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liver phys 557

How much does the liver weigh? 3lb
What is the functional unit of the liver? the liver lobule
How much of the CO does the liver represent? 27%
The liver is a _____ flow, _____ pressure system. high , low
What disease process causes an increase in pressure to fibrotic deposition around blood vessels and in the spaces of Disse? cirrhosis
What is non-steatohepatitis associated with? Type II DM and obesity
What is caused by transudation of fluid from the liver into the abdominal cavity? ascites
What are high portal pressures caused by? fibrotic deposition
Under normal conditions, how much blood is stored in the liver? 450ml
With an increase in what, the liver is capable of sequestering 500-1000ml beyond normal limits? right atrial pressure
In the absence of infection, fibrosis, or inflammation, what is possible? regeneration
Liver cells do not over-proliferate. T/F T
What plays a role in the division and growth of cells? Hepatocyte growth factor
What is HGF produced by? mesenchymal cells of the liver and some other tissues
HGF is not produced by the __________, but the hepatocytes demonstrate a mitogenic response after HGF stimulation. hepatocytes
Following complete liver regeneration, what is released by hepatic cells? cytokine
What is a potent inhibitor of liver growth? transforming growth factor
In healthy states, a liver to body weight ratio is maintained. T/F T
What cells are responsible for clearing intestinal bacteria from the portal vein? kupffer
Less than __% of the enteric microbes pass the Kupffer cell entry system. 1
The liver metabolizes what? Carbs
The liver stores what? glycogen
The liver converts galactose and fructose to what? glucose
This is the process of glucose formation from non-carbohydrate sources such as lactate. Gluconeogenesis
How is excess glucose stored in the liver? as glycogen
Glycogen is liberated when what falls? blood glucose levels
Patients with liver disease experience large fluctuations in blood glucose levels. T/F T
What two things are liberated from triglycerides and converted to glucose? Amino acids and glycerol
The liver ________ fatty acids to meet energy requirements. oxidizes
The liver _________ cholesterol, phospholipids, and lipoproteins. synthesizes
What splits lipids into glycerol and fatty acids to form acetyl CoA? beta oxidation
Acetyl CoA is converted to ________-_______ acid, which is a highly soluble acid used in the liver as energy. aceto-acetic acid
Aceto acetic acid is again converted in other bodily tissues to _________ ___ for energy. Acetyl CoA
80% of the cholesterol synthesized in the liver is converted to what? bile salts
The remaining 20% of cholesterol is transported in __________ and utilized to form membranes, cellular structures, and a multitude of physiologic active substrates. lipoproteins
Deamination of ________ ________ occurs in the liver so they can be used as an energy source for converting fats or carbs. amino acids
The liver forms urea and removes what? ammonia
The liver can form up to ____ grams of protein per day. 50
To a small extent, the _____ also participate in the deamination of amino acids. kidneys
What vitamins are stored in large amount in the liver? A,D, and B12
Iron stored as _____ in combination with _______ binds and stores excess iron until needed. ferritin and apoferritin
What coag factors are manufactured by the liver? fibrinogen, Prothrombin (FII), accelerator globulin, Factor VII, Vit K
What are the vit K dependent factors? 2, 9, 10, 12
What drugs are excreted by the liver? PCN, Amp, and sulfonamides
What hormones are associated with the liver? thyroxine, estrogens, cortisol, and aldosterone
Excess of this electrolyte is excreted in the bile for elimination via feces? calcium
What is the end product of hemoglobin degradation? bilirubin
What is the lifespan of the red blood cell? 120 days
Lysis via the reticuloendothelial system of the _____ liberates homoglobin. spleen
Once unconjugated albumin bound bilirubin enters the liver cells is released from the plasma albumin and is conjugated with glucuronic acid, what is it now called? conjugated hemoglobin or direct hemoglobin
Conjugated bilirubin is excreted from _________ by active transport into the bile canaliculi for excretion into the _____________. hepatocytes, intestine
Conjugated bilirubin is converted by bacteria in the gut to highly soluble ______________. urobilinogen
What is a normal bilirubin level? 0.5mg/dl
What occurs when levels exceed three times normal or 1.5 mg/dl? jaundice
What overwhelms the capacity of the liver, is a marked increase in free or unconjugated bilirubin in the blood, and a marked increase in urobilinogen in the gut which is excreted in the urine? hemolytic jaundice
What is caused by gallstones, cancerous tumor, hepatitis, destruction of bile ducts, bilirubin cannot pass from the blood to the intestine, and conjugation continues to occur? obstructive jaundice
With obstructive jaundice, conjugated bilirubin leaves the liver via what system? lymph
Usually conjugated bilirubin leaves the liver via the _________ and sphincter of Odi. gallbladder
In hemolytic jaundice, what is elevated? unconjugated bilirubin
In obstructive jaundice, what is elevated? conjugated bilirubin
What reaction is utilized to differentiate between conjugated and unconjugated bilirubin? van den bergh
With this type of jaundice there is no urobilinogen that is reabsorbed in the blood that can be excreted into the kidneys. total obstructive jaundice
Total obstructive jaundice also results in a lack of what? stercobilin
In ___________ obstruction jaundice, conjugated bilirubin does appear in the urine. partial
In its original form, __________ is fat soluble, not water soluble. bilirubin
What modifies bilirubin as it arrives at the liver, and converts it to a water soluble compound? glucuronyl transferase
The process of converting bilirubin to a water soluble form is called _______ ____________ because one of the steps involved is the attachment of bilirubin to another molecule. bilirubin conjugation
This is not a disease, but a sign of a disease. Jaundice
Unconjugated bilirubin, accumulates in fatty tissues, most notably the _______, where we would notice yellow pigment. skin
Most bilirubin is produced by RBC breakdown in the __________. spleen
Conjugated bilirubin does not readily cross the _____. BBB
________________ bilirubin does cross the BBB. unconjugated
What 4 possible problems could cause jaundice? 1. increased RBC breakdown 2. Failure of hepatocyte conjugation 3. failure of hepatocyte excretion of conjugated bilirubin into the bile canaliculi 4. extra hepatic obstruction (gallstones)
What happens to cause an increase in unconjugated hyperbilirubinemia? 1. increase in bilirubin production, 2. decreased hepatic uptake of bili by hepatocytes 3. decreased conjugation of the bili
Created by: Jmw015