THE LIVER- SRUCTURE & FUNCTION Flashcards by Iseoluwa Ojo

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

an outgrowth

primitive gut

diverticulum

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________ is the largest organ in the body- (

Liver

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Macroscopy of the liver

1.4-1.6kg =____% of body weight)

It lies in the ___________

2.5

right hypochondria.

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Macroscopy of the liver

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

falciform ligament

fissure of ligamentum teres

ligamentum venosum

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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

Right

Left

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macroscopy of the liver

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

Glisson’s capsule

portal hepatis.

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macroscopy of liver

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

portal vein, hepatic artery, common bile duct

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macroscopy of liver

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

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

60-70

splenic & sup.mes. vein

coeliac

30-40

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Microscopy of liver

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

hexagonal

central vein

periphery

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Microscopy of the liver

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

hepatic artery ; portal vein

small bile duct; lymphocytes

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Microscopy of the liver

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

triangular

portal tract

central vein

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Zones of the liver

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

peri-portal

mid-zone

peri-venular

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Central vein drains into the ______ vein

hepatic

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Zones of the liver

Zone ___-closest to vascular supply

Zone ___-suffers toxic injury most

 Zone ___- suffers hypoxic injury most

 Zone ___- around the central vein

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

This enter directly into the ______

Drainage occurs through the ______ Vein that drains into _________

1500 - 1900

sinusoids

hepatic

Inferior Vena Cava

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Metabolic gradient of activity of enzymes exists

T/F

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Many hepatic injuries do not exhibit zonal distribution

T/F

They do

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_____________ are the principal parenchyma cells

Hepatocytes

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Significance of the acini

Hepatocytes

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

cribriform anastomosing sheets or plates

one

central vein

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

hepatocytes

abutting

bordering

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

Large

polyhedral

eosinophilic; glycogen

The hepatocytes are uni-nucleate

T/F

Hepatocytes could be bi- nucleated with prominent nucleoli

T/F

Hepatocytes

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

PAS

bile canaliculli

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

hepatocyte plates discontinuous fenestrated central vein

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

macrophages luminal endothelium sinusoids

Space of disse- space between the ________ and ____________

sinusoid and the plate of hepatocytes

Ito cells (_____________ cells) present in the _____________.

Hepatic stellate perisinusoidal space

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

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

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

1-2 micrometer microvilli adjacent hepatocytes plates

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

reticulin fibers central vein

Connective tissue of the liver Reticulin fibers contains type ____ collagen and is continuous with the ________

IV Glisson’s capsule.

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

Reticulin PAS Shikatta orcein Perl’s Trichome

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

framework; liver cell necrosis glycogen copper; Wilson’s iron; haemochromatosis collagen; fibrous

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

glucose glycogen fasting glygenolysis & gluconeogenesis

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

endogenous hepatic protein serum proteins

LIVER FUNCTION  Protein metabolism-  3)______ formation from amino acids 4) Amino acid ________________ All except synthesis of serum proteins, vary with _________; suppressed in ______

Urea release to other tissues. dietary intake fasting

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 _____

hydrolysis Storage apo; lipoproteins cholesterol; bile; bile acids

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

Cholic& chenodeoxycholic taurine or glycine

Liver functions Formation & Excretion of bile acids.  Secondary bile acids (_________ and __________) are formed from ____________ of primary bile acids after reabsoption, then excreted in stool

deoxycholic & lithocholic deconjugation

Liver Also stores Cu T/F

Bile acids aid absorption of fat soluble vitamins T/F

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

fat; H2O; excreted in bile acetaldehyde; acetate

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

Liver Functions  sinusoid provides _______ for blood  Kupffer cells provides _______ action removing ________ from blood

depot phagocytic bacteria

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.

incr low or undetectable haemochromatosis

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 ________

Incr Chronic liver disease cirrhosis & emphysema