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nuero > heptabilliray system > Flashcards

heptabilliray system Flashcards

1
Q

how many lobes in kidney

A

2

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2
Q

how are they divided

A

left and right by the middle hepatic vein

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3
Q

inflow to liver

A

hepatic artery

portal vein

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4
Q

outflow

A

bile

hepatic veins x 3

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5
Q

how many segments to the. liver

A

8

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6
Q

how are they ordered

A

clockwise

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7
Q

what is the liver made up of

A

lobules which make up portal triads

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8
Q

Hepatic lobule is

A

Hexagonal structural unit of liver tissue

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9
Q

how is a portal triad made

A

Each corner consists of a portal triad

Links with 3x adjacent lobules

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10
Q

what is located in the centre of a lobule

A

central vein

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11
Q

what does the vien do

A

Collects blood from hepatic sinusoids → hepatic veins → systemic venous system

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12
Q

what does the hepatic artery bring

A

Brings O2-rich blood into liver to support hepatocytes ↑ more energy demands

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13
Q

Branch of portal vein

A

Mixed venous blood from GIT (nutrients, bacteria & toxins) and spleen (waste products)
Hepatocytes process nutrients, detoxify blood & excrete waste

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14
Q

bile duct and where does it go

A

Bile produced by hepatocytes drains into bile canaliculi

Coalesce with cholangiocyte-lined bile ducts around lobule perimeter

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15
Q

what is larger portal vien or hepatic artery

A

portal vein

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16
Q

how do sinusoid form

A

hepatic artery and portal vein

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17
Q

where does bile floe

A

in the opposite direction

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18
Q

what is the hepatic acinus

A

Functional unit of liver

diamond shape from a central vien to another central vein

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19
Q

how many zones in the acinus

A

3- zone 1 2 3
zone 1 in the centre of the 2 lobules
2 then 3

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20
Q

point a

A

Blood into hepatic acinus via point a (on the outside of a lobule)

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21
Q

point b

A

Blood drains out of hepatic acinus via (middle of a lobule)

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22
Q

what is the significance of zone 1

A 
Hepatocytes near outer hepatic lobule(zone 1) receive early exposure to blood contents:
Good components (O2)
Bad components (toxins)
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23
Q

what is the o2 and toxin risk in z1

A

high

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24
Q

z2

A

middle

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25
Q

z3

A

low

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26
Q

strcuture of sinosodial endothelial cell

A

No basement membrane

Fenestrated (discontinuous endothelium

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27
Q

what does it allow

A

Allow lipids & large molecule movement to and from hepatocytes

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28
Q

what is a kuppler cell

A

Sinusoidal macrophage cells

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29
Q

where are they

A

Attached to endothelial cells

within sinosoid

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30
Q

function

A

Phagocystosis

Eliminate & detoxify substances arriving in liver from portal circulation

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31
Q

what does a hepatic stellate cell do/function/s

A

Store vit A in liver cytosolic droplets
Activated (fibroblasts) in response to liver damage
Proliferate, chemotactic & deposit collagen in ECM

32
Q

how do they exist

A

in a dormant state

33
Q

hepatocytes strcuture

A

cubical

34
Q

function

A

albumin, clotting factors & bile salts
Drug metabolism
Receive nutrients & building blocks from sinusoids

35
Q

Cholangiocyte location

A

sorrounds the bile duct

36
Q

function

A

Secrete HCO3- & H2O into bile

37
Q

3 main functions of hepatocsytes

A

Metabolic & catabolic functions:synthesis & utilization of carbohydrates, lipids and proteins.

Secretory& excretory functions:synthesis &secretion of proteins, bile and waste products.

Detoxification & immunological functions:breakdown of ingested pathogens & processing of drugs

38
Q

what is the purpose of the cori cycle

A

glucose is metabolized to pyruvate and then to lactate in muscle, the lactate is released into the blood and carried to the liver, where it is reconverted to pyruvate and used for gluconeogenesis, and the resulting glucose is released and travels back to muscle.

39
Q

non esential amino acid sythesis

A

by transaminiation
Different keto-acids can be converted into multiple amino acids depending on the transaminase enzyme (vital for production of non-essential amino acids)

40
Q

what is the principle amino acid released from the body during starvation

A

alanine

41
Q

Glucose-alanine cycle

A

involves muscle protein being degraded to provide more glucose to generate additional ATP for muscle contraction
alanine trasnported to liver
alanine is shuttled to the liver where the nitrogen enters the urea cycle and the pyruvate is used to make glucose.

