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The Functions of the Liver and Liver Cancer Tutorial
Alverno College 2008Sarah Arvelo
Directions and
Objectives
Please click the buttons that contain black text and are outlined in black to move through the tutorial.
Information will be provided on the functions of the liver, normal lab values, as well as signs and symptoms caused by a dysfunctional liver. The learner will be able to test their new knowledge through questions given throughout this exercise.
When a question appears click on the correct answer.
To get started click the button on the right. Next Page
Learn and apply knowledge about the functions of the liver, i.e., labs, signs, symptoms and nursing assessment.
Learn and apply knowledge about the symptoms produced by liver cancer and what labs may be affected.
Learner will be able to verbalize a few treatments for liver cancer and how the TP53 gene plays a role in its effectiveness.
Main Menu
Anatomy and Physiology Menu
Pathology Menu
Case Study Image from Microsoft clip art
You will find information
about abnormals and information on liver cancer in this section.
You will find information about the
function of the liver in this
section.
Directions Page
References
Anatomy
LabsNursing
Assessment of the Liver
Physiology
Image from Microsoft clip art Liver Functions
and Pathology Menu
End Show
In this section you will find information on the basic anatomy of the liver.
Click below to start.
Next Anatomy Page
Anatomy and Physiology Menu
Diaphragm
Gallbladder
Cystic Duct
Common Bile Duct
Duodenum
Hepatic Duct
Lopez, E.B., 2008. Used with Permission.
The liver is covered in the Gilsson’s capsule made of a
fibroelastic material.
Next Anatomy
Page
Hepatobiliary Tree - intrahepatic and extrahepatic duct.
Common Bile Duct - formed by the cystic and hepatic ducts. Both ducts lead to the duodenum.
Bile Canalculi - lie between hepatocytes.
Sphincter of Oddi - tissue that regulates the flow of bile. Bile is produced by the
hepatocytes and is where 75% of LDL is found. Bile moves through the liver
into the duodenum of the intestine.
Next Anatomy Page
How big is the liver?
The liver has two lobes.
The visceral surface also has two lobes.
The liver has a dual blood supply. Click here for the answer.
Click here for the answer.
Click here for the answer.
Click here for the answer.
The hepatic artery and portal vein.
The caudate and quadrate lobes.
The large right lobe and small left lobe.
The liver is 3 lbs. and the largest visceral organ in the body.
Next Anatomy Page
Lobules - there are 50,000 - 100,000 lobules in the liver. Lobules empty into a central vein that connects to the hepatic vein.
Sinusoids - are hepatic cells that form a plate like structure that branch off the central vein and extend to the lobule.
Due to this structure, hepatic cells are exposed to blood that travels
through the sinusoid.
Next Anatomy Page
Kupffer’s cells line the venous sinusoids.
What do these cells
do?
They remove defective blood cells, bacteria,
and foreign material from portal blood.
They filter blood.
They also remove
enteric bacilli from blood in
from the intestine.
Next Anatomy Page
Image from Microsoft Clip art
Click on each step to organize the flow of bile.
STEP 5STEP 4STEP 3STEP 1 STEP 2 STEP 7
The hepatocytes produce bile.
Bile enters the hepatobiliary
tree.
Bile flows through the common bile
duct.
The Sphincter of Oddi opens.
Next Page
STEP 6
If the sphincter is closed the bile moves back into the
common bile duct and the gallbladder.
Bile empties into the bile canaliculi.
Bile empties into the
duodenum.
1. Hepatocytes produce bile.
2. Bile empties into the bile canaliculi.
3. Bile enters the
hepatobiliary tree.
5. Bile flows through the common bile
duct.
4. The Sphincter of Oddi opens.
7. Bile empties into the
duodenum.
6. If the sphincter is closed the bile moves back into
the common bile duct and the gallbladder.
Anatomy andPhysiology
Menu
In the following section you will find information on the different
functions of the liver.
