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Anesthesiology > Hepatic Physiology > Flashcards

Hepatic Physiology Flashcards

1
Q

What is zone 1?

A

Cells closest to portal tract that are well oxygenated

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2
Q

What is zone 3?

A

Cells closest to the centrilobular veins - most susceptible to injury because of low oxygen

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3
Q

What is the venous drainage pathway?

A

Central veins of hepatic lobules coalesce to form hepatic veins which dump into the IVC

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4
Q

What percentage of CO does the liver receive?

A

20-25%

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5
Q

What is the blood supply to the liver?

A

Hepatic artery and portal vein

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6
Q

What is hepatic artery flow directly related to?

A

Adenosine regulated dilation of the arterioles

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7
Q

What causes hepatic artery constriction?

A

Splanchnic nerve stimulation

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8
Q

What ANS receptors does the portal vein have?

A

Alpha and dopaminergic

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9
Q

When is jaundice obvious?

A

When total bili is greater than 3 mg/dl

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10
Q

What is the most important measure of liver function and it’s ability to synthesize proteins?

A

PT time

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11
Q

What is the half life of albumin?

A

2-3 weeks

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12
Q

What is the half life of PT?

A

6 hours - so it can be used to identify acute injury

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13
Q

What prolongation of PT corresponds to an INR of 1.5?

A

3-4 seconds

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14
Q

What do all anesthetics do to hepatic blood flow?

A

Decrease it in proportion to the decrease in MAP or CO

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15
Q

Which inhalation anesthetic causes the least decrease in hepatic blood flow?

A

Isoflurane

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16
Q

What does PEEP do to hepatic blood flow?

A

Reduces it

17
Q

What do opioids do to the sphincter of Oddi?

A

Cause it to spasm and increase biliary pressure

18
Q

Which opioid is the worst at causing sphincter of Oddi spasm?

A

fentanyl

19
Q

What is postop jaundice due to?

A

Overproduction of bilirubin because of resorption of a hematoma, transfusion, or biliary obstruction

20
Q

Which inhalation anesthetics can cause hepatitis?

A

enflurane and isoflurane

Anesthesiology (19 decks)

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