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Medicine Unit 8 > Histology of the Liver > Flashcards

Histology of the Liver Flashcards

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1
Q

liver location

A

largest internal organ/gland
upper right quadrant of abdomen
below the diaphragm

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2
Q

hepatic lobules, what are they

A

polygonal structures
basic functional units

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3
Q

blood supply to the liver

A

dual
hepatic artery and heptic portal vein
has supply of oxygenated and deoxygenated blood

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4
Q

liver lobes

A

major left and right
2 smaller inferior lobes

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5
Q

composition of blood supply to the liver

A

75% nutrient rich but O2 poor
25% supplies O2

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6
Q

Glissons capsule

A

Layer of connective tissue surrounding the liver
subdivides the parenchyma into lobules

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7
Q

main components of bile

A

water
bile salts
bilirubin
cholesterol
fatty acids
electrolytes

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8
Q

main functions of the liver

A

exocrine funciton
endocrine function
metabolism and detoxification
storage

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9
Q

exocrine function

A

secretion of bile into the duodenum
help digest fat
eliminate waste products: bilirubin and excess cholesterol

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10
Q

endocrine function

A

synthesis of majority of plasma proteins: fibrinogen, prothrombin, lipoproteins and albumins
and their release into the bloodstream

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11
Q

metabolism and detoxification

A

breakdown of proteins
toxic substances
many drugs
oxidation and conduction of toxins and other hormones
elimination via bile or urine

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12
Q

storage

A

iron
blood
glycogen
triglycerides
vitamin A

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13
Q

where does the hepatic portal triad enter

A

periphery of each lobule

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14
Q

where does the terminal hepatic venule enter

A

centre of the lobule
aka centralvein

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15
Q

corners of the polygonal classic lobule

A

portal triad

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16
Q

components of the portal triad

A

portal vein
hepatic artery
bile duct
(small lymphatic vessels)

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17
Q

label the image

A
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18
Q
A
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19
Q

bile flow VS blood flow

A

opposite directions

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20
Q

where does blood flow in the liver

A

branches of hepatic artery and vein empty into hepatic sinusoids
flows towards central vein

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21
Q

lining of the sinusoids

A

discontinuous
separated from radial plates of hepatocytes by space of Disse

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22
Q

bile canaliculi

A

receive bile from hepatocytes that border them
convey it to bile ducts in portal triads

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23
Q
A
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24
Q

hepatic microcirculation

A

portal triad
sinusoidal system
sinusoid lumina
terminal hepatic venule (central vein)

