THE LIVER- SRUCTURE & FUNCTION Flashcards

1
Q

Embryology-
The liver developed as _______ of the
________ (hepatic _______)

A

an outgrowth

primitive gut

diverticulum

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2
Q

________ is the largest organ in the body- (

A

Liver

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3
Q

Macroscopy of the liver

1.4-1.6kg =____% of body weight)

It lies in the ___________

A

2.5

right hypochondria.

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4
Q

Macroscopy of the liver

It has right and left lobes that are separated by the _________ anteriorly, ___________ inferiorly & that of ________ posteriorly

A

falciform ligament

fissure of ligamentum teres

ligamentum venosum

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5
Q

macroscopy of the liver

The (right or left?) lobe is larger

The _____lobe contain the caudate & quadrate lobes.

(Right or Left?) lobe is larger in infancy

A

Right

Right

Left

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6
Q

macroscopy of the liver

 It is covered by ________ which has a deep fissure at the __________

A

Glisson’s capsule

portal hepatis.

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7
Q

macroscopy of liver

 The _____,______,_________ and lymphatic enter the liver through the portal hepatis

A

portal vein, hepatic artery, common bile duct

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8
Q

macroscopy of liver

Blood flow-
 portal vein :______% (derived from ____ and ———- ),

 hepatic artery (branch of _______ artery): ________%(represent _____% of oxygen supply).

A

60-70

splenic & sup.mes. vein

coeliac

30-40

50

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9
Q

Microscopy of liver

Hepatic Lobule- ________ structure oriented around the ________ with portal tracts/triads at the ______

A

hexagonal

central vein

periphery

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10
Q

Microscopy of the liver

Portal triads each contain _______ branch, branch of ______ & a ______ , lymphatics with some scattered _______ and connective tissue in the triad

A

hepatic artery ; portal vein

small bile duct; lymphocytes

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11
Q

Microscopy of the liver

Hepatic acini (metabolic lobule)- ________ structure with _________ at the base and _________ at the apices.

A

triangular

portal tract

central vein

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12
Q

Zones of the liver

 Zone 1-_________
 Zone 2-__________
 Zone 3- ___________

A

peri-portal

mid-zone

peri-venular

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13
Q

Central vein drains into the ______ vein

A

hepatic

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14
Q

Zones of the liver

Zone ___-closest to vascular supply

Zone ___-suffers toxic injury most

 Zone ___- suffers hypoxic injury most

 Zone ___- around the central vein

A

1

1

3

3

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15
Q

Total blood flow to the liver =____-____ mls/min.

This enter directly into the ______

Drainage occurs through the ______ Vein that drains into _________

A

1500 - 1900

sinusoids

hepatic

Inferior Vena Cava

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16
Q

Metabolic gradient of activity of enzymes exists

T/F

A

T

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17
Q

Many hepatic injuries do not exhibit zonal distribution

T/F

A

F

They do

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18
Q

_____________ are the principal parenchyma cells

A

Hepatocytes

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19
Q

Significance of the acini

Hepatocytes

Are organized into __________________ of ____ cell thick and disposed about the ________

A

cribriform anastomosing sheets or plates

one

central vein

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20
Q

Limiting plate refers to the plate of ______ that is ________/_______ the portal triad/ the portal tracts

A

hepatocytes

abutting

bordering

21
Q

Each hepatocyte is a (small or large?) __________ cell with ( eosinophilic or basophilic?) cytoplasm containing _________

A

Large

polyhedral

eosinophilic; glycogen

22
Q

The hepatocytes are uni-nucleate

T/F

A

T

23
Q

Hepatocytes could be bi- nucleated with prominent nucleoli

T/F

A

T

24
Q

Hepatocytes

______ stain showing cytoplasmic glycogen & __________ between hepatocyte plates draining into portal triad

A

PAS

bile canaliculli

25
Q

Sinusoids- vascular channels which run between the _________, with (continuous or discontinuous?) / _______ endothelial cell.

They drain into the _________

A

hepatocyte plates

discontinuous

fenestrated

central vein

26
Q

Kupfer cells are fixed _______, lie on the _______ surface of the ______ within the ___________.

A

macrophages

luminal

endothelium

sinusoids

27
Q

Space of disse- space between the ________ and ____________

A

sinusoid and the plate of hepatocytes

28
Q

Ito cells (_____________ cells) present in the _____________.

A

Hepatic stellate

perisinusoidal space

29
Q

Ito cells

It is responsible for _________________ are present in this space. They also produce ________ in cirrhosis.

