Anatomy 5.1 Liver

Physiology of Hepatic Vascular System 1. receives approximately ___% of resting cardiac output 2. stores and releases ___ since it functions as a reservoir for it 3. Normally, ___to ___% of total blood volume is in the liver 4. Roughly ___% of that is in the sinusoids 5. in the case of a hemorrhage the liver adjusts its ____ volume, can eject enough blood to compensate for a ____ amount of hemorrhage

1. 30% 2. blood 3. 10-15% 4. 60% 5. blood, moderate

LIVER 1. What is the largest gland in the body? 2. The liver functions impact what body systems? 3. Functions of liver? 4. Since the liver is so complex and affects so many systems, what is one major drawback of the liver? 5. the liver is in contact with what muscle? 6. is the liver one giant organ or multi-lobed?

1. liver 2. all of them 3. stores energy, nutrients, excretes wastes helps in digestion, recycling of blood cells, immune system function 4. hepatic disease has widespread effects on virtually all other organ systems 5. with the diaphragm 6. multi-lobed

Liver Functions 3, 4, 5? Idk too many 1. Many vitamins are stored in the liver, ____ by the liver and ____ by the liver 2. What are some of these vitamins? 3. ____ ____ vitamins such as ADEK require ___ for proper absorption by intestines 4. the liver synthesizes many of the _____ necessary for blood coagulation 5. drug detoxification is a complex process and occurs in the ______ of the hepatocytes 6. the drug is inactivated and eliminated by the body usually through the ____ or secreted into ____ and passed in feces 7. biochemical processes make drugs more ____ soluble and thus easier to eliminate through kidneys 8. too much ____ causes hepatic encephalopathy 9. hepatic encephalopathy is the.... 10. can the liver break down ammonia?

1. activated, and degraded 2. B vitamins and Vitamin C, along with A, D, E, and K 3. fat soluble, bile 4. clotting factors 5. endoplasmic reticulum 6. kidneys, bile 7. water soluble 8. ammonia 9. the loss of brain function that occurs when the liver is unable to remove toxins from the blood. 10. yep

LIVER FUNCTIONS: DIGESTIVE/METABOLIC 1. synthesis and secretion of ____ 2. storage of ___ , ___, ____, _____reserves 3. maintaining normal blood ____, ____, and ______ _____ concentration 4. The liver breaks down ___ and releases ____ 5. synthesizes and releases _____ 6. inactivation of _____ since the liver is highly metabolic NON-DIGESTIVE FUNCTIONS 1. synthesis of ____ proteins, _____ factors, and inactive ________ 2. phagocytosis of damaged ____ cells 3. storage of _____ 4. breakdown of circulating hormones (____ and _____) and ________ 5. inactivation of ____-_____ drugs

1. bile 2. glycogen, lipid, iron, fat-soluble vitamins 3. blood glucose, amino acid, and fatty acid concentration 4. glycogen and releases glucose 5. cholesterol 6. toxins _______________________ 1. plasma proteins, clotting factors, inactive angiotensinogen 2. red blood cells 3. blood 4. insulin and epinephrine and immunoglobulins 5. lipid-soluble drugs

Biliary System 1. this is made of a series of channels and ducts that carries ____ to ___ ___ 2. hepatocytes arranged in "____" with their ___ surfaces facing and surrounding the sinusoids 3. hepatocytes produce ____ 4. the first channel in the biliary system, smallest division of biliary system, where bile begins its life 5. bile flows parallel to the ____ in canaliculli which is the opposite direction of ____ 6. at the ends of the canaliculi, bile flows into ___ ____ 7. Bile ducts begin very close to the terminal branches of the portal vein and hepatic artery at the ______

1. bile to small intestines 2. plates, apical 3. bile 4. canaliculi 5. sinusoids, opposite of blood 6. bile ducts 7. portal triad

Applied Anatomy Jaundice 1. What is Jaundice? 2. what are symptoms of it? 3. what is another name for it?

