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196 Cards in this Set

  • Front
  • Back
Name 3 ways aspiration is prevented;
*Glottis closes
*Epiglottis covers the glottis during swallowing
*Cough reflex-when something gets by #1 or #2
To keep food and water from moving up into nose/nasal cavities, the _____ moves up to obstruct the passageway.
Soft palate
Nasal turbinates are the thinnest, delicate bones of the body are very _______ with the same tissue lining as the respiratory tract. 2 functions of these are:
*vascular
*Heat and Cool air before it reaches lungs
--filter small particles out of the air with the aid of mucous to keep them out of the lungs.
To avoid damaging the nasal turbinates, an NG tube should be passed_____
on the ventral aspect of the nasal cavity.
All mammals have 4 salivary glands which are exocrine glands, what are they and where are they located?
*Paratid-duct opens @ top of molars
*Submandibular-opens/empties under tongue
*Sublingual- under tongue with the submandubular
Zygomatic-
What 3 nerves are involved in salivation?
VII, IX, X
CLINICAL-Dogs often get a salivary cyst from trauma to the glands from chewing on things. The will present with ________and typical treatment involves ______.
Watery thick saliva, withdrawn

Surgery to remove inflammed, encysted gland & duct
Degluttion is ________
chewing
What moves food down the esophagus to stomach?
Parastalsis--rhythmic contractions
The function of the esophagus is only to________
move food and fluids to and from stomach
Esophageal mucosa is made up of
Stratified squamous epithelium
Mucous producing exocrine glands aid in ________
reducing friction
The anatomical boundries of the thorax are:
Dorsal-Vertebral column
Ventral-sternum
Cranial-thoracic inlet
Caudal-diaphagm
the 4 types/locations of mucosa in the GI tract are:
Esophageal mucosa
Gastric mucosa-in stomach
Enteric mucosa-Small intestine
Colonic mucosa-large intestine
Glandular layers are always very_____
vascular
CLINICAL- Vomitus with frank red blood will have originated most likely from _________
esophageal injury
Veterinarians try to avoid Esophageal & ureter surgery because trauma to these results in ______
scar tissues that cause a stenosis/stricture.
CLINICAL-Cat presents with a swallowed needle and thread, and needle is suspected to have lodged in esophagus. Thread will typically wrap around base of tongue. What is the typical treatment?
***DO NOT CUT THREAD***
Under general anethesia, animal is scoped and thread is followed to the needle, needle is grasped through scope and removed.
CLINICAL-to rule out esophageal obstruction, ask if the animal is _____
eating and drinking---if they are, then it is NOT an obstruction
3 typical areas for obstruction are:
Thoracic Inlet-large objects like rubber balls tend to lodge here
Base of heart
Cardiac sphincter inlet of stomach (cranial to inlet)
CLINICAL-typical treatment for an obstruction is to ________
push it to the stomach
then surgery to remove it since the stomach heals more easily and with less complications than the esophagus
Most "tubes" witin the body are made up of smooth muscle. The esophagus is an exception in that the upper ____ is made up of skeletal muscle that is dependant on nerve supply for proper funtioning.
Two-thirds
Megaesophagus is often due to motor nerve degeneration which leads to the esophagus ________
becoming non-functional due to loss of muscle tone and therefore becoming a "bag" that holds onto the food and keeps it from moving on into the stomach.
Megaesophagus tends to be more of a problem in______
large 50+ dogs
CLINICAL- A dog with megaesophagus will present with ___
Emaciation, hunger
Eats well but vomits
Undigested material is vomited and comes out looking like a tube
CLINICAL-The treatment for Megaesophagus is:
*Raise the front end of the dog up while feeding
*Raise the food up--both of these let gravity help with movement of the food into the stomach
*Liquid diet
CLINICAL-Congenital Megaesophagus becomes apparent when?
At weaning when the puppy moves from a liguid to a solid diet
CLINICAL-To diagnose Megaesophagus, what test is often done?
Barium contrast study
Spleen is located in which quadrant?
LU
The gastric mucosa is made up of
Simple columnar cells and goblet cells that produce the mucus that protect the stomach from the HCL
Vagus nerve stimulation causes production of what 3 substances in the stomach?
Mucus
HCL
Pepcin
The peritoneum produces an anticogulant called_______ ?
Heperin
CLINICAL- Parvo wipes out ______ which leads to ________
lining of small intestine

