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WEEK 3:
Histology - liver, pancreas and pathology:
| Question | Answer |
|---|---|
| pancreas consists of what glands | exocrine and endocrine |
| exocrine portion of pancreas mass | 85-90% of organs total mass |
| exocrine portion of pancreas | organised as a compound tubuloacinar gland that synthesises and secretes digestive enzymes and alkaline fluid |
| secretions from individual acini drain into | small intercalated ducts which merge into larger ducts until they all empty into main pancreatic duct |
| simple gland | single unbranched duct |
| compound gland | branched duct system where ducts divide multiple times to drain many secretory units |
| acinar cells | small grape like clusters acting as functional units (acini) |
| each acinus consists of | ring of 4-5 pyramid shaped (pie shaped) serous cells oriented around tiny central lumen |
| basal region of acinar cells | strongly basophilic (blue purple) due to abundance of RER with a round and basally located nucleus |
| apical region of acinar cells | |
| colour of basal region of acinar cells | |
| colour of apical region in acinar cells | |
| nucleus in acinar cells | |
| duct network drains | digestive secretions and adds an alkaline bicarbonate rich fluid to neutralise stomach acid |
| centroacinar cells | pale staining of cells acting as the initial portion of the intercalated duct that projects directly into the lumen of the acinus |
| intercalated ducts are lined by | simple squamous to low cuboid epithelium receiving secretions from centroacinar cells |
| intercalated ducts receive secretions from | centroacinar cells |
| intralobular ducts located where | |
| intralobular ducts lined by | |
| intralobular ducts travel within | |
| size of intralobular ducts | |
| main pancreatic duct | final large conduit lined with columnar epithelium emptying into duodenum |
| main pancreatic duct lining | columnar epithelium |
| main pancreatic duct drains into | duodenum |
| connective tissue septa | thin capsule surrounding pancreas and send septa inward dividing parenchyma into distinct lobules, important for carrying blood vessels, lymphatics, and large interlobular ducts |
| CF | |
| effect of CF on pancreas | clogs up ducts and glands leading to atrophy and fibrosis and malabsorption, reduced protein and fat malabsorption and resulting deficiency of vitamins ADK and oedema etc due to pancreatic insufficiency, affecting 85-90% patients |
| mechanism of CF in the pancreatic epithelium | reduction in active transport of Cl due to CFTR mutation and increases Na transport into cell where water follows leading to dehydrated mucus (thick and hard to clear) |
| bile contains | water, bile salts (Na, Cl, K and HCO3-), bilirubin (colour) and cholesterol |
| bile is released where | into duodenum via common bile duct which is then eventually excreted in faeces |
| bile is release via | common bile duct |
| bilirubin comes from | senescent RBCs (breakdown product of heme) |
| jaundice | |
| route of bile | bile travels from liver and is transported through an intricate intrahepatic and extrahepatic duct system and the gallbladder before emptying into duodenum to help digest fats |
| hepatocytes secrete | bile continuously into tiny specialised channels (canaliculi/ canals of hering) |
| bile secreted from hepatocytes go where | canaliculi/ Canals of Hering |
| canaliculi drain into | small ductules located within the portal triads of the liver |
| ductules in the portal triads of liver merge to form | two larger ducts exiting the right and left lobes of liver |
| right and left hepatic ducts drain where | common hepatic duct |
| when fasting, the sphincter of oddi is | closed which forces bile up through cystic duct into gallbladder for storage |
| during digestion, where does bile go | from cystic duct to common bile duct |
| common hepatic and bile duct join to form | |
| common bile duct merges with pancreatic duct and opens through | |
| duct system consists of | ducts from liver and gall bladder to the duodenum |
| intrahepatic ducts | microscopic canaliculi inside liver |
| extrahepatic ducts | canaliculi join to form right and left hepatic ducts making common hepatic |
| common hepatic duct + cystic duct make | common bile duct |
| common bile duct joins | main pancreatic duct to open in second part of duodenum |
| sphincter of oddi | specialised ring of circular smooth muscle surrounding terminal common bile duct and pancreatic duct that regulates fluid release into small intestine |
| anatomical regions of gall bladder (3) | fundus, neck and body |
| fundus of gall bladder | rounded anterior tip |
| body of gall bladder | main storage area |
| neck of gall bladder | tapered section leading into cystic duct |
| gall bladder | pear shaped muscular sac |
| hepatocytes make how much bile | 1L/day |
| cholestasis results from | reduced bile flow eg obstruction from stones or hepatocytes damage and bile accumulates in the canaliculi and ruptures them damaging the hepatocytes and accumulating in blood leading to jaundice |
| liver position | right hypochondriac region extending across epigastrium into the left hypochondrium |
| liver functions | bile synthesis and secretion, excretion of bilirubin, metabolism, and detoxification |
| how does the liver contribute to metabolism (4) | |
| how does the liver contribute to detoxification | conjugation and elimination of metabolites and toxins |
| classic hepatic lobule | hexagonal structure centered around central vein with portal triads (branches of hepatic portal vein, artery and bile duct) at lower corners highlighting the pattern of blood drainage towards centre |
| portal lobule | functional unit centered in emphmesising the extreme flowing outwards from lobule towards central duct |
| liver acinus | functional unit based on body perfusion and metabolic activity divided into 2 zone (nutrients, zone and oygen) |
| classic lobule (structural) | |
| portal lobule (functional) | |
| liver acinus (functional) | |
| zones of hepatic acinus (3) | 1,2,3 |
| zone 1 of hepatic acinus | zone closest to central axis which includes the portal venules and hepatic arterioles |
| zone 2 of hepatic acinus | located between zone 1 and zone 3 |
| zone 3 of hepatic acinus | located around central veins which is the farthest from central axis and receives least oxygenated and nutrient poor blood |
| hepatocytes | |
| organelles in hepatocytes | abundant mitochondria and RER to support high levels of protein synthesis, detoxification and carbohydrate metabolism |
| hepatic sinusoids | |
| dual blood supply | |
| slide 35^^ IMPORTANT ASTHA SAYS 36 | |
| space of disse | |
| kupffer cells | |
| bile canaliculi | |
| hepatocytes secrete manufactured bule into where | |
| examples of liver diseases (7) | Hepatitis (inflammation), Hepatocellular carcinoma, Alcoholic liver disease, Cirrhosis (irreversible inflammation and fibrosis), Portal hypertension, Liver failure and Jaundice and cholestasis |
| cirrhosis | slowly progressive disease leading to chronic liver failure- occurs when alcohol absorbed from stomach the end product acetaldehyde (toxic to liver cells) causing hepatocytes to die and scarring (fibrosis) affecting relationship with blood/bile system |
| liver failure due to cirrhosis ends in | hepatic coma or complication of portal hypertension |
| portal hypertension | |
| causes of cirrhosis and portal hypertension | persistent hepatocyte destruction due: to alcohol toxicity, viral infection (Hep B and C), autoimmune liver disease and excessive storage of iron/copper (genetic metabolic disease - rare) |
| liver cancers | hepatocellular carcinoma can arise as a consequence of cirrhosis (90% in western countries associated with cirrhosis) |
Created by:
22tango
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