CHAPTER 2 - LIVER

Question 1

What is the functional units of liver

Answer 1

lobules

Question 2

what do lobules contain

Answer 2

hepatocytes (liver cells)

Question 3

what other stuff are in the liver?

Answer 3

capillaries ( sinusoids) lined with kupffer

Question 4

what is kuffer

Answer 4

another type of cells that perform immune function

Question 5

what are the 2 fuctions of Kuffer cells

Answer 5

1) remove bacteria and toxins from blood

2) Ingest and breakdown old red blood cells

Question 6

what is hepatic portal vein

Answer 6

Vein that brings blood from the stomach, and pancreas directly to the liver. ]This blood contains products of digestion.

Question 7

What are the functions of the liver? (8)

Answer 7

1) Destroy - destroy bacteria in portal blood
2) Metabolize - metabolize drugs, hormones, and toxins
3) Produce - Produce fatty acids, triglycerides, cholesterol, and lipoproteins ( ex. HDL and LDL)
4) Maintain - maintain blood glucose
5) Produce - Produce urea
6) Produce - produce clotting proteins, albumin, angiotensinogen, IGF
7) Produce - Produce bile salts
8) Excrete - Excrete bilirubin in the bile

Question 8

Kupffer cells are made up of

Answer 8

macrophages

Question 9

Immune function

Answer 9

Blood from gastrointestinal tract ( Containing bacteria, endotoxins, and microbes) flows to the liver where kupffer cells work to clean the blood

Question 10

In severe liver disease what happens to the blood coming from intestines?

Answer 10

Shunted and not passed through the liver as a result, bacteria and toxins are not cleaned out and left circulating in the blood.

Question 11

what does liver metabolize?

Answer 11

Metabolizes fat, carbs and proteins.

Question 12

what emulsifies fat?

Answer 12

Bile

Question 13

why do we need to emulsify fats?

Answer 13

it allows fat to be transported into the blood stream.

Question 14

liver turns fatty acids and glycerol into?

Answer 14

trygleceride and cholesterol

Question 15

the liver repackage tryglecerides and cholesterol by adding what

Answer 15

proteins

Question 16

repackaged cholesterol and trygleceride with protein is called

Answer 16

lipoprotein

Question 17

Lipoprotein is stored as

Answer 17

adipose tissue

Question 18

what is glycogenesis

Answer 18

coverts glucose to glycogen

Question 19

what is glycogenolysis

Answer 19

breaks down glycogen to glucose

Question 20

what is gluconeogenesis

Answer 20

formation of glucose from amino acids/ fatty acids

Question 21

what releases insulin and glucagon?

Answer 21

pancrease

Question 22

when is glucagon released?

Answer 22

when blood sugar is low

Question 23

when is insulin released

Answer 23

when blood glucose in high

Question 24

Prolonged fasting will lead to

Answer 24

liver converting fatty acids and glycerol into ketone bodies and using that as the bodies source (gluconegenesis)

Question 25

Protein

Answer 25

Synthesis of plasma proteins ( albumin and globulin)

Question 26

how does liver work with protein

Answer 26

breaks down amino acids (deamination) --> converts ammonia into urea to be excreted by kidneys

Question 27

what is the break down of amino acid called

Answer 27

deamination

Question 28

what is albumin?

Answer 28

major plasma protein that circulates in blood stream

Question 29

what are the 2 things that albumin do

Answer 29

1) maintains oncotic pressure | 2) plays a role in transportation

Question 30

How does liver work as metabolic detoxification?

Answer 30

alters medication, hormones, and other chemicals to make them less toxic

Question 31

what is first pass effect

Answer 31

liver reduce drug concentration before it reaches circulation

Question 32

Why is first pass effect good

Answer 32

diminishes reabsorption and facilitates excretion | prevents accumulation of side effects

Question 33

what are the example of hormones in metabolic detoxification

Answer 33

- aldosterone - estrogen - testosterone

Question 34

what are the example of chemicals in metabolic detoxification

Answer 34

- alcohol | - barbiturates

Question 35

What is the hematologic function of liver

Answer 35

synthesize most clotting factors

Question 36

what clotting factors does liver synthesize?

