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Accessory Digestive Organs: Liver, Pancreas, & Gallbladder
Morrow 4/6/11 lecture 2 hrs
84
Histology
Undergraduate 4
03/21/2011

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Term
liver and pancreas (the accesory digestive organs)
Definition
what organs are embryological outgrowths of the primitive gut?
Term
liver (also largest internal organ)
Definition
largest gland in the body
Term
right, left, quadrate, caudate
Definition
what are the 4 lobes of the liver?
Term
1) detoxification of metabolic waste (nitrogen from deamination of amino acids converted to urea)
2) metabolism and detoxification of drugs and toxns (alcohol and antibiotics)
3) destruction of senescent RBC's (along with the spleen)
4) recycling of Hb via synthesis and secretion of bile
5) synthesis of plasma proteins
6) misc. metabloic functions such as glycogen synthesis & storage, gluconeogenesis)
Definition
list the 6 major functions of the liver
Term
clotting factors, albumin, lipoproteins
Definition
list some of the plasma proteins synthesized in the liver
Term
smooth, glossy, red liver (healthy)
it was bad if there were flukes/parasites or tumors
Definition
what was a good sign in ancient times when you sacrifice an animal and look at its liver?
Term
Glisson's capsule
Definition
name of the connective tissue capsule covering the external surface of the liver
Term
monosaccharides and amino acids from digestion

also potentially toxic compounds to be conjugated or detoxified
Definition
what enters the liver via the hepatic portal vein?
Term
the hepatic portal vein (mostly unoxygenated blood goes to the liver)
Definition
what carries 75-80% of the blood to the liver?
Term
the hepatic artery, which is a branch of the celiac trunk

this supplies about 25-30% of the blood to the liver and it mixes with the deoxy blood from the hepatic portal vein
Definition
how does oxygenated blood reach the liver?
Term
hepatic vein
Definition
what vessel provides venous drainage of the liver?
Term
hepatocyte
Definition
name for a regular liver cell
Term
most are diploid, but some are polyploid and or binucleate
Definition
describe the nucleation/DNA distribution of hepatocytes
Term
they are rough ER and lysosomal products
Definition
hepatocytes contain large numbers of cytoplasmic granules which are a result of what?
Term
the brown pigment from lipofuscin
Definition
what do aging hepatocytes accumulate?
Term
anastamosing cords paralleled by venous sinusoids
Definition
how are hepatocytes arranged?
Term
sinusoidal lining cells
Definition
name for the discontinuous endothelium with gaps between the cells called fenestrae. these cells line sinusoids
Term
they keep blood in the sinusoids and prevent it from contacting the hepatocytes
Definition
what is the purpose of the sinusoidal lining cells?
Term
space of Disse or perisinusoidal space which is continuous with lymphatics
Definition
what is the name of the space between sinusoidal lining cells and hepatocytes called?
Term
reticulin fibers
Definition
made of type 3 collagen and suports hepatic cords and sinusoids
Term
Kupffer cells
Definition
fixed macrophages scattered among endothelial cells and hepatocyes
Term
Ito cells
Definition
in the liver, these are fat storing cells containing lipid droplets used for Vitamin D storage
Term
lobules
Definition
cords of hepatocytes are arranged into _____
Term
classic lobules are based on blood flow, hexagonal shaped, and have a central vein in the middle

hepatic lobules are based on bile flow, triangular shaped, and have the portal triad in the center
Definition
what is the difference between a classic lobule and a portal lobule?
Term
centrilobular vein or terminal hepatic venule
Definition
another name fot the central vein in a classic lobule
Term
a thin connective tissue septum
Definition
what surrounds classic lobules?
Term
portal artery, veins, lymph and bile duct (hepatic tetrad)
Definition
what are found at the corners of a classic lobule?
Term
central vein
Definition
blood enters from portal tracts, percolates through sinusoids of a lobule, and drains via a _____
Term
1) portal vein-largest, comonly has blood in it, oval shaped, thin endothelium
2) bile duct- has cuboidal endothelium arranged in a ring
3) portal artery- swirl of smooth muscle and endothelium
4) lymph vessel - usually collapsed
Definition
describe each component of the hepatic triad/tetrad in order of largest to smallest structure
Term
central venules are at the corners around a portal triad in the center
Definition
what forms the corners of the hepatic lobules?
Term
central vein
Definition
larger and more irregular shaped, continuous with the sinusoids draining each lobule
Term
ascinus
Definition
another lobule type that is a diamond shaped region between neighboring central veins
Term
longitudinal axis (top to bottom) = central veins

portal tracts at the sides
Definition
describe the corners of an ascinus
Term
different metabolic environments
Definition
ascini are arranged due to blood flow, oxygenation, metabolism and pathology, what do the different zones of an ascini mean?
Term
zone 1 (perilobular or periportal zone)
Definition
zone of the ascini closest to the portal tract that receives the most oxygenated blood
Term
zone 2
Definition
intermediate zone of an ascini
Term
zone 3 or centrolobular zone
Definition
zone of ascini furthest from the portal tract, closest to central vein, receives least oxygenated blood, and is therfore most susceptible to ischemic injury
Term
detoxify or metabolize drugs, toxins, and metabolites (ex: ethanol, pesticides, and carcinogens)
Definition
what do the microsomal mixed function oxidases of the sER and peroxidases of the peroxisomes (p450 system) do?
Term
toxins causing death would come from the arterial blood supply so cells in the zone closest to the portal artery would die first (zone 1, then zone 2, then zone 3)

ischemia would cause the cells to die in the reverse order: zone 3, then zone 2, then zone 1
Definition
in forensics, the order in which the zones of the acini are affected/killed tell the cause of death. which zone's cells would die first in the case of toxins? ischemia?
Term
cirrhosis
Definition
common sequela to repeated insult or chronic desease of the liver
Term
1) hepatic degeneration and necrosis
2) then fibrosis and nodular regeneration

