The Liver, Gall Bladder and Pancreas

Question 1

Where does the liver sit in the body?

Answer 1

Greater part of the right hypochondriac region, part of epigastric and part of the left hypochondriac regions

Question 2

The appearance of the liver?

Answer 2

The anterior surface is smooth and curved to fit under the diaphragm.
The posterior surface is irregular

Question 3

Functions of the Liver

Answer 3

Carbohydrate metabolism
Fat metabolism
Protein metabolism
Breakdown of blood cells + micro defence
Detoxification of drugs
Inactivation of hormones
Storage
Secretion of bile

Question 4

How many lobes does the liver have and what are the names?

Answer 4

4 lobes

Right, left, caudate (superiorly), quadrate (inferiorly)

Question 5

What is the portal fissure and what enters via there?

Answer 5

Portal fissure- is where everything enters the liver.
Portal vein
Hepatic artery
Nerve fibres
Lymph ducts
Right and left hepatic ducts

Question 6

Microstructure of the liver?

Answer 6

Made up of lobules-
Hexagonal in outline, formed from cuboidal cells called hepatocytes arrange in pairs of columns radiating from a central vein
Between the columns are sinusoids (blood vessels with incomplete walls)

Question 7

Macrostructure of the liver?

Answer 7

• Thin inelastic capsule and completely enclosed by a layer of peritoneum
• Held in place by ligaments and the pressure of the other organs
• 4 lobes
• Portal fissue

Question 8

What are macrophages and what do they do?

Answer 8

Macrophages – Kupffer cells, eat worn out blood cells and foreign particles

Question 9

What are Bile canaliculi?

Answer 9

Bile canaliculi (small channels) run between the hepatic cells and join up to form larger and larger bile canals until they form the right and left hepatic ducts. 
The liver secretes bile so it travels through the channels.

Question 10

Carbohydrate metabolism?

Answer 10

• Maintains plasma glucose levels.
• After a meal, glucose is converted into glycogen
• When glucose levels fall, glycogen is changed back into glucose again.
• All cells need glucose in order to function

Question 11

Fat Metabolism?

Answer 11

• Some fatty acids and glycerol are used to provide energy and heat.
• Some are combined to form triglycerides, the form in which fat is stored in fat depots i.e. under the skin, around in kidneys and in the omentum

Question 12

Protein Metabolism?

Answer 12

• Removes the nitrogenous portion from excess amino acids to form urea.
• Combines the nitrogenous portion to other carbohydrate molecules to form new non essential amino acids.
• Breaks down nucleic acids to form uric acid.
• Urea and Uric Acid are excreted in urine.
• Forms 90% of the plasma proteins contained in the blood steam, including albumins, globulins and blood clotting factors

Question 13

What is the special name for red blood cells?

Answer 13

Erythrocytes

Question 14

Detoxification and Inactivation of what

Answer 14

Alcohol
Waste products from other processes
Some drugs
Insulin
Glucagon
Cortisol
Aldosterone
Thyroid and sex hormones

Question 15

Storage and Heat role of the liver?

Answer 15

Stores:

• Glycogen
• Fat-soluble vitamins A, D, E, K
• Iron and copper
• Some water-soluble vitamins – e.g. B12

The liver uses lots of energy, high metabolic rate and therefore produces a great amount of heat

Question 16

Bile- how much and what does it consist of?

Answer 16

500 – 1000ml of bile is secreted by the liver each day.
It consists of-
Water
Mineral salts
Mucus
Bile pigments, mainly bilirubin 
Bile salts
Cholesterol

Question 17

Bile in fat digestion?

Answer 17

In the small intestine, the bile acids are secreted as sodium or potassium salts. These emulsify fats by turning them into tiny droplets. More easily absorbed.
Makes fat-soluble vitamins (A,D,E,K) more easily absorbed.

Question 18

What happens to bile after it is used?

Answer 18

In the terminal ilium, most bile salts are reabsorbed and return to the liver via the portal vein

Question 19

What is bilirubin?

Answer 19

• Formed by breaking down of old blood cells
• Combined with glucuronic acid to become water-soluble, it is excreted in the bile.
• Microbes in the large intestine convert bilirubin to stercobilin, which colours and deodorizes the stool
• Jaundice is yellow pigmentation of the tissues seen in the skin and conjunctiva, caused by excess blood bilirubin

Question 20

How does the bile ducts go?