Answer 36

Vitamin K - fat soluble vitamin required to synthesize clotting factors.

Question 37

what does vitamin K absorption relies on?

Answer 37

Relies on bile production in the liver

Question 38

Without fat can vitamin K be stored?

Answer 38

NO

Question 39

What does vitamin K do

Answer 39

Vitamin K helps by converting some coagulation factors into their mature form.

Question 40

what plasma protein does the liver make? what does this protein do?

Answer 40

The liver makes albumin. It helps keep fluid into the IVF via oncotic pressure in the vascular system.

Question 41

What is bilirubin

Answer 41

yellowish pigment that comes in the breakdown of old RBC

Question 42

What breaks down old red blood cells

Answer 42

Macrophages on the spleen and liver break down old RBC

Question 43

Bilirubin is a key component of what?

Answer 43

Bile

Question 44

Does bilirubin dissolve well in blood?

Answer 44

No

Question 45

what does bilirubin need to do to dissolve in blood

Answer 45

Bilirubin does not dissolve well in the blood and must be transported bound to albumin

Question 46

What do we have to do in order to make bilirubin water-soluble

Answer 46

The liver conjugates bilirubin to glucuronic acid

Question 47

In order to be excreted in the bile bilirubin has to be

Answer 47

Conjugated bilirubin ( water- soluble)

Question 48

Conjugated bilirubin is called

Answer 48

Direct

Question 49

Unconjugated bilirubin is

Answer 49

Indirect or free bilirubin

Question 50

Once in the large intestine, bacteria converts bilirubin into

Answer 50

- Stercobilinogen and urobilinogen

Question 51

Stercobilinogen is what

Answer 51

gives feces its brown colour

Question 52

what is the path way of bilirubin

Answer 52

Unconjugated --> liver --> unconjugated + glucorinic acid --> conjgated --> Bile --> small intestine --> large intestine

Question 53

urobinilogen ( by bacteria)

Answer 53

excreated or reabsorbed

Question 54

Compare conjugated bilirubin and unconjugated bilirubin

Answer 54

Unconjugated - not water soluble | conjugated - water soluble

Question 55

What is bile required for

Answer 55

Required for emulsification and absorption of fat in the intestinal tract

Question 56

what is bile made up of

Answer 56

Made up of bile salts, cholesterol, bilirubin, electrolytes, and water.

Question 57

what is bile? where is it stored

Answer 57

Dark green yellowish fluid produces by the liver and stored in the gal bladder.

Question 58

Jaundice

Answer 58

Not a disorder but can occur with variety of disease

Question 59

What is jaundice other name

Answer 59

Hyperbilirubinemia

Question 60

Jaundice results from

Answer 60

elevated bilirubin

Question 61

What does jaundice cause

Answer 61

- causes yellow discolouration - can be visible on skin, sclera of the eye, and soft palate. - May also cause pruritis ( itching)

Question 62

what are the 3 main types of Jaundice

Answer 62

1. Prehepatic - hemolitic 2. Hepatic - intrahepatic 3. Posthepatic - extra hepatic

Question 63

Prehepatic jaundice

Answer 63

- results from increase in bilirubin before reaching the liver - Overproduction of unconjugated bilirubin

Question 64

what is the main cause of prehepatic jaundice

Answer 64

- excessive hemolysis - break down of RBC | - The liver cannot conjugate the bilirubin fast enough because of the increase load

Question 65

conditions examples that causes prehepatic jaundice

Answer 65

reactions such as | - hemolytic jaundice of newborn and blood transfusion reaction

Question 66

Prehepatic jaundice is characterized by

Answer 66

1. increased unconjugated bilirubin 2. decrease hematocrit 3. normal liver enzymes 4. urine will appear normal (amber)