23 Questions
Which cell type is involved in laying down collagen in the liver?
Stellate cells
What is the hallmark of cholestasis?
Accumulation of green-brown plugs of bile pigment in hepatocytes and dilated canaliculi
What morphological type of necrosis is characterized by a zonal loss of contiguous hepatocytes beginning in zone 3 near the central vein?
Confluent necrosis
What is the term for programmed cell death?
Apoptosis
Which enzyme reflects bile duct injury?
Alkaline phosphatase
What is the AST:ALT ratio in alcoholic liver disease?
Greater than 2:1
What is the term for the end point where fibrous septa encircle regenerative hepatocytes and give rise to diffuse scarring in the liver?
Cirrhosis
What is the term for cell swelling, cytoplasmic clearing, and clumping of intermediate filaments in hepatocytes?
Ballooning degeneration
What is the term for the conversion of stellate cells into myofibroblasts in liver injury?
Stellate cell activation
What is the term for the deposition of extracellular matrix and scarring in the space of Disse, leading to the loss of sinusoidal endothelial cell fenestration?
Sinusoidal capillarization
What is the term for the process of defective plasma membrane transporter function and mitochondrial dysfunction leading to cell death?
Hepatocyte necrosis
What percentage of the blood flow to the liver is supplied by the portal vein?
60-70%
Which model consists of three zones based on blood flow in the liver?
Hepatic acinus
What is the primary function of Kupffer cells in the liver?
Phagocytosis of foreign particles
Which function involves the synthesis of proteins and storage of essential nutrients in the liver?
Synthetic function
Which test parameter is used to assess hepatocyte integrity or injury?
AST/SGOT
What does elevated levels of bilirubin and bilirubinuria indicate?
Chronic hepatocellular disorders
Which type of liver lobule is hexagonal in shape?
Classical hepatic lobule
What is the primary purpose of liver function tests?
Detect liver disease and monitor treatment response
What is the main function of the hepatic artery in the liver?
Supply 30-40% of the blood flow
Which cells are housed in the perisinusoidal space in the liver?
Stellate cells
What is the primary role of aminotransferases (AST and ALT) in liver function tests?
Assess hepatocyte integrity or injury
Which parameter is used to evaluate biliary excretory function in liver function tests?
Conjugated bilirubin
Study Notes
Microscopic Structure and Function of the Liver
- The normal adult liver weighs between 1400-1600gm and has a dual blood supply, with the portal vein supplying 60-70% and the hepatic artery supplying 30-40% of the blood flow.
- The liver's organization includes the classical hepatic lobule, portal lobule, and hepatic acinus, with the lobular model being hexagonal and the acinar model consisting of three zones based on blood flow.
- The liver is resistant to infarction due to its dual blood supply, and different zones of the hepatic acinus are affected in various conditions such as yellow fever.
- The hepatic parenchyma consists of hepatocytes organized in sheets, bile canaliculi, vascular sinusoids, Kupffer cells, and the perisinusoidal space housing stellate cells with various functions.
- The liver has metabolic, synthetic, storage, catabolic, and excretory functions, including glucose and lipid metabolism, synthesis of proteins and storage of essential nutrients, detoxification of foreign compounds, and bile excretion.
- Liver function tests, including biochemical, radiologic, and pathologic tests, are used to detect liver disease, distinguish between different types of liver disorders, gauge the extent of liver damage, and monitor treatment response.
- Basic test parameters in liver function tests include total bilirubin, conjugated bilirubin, AST/SGOT, ALT/SGPT, ALP, GGT, total albumin, glucose, PT, and serum ammonia.
- Aminotransferases (AST and ALT) are used to assess hepatocyte integrity or injury, with specific normal ranges and patterns of elevation associated with different liver disorders.
- Biliary excretory function involves the secretion of substances like bilirubin, and abnormal levels can indicate liver disease or hemolytic disorders.
- Elevated levels of bilirubin and bilirubinuria can be indicative of chronic hepatocellular disorders, and specific values are used for evaluation and diagnosis.
- A clinical case is presented to illustrate the use of liver function tests in diagnosing liver disorders and abnormal liver function.
- Liver function tests are crucial for assessing liver health and diagnosing various liver disorders, and they provide valuable insights into the liver's microscopic structure and function.
Explore the intricate microscopic structure and vital functions of the liver in this quiz. Learn about the liver's dual blood supply, hepatic lobule organization, and the roles of hepatocytes, bile canaliculi, and Kupffer cells. Understand the metabolic, synthetic, and excretory functions of the liver, and the significance of liver function tests in diagnosing liver disorders.
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