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8 Cards in this Set

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What is bile?
- Bile is the important digestive secretion of the liver
- About 0.7-1.2 litres produced in a day

Major roles
- alkali to neutralise gastric juices
- Substance to faciliate absorption of fat
- Vehicle to aid excretion of liver products
What is bile comprised of?
Bile acid-dependent fraction
- Bile acids are water soluble derivatives of cholestrol (glycocholic acid and glycochenodeoxycholic acid)(What role?)

Bile acid-independent fraction
- HCO3- rich fraction and H2O (What role)

Bilirubin breakdown products
What are the key components of a liver lobule?
Central vein
Sinusoids
Space of Disse
Terminal lymphatics
Portal vein
Hepatic artery
Bile duct
Liver cell plate
Littoral cell (Kupffer cell)
Bile canaliculi
Lympatic duct
How is bile made?
Bile acid-dependent fraction
- Production of bile acids by liver cells, also recirculation of bile from blood. Conjugation necessary to make H2O soluble. Made during the final stages of digestion

Bile acid-independent fraction
- Alkaline and isotonic - under the influence of secretin (acid chyme reaching duodenum)
What happens to bile?
- Bile directly secreted into duodenum or taken up into the gall bladder.
- In the gall bladder there is significant concentration of the bile (removal of H2O and NaCl)
- Gall bladder store of bile secreted in response to meal (cholecystokinin CCK)
- significant reabsorption of bile from ileum
What is the enterohepatic circulation?
- 90% of bile is recirculated through the portal circulation
- unconjugated bile acids cannot be reabsorbed
- Breakdown of bile acids in ileum by bacteria - excreted in faeces.
The circulation of bile Acids
Liver
Cholesterol --> (chenodeoxy-) cholic acids --> taurine conjugation

==> Gall bladder (empties on feeding)

==> Duodenum

==> Ileum
--> 10% faeces

==> 90% portal circulation
--> 5% systemic circulation

==> 95% Back to liver
What are some questions to do with bile?
What might be the consequences of interruption of bile acid production or secretion into the gut? (steatorrhoea)

Will gall stones be radio-opaque?

What sort of meal will produce the greatest amount of gall bladder contraction (biliary colic)?