Physiology Menu
Fat/Lipids
Protein
Bile Production
Synthesis of Clotting Factors
Hormones/Drugs
CarbohydrateBilirubin
Elimination
Anatomy and Physiology
MenuEnd Show
The nursing assessment of the liver includes the entire abdominal assessment. This tutorial will only focus on the specific assessment of the liver. CLICK ON THE ASSESSMENT TO FIND OUT MORE.
Liver Span
Test Your Knowledge
Palpating the Liver
Scratch Test
Fluid Wave
Anatomy and
Physiology Menu
Cirrhosis, Metastatic
Cancer, Syphilis
Abscess or Metastatic
TumorTumor
Portal Obstructio
n, Cirrhosis,
High Obstructio
n of Inferior
Vena Cava and
Lymphocytic
Leukemia
Ascites
Hepatitis Enlarged nodular
liver noted with
palpation.
Enlarged liver noted
with palpation.
Peritoneal friction rub over lower
right rib cage.
Bulging flanks when
supine. Taut skin.
Localized distention.
Pain in the RUQ.
Possible Abnormal Assessment signs that
need further investigation.
Click to find out the possible cause
Pathology of the Liver Menu
STEP 1
PERCUSSION:Start at the area
of lung resonance until a dull sound is
heard (mark this spot).
NEXT
STEP 2
Start at abdominal
tympany up until dull
sounds are heard
(mark this spot).
Nursing Assessment
MenuBack to Pictures
Finding the upper border of the liver.
Next Page Liver Span
1 2
3
Images from Sarah Arvelo
45
6
Measure between your marks, to find the
border of the liver.
Next Page Liver Span
Images from Sarah Arvelo
9-12CM (Normal Liver Span)
Next Page Liver Span
The bottom border can extend slightly past the costal margin.
Use a tape measure to compare.
Images from Sarah Arvelo
Step 1
Place left hand under
patient’s back.
Step 3
Push deeply down and under the
right costal margin.
Step 4
Have the patient take
a deep breath.
Step 2
Place right hand in the
RUQ. Fingers should be pointed toward
patient's head.
Nursing Assessment
MenuBack to Pictures
1 2
3 4
Next Page Palpating the Liver
Images from Sarah Arvelo
When the abdomen is distended or the muscles are tense the examiner can perform the scratch test to determine borders.
STEP 1
Place stethoscope
over the liver.
Next
STEP 2
Start RLQ scratch.
Make short strokes over
abdomen toward liver.
THE BORDER IS FOUND WHEN THE SCRATCHING IS MAGNIFIED.
Nursing Assessment
Menu
Back to Pictures
1 2
3
Next PageScratch Test
Images from Sarah Arvelo
This test is done when the examiner suspects fluid in the peritoneal cavity (ascites).
STEP 1
Stand on the right side of the patient .
STEP 3
Place left hand on the
person’s right flank while
the right hand strikes the left flank.
STEP 2
Have patient place hand, fingers down
and ulnar side down, on the middle of the
abdomen.A fluid wave
indicates ascites.
Nursing Assessment
Menu
Back to Pictures
1 2
3 4
Next Page Fluid Wave
Images from Sarah Arvelo
When palpating the liver what is
normal?
YesC. All of the
above
CloseA. Nothing is
felt
Almost B. The edge of the liver is
felt
Nursing Assessmen
t MenuNext
Question
Liver span can be determine
through percussion.
What is the normal size of
the liver
Correct, for and adult
Abnormal
A. 6-12 CM
B. 14-20CM
Incorrect
C. The span of the rib cage
Nursing Assessment
Menu
Next Question
Obesity produces a fluid
wave.
Obesity and gas would produce
no change.
Correct
TRUE
FALSE
Nursing Assessment Menu
PHASE I REACTIONS PHASE II REACTIONS
Chemical modification or inactivation of a substance.
Conversion of lipid-soluble substances to water-soluble.
