Liver Structure and Function Flashcards Preview

Alimentary System > Liver Structure and Function > Flashcards

Flashcards in Liver Structure and Function Deck (33):
1

What are the four lobes of the liver?

Right
Left
Caudate
Quadrate

2

Where do blood vessels, lymphatic vessels, ducts and nerves enter and exit the liver?

Via the porta hepatis

3

What are the functions of the falciform ligament?

Attaches liver to anterior surface of the abdomen
Separates the lobes

4

What is the name of the only area of the liver not covered by connective tissue?

Bare area

5

Hepatocytes make bile which runs out through the _ to the _

canaliculus
to the outer of the liver lobule and into the bile duct

6

What is the difference between the two blood supplies received by the liver?

One is oxygen rich but nutrient depleted via hepatic artery, the other is oxygen depleted but nutrient rich via hepatic vein

7

The hepatic sinusoids are

open blood vessels, so blood is in very close contact with the hepatocytes as it passes between them

8

What are the main components of bile?

Bile acids
Lecithin
Cholesterol
Bile pigments
Toxic metals
Bicarbonate

9

Bile acids, lecithin and cholesterol are synthesised in the

liver and solubilise fat

10

What feature of bile acids, lecithin and cholesterol allows them to solubilise fat and prevent the re-aggregation of fat droplets?

They are amphipathic

11

Bile pigments are breakdown products of

haemoglobin from old/damaged erythrocytes

12

Where are toxic metals detoxified?

In the liver

13

Bicarbonate neutralises

acid chyme

14

When bilirubin is extracted from the blood by hepatocytes and secreted into the bile, what colour will the bile be?

Yellow

15

Bile acids are synthesised by hepatocytes in the liver from

cholesterol

16

What happens to bile acids before secretion?

They are conjugates with glycine or taurine to produce bile salts to make them soluble and able to put into solution

17

Secreted bile salts are recycled via the

enterohepatic circulation

18

When the sphincter in the duodenum is closed, excess bile in the common bile ducts moves

to the gall bladder for storage

19

What are the main functions of the gallbladder?

Stores bile
Secretes bile into the cystic duct which secretes into common bile duct

20

What is the function of the sphincter of Oddi?

Controls the release of bile and pancreatic juice into the duodenum

21

When the sphincter of Oddi is contracted, the bile is forced

back into the gallbladder

22

By how many times does the gallbladder concentrate the bile?

5-20 times

23

The presence of fat in the duodenum stimulates cholecystokinin causing the sphincter of Oddi to

relax and the gallbladder to contract

24

Cholecystokinin causes

pancreatic enzyme secretion and bile secretion

25

Surgical treatment of gallstones is only indicated when

the patient is symptomatic

26

What are the symptoms of gallstones?

Post-cholecystectomy pain
Painful obstructive jaundice
Acute pancreatitis
Ascending cholangitis

27

What tests are most effective to identify gallstones and the structures being obstructed by them?

MRCP
EUS
Amylase and lipase
CT

28

Why would a WCC be done if suspecting gallstones?

To determine any signs of sepsis

29

What two invasive procedures might be done to gather more information once there is evidence of gallstones?

PTC
ERCP

30

What are the possible surgical options for gallstones?

Open/mini/NOTES/single port/subtotal cholecystectomy

Laparoscopic cholecystectomy - treatment of choice

31

What is the typical presentation of cholangiocarcinoma?

Obstructive jaundice
Itching
Non-specific symptoms e.g. fatigue, malaise

32

Give 6 investigations which would be done if suspecting cholangiocarcinoma

Bloods
USS
EUS
CT
MRA
MRCP
PTC
Angiography
FDG PET
ERCP
Cholangioscopy and cytology

33

What are the possible treatment options for cholangiocarcinoma?

Surgery is the only potentially curative option
Palliative care