The liver: structure and function Flashcards Preview

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Flashcards in The liver: structure and function Deck (33):
1

What are the functions of the liver?

1. metabolic
2. biotransformation (drugs, lipophilicity)
3. bile production
4. bilirubin secretion
5. Storage (glycogen)

2

What are the non-parenchymal cells of the liver?

1. Kupffer cells
2. Sinusoidal endothelial cells
3. Hepatic stellate cells (collagen synthesis)

3

What are the two vessels that supply the liver?

hepatic artery and portal vein

4

Where does the common hepatic artery branch from?

The celiac artery

5

What artery supplies the gallbladder?

Cystic arteries

6

Which two veins come together to make up the portal vein?

splenic vein and superior mesenteric vein

7

Which strutures make up the beginning of the biliary system?

Canals of Hering

8

Lymph--Where does it form? Where does it drain to?

Lymph forms in the space of disse. It drains to the lymph nodes of the hilum and vena cava

9

What keeps the liver in place?

Coronary ligaments
Right and left triangular ligaments
Falciform ligaments
Hepatoduodenal ligament

10

What is contained in the hepatoduodenal ligament?

1. hepatic artery
2. Portal vein
3. Common bile duct
4. Lymphatic vessels
5. Nerves

11

What direction does blood flow? What direction does bile flow?

Blood: From portal triad to central vein.
Bile flows in the opposite direction

12

What does the basal surface of the hepatocyte face?

Sinusoidal space

13

What does the apical surface of the hepatocyte face?

Other hepatocytes cells

14

What does the lateral surface

The bile canaliculi

15

Describe the breakdown of bilirubin

HgB-->Heme-->Biliverdin-->bilirubin. It's then transported through the blood by albumin. Taken up by hepatocytes. Conjugated by UDP-glucuronosyltransferase to be made water soluble. Excreted through bile ducts

16

What are the components of bile?

1. Conjugated bilirubin
2. Cholesterol, phospholipids
3. Bile salts
4. Water, electrolytes

17

What does bilirubin become in the bowel?

urobilinogen. Can be resorbed into the blood stream.

18

Why does your urine become dark with bile obstruction?

high levels of conjugated bilirubin and urobilinogen excreted in the kidneys

19

What are the three categoric causes of jaundice?

1. Pre-hepatic
2. Hepatic
3. Post-hepatic

20

Give examples of a pre-hepatic cause of jaundice

hemolysis
Excess production of bilirubin

21

Give examples of hepatic causes of jaundice

Liver disease. Either cannot process the bilirubin or the UDP-glucuronyltransferase is not working.

22

Give an example of posthepatic jaundice

Obstruction of bile duct

23

What causes decreased activity of UDP-glucuronosyltransferase?

Congenital (Gilbert's/Crigler-Najjar) or drugs

24

Does liver cell damage cause an increase in conjugated or unconjugated bilirubin?

Both: decreases uptake of bilirubin and decreases excretion of conjugated

25

What proteins are NOT made by the liver?

IgGs

26

What imaging studies would show liver pathology?

Ultrasound and CT scan

27

What are physical exam findings in liver disease?

1. Jaundice
2. Hepatomegaly
3. Splenomegaly
4. Spider angiomas
5. Edema
6. Ascites
7. Asterixis

28

When is AST elevated?

Dying cells=enzyme leakage

29

When is ALT elevated?

virus/toxins

30

What is alkaline phosphatase?

Liver isozyme

31

How is gamma-GT, released?

Biliary epithelium

32

If you see elevated AST and ALT, you would think:

Hepatic cause of jaundice. Might see damage to liver (cirrhosis)

33

If you see elevated AP + gamma-GT, you would think...

Biliary tract injury. Would also see an enlarged bile duct.