Water-soluble substances can be excreted unchanged in the urine or bile. Lipid-soluble substances can accumulate in the
body until they are converted by this process.
Next Page Hormones and
DrugsImages from Microsoft Clip art
PHASE I PHASE II
Drug metabolism occurs in the lipophilic membrane of the smooth endoplasmic reticulum of the liver cells.
Microsomal enzymes, located in the lipophilic membrane, are responsible for oxidation of the drug.
Conjugation occurs and is the process that breaks down the drug to make in more water soluble.
Next Page Hormones and
Drugs
Image from Microsoft Clip art
Glucocorticoids Aldosterone Sex Hormones
Cortisol is released by the adrenal gland during the stress response. The liver helps maintain blood glucose during the time when mechanisms of the body are hypoactive.
Next Page
o Bile contains water, bile salts, bilirubin, and cholesterol. The liver produces 600 - 1200 ml of bile, that is yellow-green in color, a day.
o Bile salts assist with digestion and absorption of fats.
o 94% of bile salts are reabsorbed into portal circulation and go through the system at least 18 times before being excreted in the feces.Physiology
Menu
DIRECT BILIRUBIN (CONJUGATED)
INDIRECT BILIRUBIN (FREE BILIRUBIN)
Is a part of the contents of bile and passes through bile ducts into the small intestine.
½ of bilirubin is converted into urobilinogen by the flora of the intestine.
Urobilinogen is absorbed into portal circulation or excreted in the feces.
1) Travels through blood attached to albumin.
2) Travels through the liver, releases from albumin, and moves into the hepatocytes.
3) Inside hepatocytes it is converted into conjugated bilirubin.
Physiology Menu
The liver stores excess glucose (glycogen) and releases it into circulation when glucose levels fall.
Converts excess carbohydrates into triglycerides and stores them in adipose tissue.
Physiology Menu
Image from Microsoft Clip art
Fibrinogen and C-reactive protein increase in production in the acute-phase response of inflammation.
The increased presence of these proteins increases the ESR (an important indicator of inflammation).
Deamination is the conversion of proteins, amino acids, and nucleic acids into urea.
Transamination is the conversion of an amino group to an acceptor substance, allowing amino acids to be involved in the metabolism of carbohydrates.
Next Slide Protein
Plasma proteins allow for fluid to stay in the capillary and not move into the tissue spaces.
Plasma proteins, albumin, globulins, and fibrinogen.
Next Page
Examples
Oxidation of fatty acids supply energy for other body functions.
Synthesis of cholesterol, phospholipids, and lipoproteins.
Glycerol and fatty acids split by beta oxidation
into two-carbon acetyl-coenzyme A.
Acetyl-coenzyme is converted by the citric acid cycle to produce adenosine triphosphate (ATP).
Next Lipid Page
FAT
GlycerolFatty Acids
Acetyl- CoA
BETA OXIDATION
Fat is spit and converted.
Citric Acid Cycle
Acetyl- CoA
ATP
Acetoacetic Acid (Highly
Soluble Ketoacid) Liver cannot
not use all Acetyl-CoA formed.
Next Lipid Page
Ketoacids are used to deliver energy into other tissues in the body.
Extra Acetl-CoA is used for synthesis of cholesterol and bile acids.
Physiology Menu
VLDL
triglycerideTranspor
t
Fat cells
Muscle cells
IDL
Triglyceride removed
VLDL or LDL
LDL is the main transporter of Cholesterol
Known as the (bad cholesterol)
HDL Good cholesterol Cholesterol and Triglycerides must attach
to lipoproteins to transport in the blood
Physiology Menu
The liver produces procoagulants vitamin K, factor VII, IX, X, prothrombin and protein C as well as plasma proteins that are involved in the process.
Blood clotting decreases blood loss when injury occurs.