A

storage of fat containing vitamins (A,D,E,& K)

collagen

30
Q

Bile canalliculi- are channels of _______________ size (into which numerous _______ protrude), are present between ____________________.

A

1-2 micrometer

microvilli

adjacent hepatocytes plates

31
Q

Connective tissue of the liver

The cells and sinusoids are supported by fine meshwork of _______, which radiate from ________ of each lobule.

A

reticulin fibers

central vein

32
Q

Connective tissue of the liver

Reticulin fibers contains type ____ collagen and is continuous with the ________

A

IV

Glisson’s capsule.

33
Q

Special stains used in liver histopathology

_________ stain-to demonstrate the framework to assess extent of liver cell necrosis

_____-demonstrate glycogen

__________ -to demonstrate copper in
Wilson’s disease or HBsAg in hepatocytes
 _____ stain-to demonstrate iron in haemochromatosis
______-to demostrate collagen/fibrous tissue

A

Reticulin

PAS

Shikatta orcein

Perl’s

Trichome

34
Q

Special stains used in liver histopathology

 Reticulin stain-to demonstrate the _____ to assess extent of __________

 PAS-demonstrate _______

 Shikatta orcein-to demonstrate _____ in _____ disease or HBsAg in hepatocytes

 Perl’s stain-to demonstrate ____ in ______

 Trichome-to demostrate _______/________ tissue

A

framework; liver cell necrosis

glycogen

copper; Wilson’s

iron; haemochromatosis

collagen; fibrous

35
Q

LIVER FUNCTION

Carbohydrate metabolism-
-maintains normal _____ level,
-stores ______ &
-provides energy for the body during _____ (through _______ and _________ )

A

glucose

glycogen

fasting

glygenolysis & gluconeogenesis

36
Q

LIVER FUNCTION

 Protein metabolism-

1) Form _________ from amino acids

2) synthesis of __________ including albumin, globulins such as; clotting factors 1,2,5,7,9 & 10), complement components, transferrin, haptoglobin, caeruloplasmin,alpha- feto protein, alpha1-anti-trypsin, alpha-2 macroglobulin

A

endogenous hepatic protein

serum proteins

37
Q

LIVER FUNCTION

 Protein metabolism-

 3)______ formation from amino acids

4) Amino acid ________________

All except synthesis of serum proteins, vary with _________; suppressed in ______

A

Urea

release to other tissues.

dietary intake

fasting

38
Q

LIVER FUNCTION

Liver functions
Fat metabolism-
_________ of cholesterol, PL, TG
_________ of fat
 Synthesis of ____-proteins which combine with cholesterol, PL, TG to form ______
 Synthesis of _____ which is excreted in ____ and some converted to _____

A

hydrolysis

Storage

apo; lipoproteins

cholesterol; bile; bile acids

39
Q

Liver functions

Formation & Excretion of bile acids.

 Primary bile acids (_____ and _________ acid) from cholesterol. Conjugated with ________ or _______ & secreted into bile

A

Cholic& chenodeoxycholic

taurine or glycine

40
Q

Liver functions

Formation & Excretion of bile acids.

 Secondary bile acids (_________ and __________) are formed from ____________ of primary bile acids after reabsoption, then excreted in stool

A

deoxycholic & lithocholic

deconjugation

41
Q

Liver Also stores Cu

T/F

A

T

42
Q

Bile acids aid absorption of fat soluble vitamins

T/F

A

T

43
Q

Liver Functions

Detoxification/bio-transformation of substances such as:

Drugs- ____ soluble drugs becomes ——- soluble that ends up ___________

Metabolism of alcohol (__________ to ________ that leads to CO2

A

fat; H2O; excreted in bile

acetaldehyde; acetate

44
Q

Liver helps in Detoxification/bio-transformation of hormones
T/F

A

T

45
Q

Liver Functions

 sinusoid provides _______ for blood

 Kupffer cells provides _______ action removing ________ from blood

A

depot

phagocytic

bacteria

46
Q

LIVER FUNCTION TESTS

Alpha feto protein level- ____eased in PLCC

Caeruloplasmin- _______ in Wilson’s disease

Serum Fe & ferritin- high serum Fe with high saturated iron-binding capacity suggests __________. Serum ferritin is also greatly increased.

A

incr

low or undetectable

haemochromatosis

47
Q

LIVER FUNCTION TESTS

Alcoholic liver disease leads to ____eased serum Fe

Alpha 1 anti-trypsin- not detectable in ________ due to alpha 1-anti-trypsin deficiency which can also be associated with ________ and ________

A

Incr

Chronic liver disease

cirrhosis & emphysema

48
Q

.

A

.