characteristic bloody diarrhea
CLINICAL-COlitis, inflammation of the large intestine tends to present with _______?
Frank red bloody mucus in stool
What are 3 common causes of enteritis?
Virus
bacteria
foreign body
What are typical symptoms of enteritis?
**DIARRHEA
*Burgandy colored blood in diarrhea due to break down of lining of small intestine
*Vomiting
*Dehydration is a large concern due to the V/D
*Infection due to secondary septicemic infection
CLINICAL-Treatment for enteritis involves:
*IV Fluids
*IV antibiotics
*Parenteral feeding
*Barium will coat stomach/intestinal lining to stop bleeding
Secondary septicemia is a concern with GI tract bleeding/trauma because:
NF gut bacteria move into bloodstream due to disruption of protective mucosal lining.
Parvo is a very hardy virus that can survive n the environment for:
a year or more on average
CLINICAL-If an animal presents with abdominal trauma/hemmorrhage such as in a HBC, what test may be done to localize bleeding?
A 4 quadrant abdominocentesis
The stomach liquifies contents with ______ ?
Rhythmic peristaltic contractions
CLINICAL-Treatment for enteritis involves:
*IV Fluids
*IV antibiotics
*Parenteral feeding
*Barium will coat stomach/intestinal lining to stop bleeding
Secondary septicemia is a concern with GI tract bleeding/trauma because:
NF gut bacteria move into bloodstream due to disruption of protective mucosal lining.
Parvo is a very hardy virus that can survive in the environment for:
a year or more on average
The stomach liquifies contents with ______ ?
Rhythmic peristaltic contractions
The liquified contents of the stomach as they move out of the stomach are called?
Gastric chyme
The peritoneum is made up of?
Simple quamous epithelium
The function of the peritoneum, which lines the abdominal cavity and covers all abdominal organs is what?
To reduce friction
The peritoneum is made up of gastric serosa, which is a smooth thin membrane made up of cells that secrete_______
serous fluids
WHat are the 3 exocrine secretions of the stomach?
Goblet cells produce mucus
HCL
Pepsin-which only works in an enviornment that has a ph of 2 (is ph reliant)
What does Pepsin do in the stomach?
Breaks proteins down into polypedtides ------> amino acids
The only digestion that occurs in the stomach is?
The breakdown of proteins due to the actions of Pepsin
Due to the vascularity of the stomach, anything that destroys the lining such as a gatric ulcer will lead to:
hemmorrhage
CLINICAL-Bleeding in the stomach will present with what classic sign?
"Coffee Ground" vomitus due to partially digested blood
Irritation of the stoamch lining leads to stimulation of which nerve and what results?
X-Vagus

vomiting
What are 4 things that can cause bleeding in the stomach and vomiting due to rupture of stomach lining?
Virus
Bacterial toxins
foreign bodies
ulcers
GDV/Gastric Dilitation Volvulus is more common in ?
Large dogs - 50lbs+
GDV is more commonly seen in what type of feeding schedule?
SID-especially when owners follow the once a day feeding with exercise right after
CLINICAL-Bleeding in the stomach will present with what classic sign?
"Coffee Ground" vomitus due to partially digested blood
Irritation of the stoamch lining leads to stimulation of which nerve and what results?
X-Vagus

vomiting
The peritoneum is made up of gastric serosa, which is a smooth thin membrane made up of cells that secrete_______
serous fluids
WHat are the 3 exocrine secretions of the stomach?
Goblet cells produce mucus
HCL
Pepsin-which only works in an enviornment that has a ph of 2 (is ph reliant)
The only digestion that occurs in the stomach is?
The breakdown of proteins due to the actions of Pepsin
Due to the vascularity of the stomach, anything that destroys the lining such as a gatric ulcer will lead to:
hemmorrhage
CLINICAL-A dog with GDV will present with?
Vomiting
Salivation
Very distended abdomen
Pain and distress
CLINICAL-GDV tends to have a high mortality but attempted treatment will often involve what?
*Passing an OG tube to attempt to relieve pressure
*Surgery to flip stop back over and remove necrotic tissues
*Gastropexy to keep the stomach from flipping again
CLINICAL-GDV tends to result in :
Necrosis of stoamch tissues due to compromised blood supply
Possible stoamch rupture and resulting peritonitis
What organ ruptures most often due to stomach trauma such as in HBC?
the spleen
The largest lympatic organ is ____?
the spleen
The 3 functions of the spleen are?
*Stores blood-about 1 unit, contraction puts it back into circulation, often due to trauma
*Filters the blood-removes cellular debris, bacteria foriegn protein
*Primary source of WBC-lymphocytes & monocytes
Trauma to the spleen is often treated by __________ because_________
Splenectomy