Image from Microsoft Clip art Next Slide
Intrinsic and extrinsic pathways are activated by the coagulation process. This is the 3rd step in the hemostatic process.
Factor X Activated
Prothrombin
Thrombin Fibrinogen
Fibrin (Stabilizes the
Clot)
Acts as an enzyme to convert …
Antithrombin III converts…
Physiology Menu
The purpose of these tests is to evaluate the extent
of damage as well as identify different
dysfunctions of the liver. Serum
Bilirubin
ALT/AST
GGT
ALP
PT
Prealbumin/ Albumin
Anatomy and Physiology
Menu
AFP
Image from Microsoft Clip art
Used to evaluate clotting ability.
PT measures Factor I (fibrinogen), II (prothrombin), V, VII, and X.
Normal PT 11-12.5 seconds 85 - 100%
PT is prolonged when clotting factors are lacking. Liver
Function Test Menu
Image from Microsoft Clip art
Levels greater than 2.5 mg/dl produce jaundice.
Levels can increase due to the liver’s inability to excrete bilirubin or with a defect in metabolism.
Adults normal total bilirubin is 0.1 - 1.0 mg/dl, indirect 0.2 mg/dl, direct .1 - 0.3 mg/dl.
Liver Function Tests Menu
Image from Microsoft Clip art
Measures hepatic excretory function.
GGT assists in the transport of amino acids and peptides into liver cells.
May indicate alcohol abuse.
Liver Function Test Menu
Image from Microsoft Clip art
Used to monitor diseases of the liver.
ALP is excreted in bile and found in the bile duct epithelium and canalicular membrane of the hepatocytes.
Normal levels are 30 - 85 IU/ml. Elderly levels are slightly higher. Liver
Function Tests Menu
Image from Microsoft Clip art
AST (Adult 5 - 40 IU/L)
AST is an enzyme found in tissue of the heart muscle, liver cells and skeletal muscle cells and is released when cells become injured.
This test is used to evaluate patients with possible coronary occlusive heart disease or suspected hepatocellular diseases.
Liver Function Test Main Menu
ALT (Adult 5 - 35IU/L)
Test is used to identify heptatocellular diseases because this enzyme is released when tissue of the liver is damaged.
Can indicate jaundice caused by hemolysis rather than liver damage.
Can indicate worsening of disease.Next Page AST
Prealbumin normal lab values for adults/elderly is 15 - 36 mg/dl or 150mg/L.
This test is used to assess a person’s nutritional status as well as liver function.
Prealbumin has a 1.9 day half life and is a sensitive indicator of protein synthesis and catabolism. Next Page
Albumin
Image from Microsoft Clip art
Albumin is most important in maintaining oncotic pressure (this pressure keeps water in the vascular space).
Albumin 3.5 - 5.0 g/dl
Liver Function
Test Menu
Image from Microsoft Clip art
Differentiate metastatic from primary liver cancer.
Normally this protein is found in low levels in the adult.
AFP is found in 90% of hepatomas.
Normal levels in an adult less than 40 mg/ml or greater than 40 mg/L (SI units). Liver
Function Tests Menu
Image from Microsoft Clip art
Back to Liver Function and
Pathology Menu
Cancer Review
Treatment/ Cancer
Abnormal
Assessment
Abnormal Lab Values/ Symptoms
Liver Cancer
TP53 Gene
Image from Microsoft clipart
Abnormal Assessmen
t
Possible Findings:
1)Nontender and smooth or2)Tender and smooth
Causes:
1)Fatty infiltration, portal obstruction, cirrhosis, high obstruction of inferior vena cava, lymphocytic leukemia.
2)Early heart failure, acute hepatitis, hepatic abscess
Images from Sarah Arvelo
Neoplasm - uncontrolled growth of tissue/abnormal mass of tissue.
Tumor - area of swelling.
Malignant - a neoplasm, less differentiated, that can break loose and enter circulation.
Benign - a neoplasm; a well-differentiated cluster of cells.
