Liver (Dr. Toth)

Where are the inferior vena cava, portal vein, and gall bladder found in the liver?

right lobe

What are hepatic sinusoids?

blood-filled channels that fill spaces between the plates of hepatocytes

Which major vessels supply the sinusoids?

hepatic artery & portal vein

What are bile canaliculi?

narrow channels into which the liver secretes bile

What is the first pass effect/ first pass metabolism?

hepatic metabolism of a pharmacological agent when it is absorbed from the gut and delivered to the liver via the portal circulation

What are some methods of avoiding first pass metabolism when administering drugs?

injection, suppositories, ODT, SL

List the major functions of the liver:

absorption

glucose release & storage

synthesis and secretion of blood proteins

removal and degradation

How does the liver metabolize lipids?

metabolize fats to fuel tissues

cholesterol & lipoprotein synthesis (HDL)

What is CCK?

Cholecystokinin

What is the function of CCK?

hormone that signals gall bladder to secrete bile into duodenum

What is the hepatopancreatic sphincter?

connects pancreas and gallbladder to duodenum

What is the composition of bile?

o Bile salts

o Phospholipids

o Small % of cholesterol & bile pigments (bilirubin)

What are the 3 possible outcomes for conjugated bilirubin?

fecal excretion

hepatic reabsorption for enterohepatic circulation

reabsorption then urinary excretion

What vitamins are stored in the liver?

B12, A, D, E, K

What minerals are stored in the liver?

iron & copper

Which stage(s) of liver damage is/are reversible?

fatty liver

Which stage(s) of liver damage is/are irreversible?

liver fibrosis and cirrhosis

What is the most common cause of portal hypertension

liver cirrhosis

Why does liver cirrhosis enlarge small veins (varices) in the esophagus, stomach, and rectum?

blocks blood flow and forces blood to find new pathways

What are the complications of portal hypertension?

vessel rupture (bleeding)

ascites

spleen enlargement