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92 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Describe the lobes of the liver
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Falciform ligament (FL) divides left & right lobes. The transverse fissure divides the caudate & quadrate lobes.
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What is the gland morphology of the liver?
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Compound tubular
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Which species has distinct morphologic hepatic lobules covered by areolar CT?
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Pigs
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Every hepatocyte abuts a sinusoid."
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True!
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Hepatic sinusoids are very fenestrated."
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True!
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What structure(s) hold hepatocytes together?
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Tight junctions
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Every hepatocyte contains a bile canaliculus."
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False! Canaliculi run between hepatocytes.
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Which direction does blood move in respect to the central vein? How 'bout bile?
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Blood moves toward the central vein. Bile moves away from it.
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Otherwise
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it stores
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concentrates
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Describe the flow of bile from hepatic ducts to the gallbladder.
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hepatic ducts > common hepatic duct > cystic duct > gallbladder
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Describe the flow of bile from the gallbladder to the duodenum.
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gall bladder > cystic duct> (possibly common hepatic duct) > common bile duct > duodenum
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What factor causes ejection of bile? What releases this factor? What does this factor act upon?
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CCK (cholecystokinin) from DNES cells (diffuse neuro endocrine system cells) relaxes sphincter and contracts smooth muscle in bladder walls
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Dogs have no subepithelial glands in their gall bladders while bovids do."
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True!
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What is the function of clear cells in the gall bladder?
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Mucus secretion - similar to goblet cells
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How many lobes does the liver commonly have?
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"Very species dependent
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yo!"
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What is the gland morphology of the liver?
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Compound tubular
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Which species has distinct morphologic hepatic lobules covered by areolar CT?
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Pigs
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Every hepatocyte abuts a sinusoid."
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True!
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Hepatic sinusoids are very fenestrated."
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True!
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What structure(s) hold hepatocytes together?
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Tight junctions
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Every hepatocyte contains a bile canaliculus."
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False! Canaliculi run between hepatocytes.
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Which direction does blood move in respect to the central vein? How 'bout bile?
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Blood moves toward the central vein. Bile moves away from it.
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Otherwise
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it stores
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concentrates
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Describe the flow of bile from hepatic ducts to the gallbladder.
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hepatic ducts > common hepatic duct > cystic duct > gallbladder
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Describe the flow of bile from the gallbladder to the duodenum.
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gall bladder > cystic duct> (possibly common hepatic duct) > common bile duct > duodenum
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What factor causes ejection of bile? What releases this factor? What does this factor act upon?
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CCK (cholecystokinin) from DNES cells (diffuse neuro endocrine system cells) relaxes sphincter and contracts smooth muscle in bladder walls
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Dogs have no subepithelial glands in their gall bladders while bovids do."
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True!
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What is the function of clear cells in the gall bladder?
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Mucus secretion - similar to goblet cells
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Question
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Answer
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How many lobes does the liver commonly have?
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"Very species dependent
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What is the gland morphology of the liver?
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Compound tubular
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What are the functions of the liver?
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"Synthesis
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Metabolism"
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What comprises a portal triad?
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"Hepatic a.
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Bile duct"
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Which species has distinct morphologic hepatic lobules covered by areolar CT?
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Pigs
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ID these regions of a liver
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"4 - Central canal
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10 - Portal triad"
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What are the common cell types in the liver?
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"Hepatocyte
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Fixed
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Stellate Macrophages (FSM or von Kupffer cells)
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Endothelial cells"
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FSMs and fat storage cells are both found in the space of Disse"
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"False!
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FSM = fixed
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stellate macrophage
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space of Disse = perisinusoidal space"
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What do Ito cells store?
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"Ito cells = fat storage cells in the perisinusoidal spaces of the liver
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Store fat and VITAMIN A"
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ID these two liver cells
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"A - Ito cell (fat storage cell)
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B - von Kupfler cell (Fixed Stellate Macrophage)"
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ID these regions of a hepatocyte
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"A - perisinusoidal space (space of Disse)
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C - Sinusoid"
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Every hepatocyte abuts a sinusoid."
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True!
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Hepatic sinusoids are very fenestrated."
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True!
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What structure(s) hold hepatocytes together?
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Tight junctions
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Every hepatocyte contains a bile canaliculus."
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False! Canaliculi run between hepatocytes.
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Which direction does blood move in respect to the central vein? How 'bout bile?
