path 2 exam 3

Question 1

in a liver lobule, which area has the highest O2?

Answer 1

the outer edges where the portal triads are located

if there is ischemia, it will first show up in the center where the central v is

Question 2

what does the portal triad consist of?

Answer 2

portal v, hepatic a, and bile duct

Question 3

explain liver blood flow

Answer 3

blood enters from hepatic a and portal v
branches of these vessels travel in portal triads
blood from portal triads enter hepatic sinusoids and flows to central v
central v drains into sublobular v then into hepatic v –> IVC

Question 4

what is different about bile drainage?

Answer 4

it flows in the opp direction than a and v

hepatocytes –> bile canaliculi –> bile duct –> gallbladder and common bile duct

Question 5

what are the functions of hepatocytes?

Answer 5

• protein synthesis
• oxidation and conjugation of drugs, toxins
• lipid metabolism
• carb metabolism
• produces bile (exocrine secretion)

Question 6

what tests do you order to see if there’s bile duct damages?

Answer 6

serum alkaline phosphatase
serum GGT

Question 7

distinguish btwn reversible and non-reversible hepatocyte injury

Answer 7

reversible = accumulation of FAT and bilirubin

non-reversible = NECROSIS and APOPTOSIS
- necrosis may follow hypoxia/ischemia and may be single cell death or zonal or regional
- necrosis or apoptosis may follow VIRAL INFECTION; toxin exposure; other imflam conditions

regen = by dividing hepatocytes near the site of injury, more severe will divide stem cells near canal of Hering

Question 8

what cell is involved in liver scar formation?

Answer 8

hepatic stellate cell (in space of disse)

Question 9

what are the different syndromes of viral hepatitis?

Answer 9

• acute asymp infection w/ recovery –> id thru lab studies
• acute symp infection w/ recovery –> incubation –> symp disease –> convalescence
• acute liver failure
• chronic hepatitis –> continuing or relapsing disease for > 6 m
• carrier state –> harbors and can transmit virus, in absence of symps/disease