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GI14 Liver/GB
Questions and stuff
56
Medical
Graduate
01/27/2012

Additional Medical Flashcards

 


 

Cards

Term
The _____ is the site of entry/exit of the hepatic portal vein, hepatic artery, bile duct, lymphatic vessels & nodes, and autonomic nerves.
Definition
Porta hepatis (hilum)
Term
What percentage of incoming blood do the hepatic artery and portal vein carry?
Definition

Hepatic a. 25%

Portal v. 75%

Term
Glisson's capsule
Definition
Thin connective tissue capsule covering liver surface.
Term
The liver develops as a ______ of the primitive gut endoderm.
Definition
glandular outgrowth
Term
The floor of the future duodenum gives rise to a saculation named the _____.
Definition
hepatic diverticulum
Term
The cranial part of the hepatic diverticulum becomes the
Definition
liver parenchyma and bile ducts.
Term
The caudal part of the hepatic diverticulum becomes the 
Definition
gall bladder and cystic duct.
Term

Liver lobule: the basic functional unit of the liver.

What are its major components?

Definition

Portal Triad

Central Vein

Hepatic Plates

Sinusoids

Term
Zones of hepatocyte function within hepatocyte acinus.
Definition

Zone 1: max oxygen & nutrients

Zone 2: intermediate

Zone 3: least oxygen and nutrients

Term
____ and ____ mix in the sinusoids as they flow towards the central vein.
Definition
arterial and portal blood
Term
The liver is a highly perfused organ, receiving about _____ of the total cardiac output.
Definition
25%
Term
The portal vein divides into _____ that enter the hepatic sinusoids.
Definition
left and right hepatic branches
Term
The three major hepatic veins (right, middle and left) each have a short extrahepatic segment before joining the _____.
Definition
IVC
Term
lymphatic drainage from the liver is different from other sites in that it is rich in
Definition
plasma proteins (eg albumin)
Term
Subsinusoidal space of _____ bathes hepatocytes with sinusoidal plasma and initiates lymph formation.
Definition
Disse
Term
Kupffer Cells are
Definition
macrophages that hang out within sinusoids.
Term
Lipocytes (ito or stellate cell) store
Definition
lipid and vitamin A
Term
How to recognize Portal Triad on a slide.
Definition

Hepatic arteriole: thicker muscular lining, RBCs

Portal venule: very large lumen

Bile ductule: cuboidal cell lining

Lymphatic vessel: next to arteriole, smaller, thinner walls, no RBC

Term
Sinusoids have lots of holes, or _____, allowing blood to interact with the hepatocytes.
Definition

fenestrations

(open into the Space of Disse)

Term
The _____ are found lining the tops of hepatocytes, leading to the bile duct at the portal triad.
Definition
bile cannaliculi
Term
In the acinus model, zone _ sees toxins first.
Definition
1
Term
When you have pathology, different zones react _____.
Definition
in different ways.
Term

The _____ is the space between hepatocytes and endothelial cells.

It is lined with _____ to facilitate exchange.

Definition

Space of Disse

microvilli

Term
Hepatocytes are held together by _____.
Definition
tight junctions
Term
10% of bile acids are synthesized de novo in the liver by conjugatin of _____ with _____ in the smooth ER.
Definition
cholic acid with glycine/taurine
Term
The cystic duct allows what kind of flow?
Definition

bidirectional flow into and out of the gallbladder

it connects with the common hepatic duct

Term
4 functions of hepatocyte
Definition

Protein synthesis

Metabolism (lipids/carbs/conjugatesBilirubin/convertsAmmonia->urea)

Bile secretion

Detoxification (e.g. cytochrome P450)

Term

Hepatocytes:

Large parenchymal cells

Size:

Definition
20-30 microns
Term
Hepatocyte nuclei:
Definition
1 or 2
Term
Rough ER produces
Definition
plasma proteins such as albumin, clotting factors, lipoproteins
Term
Smooth ER does what?
Definition
bilirubin conjugation, bile salt synthesis, detoxification
Term
Golgi does what?
Definition
packages proteins for release into space of Disse
Term
Peroxisomes do what?
Definition
contain oxidases and catalases
Term
What is the liver's regeneration capacity?
Definition
almost unlimited
Term
How much hepatic tissue must be lost to exhibit liver failure?
Definition
80-90%
Term
Hepatocytes can _____ after acute liver injurty to repair liver damage.
Definition
rapidly proliferate
Term

This condition usually results from repeated toxic insults to the liver (alcoholism, viral hepatitis).

Characterized by hepatocellular necrosis, hepatocellular regeneration (nodularity), and fibrosis (lipocyte activation).

Clinical consequences include liver failure, portal hypertension, cancer.

Definition
Liver Cirrhosis
Term
This common condition is due to an underdevelopment of the hepatocyte's smooth ER. As a result, the hepatocytes cannot conjugate bilirubin which then builds up in the body causing a yellow color.
Definition
Neonatal Jaundice
Term

One of the most common neoplasms word-wide (often associated with viral hepatitis).

Because of its extensive blood supply, the liver is also a common site for metastatic cancer (found in 30-50% of patients dying from malignant disease).

Definition

Liver Cancer

Primary liver cancer is aka hepatocellular carcinoma

Term
Of the cells lining the sinusoids, Kupffer cells are _____ and Ito cells are _____.
Definition
phagocytic ; fat storing
Term
The initial ductules that receive bile from the canaliculi are sometimes called _____.
Definition
Hering's canals
Term
The common bile duct is created by the joining of the 
Definition
Common hepatic duct and the cystic duct.
Term
_____ causes the gall bladder to contract.
Definition
CCK
Term
The gall bladder has an irregular _____ lining.
Definition
mucosa (which is lamina propria + epithelium)
Term
The lining of the gall bladder is _____ columnar.
Definition
simple
Term
The gall bladder has some microvilli on the surface (not enough to be considered a microvillous brush border), which helps it...
Definition
concentrate bile up to 6x by reabsorbing water
Term
The common bile duct merges with the pancreatic duct to form the _____.
Definition

Ampulla of Vater

(it also marks the transition from foregut to midgut)

Term
The exocrine function of the kidney is to produce _____. What are 'blank's' functions?
Definition

Bile

Digestion and Waste Excretion

Term

Gall bladder max volume is _____.

The liver continuously produces bile at a rate of _____.

Definition
40-70mL ; 600-1200mL/day
Term
Name the intrahepatic biliary tract.
Definition
Bile canaliculi -> canals of Hering (penetrate the limiting plate) -> bile ductules -> larger bile ducts in the Portal Triads (lined by simple cuboidal epithelium)
Term
The extrahepatic biliary tract is lined by _____ epithelium.
Definition
simple columnar
Term
The gall bladder is located on the visceral surface of the liver and is _____.
Definition
retroperitoneal
Term
_____ keeps lumen of cystic duct open to allow bidirectional flow.
Definition
Spiral fold (spiral valve)
Term
The gall bladder's simple columnar epithelium lacks _____ cells.
Definition
goblet
Term
Gall bladder muscularis externae is
Definition
a thin layer of smooth muscle in wall
Term
How does CCK control bile excretion?
Definition

(i) hormone secreted by I cells in duodenum

(ii) stimulated by presence of ingested fats & amino acids

(iii) causes gall bladder smooth muscle to contract

(iv) causes sphincter of Oddi to relax

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