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