(the liver can regenerate itself)
Definition
what characterizes cirrhosis?
Term
they accumulate toxic levels of vitamin A from consuming the seal that eats the fish, that eats the other fish that all have lots of vitamin A in their livers

(the purpose of cod liver oil way back when)
Definition
why should you not eat polar bear liver?
Term
sharks have to swim to breath, so in order to keep swimming they have to be more buoyant and store more fat/oil in their livers, and thus lots o Vitamin A
Definition
what allows sharks to breath? what does this have to do with their liver?
Term
exocrine
Definition
liver secretion that uses ducts
Term
endocrine (goes straight into blood stream)
Definition
liver secretion that does not use ducts
Term
1) synthesis of plasma proteins (fibrinogen, urea, albumin, prothrombin)
2) synthesis of glucose
3) gluconeogenesis (from non carb sources like aa's and lipids)
4) storage of glycogen, lipids, and lipoproteins
5)vitamin A storage
Definition
list the 5 endocrine functions of the liver
Term
bile synthesis
Definition
what is the exocrine function of the liver (hint: what ducts are present in the liver?)
Term
1 liter/day
Definition
how much bile is secreted/day by the liver?
Term
hormones such as secretin, CCK, and gastrin from APUD cells
Definition
what increases bile flow from the liver?
Term
hepatocytes! secreted into bile cannaliculi
Definition
what cells is bile synthesized by, and where is it secreted from there?
Term
bile cannaliculi
Definition
small canals between hepatocytes, formed by grooves in plasmamembranes of adjacent cells
Term
blood flow, biles goes into progressively larger ducts from the cannaliculi
Definition
the direction of bile flow is opposite of what flow?
Term
bile cannaliculi b/w hepatocytes
bile ducts from portal triads -intrahepatic ducts --duodenum at major duodenal papilla (after period of storage and modification int he gallbladder)
Definition
list the path of bile in the liver
Term
scattered throughout the parynchema of the liver
Definition
where are intrahepatic ducts?
Term
gallbladder
Definition
muscular sac located in depression along surface of the liver
Term
100 mL, it stores and concentrates bile
Definition
what is the normal volume of the gallbladder? what is its function?
Term
simple columnar epithelium with apical microvilli
Definition
what -thelia lines the gall bladder?
Term
used for resorption of water
Definition
what is the function of the apical microvilli in the gallbladder?
Term
muscularis mucosa
Definition
what layer of the gut is the gallbladder lacking?
Term
tubuloalveolar mucus glands
Definition
what kind of glands are found in the gallbladder?
Term
CCK cholecystokinin
Definition
what stimulates contraction of the gallbladder?
Term
water, ions, electrolytes, cholesterol + phospholipids (lecithin), biles acids/salts, & bile pigments
Definition
what is bile made up of?
Term
bilirubin
Definition
best known bile pigment, also the non-soluble breakdown product of hemoglobin
Term
bilirubin glucuronide
Definition
water soluble version of bilirubim conjugated with glucuronide
Term
jaundice
Definition
failure to absorb bilirubin or to conjugate it and secrete glucuronide
Term
gall stones, billiary calculi or cholelithiasis
Definition
supersaturation of bile
Term
choledocolithiasis leads to bile stasis or jaundice if really severe
Definition
what is the term for obstruction of the bile ducts, and what does it cause?
Term
choleycystitis
Definition
chronic inflammation of the gallbladder
Term
they should limit their fat intake
Definition
after gallbladder surgery patients cannot concentrate bile, so how should they change their diet?
Term
pancreas
Definition
highly lobulated gland with thin connective tissue capsule located in the bend of the duodenum
Term
islets of Langerhans
Definition
what is the ductless endocrine pancreatic tissue called?
Term
3
Definition
how many islet cell types are there in the pancreas?
Term
exocrine
Definition
most of the pancreas has ducts, compound tubuloalveolar serous glands called the _____ pancreas
Term
ascini
Definition
densely packed serous ______ contain pyramidal secretory cells surrounding a central lumen (duct)
Term
zymogen granules (inactive enzyme precursors)
Definition
what do ascinar cells contain?
Term
trypsinogen/protrypsin, chymotripsinogen/prochymotrypsinogen, amylase, lipase
Definition
list the zymogens of the pancreas
Term
intercalated ducts, bicarb and water is added to help neutralize the acid of the stomach
Definition
what do the pancreatic enzymes empty into once they are secreted? what is added to them?
Term
centroacinar cells
Definition
duct cells that form the beginning of intercalated ducts
Term
pancreatic duct at the major duodenal papilla
Definition
pancreatic secretions enter the duodenum via the _______
Term
polypeptide hormones that are secreted by APUD cells
Definition
principle regulators of the exocrine pancreas
Term
gastrin, G cells of the pyloric stomach (stimulates secretion of pancreatic fluid
Definition
what is the pancreas regulating hormone secreted by the stomach? what are the names of the cells that secrete it?
Term
secretin-from S cells, stimulates bicarb secretion by cells of intercalated ducts
CCK-secreted by I cells, stimulates acinar cells to secrete zymogens
enterokinase- converts trypsinogen to trypsin, which converts chymotrypsinogen to chymotrypsin (this cascade rxn prevents the pancreas from digesting itself)
Definition
what are the 3 hormones that regulate the pancreas that are secreted by the duodenum?
Term
pancreatitis
Definition
autodigestion of the pancreas brought on by alcoholism
Term
can be fatal within hours
Definition
when the cascade reaction breaks down there can be premture intracellular conversion of chymotrypsinogen to chymotrypsin. how soon is this fatal?
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