Answer 20

The right and left hepatic duct -> common hepatic duct (portal fissue) -> joined by cystic duct (from gallbladder) - common bile duct -> main pancreatic duct at the hepatopancreatic ampulla -> Ampulla of Vater which is controlled by the hepatopancreatic sphincter (Oddi)
Into the duodenum.

Question 21

What is the gallbladder?

Answer 21

• Pear-shaped sac attached to the posterior aspect of the liver
• Cover by the peritoneum on its inferior surface only
• Fundus, body, neck
• Supplied by Cystic Artery and drained by the Cystic Vein

Question 22

The function of the gallbladder?

Answer 22

• Storage of bile
• Hormone CCK (cholecystokinin) – secreted by the duodenum in response to the presence of fat and acid chyme.
• Relaxation of the Sphincter of Oddi and causes the gallbladder to contract (releases the bile).
• Concentration of bile by the absorption of water

Question 23

Pancreas region?

Answer 23

Epigastric and left hypochondriac regions

Question 24

Arteries and veins for the pancreas?

Answer 24

Supplied by splenic and mesenteric arteries and drained by splenic and mesenteric veins

Question 25

Structures that are around the pancreas (head, body, tail)

Answer 25

Head – curve of duodenum Body -behind the stomach Tail - in front of left kidney and reaches the spleen. Aorta and IVC lie behind the gland

Question 26

Exocrine Pancreas

Answer 26

-Large number of lobules, each drained by a tiny duct -Unite to form pancreatic duct Which joins the common bile duct. -Produces pancreatic juice -Digestion of carbohydrates, proteins and fats

Question 27

Endocrine Pancreas

Answer 27

-Throughout the gland are groups of specialised cells – pancreatic islets (Islets of Langerhans) -No ducts, hormones directly into blood Insulin and glucagon

Question 28

The liver weighs between 1 -2.3 kg Select one: True False

Answer 28

True

Question 29

The majority of the liver sits in the left hypochondriac region Select one: True False

Answer 29

False its in the right hypochondriac

Question 30

The liver sits anterior to the oesophagus Select one: True False

Answer 30

True

Question 31

The liver sits above the right adrenal gland Select one: True False

Answer 31

True

Question 32

The quadrate lobe is the smallest lobe of the liver Select one: True False

Answer 32

False | Its the caudate

Question 33

The portal fissure is where the blood vessels and nerve fibres enter and leave the liver Select one: True False

Answer 33

True

Question 34

A blood vessel with an incomplete wall is called a capillary Select one: True False

Answer 34

False | its a sinusoid

Question 35

Cholesterol is found in bile Select one: True False

Answer 35

True

Question 36

Bile is needed to digest protein Select one: True False

Answer 36

False

Question 37

Jaundice is caused by excess bilirubin Select one: True False

Answer 37

True

Question 38

Microbes in the large intestine convert Bilirubin to glucuronic acid Select one: True False

Answer 38

False

Question 39

The cystic duct empties at the Ampulla of Vater Select one: True False

Answer 39

True

Question 40

The gall bladder is an intraperitoneal structure. Select one: True False

Answer 40

False

Question 41

The stomach is posterior to the gall bladder Select one: True False

Answer 41

True

Question 42

The gall bladder makes bile Select one: True False

Answer 42

False

Question 43

The pancreas gets some of it blood supply from the splenic artery Select one: True False

Answer 43

True

Question 44

The pancreas consists of a head, neck and body Select one: True False

Answer 44

False | Its head, body, tail

Question 45

Hepatocytes are cuboidal cells Select one: True False

Answer 45

True

Question 46

Kupffer cells are found in the gall bladder Select one: True False

Answer 46

False, they are found in the liver

Question 47

Vitamin D is stored in the liver Select one: True False

Answer 47

True

Question 48

The common hepatic duct is formed by the right and left hepatic duct and the cystic duct. Select one: True False

Answer 48

False | its just the right and left hepatic duct

Question 49

The pancreas is both an exocrine and endocrine gland Select one: True False

Answer 49

True

Question 50

The Islets of Langerhans produce insulin Select one: True False

Answer 50

True