1. excessive quantities bilirubin accumulate in extracellular fluid 2. yellow discoloration in skin, sclera, ad mucous membranes 3. icterus

Gall Bladder 1. this is a sac like structure adhering to the liver 2. receives bile from the ____ 3. a duct called the ____ ____ leads directly into the ____ ____ duct which empties directly into the ______ 4. function of gall bladder? 5. bile is composed of ___ ___ 6. these aid in the absorption of ____ and also activate ___ in the intestine

1. gallbladder 2. liver 3. cystic duct, common bile duct, duodenum 4. storage of bile, concentration of bile, acidification of bile, sends bile to duodenum 5. bile salts 6. fats and lipases

Carbohydrate Metabolism 1. Manufactures glucose from amino acids when glycogen reserves are low 2. Syntehsization of glycogen, Excess glucose entering the blood after a meal is rapidly taken up by the liver and sequestered as glycogen 3. export of glucose back into the blood for transport to all other tissues when blood glucose levels low Fat Metabolism 1. The liver oxidizes ____ to produce energy 2. it breaks down more ____ that the hepatocytes need, and exports large quantities into ____ where it can be picked up and metabolized by other tissues 3. ___ and ____ are converted by the liver into fatty acids and triglycerides and then exported and stored in ___ tissue 4. the liver also synthesizes large quantities of _____ and ____ 5. some are packaged with ____ and made available to the rest of the body 6. the remainder is excreted in bile as ___ or after conversion to ___ ____ Protein Metabolism 1. The liver produces many proteins, it reassembles _____ into proteins 2. main protein produced by liver is ____ 3. 2 functions of albumin? 4. what is hypoprotonemia? 5. what compounds does albumin carry?

1. gluconeogenesis 2. glycogenesis 3. glycogenolysis --------------------------------------------------- 1. triglycerides 2. fatty acids, blood 3. carbs and proteins, adipose 4. cholesterol and phospholipids 5. lipoproteins 6. cholesterol, bile acids ---------------------------------------------------- 1. amino acids 2. albumin 3. prevent hypoproteinemia and carry other compounds through the bloodstream 4. a condition where there is an abnormally low level of protein in the blood, results in edema 5. Calcium, Vitamins, Hormones, fatty acids, many drugs, and bilirubin.

Formation of Lymph in Liver 1. about ____ of the lymph formed in the body is formed in the liver 2. lymph flows through the ___ of ___ to collect in small lymphatic capillaries associated with ___ __, from there to the ____ lymphatic system 3. if pressure in the sinusoids increases, there is a corresponding _____ in the rate of lymph production 4. if too much pressure builds up we get ____ or fluid build up in the abdomen

1. half 2. space of disse, portal triads, systemic 3. increase 4. ascites

Hepatic Lobule 1. what is this? a hexagonal arrangement of plates of hepatocytes radiating outward from a central vein 2. at the vertices of the lobule are regularly distributed ___ _____ 3. these triads contain what 3 things? 4. so what comes in and what leaves?

1. hepatic lobule 2. portal triads 3. bile duct, terminal branch of hepatic artery, branch of portal vein 4. blood comes in, bile and lymph leave

Unique Characteristics 1. thier portal system 2. a system of ducts that transports bile out of the liver into the small intestine 3. _____ arrangements of hepatocytes and their association with the vascular and biliary systems

1. hepatic vascular system 2. the biliary tree 3. three dimensional

Bile Acids-Applied Anatomy 1. _____ extract bile acids very efficiently from sinusoidal blood, very little escapes a healthy liver into systemic circulation 2. bile acids are then transported across the hepatocytes to be re-secreted into ______ 3. Each bile salt molecule is reused about ___ times, __ or ___ times during a single digestive phase 4. To check liver function you test what? 5. To check this you take low bile acid from ___ blood and feed the patient a high ___ meal, then you take the bile acid level a couple hours later 6. If there is a ton of ____ flowing around then we know hepatocytes (ARE or ARE NOT) taking the bile back in

1. hepatocytes 2. canaliculi 3. 20 times, 2 or 3 times 4. bile acids 5. venous blood, fat meal 6. systemic bile, ARE NOT

Sinusoids 1. what is the pressure in these channels? 2. ___ flows through the sinusoids 3. this blood empties into the ____ of each lobule 4. these veins coalesce into the ____ veins, which leave the liver and empty into the _____ _____ 5. Sinusoids also have a ton of these type of cells 6. these cells are fixed ____ which means they stay in the sinusoids 7. they assist in liver tissue ____ 8. in a pic how do you know what cells are the kupffer cells

1. low pressure vascular channels 2. blood 3. central vein of each lobule 4. hepatic veins which leave and empty into the vena cava 5. kupffer cells 6. macrophages 7. repair 8. black masses

Bile 1. bile is a complex fluid composed of what? 2. What are the 2 important function of bile? 3. bile acids are derivatives of what? 4. what are bile acids used for? 5. what are the 2 main waste products of bile? 6. what are the 2 important functions of bile ACID? 7. how do bile acids act with fat? 8. emulsification is NOT _____, this greatly increases the _____ ____ of fat, making it available for _____ by lipases 9. definition: aggregates of lipids such as fatty acids, cholesterol and monoglycerides that remain suspended in water 10. bile acids are also critical for transport and absorption of ___ ____ ____