Cancer Continued
Pathology Menu
Benign and malignant are differentiated by:
1) Cell characteristics. 2) Rate of growth. 3) Manner of
growth. 4) Capacity to metastasize and spread to other parts of the body. 5) Potential for
causing death.
Cancer Continued
Pathology Menu
Cancer cells are like normal cells.
Right! Cancer cells do not go through
normal cell proliferation and
differentiation. Lack of differentiation is called anaplasia.
Incorrect. Cancer cells can resemble normal
cells but are not exactly like normal
cells.
FALSE
Cancer Continued
Click on the right answer.
TRUE
Pathology Menu
Metastasis - the development of a second site of the primary tumor.
Metastasis occurs through:
Blood Vessels
Lymph Channels
Pathology Menu
In the following section you will find information on the above as well as questions you can answer to obtain more information on the topic.
Please click on the answer you feel best explains the question. Next Page
Symptoms and Abnormal Lab
Values
CORRECT> 2.5 mg/dl
produces jaundice.
INCORRECT
Sorry! This measures bleeding.C. Protime
B. ALT
A. Serum Bilirubin
A person with liver cancer can
become jaundiced. What liver function test results can be elevated when this
occurs?
Next Slide Symptoms
and Abnormal Lab Values
Pathology Menu
Prehepatic
is caused by excessive destruction of red blood cells. This may be caused by a hemolytic blood transfusion reaction. Red blood cells are destroyed quickly and the liver cannot compensate.
Back to question
Intrahepatic
This is directly related to the ability of the liver to remove bilirubin from the blood or its’ ability to eliminate it in the bile. Cancer of the liver can cause this type of jaundice.
Back to Question
Posthepatic
A tumor that obstructs the bile duct can produce this type of jaundice. The bile cannot move to the
intestine and removal of bilirubin is prevented. .
Back to question
C. Incorrect.
B. Correct. Albumin is a very important protein. It helps regulate oncotic pressure
which is what keeps fluid in the vascular space.
A. Incorrect. A person with a damaged liver is
malnourished, due to a decrease in appetite from
poor bile production, which is important for digestion.
C. Malnutrion
B. A decrease in circulating albumin.
A. A person can gain a lot of weight due to the swelling of
the liver. Damage to the liver can
cause a persons abdomen to increase in size. What causes this?
Next Question
Pathology Menu
.
Correct! The liver produces very
important clotting factors. See lab
function menu for more info.
C. The blood is unable to clot
properly due to the liver damage.
Incorrect. A person may be jaundiced with liver damage, but it does not cause bruising.
Incorrect. Normally,
someone with liver damage is malnourished, but it does not affect bruise formation.
B. The skin is bruised because he is jaundiced.
A. The person is
malnourished so the skin is more fragile.
A person with liver damage
is on your unit. He has
multiple bruises over
his body. What is
causing this?
Next Question
Pathology Menu
Incorrect. Can not measure bleeding
time.
C. CBC
Incorrect. Can
indicate alcohol abuse.
Correct
B. GGT
A. Protime
Bleed time is
measured by:
Next Question
Pathology Menu
B. PT
What test would be significant in evaluating the proteins synthesized by the liver involved in blood coagulation?
C. A and B
Next Question
A. Prealbumin
and Albumin
Incorrect.
Back to Question
Incorrect. Albumin is a protein, but it is an indicator of oncontic pressure and keeps water in the vascular space.
Back to Question
Correct. The liver produces prothrombin and fibrinogen which are coagulation factors.
Next question
Which test can identify the liver as a cause for jaundice rather than RBC hemolysis?
A. GGT
B. None of the tests
C. ALT
Next Question
Pathology Menu
Incorrect. Can measure alcohol abuse and excretory function of the liver
Back to question
Correct! ALT is released when the liver cells are damaged and then released into the blood causing serum levels to rise.