The very vascular nature of the spleen makes it very difficult to repair.
CLINICAL-If an animal is bleeding into the abdomen but it is still a sterile area (no gut trauma/rupture), what can you do to increase the animals circulating blood volume?
An autotransfusion-which involves an abdominocentesis to remove the blood from peritoneal cavity and injecting it back into the animals vessels.
The further distal you go from the stomach the more _________ there will be.
NF enteric bacteria, typically Gram neg
99% of nutrents are absorbed in the small intestine which can be divided into 3 parts:
Duodenem
Jejunem
Ileum
CLINICAL-Fiber retains moisture, so lack of moisture leads to constipation. What can you feed an animal to help with this?
Canned pumpkin
Ileocecal valve regulates movement of liquid from illeum to the
cecum
Primary function of the large intestine is
To absob water & bile salts
What is the path of food through the GI tract?
Mouth-food bolus is formed,
esophagus
cardiac sphincter
STOMACH
Pyloric Spincter
Duodenum
jejunem
ileum
ileocecal valve
ascending colon
transverse colon
descending colon
rectum
anus
feces
The cecum is located in the
RLQ
In small animals, the cecum is
non-functional
In large animals, the cecum is
important for digestion
Blood from the small intestine goes into portal vein to the ___________
liver
The omentum looks like a hairnet and attaches
at the greater curvature of the stomach.
THe functions of the Omentum are:
*prevents intestines from entangling
*Acts as a sponge-reabsorbs free/fluid blood
*Acts as a band-aid for free fluid/blood in the abdomen--will attach to trauma on stomach and form adhesion to aid in healing.
Mysentary is a connective tissue that has a primary funtion of
preventing the intestines from entangling.
The mysentary has lymph nodes that:
* filter blood and lymph and produce lymphocytes
Hypertrophy of the gut leads to bacteria moving into:
the mysenteric lymph glands
Mysenteric volvulus is more common in horses and involves
the twisting of the mysentary
Chronic diarrhea can lead to ________, due to hyperstalsis and this involves the intestine scoping into itself and cuts off blood supply, which can lead to additional issues with obstruction.
intussesception
Tissue involved in an intussception and/or an obstruction can become __________, which can lead to gut rupture and ___________. This is more common in young animals,
necrotic

peritonitis
Treatment for intussusception involves:
Removal of segment, anastamosis and antibiotics
The gut associated lymphatic tissue (GALT) is the enteric submucosa that has a few important functions and they are:
*Help keep NF bacteria in the intestines from reaching the bloodstream.
*About 70% of the body's immune system is found in the digestive tract. The GALT is made up of several types of lymphoid tissue that store immune cells, such as T and B lymphocytes, that carry out attacks and defend against pathogens.
Tonsils are locatedat 2 & 10 o'clock in the back of the throat in tonsular crypts. Typically, they are only seen if there is case of
tonsilitis
CLINICAL-A pet with tonsilitis will present with _______ and the owner will complain of the animal vomiting but the vomitus will be ________ rather than food.
gagging

white foamy substance
The Pancreas is a mixed gland because is contains
exocrine and endocrine glands
The pancreatic endocrine glands secrete
hormones
The pancreas is stimulated to secrete by motor-electrical impulses from the
X Vagus nerve
The pancreas exocrine glands secrete
digestive hormones
The Glandular acini of the pancreatic exocrine glands produce 4 substances to aid digestion. What are they?
*Sodium bicarbonate
*Pancreatic amylase
*Pancreatic lipase
*Pancreatic trypsin
For the Pancreatic exocrine substance, Sodium bicarbonate, what does it do and break down into?
It neutralizes HCL from stomach and breaks it down into carbonic acid
For the Pancreatic exocrine substance, Pancreatic Amylase, what does it do and break down into?
It breaks down carbs into glucose
For the Pancreatic exocrine substance, Pancreatic lipase, what does it do and break down into?
It breaksdown fats and lipids into fatty acids and glycerol
For the Pancreatic exocrine substance,Pancreatic Trypsin, what does it do and break down into?
It breaks down protein into amino acids
Pancreatic insufficiency involves the pancreas not producing the apprpriate
amounts of the 4 pancreatic exocrine digestive substances, often due to scar tissue.
CLINICAL-An animal with Pancreatic insufficency will present with _______________________________ since the food/fat is not digested, it may be recognizable in the stool.
an emaciated appearance despite eating well.
A classic sign of Pancreatic insufficency, in addition to the undigested food in the feces, is ______
steatorrhea-foul smelling stools due to having undigested fat in the stools.
Viocase is
A medication made up of ground up pancease and it helps to improve digestion of food by replacing digestive enzymes.
What is the treatment for Pancreatic insufficiency?
It is not curable but can be maintained.
-Food is softened
-Sodium bicarb is added
-Viocase is added to the food
-Food is allowed to predigest before feeding.
Acute pancreatitis is more prevalent in___________ and rare in ______
small animals