1. made of electrolytes, cholesterol, bile acids, bile salts, bilirubin, and globulins 2. contains bile acids and bile eliminates waste products 3. cholesterol 4. digestion and absorption of fats and fat-soluble vitamins in the small intestine 5. bilirubin and cholesterol 6. emulsification of lipid aggregates, bile acids form micelles 7. detergent action, cause fat globules to break down into microscopic droplets 8. digestion, surface area, digestion 9. micelles 10. fat-soluble vitamins

Space of Disse 1. since the sinusoidal endothelial cells are highly fenestrated this allows unimpeded flow of _____ from sinusoidal blood into the space of disse 2. this has two important consequences 3. _____ are bathed in nutrient-rich plasma derived from venous blood returning from the ____ _____ 4. Plasma which collects in the ___ ____ flows back toward the portal tracts, collecting in ____ vessels and forming a large fraction of the body's lymph

1. plasma 2. two 3. hepatocytes from small intestine 4. space of disse, lymphatic vessels

Hepatic Vascular System 1. 75% of the blood entering the liver is venous blood from the ______ 2. The venous blood is returning from where? 3. The remaining 25% of the blood supply to the liver is _______ from the ____ artery

1. portal vein 2. small intestine, stomach, pancreas, spleen--> converges from portal vein 3. arterial blood from the hepatic artery

Hepatocytes 1. hepatocytes are active in the synthesis of ___ and ___ for export 2. hepatocytes have a great deal of ___ and ____ ____ bc of their exports 3. _____ aggregates in hepatocytes varies since following a meal it is ____, but after a prolonged fast it is ____ 4. hepatocyte nuclei are distinctly ____ 5. _____ cells are common

1. proteins and lipids 2. rough and smooth endoplasmic reticulum 3. glycogen, abundant, minimal 4. round 5. binucleated

Architecture of Hepatic Tissue 1. this tissues are connective tissue capsule branches and extends through the liver as ____ 2. the connective tissue provides ____ 3. this is a highway for ___ ___ vessels, ____ vessels, and ___ ducts to traverse the liver 4. sheets of connective tissue divide the ______ into very small units called _____ 5. connective tissue septae invaginating from the capsule form ____ _____ 6. these are the ____ and ____ unit of the liver

1. septae 2. support 3. afferent blood vessels, lymphatic vessels, and bile ducts 4. parenchyma, lobules 5. hepatic lobules 6. structural and functional

Liver Blood Supply 1. Terminal branches of the hepatic portal vein and hepatic artery empty together and mix as they enter _______ 2. distensible vascular channels lined with ______ 3. it is also lined with _______ 4. this area provides a major fraction of the body's lymph 5. this space is in between the _____ cell and ______

1. sinusoids 2. highly fenestrated endothelial cells 3. hepatocytes 4. Space of Disse 5. endothelial cells and hepatocytes

Metabolic Functions 1. hepatocytes are metabolic super achievers, how so? 2. The liver also has the ability to regenerate

1. synthesizing molecules that are utilized elsewhere to support homeostasis converting molecules of one type to another regulating energy balances 2. just know

Bilirubin 1. what is bilirubin? 2. is this generated in large or small quantities? 3. dead and damaged RBCs are picked up by _____ cells 4. ___ is recycled, ___ chains and ___ are catabolized and parts are recycled, however ___ cannot be recycled and must be eliminated Elimination of Heme 1. phagocytic cells convert heme into free ____, which is released into the ____ and binds to ______ 2. Why is it called free? 3. free bilirubin is stripped off ____ and absorbed by _____ 4. within these cells the free bilirubin is _____ into _____ bilirubin 5. this bilirubin is secreted into the ____ canaliculus and is delivered to the ____ 6. ____ in the intestines metabolize the bilirubin to a series of other compounds which are eliminated into feces or after reabsorption, in urine.

1. useless and toxic breakdown product of hemoglobin, yellowish pigment 2. large 3. phagocytic cells like kupffer cells 4. Fe, globin chains and protein, Heme -------------------------------------------------- 1. bilirubin, plasma, albumin 2. hasn't bonded to anything yet 3. albumin, hepatocytes 4. conjugated into conjugated bilirubin 5. bile, small intestines 6. bacteria