Liver Anatomy and Physiology

1. protective cover- Glisson's capsule ing surrounding the liver 2. hepatic portal vein: - veins dividing liver into R + L lobes - drains GI tract + spleen 3. Falciform ligament: structure attaching liver to diaphragm + abdominal wall 4. What does the hepatic vein drain into? inferior vena cava 5. Sinusoids: blood vessels carrying blood from supply to central vein 6. 5 vessels of the liver: - bile duct - lymph vessel - hepatic portal vein - hepatic artery - central vein 7. Describe endothelial liver cells: - line the inside of sinusoids - big gaps for proteins but not for RBC / WBC 8. Kupffer cells: - phagocytic cells surrounding liver sinusoids - prevent pathogens leaving sinusoids 9. What is the area between sinusoidal endothelium + hepatocytes in the Space of Disse? liver 10. What is the func- the space between the liver sinusoids + hepatocytes altion of the Space lows for blood to interact with hepatocytes + formation of of Disse? a lymph that is dense in protein 11. What do dendrit- act as antigen presenting cells (APC) to lymphocytes ic cells do? 12. Hepatic acinus: functional unit of liver tissue 1/4 13. What are Zone 1 liver cells near portal venule, resistant to injury hepatocytes? 14. What are the fea- - respond readily to change in glucose/insulin levels tures of Zone 1 - responsible for glycolysis + gluconeogenesis Hepatocytes? - carry out protein synthesis - cholesterol synthesis - bile acid secretion 15. What do hepato- - absorb nutrient rich liquid from the space of disse cytes do? - release substances into the space also 16. What are zone 3 - liver cells near central venule hepatocytes? - susceptible to injury 17. What do Zone 3 responsible for cytochrome P450 activity + NADPH + hepatocytes do? NADH reductase metabolism 18. bile acids: emulsify dietary lipids for digestion + vitamin absorption 19. Hepatic bile: bile produced by hepatocytes in the liver 20. Ampulla of Vater: site where bile is secreted into the duodenum 21. What does the Sphincter of Oddi do? prevents bile being released when fasting 22. Coagulation fac- proteins involved in blood clotting synthesised by the liver tors: 23. What is transfer- iron transport protein rin? 24. Urea cycle: process converting excess nitrogen to urea in the liver 25. Glycogenolysis: breakdown of glycogen to maintain glucose levels in fasting state 2/4 26. Gluconeogenesis: production of glucose from non-carbohydrate sources in the liver 27. Lipoproteins: transport fats, cholesterol + triglycerides from gut/liver to tissues 28. Cholesterol func- - maintains cell membrane fluidity tions: - precursor for hormones - bile acids 29. Triglycerides: liver-synthesised energy source, absorbed from GIT 30. Describe biliru- - RBCs broken down in Kupfer cells in the spleen bin metabolism: - unconjugated bilirubin is water insoluble so binds to albumin in plasma + is transported to the liver - its taken up into hepatocytes + conjugated to water-soluble forms - excreted in bile 31. What does Rifampicin do? inhibits the carrying of bilirubin on albumin 32. Detoxification key points: - liver site for drug metabolism - involving P450 + conjugation 33. Bilirubin excretion: conjugated bilirubin converted to urobilinogen for excretion 34. Liver storage: - store J - vitamins - minerals - toxins 35. Liver disease symptoms: - jaundice - fever - pain - GI bleeds 3/4 - pruritis - endocrine changes 36. Portal hyperten- - impaired hepatic blood flow causing ascites sion: - varices - splenomegaly 4/4