Next Question
Incorrect
Back to Question
What is the purpose of liver function tests?
B.
Evaluate if there is
damage to the liver
Pathology Menu
Next Question
No
Back to Question
Close. This is part of it. If the tests monitor function of the liver what could they also indicate.
Pathology Menu
Yes. The purpose of this test is to evaluate extent of damage as well as identify different dysfunctions of the liver.
Next Question
Chemotherapy
Biotherapy
Bone Marrow
Transplant
Hormonal Therapy
Radiation Therapy
Surgery
Pathology Menu
Targeted Therapy
The following are treatments for all cancers and are not specific to the liver.
Treatment of Cancer
Menu
Image from Microsoft Clip art
Incorrect
Incorrect! This test is helpful in identifing
possible liver damage.
Albumin is produced by
the liver.
Correct! Levels are
normally low in an adult but occur in
90% hepatomas
Metastatic cancer is more common than
primary cancer. What lab test
can be used to differentiate the
two?
C. All of the above
A. AFP
B. albumin
Next Question
Image from Microsoft Clip art
Pathology Menu
First line of treatment for solid tumors.
90% of people with cancer will have some type of surgical intervention.
Surgery used for dx, staging, or palliation.
Prophylaxis if strong family history.
Can be used in combination with chemotherapy and or radiation. Treatmen
t of Cancer Menu
60% of patients will have radiation.
Can target the affected organ.
Can be palliative to reduce symptoms.
Damaging to all proliferating cells.
Treatment of Cancer Menu
Systemic treatment (administered intravenously).
Prevents cell growth and replication.
Can be used in combination with other therapy.
Treatment of Cancer Menu
Therapy is used to alter the environment of the cancer cell.
Prevent hormonal signals that tell cancer cells to divide.
Cancer can become resistant to hormonal treatment.
Some of the drugs will suppress the hormone relating the organ affected or will decrease hormone receptors.
Next Hormonal Therapy
Page
Androgens - desensitizes the pituitary to decrease hormone levels.
Aromatase Inhibitors - inhibit biochemical processes used to convert androstenedione to estradiol in the peripheral tissues.
Exogenous hormones - produce a decrease in hormone receptors.
Antiandrogens - bind to receptor sites and decrease stimulation.
Treatment of Cancer Menu
Combination of immunotherapy and biologic response therapies.
Immunotherapy is the transfer of cultured immune cells into the host.
Biologic response modifiers are cytokines, monoclonal antibodies, and hematopoietic growth factors.
Next Biotherapy
PageImage from Microsoft clip art
Interferons - inhibit viral replication, tumor protein synthesis, and prolonging the cell cycle.
Interleukins - bind to receptor sites on the cell-surface membranes on the target cells to provide communication between cells.
Monoclonal Antibodies - antibodies from cloned cells or hybridomas. The cancer cell must have the right antigen.
Hematopoietic Growth Factors - control the production of neutrophils, monocytes-macrophages, erythrocytes, and thrombopoietin.
Treatment of Cancer MenuImage from Microsoft clip art
Treatment of previously incurable cancers.
High dose chemo and radiation.
Stem cell transplantation takes stem cells from the patient’s blood.
Stem cells are taken from the bone marrow in the bone marrow transplant.
Treatment of Cancer
Menu
Image from Microsoft clip art
Currently being developed to have therapies for that are specific to the particular cancer being treated i.e.
Drugs that would only harm cancer cells
Vaccines used to boost the tumor’s response to treatment
Treatment of Cancer Menu
HEPATOCELLULAR CARCINOMA CHOLANGIOCARCINOMA
Liver cells Possible causes: chronic
viral hepatitis, cirrhosis, exposure to environmental agents(aflatoxins), drinking contaminated water (arsenic).
Bile duct cells Possible causes can be
unknown, cirrhosis, or chronic hepatitis.
Pathology Menu
Next Slide Liver Cancer
5 year survival rate of about 7%
Advanced at the time of diagnosis.
