-
The liver is what percent of body weight in:
a) an adult
b) neonate
-
the liver has ____ lobes
2
-
the liver has ____ surgical segments
8
-
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
70!
-
Total hepatic blood flow=
1200-1400 ml/min
-
total hepatic blood flow is what percentage of cardiac output?
25%
-
the portal vein receives a large percentage of blood flow from what 2 organs? (with percentages)
- stomach- 20%
- Intestine- 60%
-
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
- hepatic arteriole
- bile duct
- lymph vessels and nerves
-
hepatic blood flow: ____flow, _____ resistance
-
the liver is a reservior for _______.
blood
-
normal amount of blood in liver, _____ ml. Can expand up to ____L
-
what organ contains up to half of body lymph?
LIVER
-
Sinusoids are permeable to _____ and ______. This can lead to _____ with high vascular pressure.
- fluids and proteins
- ascites
-
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?
yes- highly
-
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
- autoregulation
- -h.a. vasoconstriction
- -myogenic resp to smooth musc. stretch
- -local blood flow- arterial
- metabolic control
- -arterial hypoxemia
- -decrease in blood pH
- -hyperosmolarity
-
Liver flow has 2 modes of control- Extrinsic
- Neural control
- -vagus/splancnic
- -symp stim decreases bf
- -500ml can be expelled in seconds
- Humoral
- -epi (a-vasoconstriction, b-vasodilation)
- -glucagon
- -angiotensin
- -vasopressin
-
Name 2 anesthetic related techniques that decrease hepatic flow:
- anything that decreases cardiac output
- regional anesthesia
-
Name an anesthetic related techniques that decrease portal venous flow:
Controlled ventilation
-
does NITROPRUSSIDE alter hepatic flow?
NO
-
What type of surgery can decrease hepatic blood flow up to 60%?
Abdominal
-
which anes gasses are best for hepatic flow management?
- ISO first
- sevo close second
-
what is a reliable predictor of chronic liver dz?
Serum Albumin
-
Albumin: vital to maintenance of ______
- oncotic pressure.
- 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
PT
-
What four things does the liver metabolize?
- amino acids
- carbs
- fat
- bilirubin
|
|
