Liver and friends

Question 1

give 3 purposes of the aqueous (HCO3- rich) secretion by the parcreas

Answer 1

buffer the duodenum against acid entering it from the stomach and providing a suitable pH for the action of enzymes in the intestine, the low pH also stops the action of pepsin from the stomach

Question 2

what electrolytes’ concentrations are relatively constant in the pancreatic juices?

Answer 2

Na+ and k+

Question 3

in a high flow rate, is the pancreatic juice high in Hco3- or cl-?

Answer 3

HCO3-

Question 4

what blood vessel does the pancreas mainly receive its blood supply from?

Answer 4

the splenic artery

Question 5

which bud of the pancreas is the one that rotates in its development to fuse with the other

Answer 5

the ventral bud

Question 6

Santorini’s duct forms what duct of the pancreas and is it part of the ventral or dorsal bud to start with?

Answer 6

the accessory duct. the dorsal bud

Question 7

at what week in utero do the ventral and dorsal buds of the pancreas form?

Answer 7

week 5

Question 8

what is the common bile duct a fusion of?

Answer 8

the pancreatic duct and bile duct

Question 9

what type of muscle surrounds the sphincter of Oddie?

Answer 9

circular smooth muscle

Question 10

is the minor papilla above or below the major papilla?

Answer 10

above

Question 11

what is the main exocrine tissue of the pancreas called?

Answer 11

the acinar tissue

Question 12

histologically, is the pancreatic endocrine or exocrine tissue usually lighter in colour?

Answer 12

endocrine

Question 13

what cells in the pancreas produce and secrete the enzymes eg trypsinogen? so do they appear darker or lighter histologically due to them being protein rich?

Answer 13

the acinar cells. they appear darker

Question 14

what cells of the pancreas secrete bicarbonate?

Answer 14

the centro-acinar cells

Question 15

what does simulation of the bicarbonate-releasing duct cell of the pancreas result in an increase of?

Answer 15

intracellular cyclic AMP.

Question 16

what 2 things does the increase in cAMP in the duct cells of the pancreas cause?

Answer 16

1. movement of tubulovesicles that contain H+ pumps to move to the basolateral membrane
2. dis-aggregation and activation of CFTR

Question 17

what moves out of the basolateral membrane of the pancreatic duct cell and via what?

Answer 17

H+ via the H+ pumps that were contained in tubulovescicles by active transport

Question 18

what ion is exchanged for HCO3- at the apical membrane of the duct cell of the pancreas via CFTR

Answer 18

cl-

Question 19

what enzyme catalyses the formation of h2co3 and vice versa from carbon dioxide and water in the pancreas duct cell

Answer 19

carbonic anhydrase

Question 20

other than providing hco3- substrate for the transport out via the apical membrane what is another benefit of forming h2co3 within the duct cell of the pancreas

Answer 20

maintaining a concentration gradient for the continuous movement of water and carbon dioxide into the duct cell

Question 21

what hormone stimualtes Hco3- secretion in the pancreas?

Answer 21

secretin

Question 22

what hormone stimulates enzymatic production and secretion in the pancreas and is produced in the duodenum?

Answer 22

CCK

Question 23

what paracrine agent is produced in the pancretic islets, by delta cells and stops exocrine secretion by the pancreas?

Answer 23

somatostatin

Question 24

what receptors do CCK and gastrin bind to in the pancreas to stimulate exocrine secretion

Answer 24

CCK A receptors

Question 25

what receptors do secretin and VIP bind to in the pancreas

Answer 25

VIP receptors

Question 26

what 2 enzymes can activate all other zymogens once in the intestine

Answer 26

trypsin and enterokinase

Question 27

what is the zymogen equivalent of elastase

Answer 27

proelastase

Question 28

what is the zyogen to carboxypeptidase

Answer 28

pro-carboxypeptidase

Question 29

what cells is enterokinase in? what type of enzyme is it?

Answer 29

enterocytes. a proteolytic enzyme

Question 30

what 2 enzymes are already secreted in the active form from the pancreas?

Answer 30

amylase and lipase

Question 31

other than the intestinal phase that causes secretions from the pancreas to increase what 2 stimuli from the gastric and cephalic phase also cause increased pancreatic secretion?

