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Flashcards in Liver failure Deck (64)
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1

Which lobe of the liver is the gallbladder closest to?

Right lobe

2

What does the gallbladder do?

Stores bile produced by the liver

3

What does the gibsons capsule do?

Is a layer of connective tissue surrounding the liver and protecting the hepatic artery, portal vein, and bile ducts

4

What do kupffer cells do?

Phagocytic and macrophagic properties, engulf bacteria in the sinusoids

5

What is the portal triad?

1) Hepatic artery (25% blood flow)
2) Portal vein (75% blood flow)
3) Bile duct

6

What is the dual blood supply of the liver?

1) Hepatic artery supplies the liver with oxygenated blood, arises from the celiac artery (25% blood flow)

2) Portal vein supplies liver with deoxygenated blood (75% blood flow) from stomach, spleen, intestines, etc

7

What is supplied in the portal vein circulation?

Deoxygenated blood, rich in nutrients, hormones, toxins, bacteria etc

8

What are the functions of the liver?

Carbohydrate, protein, fat metabolism, bile formation, vitamin and mineral storage, hematological functions, detox

9

How does the liver metabolize carbohydrates?

Stores serum glucose as glycogen (glucogenesis)

Breakdown of glycogen (glycogenolysis)

Creates glucose from proteins, fats (gluconeogenesis)

10

How does the liver metabolize proteins?

Synthesis of proteins such as albumin

Breakdown of proteins into ammonia, urea

11

How does the liver metabolize fats?

Synthesis of phospholipids, cholesterol

Breakdown of fats into glycerol, fatty acids, ketones

12

What are the hematological function of the liver?

Synthesis of albumin, clotting factors (fibrinogen, prothrombin, vitamin K)

Kuffer cells filter blood to remove bacteria

13

What are the detoxification functions of the liver?

Deactivates hormones such as estrogen

Conjugates steroids and hormones

14

What is cirrhosis?

Chronic liver disease where normal liver cells and structures are altered by regenerating nodules / scar tissues that interrupt arterial, portal, and bile circulation.

Liver becomes congested with increased resistance

15

What 2 things does cirrhosis cause?

1) Portal hypertension
2) Ascites

16

What is portal hypertension?

Backup of blood into portal venous system causing vein distention in:
Esophagus
Intestine, stomach
Spleen
Umbilicus, rectum

17

What does vein distention due to portal hypertension cause?

Varices with risk of hemorrhage

18

What is ascites?

Accumulation of serous fluid in the peritoneal cavity

19

What causes ascites?

Portal hypertension (increased hydrostatic pressure forces fluid out of veins into peritoneum)

Hypoalbuminemia (decreased oncotic pressure causes fluid to leave blood vessels)

Impaired water excretion

20

What does ascites result in?

Third spacing, generalized edema, eventually causes hypovolemia

21

What compensatory mechanisms are activated when the body gets ascites?

Triple A:

ADH
Aldosterone
Angiotensin

Try to compensate by retaining fluid but just makes ascites worse

22

What is the treatment for ascites?

Albumin infusion, diuretics, abdominal paracentesis

23

How can GI hemorrhages be prevented?

GI prophylactics, early enteral feeding

24

How can GI hemorrhage due to cirrhosis be treated?

Meds to constrict splenic arteries such as vaso

Vitamin K to help clotting

Special NG tubes to tamponade the blood (usually esophageal)

25

What is hepato-renal failure?

Acute renal failure as a complication of hepatic failure d/t hypovolemia or impaired renal perfusion from ascites

26

What does hepato-renal failure cause?

Fluid overload and eventual respiratory failure

27

What is acute liver failure?

Severe liver damage with rapid onset (e.g. tylenol OD)

May occur with or without pre-existing liver disease, massive necrosis of hepatocytes and onset of encephalopathy

28

What can cause acute liver failure?

Viral hepatitis, meds, toxins, overdose e.g. Tylenol

29

What are assessment findings correlated to liver damage?

Hepatic insufficiency:
Ankle edema, ascites, anemia, jaundice, hemorrhagic tendency, coma or decreased LOC

Hyperestrogenism:
Testicular atrophy, gynecomastia, red palms, altered hair distribution, spider nevi

30

What are spider nevi and what do they represent?

Collection of small dilated arterioles clustered close to surface of the skin (web like), sign of cirrhosis and hyperestrogenism