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Flashcards in Liver A&P Deck (37):
1

Major disease of liver

Viral, toxic and alcoholic hepatitis, cirrhosis, portal hypertension

2

Lobes of the Liver

Right lobe (largest)
Left lobe
Caudate lobe
Quadrate lobe

3

Liver to the diaphragm via

Falciform ligament

4

Blood supply of liver

Contains about 30% of all the blood and it receives it via arteries and veins

5

Normal Portal Blood Pressure and Abnormal BP

5-10 mmHg
Increase in greater than 12 leas to portal hypertension which leads to ascites, bleeding, encephalopathy, coagulation disorders

6

***Macroscopic Anatomy

Weighs 1500 mg
30% of resting cardiac output and reservoir for blood
Largely from venous blood (75%) via portal vein (stomach, small intestine, pancreas and spleen)
25% of blood supply is from hepatic artery

7

What is the functional units of the liver?

Live Lobules (have a central vein and are surrounded by connective tissue)

8

Hepatopancreatic ampula =

Bile duct and pancreatic duct

9

Sphincter of Oddi and Bile

Controls release of bile from bile duct which is important for digestion

10

***Microscopic Anatomy (Plasma + space, ascites, central vein and bile)

Plasma is filtered into the space of Disse were it contacts hepatocytes
Fluid is is protein containing and is continuous with lymph capillaries (can form ascites)
Hepatic blood empties into the central vein of each lobe
Bile does not mix with blood

11

How does bile not mix with blood?

Biliary system starts with canaliculi formed by two hepatocytes which secrete bile into it
Bile canaliculi transport bile retrogradely to the bile duct

12

Define Hepatocytes

Parenchymal cells
Define the liver functions and are linked to desmosomones (gap junctions)

13

Define Endothelial cells

Sinusoids with fenestrations (holes where things can be exchanged)

14

Define Kupffer cells

Tissue macrophages and scavenge bacteria
- Biliary duct cells
- Pit cells (NK)
- Ito cells (fat-storing cells, Vit A)

15

Define Glycogenesis

Liver removes glucose from the blood and builds glycogen

16

Define Glycogen Storage

2 day supply of glucose

17

Define Glycogenolysis

If hypoglycemia occurs, epinephrine and glucagon will induce glycogenolysis
- During starvation ketones = fuel

18

Define gluconeogensis

Liver will convert amino acids to glucose
Stimulated by glucocorticoids

19

Free Fatty Acids make

TGs

20

Cholesterol + Lipoproteins make

VLDL secreiton

21

Ketone bodies =

Oxidation of fatty acids
Acetoacetate
Beta-hydroxybutyrate

22

Syntehsis of fat and cholesterol

Fat: excess glucose, amino acids and alcohol

23

Cholesterol and Bile

Liver synthesizes large amounts of cholesterol and bile acids
Liver clears excess cholesterol from blood (produces VLDL)
Liver secretes bile, which serves to emulsify lipids in the small intestine and to excrete cholesterol and bilirubin

24

Major pathway to get rid of excess cholesterol

Synthesis of bile acids and secretion of bile

25

Protein Metabolism in the Liver

Deamination of amino acids
Form urea for removal of ammonia
Formation of blood proteins

26

Albumin

Determines osmotic pressure

27

Transferrin

Transport proteins

28

Alpha1-anti-trypsin

Protease inhibitor

29

Coagulation factors

Prothrombin and fibrinogen
Factor VII, IX, and X

30

***Liver + Protein Metabolism/Breakdown

Converts to urea
-Liver dysfunction results in an increase of ammonia in the blood (hepatic encephalopathy)

31

***Liver + Hgb Breakdown

Liver takes up bilirubin and couples with 2 molecules of glucuronic acid for final excretion into bile
Liver dysfunction leads to accumulation and jaundice

32

Define Bilirubin

Waste product from the catabolism of heme
Conjugated bilirubin is yellow

33

Brown color of poop?

Bilirubin produces sterocobilins

34

Liver + Hormones and Nutrients

Hydroxylates vitamin D3 to active form
Stores iron
Stores vitamins (A, D, B12)

35

Phase 1

Mainly P450 through HYDROXYLATION (addition of an OH)
Enzymes synthesized in liver
High energy
Slow capacity

36

Phase 2

Makes things more water soluble for excretion through CONJUGATION
Enzymes synthesized in liver
Low energy
High capacity

37

Benzoapyrene Metabolism

Resistant to hydrolyation by epoxide so it covalent binds to DNA leading to a mutation on the Hras oncogene which causes lung and skin tumors