Answer 31

vagal cholinegics from the cephalic phase and stimulation of the G cells of the stomach to produce gastrin by the vagus nerve and the gastrin causes the acinar cells to release enzymes and the duct cells to secret electrolytes, this is the gastric phase

Question 32

what sort of stimuli mediate the gastric phase?

Answer 32

swallowing of food and hypoglycaemia

Question 33

what is involved in the intestinal phase to cause secretion of bicarbonate from the duct cells

Answer 33

increased acidity, fatty acids and amino acids in the duodenum stimulates the S cells of the stomach to secrete secretin and the secretion of CCK by enteroendocrine cells (specifically L cells) and so the duct and acinar cells are stimulated to release enzymes and bicarbonate and water

Question 34

what are the 2 surfaces of the liver

Answer 34

diaphragmatic and visceral

Question 35

what are the 2 recesses on the diaphragmatic surface of the liver

Answer 35

subphrenic recess and hepatorenal recess (between the liver and the right kidney and suprarenal gland

Question 36

what is the left triangular ligament of the liver formed of

Answer 36

the falciform ligament and ligamentum venosum

Question 37

what does the falciform ligament attach the liver to?

Answer 37

the anterior abdominal wall (the diaphragm)

Question 38

what is at the colic impression of the liver?

Answer 38

the right hepatic flexure of the colon (start of the transverse colon

Question 39

what is the portal triad within and what does it contain?

Answer 39

the porta hepatis, the portal vein, hepatic artery and bile duct

Question 40

the porta hepatis is mainly thought of an entry point to the liver but what is it an exit point for?

Answer 40

the hepatic ducts

Question 41

where is the gastric impression on the liver and what impression is right to it?

Answer 41

the top of the liver on the left (so the left lobe of the liver), the oesophageal impression is right of it

Question 42

is the caudate or quadrate lobe above?

Answer 42

caudate

Question 43

what is the right triangular ligament composed of and what is between here?

Answer 43

the anterior and posterior coronary ligaments. the bare area

Question 44

what ligament connects the liver to he stomach and has muscle in it?

Answer 44

hepatogastric ligament

Question 45

what 4 ligaments connect the liver to the diaphragm?

Answer 45

the right and left coronary ligaments, and the right and left triangular ligaments

Question 46

what divides the liver into right and left a. anatomical lobes b.functional lobes

Answer 46

a. falciform ligament b. fossae for the gallbladder and inferior vena cava

Question 47

which lobe of the liver is anatomically smaller?

Answer 47

left

Question 48

the quadrate and caudate lobes are anatomically part of which lobe of the liver?

Answer 48

right (right of falciform ligament)

Question 49

is the quadrate or caudate lobe visible on the anterior part of the liver?

Answer 49

quadrate

Question 50

what bounds the quadrate lobe of the liver anatomically

Answer 50

on the right by the fossa for the gallbladder and on the left by the ligamentum teres

Question 51

the quadrate lobe is functionally part of which lobe?

Answer 51

left

Question 52

the caudate lobe is functionally part of which lobe?

Answer 52

none. it is functionally distinct

Question 53

what ligament of the liver also runs anteriorly as well as being superior?

Answer 53

falciform liament

Question 54

what 3 organs is the blood draining into the portal vein from?

Answer 54

the stomach, intestines and spleen

Question 55

from the liver, where does the blood go before draining into the inferior vena cava?

Answer 55

the hepatic vein

Question 56

what is the blood supply to the gall bladder

Answer 56

cystic atery off right hepatic artery off the coeliac trunk

Question 57

how would you describe the appearance of the mucosa within the gallbladder?

Answer 57

honeycomb

Question 58

what name is given to the valve of the cystic duct before it gets into the common bile duct

Answer 58

spiral valve

Question 59

what part of the gut does the liver derive from?

Answer 59

the foregut

Question 60

how many veins do the hepatic veins divide into?

Answer 60

8

Question 61

what artery is given off from the hepatic artery once the gastroduodenal artery has already been given off and what name is now given to the hepatic artery

Answer 61

the right gastric artery, hepatic artery proper

Question 62

what does he pancreas lack that means that disease of it causes it to spread to adjacent viscera

Answer 62

a capsule

Question 63

what vessels travel behind the neck of the pancreas but infront of the uncinate process?

