AP EXAM 3- hepato 1
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AP EXAM 3- hepato 1
emory aa anesthesia ap
ap exam 3 lecture 3/18/13 part 1
The liver is what percent of body weight in:
a) an adult
the liver has ____ lobes
the liver has ____ surgical segments
what are the 2 functional units of the liver?
the liver has a large vascular capacity. It contains __-___ ml blood/ 100gm tissue, and ___-___% of total blood volume.
hepatic blood flow is ____% venous
Total hepatic blood flow=
total hepatic blood flow is what percentage of cardiac output?
the portal vein receives a large percentage of blood flow from what 2 organs? (with percentages)
define hepatic acinus:
functional microvascular unit, cluster of parenchimal cells, formed about a VERTICAL axis.
the vertical axis of acinus consists of: (thbl)
terminal portal venule
lymph vessels and nerves
hepatic blood flow: ____flow, _____ resistance
the liver is a reservior for _______.
normal amount of blood in liver, _____ ml. Can expand up to ____L
what organ contains up to half of body lymph?
Sinusoids are permeable to _____ and ______. This can lead to _____ with high vascular pressure.
fluids and proteins
what is the hepatic artery system? describe time scale.
with low venous flow, hepatic artery can compensate. can perfuse entire organ. this adjustment can occur within MINUTES!
Is the liver compliant?
liver compliance is:
2-3ml/mmHg per 100g liver
raising venous pressure by 1mmHg results in an increase of _____. normal is 210-250 mls, ________ is about 600 ml.
During sympathetic stimulation, 6% of blood volume is mobilized by the ______, 12% by the ______, and 3% by the intestine.
liver, spleen, intestine
Liver flow has 2 modes of control- Intrinsic
-myogenic resp to smooth musc. stretch
-local blood flow- arterial
-decrease in blood pH
Liver flow has 2 modes of control- Extrinsic
-symp stim decreases bf
-500ml can be expelled in seconds
-epi (a-vasoconstriction, b-vasodilation)
Name 2 anesthetic related techniques that decrease hepatic flow:
anything that decreases cardiac output
Name an anesthetic related techniques that decrease portal venous flow:
does NITROPRUSSIDE alter hepatic flow?
What type of surgery can decrease hepatic blood flow up to 60%?
which anes gasses are best for hepatic flow management?
sevo close second
what is a reliable predictor of chronic liver dz?
Albumin: vital to maintenance of ______
produced in liver
what are the vitamin K dependent factors?
II, VII, IX, X
what are the non-K dependent factors?
V, XI, XII, XIII, fibrinogen
What test is a good indicator of
1) acute hepatic disfunction
2) vit k dep factor deficiency
What four things does the liver metabolize?