large animals
Bile is a very _______ substance that can be irritating to tissues such as the CBD and small intestines.
caustic
Acute Pancreatitis is usually seen when a high fat diet, usually due to dietary indiscretion, causes bile to be release to ___________, which ends up irritating the ________, causing them to swell shut and then the pancreas swells, backs up and possibly ends up ______________
small intestine

Pancreatic ducts

possibly digesting itself, leading to paeritonitis.
CLINICAL- An animal with Acute pancreatitis will present with
V/D, dehydration
CLINICAL-Treatment for Acute pancreatitis would include:
*Antibiotics
*Nothing PO
*Administer Atropine-this blockades X Vagus nerve to stop pancreas from producing enzymes
*Relieve inflammation (corticosteriods?)
The Islets of Langerhans are
groups of endocrine cells located through the pancreas
Islets of Langerhans are responsible for the hormones that regulate
blood glucose level (Insulin and glucagon)
The normal range for bloood glucose levels are:
70-100 mg
Insulin is produced by ________ in the Islet of Langerhans.
beta cells
Glucagon is produced by__________ in the Islet of Langerhans and the target organs for this hormone are the ___________________
Alpha cells

liver and heart
Insulin and glucagon are antagonistic hormoses for the regulation of blood glucose levels. Insulin ______ blood glucose while glucogon _______ blood glucose levels.
Decreases

Increases
The liver stores glucose as glycogen and the effect of glucogon is to change the glycogen back into ________ thereby increasing glucose levels in the blood.
glucose
High levels of blood glucose is called:
hyperglycemia
Increased levels of glucose ________ cardiac output.
increase
Insulin is produced by the beta cells of Islets of Langerhans and the target cells for this hormone are the ____________
cell membranes to allow them to be permeable to glucose.
Hypoglycemia is the result of
insulin lowering blood glucose levels
If a urinalysis is done, how much suger should be in the urine?
NONE
The medical term for blood in the urine is?
glycosuria
What are the symptoms of Diabetes Mellitus?
*PU/PD
*Early in disease----> weight gain
*Ravenous appetite
*Hyperglycemic
What is the Renal Threshold?
The maxium amount of glucose the kidneys can handle. The concentration level above which all glucose is not reabsorbed in the blood, but the excess above the threshold concentration remains in the urine.
When the Renal threshold is reached, the excess glucose that is not absorbed by the kidneys draws water with it which leads to ---
classic symptoms of PU which leads to PD because of the excess water being drawn out of circulation by kidneys.
Excess weight gain at the begininng stages of Diabetes Mellitus is due to liver turning
excess glucose into FAT.
The ravenous appetite that is a symptom of Diabetes Mellitus is attributed to the body _________
not getting fuel it needs.
Eventually Diabetes Melletius will result in excess weight loss due to the fact that the cells
use the stored fats since glucose is not available for energy.
the burning of fat due to lack of glucose in the latter stages of Diabetes leads to production of____________ , excess levels of which are toxic.
acetone
The body shifting to burning fats instead of glucose since it is no longer available to the cells in Diabetics leads to excess production of acetone, which then inceases blood ph and this cluster of symptoms is called:
Diabetic ketoacidosis
Diabetic ketoacidosis is a MEDICAL EMERGENCY because it typically will go long lead to death due to:
Metabolic Acidosis --->elevates the potassium levels in the blood-----> excess levels in the heart lead to cardiac arrest---->death
Being overweight predisposes animals and people to diabetes and the type that is associated with this is ______ and part of this is due to "burning out" the pancreas
TYPE II
Insulin levels tend to peak about ___hours after inulin shots, so this is the _________ time for primary meal.
8

