Case 6 - The liver in health and disease Flashcards
(32 cards)
hepatic functions
production of bile (exocrine)
production of hormones and plasma proteins (endocrine)
metabolism
storage
detoxification and elimination
where is the liver located
Located in the upper right quadrant of the abdominal cavity
name the accessory digestive organs
accessory organ is An organ that helps with digestion but is not part of the digestive tract.
The accessory digestive organs are the tongue, salivary glands, pancreas, liver, and gallbladder
The liver receives blood from two main sources: (these vessels carry blood into liver)
Hepatic artery – This carries oxygen-rich but nutrient-poor blood from the aorta into the liver
Hepatic portal vein – This carries nutrient-rich but oxygen-poor blood from the gastrointestinal tract and spleen into the liver
cystic artery arises from what?
Cystic artery arising from hepatic artery.
what artery supplies gallbladder
cystic artery
blood enters liver via hepatic artery and portal vein and then the blood from the liver is drained by what?
Inferior vena cava
Bile is secreted by the ___1___. Then it’s Released into ___2___which merge to form bile ducts
1 - liver hepatocytes
2 - bile canaliculi
Though bile secretion is __1__just after a meal, the liver is always secreting some bile.
1 - greatest
Bile can either:
Bile can either:
Enter the duodenum via the common bile duct.
or the Sphincter of Oddi is closed and the bile is shunted into the gallbladder via the cystic duct (between meals).
Sphincter of Oddi prevents what?
Sphincter of Oddi prevents reflux of bile.
what about bile?
bile salts
bile pigments
cholesterol
lecithin (phospholipid)
organic waste
trace metals
bicarbonate ions
mucus
pH 7-8
bile salts are Conjugated to ___1___ (e.g. glycine) to form ____2____ bile salts.
1 - amino acids
2 - water-soluble
Majority of bile salts are recycled (____1____circulation).
1 - enterohepatic
The exocrine pancreas secretes around 1.5L of fluid per day (ductal cells)
Rich in _____1______ (pH around 8) to help _____2_____the acidic chyme.
Contains all major enzymes for digestion of fats, carbohydrates and proteins.
1 - bicarbonate ions
2 - neutralise
Endocrine portion consists of the _______ (~2% of the total organ).
1 - islets of Langerhans
endocrine pancreas is made up of 4 distinct cell types which are: & and what do they release
Alpha cells (25%) which secrete glucagon.
Beta cells (60%) which secrete insulin.
Delta cells (10%) which secrete somatostatin.
F cells (1%) produce pancreatic polypeptide.
[Remaining 4% is connective tissue]
Fat absorption.
Bile salts and phospholipids act as emulsifying agents.
Pancreatic lipase hydrolyzes fat molecules.
- Colipase essential co-factor.
Pancreatic lipase produces:
- 2 free fatty acids
- 1 mono-glycerol.
Individual fatty acids/glycerols diffuse across cell membranes - these Recombine to form triglyceride
Cholesterol homeostasis.
The liver synthesizes 20-25%/around a quarter of total daily cholesterol (via HMG CoA reductase) and extracts cholesterol from the blood.
cholesterol is transported in blood, bound to lipoproteins (HDL/LDL).
Bile is the main route by which the body excretes cholesterol.
Cholesterol lowering drugs and dietary fibre can lower plasma cholesterol.
gallstone formation
Excess cholesterol may precipitate → forming crystals in the bile.
gallstones may also form from bile pigments (such as bilirubin)
Calcium and phosphate may then be deposited.
Treatment for gallstones
Treatment by gallstone dissolving drugs, shock wave therapy, or surgery.
gallstones can result in what?
Gallstones result in obstructive jaundice.
[obstructive jaundice can also be caused by pancreatic cancer]
Impact of liver disease? name 2-3
Liver damage has wide-ranging impact on human physiology:
Haemorrhage.
Fluid imbalance.
Jaundice.
Mental state alterations.
Loss of consciousness.
High blood pressure.
Liver Disease Classification
Clinical Presentation
- Acute vs chronic
Pathological appearance
- Pattern of involvement
Cause of Disease