Answer 63

the superior mesenteric artery and vein

Question 64

what is another name for the ampulla of vater

Answer 64

the hepatopancreatic ampulla

Question 65

what duct ends in the uncinate process of the pancreas?

Answer 65

the accessory duct

Question 66

what is the superior pancreaticoduodenal artery a branch off? and the inferior pancreaticoduodenal artery?

Answer 66

a. the gastroduodenal artery that was off the common hepatic artery b. superior mesenteric artery

Question 67

which one is more superior? the ligamentum teres or ligamentum venosum

Answer 67

ligamentum venosum

Question 68

give 4 functions of the liver

Answer 68

as a storage organ, removes toxic compounds that were ingested or are metabolic products and targets them for secretion via the urine or via the bile, makes coagulation proteins, makes glycoproteins from proteins that it breaks down and oligosaccharides that it has

Question 69

what cells make and secrete bile salts?

Answer 69

hepatocytes

Question 70

what is the main way that bile is concentrated and which cells do this specifically?

Answer 70

by reabsorption of water, epithelial cells of the gallbladder

Question 71

what are the 3 components of bile?

Answer 71

cholesterol, lecithin and bile acids

Question 72

give 2 functions of bile

Answer 72

an emulsifier and to act as an excretory pathway for many steroid hormones (so via faeces)

Question 73

what must be closed for the bile to enter the gall bladder via the hepatic ducts then the cystic duct from the liver?

Answer 73

the ampulla of vater

Question 74

what causes the gallbladder to contract?

Answer 74

CCK

Question 75

where does the gall bladder's venous blood drain directly into

Answer 75

the liver sinusoids

Question 76

what type of blood is in the siusoids

Answer 76

mixed hepatic and portal blood

Question 77

the blood in the portal triad at the corner of each lobule runs in the opposite direction to what? that is in what structure?

Answer 77

bile, canaliculi

Question 78

the kupffer cells line the endothelial cells pf what in the liver?

Answer 78

sinusoids

Question 79

what cells produce the extracellular matrix in the space of disse in the liver?

Answer 79

stellate cells

Question 80

what 3 types of junctions are between the cells of the canaliculi

Answer 80

gap junctions, desmosomes and tight junctions

Question 81

what is in the canaliculi that pumps the bile towards the bile duct or ductule of the portal triad

Answer 81

actin filaments

Question 82

what does the gallbladder do to enable its size to increase but not the pressure within it

Answer 82

adaptive relaxation

Question 83

what is a grouped name given to lecithin and cholesterol

Answer 83

secondary bile salts

Question 84

why is bile put into miscelles along with lecithin and cholesterol to be transported to the duodenum?

Answer 84

it's a powerful detergent and can destroy cell membranes of route

Question 85

what is secreted into the bile in the gallbladder to increase its viscosity?

Answer 85

mucin

Question 86

what is the main way of concentrating the bile in the gall bladder

Answer 86

active absorption of electrolytes from the bile, so that the electrolyte concentration goes down and water follows by osmosis out of the bile

Question 87

what is the only 2 electrolyte who's concentration in the bile increases in the gallbladder?

Answer 87

HCO3- and ca2+

Question 88

what is another name for obstructive jaundice? and where are the gallstones impacted?

Answer 88

deep jaundice or post hepatic duct. the common bile duct

Question 89

define jaundice

Answer 89

a term used to describe the yellowing of the skin and sclera that is caused by a buildup of billirubin in the blood and the body's tissues.

Question 90

what are you malabsorbing as a result of gallstones leading to jaundice?

Answer 90

fat

Question 91

what causes the calcification of gallstones

Answer 91

calcium

Question 92

what is haemolytic anaemia? what type of jaundice does it cause?

Answer 92

an increased breakdown of red blood cells and so increased bilirubin is made by the body. prehepatic

Question 93

what causes prehepatic jaundice and give 2 examples of conditions causing it

Answer 93

increased bilirubin in the blood before it has been transported to the liver. haemolytic anaemia and sickle cell anaemia

Question 94

what causes intrahepatic jaundice and give 2 examples of coditions

Answer 94

disruption to bilirubin removal in the liver. cirrhosis and gillbert's syndrome

Question 95

what causes post-hepatic jaundice and give 2 examples of such conditions

Answer 95

prevents the bile and bilirubin in it from draining out of the gallbladder and into the digestive system. gallstones and tumour.