BEST--critically important
CLINICAL-What would a typical/ideal Insulin and feeding schedule look like for a diabetic pet?
*Urine sample to test sugar levels
-high suger-increase dose
-low suger-decrease dose
*Insulin shot
*small snack, meal about hour later
*Primary meal about 8 hours post Insulin shot when blood glucose levels are peaking.
Insulin shock is due to a severe drop/spike in glucose levels-hypoglycemia/hypergycemia- and this drop is below levels that the
brain can tolerate and can lead to DEATH
CLINICAL-A pet presenting with insulin shock will
have increased body temp and convulsions
CLINICAL-In a know diabetic, what can we tell an owner to give their pet if they are having insulin shock?
Suger--Karo syrup is ideal
In the clinic, what would we administer to a patient presenting with insulin shock?
Suger-SQ, IV or PO
An esophageal stethoscope tells us that
the VALVES of the heart are working
NPH insulin releases over
12-24 hours
Patient routine for feed and exercise __________ to maintain insulin levels.
is VITAL

*feed at same time of day, same foods

*same amounts of exercise, same time
--any changes must be gradual and monitored
Areas of concern for giving insulin:
1) Right TYPE of syringe for each type of insulin which has its own type of bottle and syringe
2) Giving the right UNITS of insulin
3) It has to be refrigerated
4) It has to be mixed right--rolled, not shaken
Hypoglycemia is a symptom of ______ but is not the disease itself
diabetes
Beta cell tumors/insulinoma is a functional tumor that causes an increased
secretion of insulin which leads to convulsions. Ferrets are most prone to this.
The liver is located behind the 13th rib and normally _________ palpated.
cannot be
If no gall bladder is present, liver bile___________________
goes directly to small intestine.

(such as in Sx removal of or in horses and rats which have no gall bladder)
Fat triggers gall bladder to release
bile to small intestine
Bile is made up of waste products broken down by
liver
The portal vein carries nutrient rich blood from ___________ to __________.
intestines

liver
Hepatic vein carries blood from _____ to _____________.
liver

caudal vena cava to heart
Kupffer cells are stationary macrophages located in the _______
liver and they get ride of debris such as bacteria, toxins, poisons, worn out RBCs as blood filters through.
Hepatocytes take glocose and convert it into ___________
glycogen
Blood from the portal vain filters through the hepatic capillaries, also called the hepatic sinusoids of the hepatic portal system and the macrophages filter out the stuff the body does not need or want and stores and or metabolizes stuff the body does need such as
glucose
amino acids
vitamins and minerals
Bile and wastes from hepatocytes are filtered past the Kupffer cells, into small canals that form bile ducts, then hepatic ducts and from there move through to the
gall bladder in species that have them and then through the common bile duct to duodenum(small intestine in those that don't--horses and rats)
The liver is a major source of important blood proteins such as ____________
albumin, which plays a major role maintaining proper fluid balance within the blood. Improper balance allows water to leak out of capillaries resulting in fluid moving into tissues.
The major functions of the liver are:
*Storage of nutrients
*Synthesis of blood proteins
*Biotransformation/detoxification
*Filtration of the blood
*Production of bile and bile salts
The liver takes glucose and converts it
to glycogen for storage and back to glucose when needed (such as when not eating)
The liver stores ____________ of glycogen and the excess sugar, proteins and lipids become fat.
24 hours
The liver stores a pool of amino acids which are the building blocks of proteins and an injury results in the liver reacting by_____________
dumping the right mix of proteins into the bloodstream for repair of damaged tissues.
The Liver stores some glycerol and
fatty acids.
The liver stores __________ days worth of fat soluble vitamins A, D, E, K
120
The liver is responsible for synthesis of blood proteins such as:
Albumin
Globulins--->antibodies
Transport proteins
Clotting proteins
Albumin, produced by the liver, is responsible for binding water and keeping blood liquid and in
the bloodstream.
Edema is related to
not enough Albumin in the blood--->presents as pitting edema and is typical of liver problems.
Transport proteins are responsible for transporting proteins and substances thoughout the body and one example of one is
transferrin, which transports iron to bone marrow for making new RBC's.
3 things you must have for clotting:
Platelets

Prothrombin

fibrinogen
Prothrombin and fibrinogen typically floats around in the blood
inactive until needed.
Typical clotting time is _____________
3 minutes
What is the typical sequence of events in the formation of a clot?
***injury*** rupturing of cells starts process
*vasoconstriction
*platelet plug---Activates production of thromboplastin, an initiating enzyme
*Prothrombin formation is activated and with the addition of thromboplastin becomes---THROMBIN
*Fibrinogen and FIbrin makes Fibrin which forms clot
*calcium and Vit K are a vital part of the clotting cascade
CLINICAL-D-Kon, a rodenticide, binds up Vit K, so there is no prothrombin formation which leads to
no clotting

hemorrhage

death
CLINICAL- Treatment for D-kon, rodenticides of same type, is to:
*induce emisis IF w/in 4 hours of ingestion
*Administer Vit K shot IV
*Follow with vit K PO for 30 days ($$$)
*Blood transfusion is another possible treatment.
*
With liver disease, due to less ability of liver to detoxify blood, ____________ doses of meds are required to avoid _________.
lower

