Clinical Chemistry: Liver Function Tests and Anatomy
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Questions and Answers

What is the approximate weight of the liver in an adult?

  • 1.2 – 1.5 kg (correct)
  • 2.0 – 2.5 kg
  • 3.0 – 3.5 kg
  • 0.5 – 1.0 kg

What is the purpose of the falciform ligament in the liver?

  • Filters toxins from the blood
  • Separates the right and left lobes of the liver (correct)
  • Regulates blood flow to the liver
  • Stores bile produced by the liver

What is the main function of the hepatic artery?

  • Carries oxygenated blood to the liver (correct)
  • Drains bile from the liver
  • Regulates liver function
  • Carries blood from the alimentary tract to the liver

What is the function of the sinusoids in the liver?

<p>Blood-carrying vascular channels (A)</p> Signup and view all the answers

What percentage of the liver mass is composed of hepatocytes?

<p>60% (B)</p> Signup and view all the answers

What is the function of the smooth endoplasmic reticulum in the liver?

<p>Bilirubin conjugation and drug detoxification (D)</p> Signup and view all the answers

What is the primary source of bilirubin production in the body?

<p>Heme of the hemoglobin (D)</p> Signup and view all the answers

What is the main function of the liver regarding immunoglobulin abnormalities?

<p>Sequestering dimeric IgA and secreting it into the bile (A)</p> Signup and view all the answers

What is a consequence of decreased synthesis of clotting factors in liver disease?

<p>Generalized hemorrhagic tendency (A)</p> Signup and view all the answers

What is the main function of the liver regarding organic anions?

<p>Excreting organic anions into the bile (B)</p> Signup and view all the answers

What is the average daily bilirubin production in the body?

<p>250-300 mg (D)</p> Signup and view all the answers

What is the primary transporter of bilirubin in the blood?

<p>Albumin (B)</p> Signup and view all the answers

What is the primary function of the Golgi complex in the liver?

<p>Produces lipoproteins and glycoproteins (B)</p> Signup and view all the answers

What is the normal pressure of the portal vein?

<p>5-10 mmHg (B)</p> Signup and view all the answers

What is the term for the accumulation of fluid within the peritoneal cavity?

<p>Ascites (C)</p> Signup and view all the answers

What is the characteristic odor associated with hepatic encephalopathy?

<p>Fetor hepaticus (C)</p> Signup and view all the answers

What is the consequence of altered drug metabolism in hepatic dysfunction?

<p>Drugs undergo limited or aberrant transformation and accumulate (C)</p> Signup and view all the answers

What is the endocrine abnormality observed in men with liver disease?

<p>Feminization (D)</p> Signup and view all the answers

Flashcards

What is the liver?

The largest organ in the adult human body, weighing around 1.2-1.5 kg, located in the upper right quadrant of the abdomen.

How many lobes does the liver have?

It's divided into two main lobes by the falciform ligament, with the right lobe being much bigger.

How does the liver get its blood?

The liver receives blood from the portal vein, carrying nutrients from the digestive system, and from the hepatic artery, carrying oxygenated blood.

What are the building blocks of the liver?

The liver is made up of small units called lobules, separated by connective tissue and containing blood vessels and bile ducts.

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What's the central vein in each lobule?

The central hepatic vein is found in the middle of each lobule, playing a key role in blood drainage from the liver.

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What are sinusoids in the liver?

Sinusoids are tiny blood-carrying channels found within the lobules, facilitating the exchange of substances.

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What lines the sinusoids?

These cells line the sinusoids and include endothelial cells and Kupffer cells, which are specialized macrophages removing debris.

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What is the space of Disse?

This space between endothelial cells and hepatocytes allows for the exchange of nutrients and waste products.

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What are hepatocytes?

Hepatocytes are the main cells of the liver, making up a significant portion of its mass, and performing various vital functions.

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What are the surfaces of a hepatocyte?

