GI 7 - The Liver Flashcards Preview

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Flashcards in GI 7 - The Liver Deck (30):
1

Name the anatomical lobes of the liver:

- Left lobe
- Right lobe
- Caudate lobe
- Quadrate lobe

2

Name the ligaments associated with the Liver:

- Falciform ligament (containing ligamentum teres hepatitis)
- Ligamentum venosum
- Coronary ligaments
- Triangular ligaments

3

What structures enter/leave the Liver at the porta hepatits?

- Hepatic portal vein
- Hepatic artery proper
- Hepatic bile ducts

4

Name the duct formed when the hepatic bile ducts join the cystic duct:

Common bile duct

5

Name the duct formed when the common bile duct joins the pancreatic duct:

Ampulla of Vater

6

How many functional lobes make up the Liver?

8

7

What is the blood supply to the Liver?

- Hepatic artery proper ~ 30%
- Hepatic portal vein ~ 70%

8

Describe the breakdown of haem:

Haem
- into biliverdin
- into unconjugated bilirubin
- Liver conjugates bilirubin
- GI breaks it down to Stercobilin + Urobilinogen

9

What volume of bile is secreted by the Liver per day?

~ 250 - 1000 ml/day

10

What is the main function of bile?

Emulsifies fats to increase surface area for lipases

11

List the contents of bile:

- Bile salts ~ 60%
- Fatty acids ~ 12%
- Cholesterol ~ 9%
- Proteins
- Bilirubin

12

What are bile salts made up of?

- Bile acids (Cholic acid + Chenodeoxycholic acid
- Amino acids (Glycine + Taurine)

13

Which of bile acids and bile salts are soluble at duodenal pH?

Bile salts

14

What 3 vessels are present in a hepatic triad?

- Bile duct
- Hepatic arteriole
- Portal venule

15

What shape is a hepatic lobule?

Hexagonal

16

Which zone of a hepatic acinus is most susceptible to hypoxic damage? Why?

Zone 3
Furthest from oxygenated blood supply

17

Which zone of a hepatic acinus is most susceptible to toxic damage? Why?

Zone 1
Closest to blood supply

18

What is a Kupffer cell, and where are they found?

Phagocytic cell
Lining hepatic sinusoids

19

What are the 2 mechanisms of bile secretion?

- Bile acid independent
- Bile acid dependent

20

Name the cells which produce the bile acid independent fraction of bile:

Hepatocytes lining the canaliculi

21

Name the cells which produce the bile acid dependent fraction of bile:

Intra-hepatic bile duct cells

22

Describe the circulation of bile salts:

- Secreted by Liver
- Emulsify fats and form micelles in GI tract
- Fats diffuse into epithelia lining GI tract
- Bile salts stay in gut, reabsorbed @ terminal ileum
- Return to Liver via Portal vein

23

Why does the Liver only need to synthesise very low amounts of bile salts?

Most bile salts are cycled back to the Liver from the GI tract, and re-used, so no need to continuously synthesise more

24

What is achlorhydria, and what can cause it?

- Low level or absence of HCl in gastric secretions

- Helicobacter pylori
- PPIs
- H2 antagonists

25

Name the 3 types of jaundice:

- Pre-hepatic
- Hepatic
- Post-hepatic

26

List some causes of pre-hepatic jaundice:

Haemolytic anaemia:
- Hb abnormalities ie SCA
- Infections
- Drugs
- Burns

27

List some causes of hepatic jaundice:

Liver failure:
- Alcohol
- Fatty-liver disease
- Drug overdose
- Autoimmune
- Viral

28

List some causes of post-hepatic jaundice:

Obstruction:
- Gallstones
- Pancreatitis
- Pancreatic cancer

29

What additional symptom is associated with post-hepatic jaundice, but not pre- or hepatic jaundice?

Steatorrhoea due to blocked bile duct

30

Liver function tests include measuring AST and ALT levels. What do AST and ALT stand for?

AST = Aspartate transaminase
ALT = Alanine transaminase