42
Q

routes of glucose in liver

A

glucose -> glycerol

glucose -> pyruvate -> acteyl CoA -> fatty acid or cholesterol

43
Q

what next routes

A

glycerol and fatty acid to triglycerides

lioprotiens and cholesterol to apoprotiens phospholipids

44
Q

function of cholesterol

A

make hormones

mantain cell membrane

45
Q

what are the fat soluble vitamins that are stores

A

a d e k

46
Q

what else is stored

A

ferritin

47
Q

what other vit is stored

A

k

48
Q

what happens in detoxification

A 
Phase 1 (modification)
      – more hydrophilic

Phase 2 (conjugation)
– attach water soluble side chain
to make less reactive

49
Q

main component of bile

A

water

50
Q

function of bile

A

Cholesterol homeostasis

Absorption of lipids & lipid soluble vitamins (A, D, E, & K)

Excretion of:
xenobiotics/drugs
cholesterol metabolites
adrenocortical & other steroid hormones
Alkaline phosphatase
51
Q

what colour is bile

A

yelloe

52
Q

biliverdin

A

green

53
Q

what is responsible for primary secretion of bile

A

hepatocystes
Bile secretions reflect serum concentrations
Secretion of bile salts (acids), lipids & organic ions
60%

54
Q

what are Cholangiocytes responsible for

A

Secrete 40% of total bile

Secondary modification

55
Q

what are secondary modifications

A

Alteration of pH (alkaline electrolyte solution)
H2O drawn into bile by osmosis via paracellular junctions
Luminal glucose & organic acids reabsorbed
HCO3- & Cl- actively secreted into bile by CFTR (Cystic Fibrosis Transmembrane Regulator)
IgA exocytosed

56
Q

what do bile transporters do

A

Biliary excretion of bile salts & toxins performed by biliary transporters on apical surface & basolateral membranes of hepatocytes + cholangiocytes

57
Q

what is bile sythesised from

A

cholesterol

58
Q

what happens to 2 primary bile acids i

A

produced in the liver

converted to secondary bile acids by gut bacteria

59
Q

bile salt function

A

Reduce surface tension of fats

Emulsify fat prior to its digestion & absorption

60
Q

define amphipathic

A

2 faces

61
Q

what are they

A

hydrophobic

hydrophilic

62
Q

what causes bile storage and release

A

Between meals Sphincter of Oddi closed → bile diverted into gall bladder for storage

Eating → Sphincter of Oddi relaxes

Gastric contents (FFAs, AAs > CHOs) enter duodenum causing release of cholecystokinin (CCK)

CCK causes gall bladder to contract

63
Q

what happens to the bile

A

95% bile salts reabsorbed from terminal ileum

By Na+/bile salt co-transport Na+-K+ ATPase system

64
Q

what happens to the other 5 percent

A

5% converted to 2o bile acids in colon:
All Deoxycholic acid absorbed
99% Lithocolic acid excreted in stool
absorbed B.salts back to liver & re-excreted in bile

65
Q

how does the gall bladder (GB) constrict

and what does Gb do to the bile

A 
. Stores bile (50 mls)
     - concentrates bile 
     - acidifies bile
.  GB contraction triggered by CCK
     - Binds to CCKA receptors & neuronal plexus of GB wall (innervated by preganglionic parasympathetic fibres of vagus nerve)
66
Q

what is free Bilirubin

A

BR (indirect/unconjugated)

= H2O-INSOLUBLE, yellow pigment

67
Q

what is the source of free BR

A

75% BR from Hb (erythrocytes) breakdown
22% from catabolism of other haemoproteins
3% from ineffective BM erythropoiesis

68
Q

how does free BR get conjugated

A

in the liver

69
Q

how

A

Free BR bound to albumin in blood
Most dissociates in liver & enters hepatocytes
BR conjugated with 2x molecules of UDP-glucuronate → bilirubin diglucuronide (direct bilirubin)
Secreted ACROSS concentration gradient into biliary canaliculi → GIT

70
Q

what is a useful test for liver function

A

free BR –> low

albumin –> high

71
Q

what happens when BR gets to the gut

A

85% excreted in faeces
15% enters enterohepatic circulation
1% enters systemic circulation & excreted by kidneys

72
Q

how is Br converted to rubbish

A

BR → urobilinogen → stercobilinogen→ stercobilin (brown compound)

73
Q

what gives feaces its brown colour

A

stercobilin

74
Q

what happens in obstructive jaundice

A

bilrubin cant enter into the gut
so no stercobilin
pale feaces
but dark urine as enters systemic circulation

75
Q

causes of jaundice

A

pre hepatic -> hemoloysis
intrahepatic
post hepatic

76
Q

Endoscopic Retrograde Cholangiopancreatography (ERCP)

A

is a procedure to diagnose and treat problems in the liver, gallbladder, bile ducts, and pancreas. It combines X-ray and the use of an endoscope

77
Q

PTC

A

an x-ray procedure that involves the injection of a contrast material directly into the bile ducts inside the liver to produce pictures of the bile ducts. This procedure is usually performed by an interventional radiologist.

nuero (36 decks)

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