Patho1Liver
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| Digestive system consists of 2 main components: | a long tube from the mouth to the anus. Gastrointestinal tract. And the accessory organs.
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| The digestive system is the way we obtain nutrients. So it will go through a continuous process consisting of ingestion: | Whatever you put in the mouth and swallow.
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| Digestion is the process by which we transform the nutrients into... | Very small particles that can go into the bloodstream.
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| When nutrients go into the bloodstream this is called... | Absorption.
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| Nutrients that are absorbed go to the... | Liver first.
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| Why do nutrients that are absorbed go to the liver first? | Because all the digestive venous blood goes through the liver first for the purpose of filtering and metabolic processes.
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| Where does blood go after the liver? | From there will go to the cardiac veins: inferior vena cava.
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| 2 types of movement in the digestive system: | Propulsion and segmentation.
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| What is the only function of the esophagus? | To connect the mouth to the stomach.
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| The main definition for peristalsis is... | The segmental contraction of the smooth muscles of the digestive tract to push forward the content to the next step.
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| There is another type of movement but this is not to move the content forward, it is to mix. It is known as <blank> when it happens in the intestine, if it happens in the stomach it is called <blank>, and in the mouth it is <blank>. | Segmentation, churning, and mastication.
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| Two types of digestion: | Mechanical and chemical.
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| What gets mechanically digested in the mouth? | Everything!
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| What gets digested in the esophagus? | Nothing!
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| All types of nutrients have mechanical digestion because it is not... | Selective.
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| Chemical digestion is the other part of digestion. It is also trying to... | Reduce in size and complexity of the molecules so that they can be absorbed.
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| Chemical digestion requires the presence of a chemical substance capable of chemically acting on the substrate and these substances are known as... | Digestive enzymes.
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| We have mechanical digestion of all nutrients in the mouth and chemical digestion of... | Carbohydrates in the mouth.
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| True or false: chemical digestion of carbohydrates in the mouth. As the action of the digestive enzyme called Salivary Amylase. No other nutrients suffer chemical digestion in the mouth. All nutrients mechanical, carbohydrates chemical. | True.
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| In the esophagus, no... | Digestion.
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| In the stomach, there is mechanical digestion for all nutrients. In the stomach, chemical digestion of carbohydrates... | Stops.
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| What is chemically digested in the stomach? | Proteins.
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| What causes digestion of proteins? | Pepsin and HCl.
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| Where does HCl come from? | It is secreted in the stomach.
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| How does HCl digest proteins? | The first step is denaturation which happens very quickly in the presence of very acidic conditions.
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| Pepsin-peptitic bond in protein. In the stomach: mechanical for all, chemical for... | Proteins.
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| Highly acidic partially digested stuff called <chyme> goes to the small intestine. It is highly acidic so it has to go <blank>. | Chyme, slowly.
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| What is at the bottom of the stomach? | Pyloric sphinchter.
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| What is the purpose of the pyloric sphinchter? | To let the highly acidic chyme go slowly into the unprotected alkaline small intestine.
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| In the first part of the small intestine (called duodenum) all get mechanical digestion with segmentation. Also chemical digestion for... | All nutrients.
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| Here we resume the chemical digestion of carbohydrates(started in the mouth) and continue the chemical digestion of protein from the stomach and start the chemical digestion of fats. | Small intestine.
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| True or false: There are some hormones acting in the duodenum. They detect the presence of food and will either bring pancreatic enzymes (digest everything) or bile(digest fat). | True.
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| True or false: After the duodenum we have absorption: most of the absorption happens in the small intestine. There is little absorption in the large intestine and it is mostly water in the large intestine. | True.
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| Histologically: stomach: mucus has holes or depressions known as... | Gastric pits.
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| There are different epithelial cells lining gastric pits: | Mucous neck cells, chief cells or simogenic cells, and parietal cells
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| What is the purpose of mucous neck cells? | They secrete a mucous thick substance which covers the lining of the stomach, protecting it against the highly acidic HCl acid and also protecting the stomach against its own digestive pepsin.
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| Proteins are digested by the combo of... | HCl and pepsin.
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| What do chief cells secrete? | Pepsinogen and intrinsic factor.
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| What does pepsinogen do? | Become pepsin in the presence of HCl.