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25
sinusoidal system
interconnecting system of capillary like channels close contact with hepatocytes
26
central venues convergence
into larger veins eventually form 2 or more large hepatic veins empty into inferior vena cava
27
label the hepatic microcirculation
28
what are the bile canaliculi
enlarged intercellular spaces between 2 adjacent hepatocytes
29
where do hepatic sinusoids carry blood to
glucose rich and oxygen rich to hepatocytes through space of Disse
30
what is the space of Disse
between endothelial cells of hepatic sinusoid and hepatocytes
31
label the image
32
hepatocytes
large polyhedral spherical nuclei, often binucleated acidophilic cytoplasm sER, rER lots of mitochondria peroxisomes multiple small Golgi form plates/cords in liver store glycogen
33
what is in the image
hepatocyte B- binucleate hepatocyte S- sinusoid lining cell
34
what occurs at periphery of each hepatic lobule
many bile canaliculi join with bile canals of Hering
35
bile canals of Hering
cuboid epithelial cell lining called cholangiocytes
36
cholangiocytes
allow bile modification
37
where do bile canals of herring join and drain
join bile ductules in portal areas drain into biliary tree
38
cholecystokinin funciton
hormone regulates bile release from liver and gall bladder causes gall bladder contraction and expansion of bile
39
where does cholecystokinin come from
enteroendocrine cells in intestinal mucosa releases as fats in chyme
40
bile ductules pathway
canaliculi canals of herring bile ductules bile duct
41
label bile ductule
42
Ito cell funciton
vitamin A storage supporting cells
43
Kupffer cells
stellate macrophages antigen presenting cells remove worn out red blood cells recycle iron molecules remove bacteria/debris in portal blood
44
cytoplasm in hepatocyte
acidophilic
45
basal surface of hepatocytes
contact with perisinusoidal space of Disse
46
apical surface of hepatocytes
connected to adjacted hepatocyte form bile canaliculus
47
what is in the image and label
PV - Portal vein B - Bile ductules A - Hepatic artery L - lymphatics H - Hepatocytes S - Sinusoids
48
lymphatics in histology
present in total traces walls are delicate and often collapsed less easily identified
49
what surrounds the portal tract
anastomosing plates of hepatocytes called hepatic sinusoids
50
3 ways to describe structure of the liver as a functional unit
classic lobule portal lobule liver acinus
51
classic lobule shape
polygonal
52
portal lobule shape
triangular
53
liver acinus she
diamond 3 zones and correlates to blood perfusion, metabolic activity and liver pathology
54
label the image of liver organisation
55
short axis of the acinus
defined by the terminal branches of portal triad lie along border between 2 classic lobules
56
long axis of acinus
line drawn between 2 central veins closest to the short axis
57
hepatocyte arrangement in liver acinus
3 concentric elliptical zones
58
zone 1 acinus
periphery of classic lobules closest to short axis and blood supply from penetrating branches of portal vein and hepatic artery
59
zone 2 acinus
between zones 1 and 3 no sharp boundaries
60
zone 3 acinus
most central part of classic lobule surrounds terminal hepatic vein furthest from short axis
61
describe images
a. hepatocytes b. reticulin along plates of hepatocytes c. central vein, more collagen than smaller sinusoids d. peripheral portal areas with more connective tissue, site of portal triad
62
what is the gall bladder
hollow organ inferior to the liver
63
function of gall bladder
store and concentrate bile
64
where is bile produced
liver hepatocytes
65
connections of gall bladder
to liver and duodenum by biliary duct system organ drains through cystic duct joins common hepatic duct forms common bile duct
66
how is bile released
in response to fats in duodenum due to cholecystokinin
67
how does bile enter the duodenum
sphincter muscles relax gallbladder contacts forces bile in
68
69
function of bile acids and salts
emulsify lipids in duodenum promote digestion and absorption
70
bile flow
leaves liver in left and right ducts merge to common hepatic connects to cystic duct that serves gall bladder these ducts merge to form common bile duct
71
where does the main pancreatic duct merge with common bile duct
hepatopancreatic ampulla
72
where does the hepatopancreatic ampulla enter duodenum
at major papilla of Vater
73
where does the hepatopancreatic ampulla enter duodenum
at major papilla of Vater
74
where does the accessory pancreatic duct enter the duodenum
minor papilla
75
what mixes before releasing into the duodenal lumen
bile and pancreatic juices
76
layers of the wall of the gall bladder
mucosa muscularis propria serosa
77
label the image of the gall bladder
78
what reduces the volume of the gall bladder
contractions of the muscularis externa forces bile out through the cystic duct and common bile duct
79
lining of hepatic, cystic and common bile duct
mucous membrane simple columnar epithelium of cholangiocytes
80
apical histological surface of the gall bladder
simple columnar epithelial cells many microvilli
81
lamina propria gall bladder
highly cellular connective tissue scattered smooth muscle cells from musculris
82
muscularis gall bladder
circular smooth muscle bundles, longitudinal and oblique random orientation intervening connective tissue and blood vessels
83
outer layer gall bladder
thick fibrous connective tissue contains nerves, blood and lymphatic plexus externally covered by peritoneum so called srrosa
84
extra hepatic bile ducts
contain all layers of gall bladder wall lined by epithelium similar to gall bladder
85
name of gall stones
cholelithiasis
86
components of gall stones
often solid deposits of cholesterol or calcium salts
87
symptoms and treatment of gall stones
no symptoms can cause jaundice due to blocked bile flow laparoscopic surgery
88
biliary colic
severe abdominal pain
89
gallstones risk factors
female obesity oral contraceptives
90
complications of gallstones
acute or chronic cholecystitis blockage of ampulla of Vater so may lead to acute pancreatitis
91
cholecystitis
gall bladder contracts more strongly to try overcome obstruction musculature thickens consequently high pressure in gall bladder lumen pushes pouches of mucosa into muscle layers
92
jaundice
yellow discolouration of tissues due to increased levels of bilirubin and associated deposition of bile pigments
93
bilirubin
Bilirubin is yellowish pigment that is made during the normal breakdown of red blood cells. Bilirubin passes through the liver and is eventually excreted out of the body.
94
hyperbilirubinaemia
(raised blood level of bilirubin)
95
classifications of hyperbilirubinaemia
prehaptic jaundice hepatic jaundice post hepatic jaundice/ obstructive jaundice
96
prehapetic jaundice
occurs due to increased production of bilirubin, such as when there is excessive red cell breakdown in sickle cell anaemia.
97
hepatic jaundice
occurs when there is acute or chronic damage to the liver, reducing its ability to metabolise and excrete bilirubin.
98
Posthepatic jaundice AKA obstructive jaundice 
when there is some form of mechanical blockage which interrupts the flow of bile into the biliary system, such as gallstones.

Medicine Unit 8 (24 decks)

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