OD'ing patient
The liver functions as a detoxifyer and biotranformer of substances such as:
Drugs, antibiotics---liver destroys as it is repeated filtered through

Anesthesia

metabolic wastes
Some symptoms of liver disease are:
*Hepatomegaly
*icterus
*pitting edema
*no blood clotting, less ability to clot
*Blood analysis will reveal elevated enzymes and degree of elevation will tell you degree of damage.
The liver is responsible for biotranformation of substances and this refers to
the series of chemical alterations of a compound (e.g. a drug) occurring within the body, as by enzymatic activity. The metabolism of a drug may produce products that have different effects to those of the parent drug. This biotransformation may differ markedly between animal species and affect the dose rate to be used, or the usefulness of the drug.
The liver biotransforms alcohol with the aid of alcohol dehydronase which....
An enzyme that catalyzes the oxidation of ethanol to acetaldehyde, the first step in the metabolism of alcohol by the liver.
CLINICAL-Antifreeze is a nephrotoxic drug that is picked up by the liver where the liver attempts to detoxify it and the attempts to do so make it
more toxic and The transformation of antifreeze leads from glycoaldehyde to glyoxcylic acid, formic acid, and oxalate. It is the glycolic acid and oxalate that is most responsible for kidney damage and resulting uremia. These compounds also seriously damage the central nervous system. There is no treatment that will reverse this damage. It can be so severe as to be fatal in a matter of a few days
Icterus and jaundice both refer to
skin and the whites of the eyes are discolored yellow due to an increased level of bile pigments in the blood resulting from liver disease
Cirrhosis of the liver refers to a condition that is
a chronic, degenerative disease in which normal liver cells are damaged and are then replaced by scar tissue.
Cirrhosis of the liver causes symptoms after only _____of it is destroyed.
70%
Cirrhosis causes the liver to shrink and this damage_______ show up on blood tests.
may or may NOT
Anesthesias short acting effects are due to the livers repeated filtering and biotransforming of the medications. The short acting pre-anesthetic meds that are of concern are
barbituates such as sodium pentathal
The liver is responsible for biotransforming waste products such as Ammonia (NH3). Ammonia is biotransferred to _________
urea and is filtered by kidneys and becomes urine.
CLINCAL-An animal with liver dysfunction that is affecting its ability to filter ammonia leads to increase levels of ammonia and________________
Hepatic coma-->
with a pathology of drugged, dopey, appearance and seizures
The liver functions as a filter and filters out bacteria with the aid of ________ as well as damaged RBC's, which have a typical lifespan of___________
Kupffer cells such as salmonella bacteria
120 days
Kupffer cells break down worn out RBC's into 3 things:
Protein which goes to bone marrow

Iron moves to bone marrow w/aid of transferrin

Uncongegated bilirubin
Describe the journey of a damaged RBC:
*Kupffer cells break RBC down into it's 3 components
*The Unconjugated bilirubin of the broken down RBC, a non-water soluble waste product, is transferred to the HEPATOCYTE where it is combined with GLUCOCERONIDE-->makes it water soluble
*It is now CONJUGATED Bilirubin
*goes to gallbladder
*goes to CBD
*goes to Small intestines
*Is combined with stercobilin to become apart of the pigments of urine and feces
CLINICAL--A blood test shows high levels of unconjugated bilirubin, what is one possible cause?
hemolysis--RBC's being destroyed at a rate faster than the liver can filter
CLINICAL--A blood test shows a high level of conjugated bilirubin, what may be going on?
liver disease
Heptatomeglia is an
inflamed and enlarged liver
Hepatomeglia is often due to ________ which invade the hepatocytes, reproduce then rupture the liver cell as will as _____ and chemical toxins such as spot stain remover-Carbon tetrachloride which immediately ruptures hepatocytes.
viruses

bacteria
Secondary Metastasis refers to a cancer that has spread from the primary site to another, the secondary site. A secondary metastasis tumor of the liver typically comes from:
abdominal cancers