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Flashcards in Hepatic Pathophysiology Deck (78)
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1

What is the largest organ in the body?

Liver

2

The vascular capacity of the liver is what percent of total blood volume?

10-15%

3

The vascular capacity of the liver consists primarily of venous or arterial blood?

70% venous

4

Total hepatic bloodflow is what percent of the cardiac output?

25%

5

The vast majority of hepatic bloodflow goes through which vessel?

Portal vein 70-80%

Hepatic artery 20-30%

6

What is the functional microvascular unit of the liver?

Hepatic acinus

7

What are the four main components of the hepatic acinus?

Terminal portal venule
Hepatic arteriole
Bile duct
Lymph vessels and nerves

8

Describe the characteristics of hepatic bloodflow and resistance

High blood flow
low resistance

9

What is the normal amount of blood stored in the liver?

450 mL (10% TBV)

10

The liver contains what percentage of the body's total lymph?

Half

11

Which vessel is primarily responsible for perfusing the liver?

The hepatic artery

12

What happens to the SVR, cardiac output, and arterial pressure in patients with liver disease?

Low SVR
Elevated cardiac output
Low arterial pressure

13

The ability of the hepatic artery to perfuse the liver is dependent upon what?

Systemic arterial pressure

14

True or false: splanchnic volume has a major role in the cardiovascular response to hypovolemia

True

15

Intrinsic regulation of blood flow in the liver is dependent upon what two factors?

1. Autoregulation
-hepatic artery vasoconstricton
2. Metabolic control
-osmolarity
-arterial hypoxemia
-blood pH

16

Extrinsic regulation of hepatic bloodflow is dependent upon what two factors?

1. Neural control
-vagus and splanchnic
2. Humoral factors
-vasoconstriction/dilation from hormones

17

All anesthetics and techniques that decrease cardiac output will do what to the total hepatic blood flow?

Produce a proportional decrease in hepatic bloodflow

18

What effect can upper abdominal surgery have on hepatic blood flow?

Can decrease blood flow up to 60%

19

What protein is a reliable predictor of chronic liver disease?

Serum albumin

20

All coagulation factors are produced in the liver except what?

Von Willebrand

21

What must happen to the liver function before coagulation is decreased?

Liver function must be significantly impaired

22

List the vitamin K dependent factors

II, VII, IX, X

23

What coagulation study is a good indicator of acute hepatic dysfunction as well as K dependent coagulation factor deficiencies?

Prothrombin time (PT)

24

What happens to amino acid metabolism in both acute and chronic hepatic disease?

It's impaired

25

What is Bilirubin?

Byproduct of the breakdown of red blood cells in the spleen
-Conjugated in the liver so it can be excreted

26

How much yellow bile does deliver secrete per day?

500 to 1000 mL

27

What happens to the bile that is not secreted by the liver?

Stored in the gallbladder

28

What effect do narcotics have on bile formation?

All narcotics increase common bile duct pressure

29

What percent of insulin is degraded when passing through the liver?

50%

30

What is drug biotransformation?

Conversion of lipophilic substances to excretable metabolites