Study guide Flashcards
Bilirubin is a major end product of _____
hemoglobin degradation
Bilirubin can be used to diagnose _____ and ____
hemolytic blood diseases
liver disease
Bilirubin is conjugated with _____ (80%) or ____ (10%), and excreted into ______ and into the intestines as a “bile pigment”.
glucuronide (80%) or sulfate (10%)
excreted into bile canaliculi
Circulating _______ is at low levels, and is not found in the urine UNLESS there is a build-up in the blood from _______ associated with jaundice.
conjugated bilirubin
from obstructive liver disease (blood flow through liver is obsructed)
In the intestines, bacterial action forms ______, and the majority of this product is absorbed into the portal blood and into systemic circulation. A portion is filtered at the kidneys and excreted into the urine.
urobilinogen
Ureter blood supply: “Randy goes crazy if angered”
Renal, gonadal, common iliac, internal iliac and aorta
“Randy goes crazy if angered”
greater splencnic nerve comes into the abdomen right through the ____ and goes up to _____
right crus
goes up to celiac plexus
Aortic haitus
Aortic haitus – azy, thoracic duct and aorta (AATD)
Esophageal haitus
– esophagus , A/p vegal trunks
Caval haitus
– IVC, Right phrenic nerve
How do the splnencnics enter abdomen?
Splencnics go through cruses
Right gonadal vein terminates in _____
L gonadal in ______
Right gonadal vein terminates in IVC
L gonadal in L renal vein
L GO vein terminates in _____
R GO in _____
L GO vein terminates in splenic vein
R GO in gastro-duadonal vein
L colic terminates in ___
R colic vein terminates in ___
L colic terminates in inferior mesenteric vein
R colic vein terminates in SMV
L suprarenal vein terminates in the ______
R suprarenal vein terminates in the ____
L suprarenal vein –> L renal vein
R suprarenal vein –> IVC
L hepatic terminates in ____
R hepatic terminates in_____
BOTH in IVC
Cremasteric reflex is innervated by
genital branch of genito femoral nerve ( runs anterior to psoas muscle)
Adrernal glands get flow from these 3 vessels
Adrernal glands get flow from inferior phrenic artery and Celiac trunk nad renal artery
Extrinsic nerve plexus are found ___
Extrinsic = Pre-vertebral plexus, runs anterior to ab aorta.
(celiac plexus on top of celiac trunk, superior hypogastric plexus around inf mesenteric artery, aortic plexus about half way in between the two,)
elevated levels of 3 liver enzymes indicate liver failure or infection. Whihc one is specific for liver disease?
ALT (alanine transaminase) – involved in protein metabolism, produced in hepatocytes ** a specific marker for liver disease**
AST (aspartate transaminase) – protein metabolism, but less specific than ALT (found in other tissues)
ALP (alkaline phosphatase) – found in all tissues, but concentrated in liver, bile duct, kidneys, bone and placenta. can be elevated in liver, and non-liver related diseases.
yellow of urine is due to ___, if urine is darker, distinct from the yellow, then ___ is being excreted (NOT normal)
urobilin (=oxidized urobilinogen, which came from bilirubin metabolized by intestinal bacteria.)
Conjugated bilirubin (Normally not excretd in urine, BUT when plasma conjugated bilirubin is elevated, excess is excreted in urine, makes a dark color in the urine)
(~20-40%) of the urobilinogen is absorbed in the ___ and can be recycled into ___ or ___
- terminal ileum
- recycled into small intestine or enter systemic circulation
Pepsinogen is secreted where?
secreted in chief cells of oxynitic glands
converted to pepsin at pH below 5
starts digestion of proteins in stomach
___ is secreted by upper portion of oxynic and pyloric glands, protect epithelial lining of stomach
HCO3- and mucus
