Flashcards in Liver failure Deck (64)
Which lobe of the liver is the gallbladder closest to?
What does the gallbladder do?
Stores bile produced by the liver
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
What do kupffer cells do?
Phagocytic and macrophagic properties, engulf bacteria in the sinusoids
What is the portal triad?
1) Hepatic artery (25% blood flow)
2) Portal vein (75% blood flow)
3) Bile duct
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
What is supplied in the portal vein circulation?
Deoxygenated blood, rich in nutrients, hormones, toxins, bacteria etc
What are the functions of the liver?
Carbohydrate, protein, fat metabolism, bile formation, vitamin and mineral storage, hematological functions, detox
How does the liver metabolize carbohydrates?
Stores serum glucose as glycogen (glucogenesis)
Breakdown of glycogen (glycogenolysis)
Creates glucose from proteins, fats (gluconeogenesis)
How does the liver metabolize proteins?
Synthesis of proteins such as albumin
Breakdown of proteins into ammonia, urea
How does the liver metabolize fats?
Synthesis of phospholipids, cholesterol
Breakdown of fats into glycerol, fatty acids, ketones
What are the hematological function of the liver?
Synthesis of albumin, clotting factors (fibrinogen, prothrombin, vitamin K)
Kuffer cells filter blood to remove bacteria
What are the detoxification functions of the liver?
Deactivates hormones such as estrogen
Conjugates steroids and hormones
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
What 2 things does cirrhosis cause?
1) Portal hypertension
What is portal hypertension?
Backup of blood into portal venous system causing vein distention in:
What does vein distention due to portal hypertension cause?
Varices with risk of hemorrhage
What is ascites?
Accumulation of serous fluid in the peritoneal cavity
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
What does ascites result in?
Third spacing, generalized edema, eventually causes hypovolemia
What compensatory mechanisms are activated when the body gets ascites?
Try to compensate by retaining fluid but just makes ascites worse
What is the treatment for ascites?
Albumin infusion, diuretics, abdominal paracentesis
How can GI hemorrhages be prevented?
GI prophylactics, early enteral feeding
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)
What is hepato-renal failure?
Acute renal failure as a complication of hepatic failure d/t hypovolemia or impaired renal perfusion from ascites
What does hepato-renal failure cause?
Fluid overload and eventual respiratory failure
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
What can cause acute liver failure?
Viral hepatitis, meds, toxins, overdose e.g. Tylenol
What are assessment findings correlated to liver damage?
Ankle edema, ascites, anemia, jaundice, hemorrhagic tendency, coma or decreased LOC
Testicular atrophy, gynecomastia, red palms, altered hair distribution, spider nevi