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59 Cards in this Set
- Front
- Back
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the average weight of a normal adult liver is
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1400-1600 gms
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what capsule covers the surface of hte liver
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Glissons
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the liver has how many lobes
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Four
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The names of the lobes of the liver are
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Right, left, quadrate and caudate
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the two microscopic structual units of hte liver are
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Lobule and acinus
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sinusoids
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vascular sinusoids are between the cords and hepatocytes. arterial and portal venous blood traverses the sinusoids and exits into the terminal hepatic vein
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canaliculi
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btwn abutting hepatocytes are bile canaliculi which are 1-2mm in diameter formed by grooves in the plasma membranes of the facing cells from the vascular space
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the monocytic-phagocytic cells lining the sinusoids are known as
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Kupffer cells
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the liver has a dual vascular supply coming from the
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portal vein and hepatic artery
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Jaundice
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yellow dicoloration of the skin and sclerae due to bile formation disruption adn retention of pigmented bilirubin
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Cholestasis
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systemic retention of not only bilirubin but also other solutes eliminated in bile
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five mechanisms that produce jaundice
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excessive production of bilirubin, reduced hepatic uptake, impaired conjugation, decreased hepatic excretion, impaired bile flow
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list three types of disease processes that may lead to hepatic failure
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massive hepatic necrosis, chronic liver disease, hepatic dysfunction without over necrosis
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pathophysiology of hepatic encephalopathy
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cuased by abnormal neurotransmission in the CN and nms and appears to be associated with elevated blood ammonia levels
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hepatorenal syndrome
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refers to the appearance of acute renal failure in patients with severe liver disease in which there are no intrinsic morphologic of functional causes for renal failure
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passive congestion of hte liver is caused by
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right sideded cardiac decompensation. the liver is slightly enlarged, cyanotic with rounded edges.
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centrilobular hemorrhagic necrosis of the liver is caused by
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left sided cardiac failure or shock leading to hepatic hypoperfusion and hypoxia hepatocytes in the central region lobule undergo ischemic necrosis
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Budd Chiari syndrome
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hepatic vein thrombosis subacute and chronic occlusive syndromes characterized by hepatomegaly weight gain ascites and abdominal pain
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occlusive disease of portal vein typically porduces
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abdominal pain ascites, esophageal varices that are prone to rupture,
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list some of the causes of fatty change of liver
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Toxins, protein malnurtion, diabetes mellitus, obesity, anorexia, and the most common alcohol abuse
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prolonged severe chronic passive congestion or centrilobular hemorrhagic necrosis of liver associated with the hear leads to
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Hepatic fibrosis and Cardiac cirrhosis
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Centrilobular necrosis of the liver
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necrosis of hepatocytes immediately around the terminal hepatic vein ischemic injury drug or toxic reactions
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Midzonal and periportal necrosis of the liver
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eclampsia
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focal necrosis of the liver
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limited to scattered cells within hepatic lobules
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Bridging necrosis of the liver
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necrosis of contigous hepatocytes spanning adjacent lobules
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Submassive necrosis of liver
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necrosis of an entire lobule
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Massive necrosis of the liver
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necrosis of most of the liver
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predictable drug reactions
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occur in anyone who accumulates a sufficent dose-acetaminophen, tetracycline, antineoplastic agents
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unpredictable drug reactions
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depend on idiosyncrasies of the host, particularly the host propensity to moutn an immune response to antigenic stimulus and the rate at which the host metablizes the agent
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Neonatal hepatitis
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prolonged nenonatal cholestasis with variable degrees of hepatic synthetic dysfunction such as hypoprothrombinemia
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extraphepatic biliary artesia
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complete obstruction of bile flow due to destruction or abscence of all or part of the extrahepatic bile ducts
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cholangitis
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term used for bacterial infection of the bile ducts, can result from any lesions creating obstruction of bile flow
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what are the four phases of acute viral hepatitis
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incubation period, symptomatic preicteric phase, symptomatic icteric phase, convalscence
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chronic hepatitis
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symptomatic biochemical or serologic evidence of continuing or relapsing hepatic disease for more then 6mnths with documented inflammation and necrosis
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cirrhosis
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the liver is subdivided into nodules of regenerating hepatocytes surrounded by scar tissue
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three characteristics of cirrhosis
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bridging fibrous septa, parenchymal nodules, disruption of the architecture of the entire liver
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four major clinical consequences of portal hypertension
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ascites, formation or portosystemic venous shunts, congestive splenomegaly, hepatic encephalopathy
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three main cuases of portal hypertension
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increased resistance to portal blood flow, prehepatic, intrahepatic, posthepatic
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three distinct forms of liver disease associated with chronic alcohol consumption
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hepatic steatosis, alcoholic hepatitis, cirrhosis
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eosinophilic cytoplasmic inclusions dispersed about the nucleus in alcoholic cirrhosis are known as
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Mallory bodies
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five proximate causes of death in the end stage alcoholic
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hepatic coma, massive gastrointestinal hemorrhage, intercurrent infection, hepatorenal syndrome, hepatocellural carcinoma
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what is the most common benign hepatic lesion
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cavernous hemangioma
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the most common preexisting condition associated with carcinoma of the liver
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Hepatitis B virus
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what malignancy is not associated with carcinoma of the liver
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cholangiocarcinoma
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what major protease inhibitor is frequently elevated in primary cancers of the liver
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Alpha-fetoprotein
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Wilson disease
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autosomal recessive disorder marked by the accumulation of toxic levels of copper in many tissue and organs principally the liver brain and eye
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what is the name of the eye lesions found in patients with Wilson disease
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Kayser-Fleischer rings
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primary biliary cirrhosis
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chronic progressive and often fatal cholestatic liver disease
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secondary biliary cirrhosis
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secondary inflammation resulting from biliary obstruction initiates periportal fibrosis which eventually leads to scarring and nodule formations
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most metastatic tumors of the liver generally arise from what primary organs
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breast, lung and colon
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the three parts of the gallbladder are
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fundus, body and neck
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the four histologic layers of the gallbladder
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mucosal lining with single layer of columnar cells, fibromuscular layer, layer of serosal fat with arteries veins and lymphatics, pertioneal covering
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the spiral valves in the neck of the gallbladder are known as
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spiral valves of Heister
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the mural sinuses associated with diagnosis of chronic cholecystitis are known as
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Phrygian cap
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the two main types of gallstones are
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cholesterol stones and pigment stones
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the five major factors associated with formation of gallstones are
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ethnic-geographic, age, sex, environmental factors, acquired disorders, and hereditary factors
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hydrops of gallbladder
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progressive mucosal removal of luminal lipids in obstructed inflammed gallbladders may have clear mucosa secretions-or mucocele of the gallbladder
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cholestorolosis
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cholestrol enters gb mucosa by free exchange with the lumen maybe esterified by acyl COA, hypersecretion of cholestoral by liver promotes excessive accumulation of cholestrol esters
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Courvoisiers Law
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dilatation of the gb. disease processes that cause sudden blockage of the common bile duct do not usually cause dilationof duct when it is obstructed slowly dilatation is prsent
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