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| What does intrinsic factor do? | required for the absorption of vitamin B-12(extrinsic factor) this is indespinsible in the production of RBCs.
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| Without Vit B-12 you cannot make proper erythrocites and you will suffer from pernicious anemia. Where do you get Vit B 12? | Red meat.
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| What do parietal cells do? | Produce HCl.
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| Small intestine. Epithelial lining is modified not for secretion but for... | Absorption.
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| What does the small intestine have to help increase surface area? | Microvili.
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| Each individual vilus contains 3 components: | One vascular component (capillaries, arterial and venous) and a central lacteal (vessel-like structure).
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| Lacteal: | So the lacteal is for absorption of excess of water and substances that cannot be absorbed by the capillaries and also the fat because fat cannot be absorbed directly by the capillaries so it is absorbed by the lacteal.
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| The connection in the point of excretion for both pancreas and liver: | The bile duct.
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| The pancreas is a dual organ with an... | Exocrine and endocrine function.
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| What is the exocrine(not going directly into the bloodstream) function of the pancreas? | Produces digestive enzymes.
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| What is the endocrine function of the pancreas? | Produces insulin and glucogon.
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| Pancreas have several ducts: | Main and accessory to transport digestive enzymes from the site of production.
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| The head of the pancreas is close to the duodenum and... | The place where the bile is also drained.
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| The hepatic ducts from the liver lobe converge to form the... | Common hepatic duct.
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| The common hepatic duct combines with the cystic duct from the gallbladder to form the... | Common bile duct.
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| The common bile duct and the pancreatic duct combine to form the... | Hepatopancreatic ampulla.
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| The hepatopancreatic ampulla empties into the duodenum at the... | Major duodenal papilla.
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| Liver produces bile continuously. It is stored in the... | Gallbladder.
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| Gallbladder is connected to the circulatory pathway by way of the... | Cystic duct.
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| Hepatic duct converts to be hepatic common duct and joins the cystic duct and forms... | the common bile duct.
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| Hepatic duct to... | Hepatic ducts to cystic duct to common bile duct.
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| True or false: Bile goes to small intestine to digest fat. Spleen which is hematological/immune organ not related to digestion at all. | True.
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| Action of bile: | Emulsification of fats.
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| Bile's only function is to... | Help with digestion of fats.
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| Liver has four lobes: | Caudate, Quatrate, Left, Right.
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| What is the largest lobe of the liver? | Right lobe.
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| Functional unit of the liver? | Liver or hepatic lobule.
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| Should you be able to palpate the liver in the abdomen? | Not much in a healthy person.
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| Lobule means small lobe. They are organized around a central vascular structure known as... | Central vein.
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| All the central veins drain into one of the two... | Hepatic veins.
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| Where is the liver? | Intraperitoneal. Located in the right hypochondriac region.
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| Liver in relation to other organs? | Its superior portion is in contact with the inferior portion of the diaphragm and the gallbladder is located in the inferior region of the organ.
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| What are the 4 functions of the liver? | Vascular: to store and filter blood, Metabolic, Secretory(bile and others) and Excretory.
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| Structure of the liver lobule(like 4 hepatic lobules) is constructed around central vein, each consisting of plates of hepatic cells called... | Hepatocytes.
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| Each plate of hepatocytes is flanked on both sides by... | Sinusoids.
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| True or false: the liver is a sinusoidal organ with a lot of blood circulating continuously. | True.
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| What is the main metabolic structure in the body? | The liver.
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| The lobule is constructed around a central drainage point (central vein) what converges to that central vein is... | A series of channels which are called sinusoids.
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| True or false: At one side of hepatocyte we have sinusoids. That means that a liver cell has access to blood all the time. This is because the function of the cells is to work with the blood circulating there. | False. And at BOTH SIDES of hepatocyte we have sinusoids. That means that a liver cell has access to blood all the time from both sides. This is because the function of the cells is to work with the blood circulating there.
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| Blood comes not from the central vein, but comes from the outside in a structure known as <blank>. These are a branch of the hepatic artery which brings arterial, oxygenated blood to the sinusoids. | Triads.
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| What are the 3 components of a hepatic triad? | A branch of the hepatic artery, a branch of the hepatic portal vein, and the bile cannuliculi or bile duct.
