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59 Cards in this Set

  • Front
  • Back
the average weight of a normal adult liver is
1400-1600 gms
what capsule covers the surface of hte liver
Glissons
the liver has how many lobes
Four
The names of the lobes of the liver are
Right, left, quadrate and caudate
the two microscopic structual units of hte liver are
Lobule and acinus
sinusoids
vascular sinusoids are between the cords and hepatocytes. arterial and portal venous blood traverses the sinusoids and exits into the terminal hepatic vein
canaliculi
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
the monocytic-phagocytic cells lining the sinusoids are known as
Kupffer cells
the liver has a dual vascular supply coming from the
portal vein and hepatic artery
Jaundice
yellow dicoloration of the skin and sclerae due to bile formation disruption adn retention of pigmented bilirubin
Cholestasis
systemic retention of not only bilirubin but also other solutes eliminated in bile
five mechanisms that produce jaundice
excessive production of bilirubin, reduced hepatic uptake, impaired conjugation, decreased hepatic excretion, impaired bile flow
list three types of disease processes that may lead to hepatic failure
massive hepatic necrosis, chronic liver disease, hepatic dysfunction without over necrosis
pathophysiology of hepatic encephalopathy
cuased by abnormal neurotransmission in the CN and nms and appears to be associated with elevated blood ammonia levels
hepatorenal syndrome
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
passive congestion of hte liver is caused by
right sideded cardiac decompensation. the liver is slightly enlarged, cyanotic with rounded edges.
centrilobular hemorrhagic necrosis of the liver is caused by
left sided cardiac failure or shock leading to hepatic hypoperfusion and hypoxia hepatocytes in the central region lobule undergo ischemic necrosis
Budd Chiari syndrome
hepatic vein thrombosis subacute and chronic occlusive syndromes characterized by hepatomegaly weight gain ascites and abdominal pain
occlusive disease of portal vein typically porduces
abdominal pain ascites, esophageal varices that are prone to rupture,
list some of the causes of fatty change of liver
Toxins, protein malnurtion, diabetes mellitus, obesity, anorexia, and the most common alcohol abuse
prolonged severe chronic passive congestion or centrilobular hemorrhagic necrosis of liver associated with the hear leads to
Hepatic fibrosis and Cardiac cirrhosis
Centrilobular necrosis of the liver
necrosis of hepatocytes immediately around the terminal hepatic vein ischemic injury drug or toxic reactions
Midzonal and periportal necrosis of the liver
eclampsia
focal necrosis of the liver
limited to scattered cells within hepatic lobules
Bridging necrosis of the liver
necrosis of contigous hepatocytes spanning adjacent lobules
Submassive necrosis of liver
necrosis of an entire lobule
Massive necrosis of the liver
necrosis of most of the liver
predictable drug reactions
occur in anyone who accumulates a sufficent dose-acetaminophen, tetracycline, antineoplastic agents
unpredictable drug reactions
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
Neonatal hepatitis
prolonged nenonatal cholestasis with variable degrees of hepatic synthetic dysfunction such as hypoprothrombinemia
extraphepatic biliary artesia
complete obstruction of bile flow due to destruction or abscence of all or part of the extrahepatic bile ducts
cholangitis
term used for bacterial infection of the bile ducts, can result from any lesions creating obstruction of bile flow
what are the four phases of acute viral hepatitis
incubation period, symptomatic preicteric phase, symptomatic icteric phase, convalscence
chronic hepatitis
symptomatic biochemical or serologic evidence of continuing or relapsing hepatic disease for more then 6mnths with documented inflammation and necrosis
cirrhosis
the liver is subdivided into nodules of regenerating hepatocytes surrounded by scar tissue
three characteristics of cirrhosis
bridging fibrous septa, parenchymal nodules, disruption of the architecture of the entire liver
four major clinical consequences of portal hypertension
ascites, formation or portosystemic venous shunts, congestive splenomegaly, hepatic encephalopathy
three main cuases of portal hypertension
increased resistance to portal blood flow, prehepatic, intrahepatic, posthepatic
three distinct forms of liver disease associated with chronic alcohol consumption
hepatic steatosis, alcoholic hepatitis, cirrhosis
eosinophilic cytoplasmic inclusions dispersed about the nucleus in alcoholic cirrhosis are known as
Mallory bodies
five proximate causes of death in the end stage alcoholic
hepatic coma, massive gastrointestinal hemorrhage, intercurrent infection, hepatorenal syndrome, hepatocellural carcinoma
what is the most common benign hepatic lesion
cavernous hemangioma
the most common preexisting condition associated with carcinoma of the liver
Hepatitis B virus
what malignancy is not associated with carcinoma of the liver
cholangiocarcinoma
what major protease inhibitor is frequently elevated in primary cancers of the liver
Alpha-fetoprotein
Wilson disease
autosomal recessive disorder marked by the accumulation of toxic levels of copper in many tissue and organs principally the liver brain and eye
what is the name of the eye lesions found in patients with Wilson disease
Kayser-Fleischer rings
primary biliary cirrhosis
chronic progressive and often fatal cholestatic liver disease
secondary biliary cirrhosis
secondary inflammation resulting from biliary obstruction initiates periportal fibrosis which eventually leads to scarring and nodule formations
most metastatic tumors of the liver generally arise from what primary organs
breast, lung and colon
the three parts of the gallbladder are
fundus, body and neck
the four histologic layers of the gallbladder
mucosal lining with single layer of columnar cells, fibromuscular layer, layer of serosal fat with arteries veins and lymphatics, pertioneal covering
the spiral valves in the neck of the gallbladder are known as
spiral valves of Heister
the mural sinuses associated with diagnosis of chronic cholecystitis are known as
Phrygian cap
the two main types of gallstones are
cholesterol stones and pigment stones
the five major factors associated with formation of gallstones are
ethnic-geographic, age, sex, environmental factors, acquired disorders, and hereditary factors
hydrops of gallbladder
progressive mucosal removal of luminal lipids in obstructed inflammed gallbladders may have clear mucosa secretions-or mucocele of the gallbladder
cholestorolosis
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
Courvoisiers Law
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