Liver anatomy Flashcards

1
Q

What are the functions of the healthy liver?

A

Exocrine functions, metabolism, a source of plasma proteins, endocrine function, excretory and degradative functions and iron storage.

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2
Q

What are the livers exocrine functions?

A

The synthesis and secretion of bile for the adequate absorption and digestion of fats. Bile is secreted into a bicarbonate rich solution to help neutralize acid in the duodenum.

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3
Q

What are the endocrine functions of the liver?

A

Insulin-like growth factor (IGF-1) is secreted in response to growth hormone to promote cell division in a number of tissues, including the bone.

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4
Q

How significance does the liver have towards clotting factors?

A

It produces many clotting factors such as prothrombin and fibrinogen.

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5
Q

Why are bile salts needed to form clotting factors?

A

They are essential for the absorption of fat soluble vitamin K. Vitamin K is needed for the formation of clotting factors.

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6
Q

What is an example of a plasma protein the liver produces?

A

Albumin.

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7
Q

What is the livers role in the metabolism?

A

It converts glucose to glycogen and triglycerides, as well as amino acids to fatty acids. Triglycerides are synthesised and secreted as lipoproteins and produces glucose from glycogen. It also converts fatty acids to ketones during fasting as well as producing urea.

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8
Q

How is the liver involved in cholesterol metabolism?

A

It produces cholesterol and releases into the blood and bile, and also converts plasma cholesterol into bile salts.

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9
Q

Where is the liver found in the body?

A

The right upper quadrant of the abdomen, immediately below the diaphragm. It sits below the diaphragm and above the visceral organs.

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10
Q

What is the difference between the anatomical lobes and the functional lobes?

A

It has 4 anatomical lobes but 2 functional lobes.

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11
Q

What is the diaphragmatic surface?

A

The superior upper surface of the liver.

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12
Q

What is the visceral surface?

A

The surface that faces adjacent abdominal organs - the porta hepatis and gallbladder are on this surface.

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13
Q

What is the difference between the superior surface and the inferior surface?

A

The inferior surface has crevices.

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14
Q

What is the falciform ligament?

A

It is a ligament that separates the major right and left lobes and attaches the liver to the diaphragm and anterior abdominal wall.

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15
Q

What is the round ligament?

A

It is the ligament found at the lower edge of the falciform ligament.

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16
Q

Where is the gall bladder in relation to the liver?

A

It is an accessory organ that rests in a recess on the inferior, visceral surface of the liver.

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17
Q

What are the two sources that the liver receives blood from and which provides the greatest supply?

A

The heart and the GI tract. The GI tract - 75-80%.

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18
Q

What are the two blood vessels that provide the blood to the heart?

A

The hepatic portal vein carries blood from the GI tract, spleen and pancreas whereas the hepatic artery provides blood from the heart.

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19
Q

What does the hepatic vein do?

A

Carries blood away from the liver back to the heart.

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20
Q

What are the functional units that make up the liver?

A

Liver lobules.

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21
Q

What are the main cells that make up the liver lobules?

A

Hepatocytes.

22
Q

What are portal triads?

A

They are at the end of each lobule and are formed by the hepatic portal vein, artery and bile duct.

23
Q

How many portal traids are associated with a central vein?

A

6.

24
Q

In what direction does blood flow, regarding the portal traids and central vein?

A

From the portal triad (hepatic artery and portal vein) towards the central vein.

25
Q

In what direction does bile flow regarding the portal triads and central vein?

A

From the central vein towards the portal triad, containing the bile duct.

26
Q

What are hepatic sinusoids?

A

Thin-walled leaky capillaries where venous and arterial blood mix as they slowly flow through the hepatic lobe towards the central vein.

27
Q

Where does bile collect?

A

The bile caniliculi.

28
Q

What does it mean that hepatocytes are polarised?

A

The part of the cells that face the bile duct are different to those that face towards the blood circulation.

29
Q

What is bile?

A

It is an exocrine secretory product of the liver that contains HCO3-, cholesterol, lecithin, bile pigments and bile salts.

30
Q

What is the significance of bile salts?

A

They are important for the absorption of water insoluble fats.

31
Q

Where is bile stored and when is it released?

A

It is stored and concentrated in the gall bladder and released during meals.

32
Q

What is the space of Disse?

A

The space between hepatocytes and endothelial cells.

33
Q

What is the special about the endothelial cells in the liver?

A

They are fenestrated to allow larger molecules to move out of the liver.

34
Q

What is a cluster of fenestrations in the endothelial cells called?

A

Liver sieves.

35
Q

What are liver sinusodial endothelial cells?

A

The filter between the lumen of sinusoids and hepatocytes.

36
Q

What is the role of the liver sinusodial cells?

A

They minimise any barrier for the bi-directional transfer of small or soluble substrates between blood and the extracellular space of Disse.

37
Q

What are Kupffer cells?

A

The resident macrophages of the liver.

38
Q

What is the other name for Kupffer cells?

A

Stellate macrophages.

39
Q

Where are Kupffer cells found?

A

In the lumen of the sinusoids.

40
Q

What is the role of the Kupffer cells?

A

They are the first line of defence.

41
Q

What are stellate cells?

A

They are spindle-shaped cell bodies with oval/elongated nuclei that are involved in fibrosis formation.

42
Q

What is fibrosis in the liver?

A

It is when the liver replaces damaged cells by the formation of scar tissue.

43
Q

Where are stellate cells found?

A

In the subendothelial space between the basolateral surface of hepatocytes and the anti-luminal side of the sinusoidal endothelial cells (they wrap around sinusoids)

44
Q

How is bile transported?

A

It goes down bile canaliculi and empties into bile ductules into bile ducts. The bile directly enters the duodenum or is diverted to the cystic duct in the gall bladder.

45
Q

What are the three regions of the gall bladder?

A

The fundus, body and neck.

46
Q

What is the fundus of the gall bladder?

A

The wide end that projects from the interior border of the liver.

47
Q

What is the body oft the gall bladder?

A

It contacts the visceral surface of the liver.

48
Q

What is the neck of the gall bladder?

A

It is narrow and tapered and makes an S bend into the cystic duct.

49
Q

What is the cystic duct?

A

It connects the neck of the gall bladder to the common hepatic duct.

50
Q

What are cholangiocytes?

A

Epithelial cells that line the itnra and extra-hepatic ducts of the biliary tree. They modify bile to make ductal bile.

51
Q

What is the sphincter of oddi?

A

It is a sphincter that can open and close. It is under hormonal control and controls release of bile into the cystic duct.