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| What is the purpose of the branch of the hepatic artery in the triad? | To bring oxygenated blood to the sinusoids.
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| What is the purpose of the branch of the hepatic portal vein in the triad? | To bring all the nutrients from the GI tract.
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| What is the purpose of the bile cannuliculi or bile duct in the triad? | To take bile from the central part out.
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| True or false: in the hepatocyte flows toward the central canal, while bile flows down the bile duct in the opposite direction. | True. Blood comes from the tirad toward the central vein, while bile is coming from the central part to the triad.
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| All the central veins join to form finally the <blank> which drain the venous blood from the liver. | Right and left hepatic veins.
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| All the bile ducts are joined to form the <blank> which continue with the common hepatic duct. | Right and left hepatic ducts.
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| In the sinusoids we have some cells known as <blank>. These are like cleaning and part of the immune system, the leukocytes. | Kupfer cells.
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| What do Kupfer cells do? | They are in the sinusoids and are cleaning and part of the immune system.
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| The Kupfer cells work so well that only <blank> of pathogens get into the central vein. | Less than one percent.
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| Sinusoids and cells around them are always in contact with... | Portal blood.
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| Every minute <blank> of blood flows from the portal vein into the liver sinuses and <blank> of arterial blood making a total of. | 1.1 liters, 350mL, 1.45L.
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| How much CO for the liver? | 29% of resting CO.
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| What percentage of total body blood flow for the liver? | 33%.
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| The liver is an expandable organ. It normally stores about <blank> of blood or about <blank> of the body's total blood volume. | 450 mL, 10%.
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| Liver converts glucose into glycogen and glycogen into glucose and also stores... | Glycogen.
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| We have little amounts of glycogen in liver and... | Skeletal muscles.
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| We store excess energy as... | Fat.
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| What is sucrose? | Glucose and fructose.
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| What is lactose? | Glucose and galactose.
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| What is maltose? | Glucose and glucose.
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| We have 2 types of essential carbohydrates: | pentoses and exoses(6 carbon carbohydrates) (monosaccharides).
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| We have 2 types of essential carbohydrates: pentoses (which are for<blank>) and the exoses(6 carbon carbohydrates) (monosaccharides) which are for <blank>. | Making nucleic acids and ATP formation, nutrition.
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| Liver converts one type of <blank> into another. | Monosaccharide.
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| Formation of glucose from non-carbohydrates like fats and proteins is <blank> and is done in the liver. | Gluconeogenesis.
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| Long chains of maltose form... | Glycogen (and starch).
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| Lactic acid is eliminated (converted into glucose) in the liver in the... | Cori cycle.
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| What does the Cori cycle do? | Eliminates lactic acid by converting it into glucose.
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| Accumulation of lactic acid is related to... | Hepatic problems.
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| Metabolism of fats in the liver: Fats are 3 different types: | Neutral fats(triglycerides), phospholipids and steroids.
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| Fats can’t be transported alone they must be combined with a protein called the... | Lipoproteins.
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| Where are lipoproteins formed? | In the liver.
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| There is an organ which normally uses fatty acids mostly for metabolism instead of glucose: | The heart.
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| The liver will directly oxidize fats in order to... | Provide energy.
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| True or false: the liver can convert fat into carbs, carbs into fat, fat into protein…all conversions are possible. | True.
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| The liver can synthesize cholesterol and phospholipids, and <blank> percent of cholesterol is converted into bile salts. | 80.
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| What are the liver's two crucial functions related to protein metabolism? | Deamination and transamination.
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| What is deamination? | Removing the amino group from the amino acid.
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| What is transamination? | The conversion of one amino acid into another.
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| When the liver starts to fail we start to lose deamination capacity and we start to... | Accumulate urea. And if things are bad we have hepatic encephalopathy.
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| Once liver removes the amino from the amino acid (deamination) it converts the nitrogen into... | Urea.
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| True or false: Except for the 8 essential acids which cannot be synthesized by the liver and must be taken in from the outside, the liver can transform(make) any amino acid that we need. | True.
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| Formation of plasma proteins. All of them are produced by the liver. They are... | Albumin, globulins, and the coagulation proteins.
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