Chemotherapy and radiation are palliative. Liver transplant could be possible treatment but
the organ is scarce.
Metastatic tumors are more common than primary tumors. Pathology
Menu
A 78 year old man, with newly diagnosed pancreatic cancer, arrives for placement of a biliary stent. In his physical assessment you note that he is jaundiced, he has a protruding belly, and has thin arms and legs. He states that he was recently taken off the medication statin. The patient does not have any prior health issues, other than a history of obesity, but has lost 120 lbs. over the last 6 months and has high cholesterol.
Click here to move to the next page and test your knowledge of the liver.
Liver Function
and Pathology
Menu
If he has pancreatic cancer, why does he need a biliary stent?
You noted that he was jaundiced. What is the cause of his jaundice? (RELATES TO THE ANSWER OF THE FIRST QUESTION)
Due to the structure and placement of the pancreas, a tumor can cause
narrowing of the common bile duct.
Click here for the answer.
Click here for the answer.
The liver produces cholesterol and if the liver is dysfunctional it can longer perform
this function.
This patient was on statin. Why wouldn’t he need this medication now that his liver is not working properly?
Click here for the answer.
Liver Function and Pathology
Menu
Oncogenesis:
a process that transforms
normal cells into cancer
cells.
3 types of genes
control cell growth
PROTO-ONCOGENES
TUMOR SUPPRESSOR
GENES
APOPTOSIS
Pathology Menu
Next Page Tumor
Suppressor Genes
Image from Microsoft clip art
These genes inhibit
proliferation of cells in a
tumor.
What would happen if one of these genes was defective?
Pathology Menu
Next Page Tumor
Suppressor Genes
Image from Microsoft clip art
Mutations of the
TP53 Gene Linked to: Development
of lung, breast, liver,
and colon cancer.
Pathology Menu
Next Page
Image from Microsoft clip art
TP53 GeneInitiates Apoptosis with
chemotherapy and radiation.
Apoptosis is the process
of cell death.
What could
happen to apoptosis if there was a
mutation?Pathology Menu
Image from Microsoft clip art
Jarvis, C., (2000).Physical examination and health assessment, 4th edition. Saunders.
Lewis, S.M., Heitkemper, and Dirksen, 2000. Medical Surgical Nursing, 5th edition. Mosby.
Lopez, E.B., 2008. Used with Permission.
Microsoft Office clip art available from http://office.microsoft.com/en-us/clipart/default.aspx
Pagana, K.D. and Pagana, T.J., 1998.Diagnostic and laboratory tests.Mosby.
Personal Pictures Sarah Arvelo Collection, 2008.
Porth, C.M., 2005.Patholophisiology, 7th edition. Lippinicott. End of Tutorial
If a person had a tumor in the liver
which obstructed the bile duct what type of
jaundice would the person have? Please
click on the right answer.
Jaundice (icterus) can be categorized by cause; Preheptic, Intrahepatic, or
posthepatic.
A. Prehepatic
C.Posthepatic
B. Intrahepatic
Pathology Menu
Posthepatic
A tumor that obstructs the bile duct can produce this type of jaundice. The bile cannot move to the
intestine and removal of bilirubin is prevented.
Back to Question
Complement System
The complement system consists
of a group of proteins. Almost all proteins are
produced by the liver.
Activation Enhances
Inflammatory responses
The lysis of foreign cells, and increases
phagocytosis.
Afects the humoral and innate immune responses. Next Protein
Page
The Complement System plays a role in inflammation
1) Vasodilatation and increases
vascular permeability 2)Leukocyte
activation, adhesion,
and chemotaxis
3) Phagocytosis
Physiology
The Glucocorticoid, Cortisol, regulates
the metabolic functions of the body and control the inflammatory response during
the stress response.
Stimulates the liver to
glycogen
Protein Breakdown
Mobilizes fatty acids
Physiology