Hepatocytes have three surfaces: the sinusoidal surface facing the blood, the intracellular surface connecting with other cells, and the canalicular surface for bile secretion.

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What organelles are found in hepatocytes?

Hepatocytes contain various organelles, including mitochondria, lysosomes, and endoplasmic reticulum, each with specific roles in the liver's functions.

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What is the function of mitochondria in hepatocytes?

Mitochondria are responsible for energy production through oxidative phosphorylation and fatty acid breakdown.

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What are lysosomes in hepatocytes?

Lysosomes carry hydrolytic enzymes for breaking down cellular debris and waste products.

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What does the endoplasmic reticulum do in hepatocytes?

The endoplasmic reticulum is involved in various functions, including drug detoxification, bile acid synthesis, and protein production.

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What are the functions of smooth ER in hepatocytes?

Smooth ER plays a role in conjugation of bilirubin, detoxification of drugs, and cholesterol synthesis.

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What does the rough ER produce?

Rough ER synthesizes proteins, including those affecting hormone levels, which can lead to conditions like gynecomastia or testicular atrophy in cases of increased estrogen.

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What is the hepatic excretory function?

The liver removes substances from the blood and excretes them into bile, influencing the body's waste elimination.

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What is bilirubin metabolism?

The liver plays a crucial role in breaking down bilirubin, a waste product from healthy red blood cell breakdown, and preparing it for excretion.

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What are the main functions of the liver?

The liver plays a central role in storing and processing nutrients, synthesizing important proteins, and contributing to the immune system.

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Study Notes

Anatomy of the Liver

  • Largest organ in the adult human body (1.2-1.5 kg) located in the right upper quadrant of the abdomen
  • Composed of two main lobes separated by the falciform ligament, with the right lobe being 6 times larger than the left lobe
  • Dual blood supply: portal vein (carries blood from the alimentary tract) and hepatic artery (carries oxygenated blood)

Microscopic Anatomy

  • Composed of lobules demarcated by connective tissue (CT) septa and vascular and biliary vessels
  • Central hepatic vein found in the center of the lobule
  • Sinusoids are blood-carrying vascular channels on either side of the liver cell plates
  • Lining cells: endothelial cells or Kupffer cells (the largest group of fixed macrophages)
  • Space of Disse: tissue space between endothelial cells and hepatocytes, filled with interstitial fluid for nutrient and waste product transfer

Hepatocytes

  • Polygonal cells that constitute 60% of liver mass
  • Specialized surface:
    • Sinusoidal surface
    • Intracellular surface
    • Canalicular surface

Ultrastructure

  • Hepatic parenchymal cells have a well-developed organellar substructure:
    • Mitochondria: energy generation (oxidative phosphorylation and fatty acid oxidation)
    • Lysosomes: degradative functions (hydrolytic enzymes)
    • Endoplasmic reticulum: site of many functions, including drug metabolism and bile acid synthesis
    • Smooth ER: bilirubin conjugation, drug detoxification, and cholesterol synthesis
    • Rough ER: synthesis of specific proteins (e.g., gynecomastia and testicular atrophy due to increased estrogen effect)

Biochemical Assessment of Liver Function

  • Hepatic excretory function: removal of organic anions from sinusoidal blood and excretion into bile

Bilirubin Metabolism

  • Daily bilirubin production: 250-300 mg
  • 85% of bilirubin is derived from hemoglobin (Hgb) catabolism
  • 15% of bilirubin is derived from erythrocyte precursors destroyed in the bone marrow and catabolism of other heme-containing proteins
  • Bilirubin is transported by albumin

Functions of the Liver

  • Receives, processes, and stores materials absorbed from the digestive tract (e.g., amino acids, carbohydrates, fatty acids, cholesterol)
  • Synthesizes multiple plasma proteins and contributes to the body's immune system

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Description

Test your knowledge of liver function tests, including bilirubin, and the anatomy of the liver, including its structure, dual blood supply, and microscopic composition. This quiz is based on a lecture and text from a clinical chemistry course.

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