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Blood moves toward the central vein. Bile moves away from it.
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What is the epithelium of a bile canaliculi? How 'bout an intrahepatic bile duct?
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"simple cuboidal or columnar epithelium
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simple columnar epi. w/goblet cells"
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What is found in the portal canal?
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"Portal triad
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Lymphatics"
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Which 3 make up the portal triad?"
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"A - Lymphatic
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B + C + D = portal triad"
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Away from the liver?"
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"Hepatic a. and Portal v. carry blood to liver.
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Hepatic vv. carry blood away."
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What percentage of blood is carried to the liver by each type of afferent vessel?
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"Hepatic a. - 20%
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Portal v. - 80%"
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B? C?"
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"A - Hepatic lobule
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C - Hepatic acinus"
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What lies in the center of a hepatic lobule? What shape is it? What are at the corners?
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"Central vein
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Portal triads"
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What lies in the center of a portal lobule? What shape is it? What are at the corners?
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"Portal triad (interlobular bile duct)
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Central veins"
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What lies in the center of a hepatic acinus? What shape is it? What are at the corners?
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"Hepatic artery
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Central veins/portal triads (opposite corners)"
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What's a gall bladder good for?
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"Nothing if you're a horse!
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Otherwise
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it stores
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Describe the flow of bile from hepatic ducts to the gallbladder.
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hepatic ducts > common hepatic duct > cystic duct > gallbladder
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Describe the flow of bile from the gallbladder to the duodenum.
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gall bladder > cystic duct> (possibly common hepatic duct) > common bile duct > duodenum
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Name some species without a gall bladder.
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"Horse
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Deer"
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What factor causes ejection of bile? What releases this factor? What does this factor act upon?
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CCK (cholecystokinin) from DNES cells (diffuse neuro endocrine system cells) relaxes sphincter and contracts smooth muscle in bladder walls
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ID these gall bladder regions:
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"A - Lumen
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E - Lamina propria"
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Dogs have no subepithelial glands in their gall bladders while bovids do."
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True!
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What is the function of clear cells in the gall bladder?
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Mucus secretion - similar to goblet cells
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What are the 4 clinical syndromes of liver disease
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1) portal hypertension
2) liver failure 3) cirrhosis 4) cholestasis |
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Describe the pathogenesis of cirrhosis
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1) damage to hepatocytes causes release of ROS, cytokines, growth factors activating Kuppfer cells and stelate cells in spaces of Disse
2) Stelate cells are transformed into myofibroblasts, producing types I, III collagen instead of fine type IV 3) Clockage of fenestrations prevents solute passage, albumin etc 4) Sinusoids are converted into portal-hepatic vein shunts 5) Fibrosis causes: fibrous covered nodules containing regenerating hepatocytes, loss of architecture (ie loss of single layer plates of hyepatocytes and lobular architecture), |
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What are the types of peritonitis
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primary: haematogenous dissemination of immunocompromised state eg cirrhosis, burns. Bacterial translocation from intraluminal source or haematogenous source
secondary: perforated viscus, strangulation, necrotising pancreatitis, volvulus tertiary: recurrent infection after initial therapy. Repeated therapy causes resistance. Patients are immunocompromised, have preexisting comorbidities eg diabetes, renal failure. - mainly nosocomial gram negs eg E.coli, klebsiella, pseudomonal |
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What are factors causing peritonitis
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Altered fibrin deposition by plasminogen activator, abcess formation by bacteria mixed in fibrin
Bacterial virulence eg capsules |
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What are signs of peritonitis
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Distended abdomen
Guarding, rigidity Signs of sepsis: HR, RR, temp, BP Turners sign - greyness of. flanks caused by bruising due to DIC |
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How is peritoneal fluid investigated
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Neutrophils > 500/ul
Glucose Presence of bacteria LIGHT criteria to determine transudate v exudate |
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What can imaging show in the GI
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Supine and upright to identify free air under diaphragm, distension and gas in bowel
US is for solid organs only, upper right quadrant, pelvic structures. Not useful for intestinal pathology CT: if clinical diagnosis is uncertain and is investigation of choice, first line for guidance of needle aspiration of abcesses Contrast studies: used for diagnostic purposes but not used in critical patient with suspected peritonitis |
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What are the causes of ACS
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Primary: external compression, pancreatitis, ascites, ilius, gastroparesis
secondary: burns, fluid overload tertiary: chronic disease |
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