Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
75 Cards in this Set
- Front
- Back
|
What surrounds hepatocytes?
|
Portal tracts
|
|
|
What do portal tracts consist of?
|
portal vein. Hepatic arteriole and bile duct
|
|
|
What is the centre of a liver lobule?
|
Central vein
|
|
|
What is the terminal vein?
|
The central (centrilobular vein)
|
|
|
What is at the centre of the acinus?
|
Portal tracts
|
|
|
Where does the liver get it bloods supply?
|
Mixed from hepatic portal vein and hepatic artery.
|
|
|
Where does all the blood drain to from the hepatic artery and hepatic portal vein?
|
Centrilobular vein.
|
|
|
What do the central veins coalesce to form?
|
Hepatic veins
|
|
|
What is the centre of the acinus?
|
Portal triad.
|
|
|
Where is zone 1?
|
Centred around the portal triad.
|
|
|
What is the regeneration capacity and metabolic activity of zone1?
|
High metabolic and good regen
|
|
|
What does the regions between the portal triads remind you of?
|
Magnetic lines
|
|
|
What does blood flow through to get to the central vein?
|
Sinusoids.
|
|
|
What percentage of blood is from the portal vein?
|
75%
|
|
|
There are 3 functions of the liver, which of these does not produce immunoglobulins?
|
Protein metabolism
|
|
|
What does protein metabolism in the liver produce?
|
Albumins, fibrinogen and most globulins.
|
|
|
What are the globulins?
|
a type of serum protein.
Responsible for various things such as transport, muscle contraction, enzymes (eg proteases). also included are immunoglobulins. |
|
|
Other than globulin production, what is the liver responsible for regarding protein metabolism?
|
Metabolism of proteins fats and carbs.... This lecture is rubbish
|
|
|
How is bile formed?
|
adfgb
|
|
|
What storage roles does the liver do?
|
glycogen, fat vit a + b etc
|
|
|
What do cells in zone 1 do?
|
Metabolism of fat mostly.
|
|
|
What is zone 3 most susceptible to?
|
hypoxia/ischaemia
|
|
|
What zone has the highest levels of cytochrome p450?
|
3
|
|
|
what is jaundice?
|
Hyperbilirubinemia severe enough to causae discoloration
|
|
|
3 broad causes of jaundice
|
Prehepatic
hepatic post hepatic |
|
|
phase 1 reaction are:
|
OILRIG + hydrolysis
|
|
|
Phase 2 are conjugation
|
Phase 2 conjugation
|
|
|
Two broad categories of bile contents
|
Pigments and acids
|
|
|
What is bilirubin?
|
Hb breakdon from erythrocytes phagocytosed my macrophages in spleen liver and bone marrow
|
|
|
How are bile acids produced
|
Conjugated cholestrol
|
|
|
There is an excess production of bilirubin - what do?
|
Prehepatic jaundice
|
|
|
Prehepatic jaundice caused by Haemolysis can be a result of...
|
IMHA, pyruvate kinase deficiency, hemolytic septicemia/bacteremia.
LEPTO, BABESIOSIS |
|
|
What is the cause of hepatic Jaundice?
|
Hepatic disease Causes reduced ability to uptake conjugate and excrete bilirubin
|
|
|
What is bilirubin bound to in the blood?
|
Albumin
|
|
|
Examples of diseases causing Diffuse and severe injury
|
Toxins
Septicemia Bacteremia Hepatitis End liver |
|
|
What is the cause of intra hepatic obstructive jaundice
|
Bile flow impaired in caniculi
|
|
|
Why might bile flow in caniculi be impaired
|
Inflammation
Congenital disease Hypoxia End stage |
|
|
Cause of extra hepatic obstructive jaundice
|
Impaired through bile ducts
|
|
|
Cause of impaired bile through ducts
|
Neoplasia
Lymph nodes Pancreatitis Parasites Cholelithiasis Ruptured gall |
|
|
What are the signs of hepatic encephalopathy?
|
Head pressing
Ataxia Altered behaviour Depression Seizures |
|
|
Causes of hepatic encephalopathy?
|
End stage liver
Vascular shunts Accumulation of ammonia neurotoxic |
|
|
Why do you get hypoproteinaemia in hepatic insufficiency
|
Reduced synthesis of plasma proteins
|
|
|
Why do you get clotting defects?
|
Reduced synthesis of clotting factors
|
|
|
What happens to fibrin degradAtion products?
|
Impaired removal
|
|
|
What happens to vitamin k Uptake?
|
Impaired
|
|
|
Why vit kimpaired?
|
Uptake with fat
|
|
|
Cause of portal hypertension?
|
Increased resistance to Portal blood flow, fibrosis.
Possibility of portal shunts |
|
|
Causes of ascites
|
Increased portal pressure
Hypoproteinaemia Increased lymph |
|
|
Cause of hePatocutaneoous syndrome?
|
Metabolic abnormalality
|
|
|
What causes hepatic photosensitation?
|
Accumulation of phylloerythrin
Activated by uv |
|
|
When will hepatic atrophypccur?
|
Lack of nutrients.
Blood supply Malnutrion etc |
|
|
Degeneration is commonly
|
Vaculoar
|
|
|
Whta types of vaculoar change can be present?
|
Hydropic
Fatty Excess glycogen |
|
|
What are the patterns of hepatcellularnecrosis?
|
Random foci
Zonal Massive |
|
|
Typical causes of random foci?
|
Infectious such as canine herpes, salmonella
|
|
|
What is the most common zone to be affected?
|
Zone 3
|
|
|
What does zone 3 surround?
|
Central vein
|
|
|
What is the most common cause for zone 3 necrosis and degen?
|
Hypoxia? Right sided heart failure
Congestion |
|
|
What will activate toxins in zone 3?
|
Cytochrome p450
Eg paracetamol |
|
|
What is massive degen or necrosis caused by?
|
Necrosis of entire lobules. Panlobular
|
|
|
What is the typical characteristics of chronic hepatitis?
|
Iflammation
Fibrosis Regen changes |
|
|
What species does cooper associated hepatitis affect?
|
Dogs
|
|
|
What type of inflam cells are you likely to see?
|
Lymphocytes, plasma, macro
|
|
|
What is reactive hepatitis?
|
Response to systemic illness
No necrosis |
|
|
What is cholangitis?
|
Iflam of bile ducts
|
|
|
When might you see biliary hyperplasia?
|
Non specific change
Chronic hepatitis, cholangihepa Particulary pbstructive |
|
|
Despite having great regenerative capacity, what cannot by created?
|
Lobes or lobules
|
|
|
If it cannot Replicate new cells fast enough, what happens?
|
Nodular regeneration
|
|
|
When will you commonly see nodular regenration?
|
Chronic hepatitis
|
|
|
What doe regenerative nodules normally lack?
|
Structure, but have fibrious capsule surround
|
|
|
Why do nodules have reduced functional capacity?
|
Abnormal blood flow and bile production
|
|
|
What is cirrhosis?
|
End stae liver
|
|
|
What factors lead to cirrhosis?
|
Diffuse changes, disruption of architecture, Fibrosis, regen nodukes, shunting, hepatic hypertension
|
|
|
What might cirrhosis lead to
|
Heoatic failure via insufiency first
|
|
|
List signs of hepatic failure
|
Portal hypertension
Ascites Hypoprot Hepatic encepha Jaundice Clotting defecs Photosensit Immunological disorders |
