of total bilirubin (_______) in the serum, and of this amount, the majority is in the unconjugated form.

0.2 to 1.0 mg/dL

approximately_____ of the daily production of cholesterol (roughly 1.5 to 2.0 g) is produced by the liver.

70%

Almost all proteins are synthesized by the liver except for the ______ and _____

immunoglobulins and adult hemoglobin

The liver serves as a gatekeeper between substances absorbed by the gastrointestinal tract and those released into systemic circulation. Every substance that is absorbed in the gastrointestinal tract must first pass through the liver; this is referred to as_______

first pass

This is an important function of the liver because it can allow important substances to reach the systemic circulation and can serve as a barrier to prevent toxic or harmful substances from reaching systemic circulation.

First pass

Anatomy Of The Liver Flashcards

(87 cards)