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Hepatic Artery

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Hepatic Artery Ingegneria delle tecnologie per la salute Fondamenti di anatomia e istologia aa. 2019-20 Lesson 7. Digestive system and peritoneum Liver • hepatic artery delivers oxygenated blood from heart to liver, hepatic portal vein delivers partially deoxygenated blood containing nutrients (+ drugs and toxins) absorbed from the small intestine and actually supplies more oxygen to liver than do much smaller hepatic arteries; after processing bloodborne nutrients and toxins, liver releases nutrients needed by other cells back into the blood, which drains into central vein and then through hepatic vein to inferior vena cava. • hepatic portal circulation = all blood from alimentary canal passes through liver (explaining liver most common site for alimentary canal cancers metastasis) Liver: Histology = 3 main components: 1 hepatocytes [liver’s main cell type, accounting for around 80% of liver's volume, playing a role in a wide variety of secretory, metabolic, and endocrine functions; plates of hepatocytes called hepatic laminae radiate outward from portal vein in each hepatic lobule] = from their central position, hepatocytes process nutrients, toxins, and waste materials carried by blood: materials such as bilirubin processed and excreted into bile canaliculi, other materials including proteins, lipids, and carbohydrates processed and secreted into sinusoids or just stored in cells until called upon. Liver: Histology = 3 main components: 2 bile canaliculi [grooves in cell membranes between adjacent hepatocytes accumulating bile produced by hepatocytes: from here, bile flows first into bile ductules and then into bile ducts, uniting to form larger right and left hepatic ducts, which themselves merge and exit liver as common hepatic duct, that joins with cystic duct from gallbladder, forming common bile duct through which bile flows into small intestine] Liver: Histology = 3 main components: 3 hepatic sinusoids [open, porous blood space formed by fenestrated capillaries from nutrient-rich hepatic portal veins and oxygen-rich hepatic arteries, where hepatocytes are tightly packed around, giving them easy access to the blood] = combine and send blood to a central vein and then through hepatic vein into inferior vena cava (this means that blood and bile flow in opposite directions); also contain star-shaped reticuloendothelial cells (Kupffer cells), phagocytes removing dead red and white blood cells, bacteria, and other foreign material that enter sinusoids Liver: Histology Liver: Histology Liver: Histology Liver: Histology Liver: Histology portal triad = distinctive arrangement around perimeter of hepatic lobules, consisting of 3 basic structures: a bile duct, a hepatic artery branch, and a hepatic portal vein branch. Liver: Histology portal triad Liver: Histology portal triad Blood flow Bile flow Liver: Histology Liver: Histology Liver: Histology Liver: Histology Liver: Histology Liver: Histology Liver: Histology Liver: Histology Liver: Histology Liver: Bile • lipids are hydrophobic (= do not dissolve in water), before they can be digested in watery environment of small intestine, large lipid globules must be broken down into smaller lipid globules (= emulsification) • Bile = yellow-brown or yellow-green alkaline solution (pH 7.6 to 8.6) mixture of water, bile salts, bile pigments, phospholipids (such as lecithin), electrolytes, cholesterol, and triglycerides secreted (about liter each day) by liver to accomplish emulsification of lipids in small intestine. • bile salts and phospholipids = components most critical to emulsification having a nonpolar (hydrophobic) region as well as a polar (hydrophilic) region [hydrophobic region interacts with large lipid molecules, whereas hydrophilic region interacts with watery chyme in intestine: large lipid globules being pulled apart into many tiny lipid fragments of about 1 μm , dramatically increasing surface area available for lipid-digesting enzyme activity] Liver: Bile • While most constituents of bile are eliminated in feces, bile salts are reclaimed by enterohepatic circulation: once bile salts reach ileum, they are absorbed and returned to liver in hepatic portal blood; hepatocytes then excrete bile salts into newly formed bile. • bilirubin = main bile pigment [waste product produced when spleen removes old or damaged red blood cells from circulation, including proteins, iron, and toxic bilirubin, transported to liver via splenic vein of hepatic portal system: proteins and iron recycled, whereas bilirubin excreted in bile, accounting for green color of bile, and transformed by intestinal bacteria into stercobilin (= brown pigment giving stool its characteristic color: in some disease states, bile does not enter intestine, resulting in white (‘acholic’) stool with a high fat content, since virtually no fats are broken down or absorbed)] Liver: Bile • Hepatocytes work non-stop, but bile production increases when fatty chyme enters duodenum and stimulates secretion of gut hormone secretin. Between meals, bile is produced but conserved. The valve-like hepatopancreatic ampulla closes, allowing bile to divert to gallbladder, where it is concentrated and stored until next meal. Liver & Pancreas Pancreas = soft, oblong, glandular organ lying transversely in retroperitoneum behind stomach: head nestled into “c-shaped” curvature of duodenum with body extending to left about 15.2 cm (6 in) and ending as a tapering tail in hilum of spleen [curious mix of exocrine (secreting digestive enzymes) and endocrine (releasing hormones into blood) functions] Pancreas • exocrine part = arises as little grape-like cell clusters, each called an acinus (plural = acini), located at terminal ends of pancreatic ducts, secreting enzyme-rich pancreatic juice into tiny merging ducts that form 2 dominant ducts [larger duct, Wirsung, fuses with common bile duct (carrying bile from liver and gallbladder) just before entering the duodenum via a common opening (hepatopancreatic ampulla)]; smooth muscle sphincter of hepatopancreatic ampulla controls release of pancreatic juice and bile into small intestine; second and smaller pancreatic duct, the accessory duct (duct of Santorini), runs from pancreas directly into duodenum, approximately 1 inch above hepatopancreatic ampulla. • Scattered through sea of exocrine acini are small islands of endocrine cells, islets of Langerhans, producing hormones pancreatic polypeptide, insulin, glucagon, and somatostatin PANCREAS ANATOMY esophagus stomach ductus choledocus pancreas duodenum duct of Santorini duct of Wirsung Pancreas PANCREATIC SECRETIONS 1. PROTEASES (70%) Endopeptidases (trypsin, chymotrypsin, elastases) Exopeptidases (carboxypeptidases) trypsinogen trypsin activates all other precursors enterokinase (duct walls) 2. NUCLEASES (DNAase, RNAase) 3. PANCREATIC AMYLASE (hydrolyse starch and gl;ycogen) 4. PANCREATIC LIPASE (triglycerides fatty acids and glycerol) REGULATION OF SECRETION 1. SECRETIN food in release of release of secretin secretion of alkaline pH stomach stomach acid into blood by bicarbonate (ideal for into duodenum duodenal cells by duct cells pancreatic enzymes) 2. PANCREOZYMIN (cholecystokinen) amino acids and release of pancreozymin relase of pancreatic enzymes fats in intestine by intestinal mucosa into the intestine into blood 3. GASTRIN food in stomach gastrin secretion release of pancreatic enzymes by stomach mucosa into the intestine 4. AUTONOMIC INNERVATION (vagus nerve) Pancreas: Histology Pancreas: Histology islet of Langerhans pancreatic acini islet of pancreatic lobe Langerhans BV Pancreas: Histology LARGE SECRETORY DUCT INTERLOBULAR DUCT PANCREATIC SECRETORY DUCTS simple cuboidal epithelium acinus simple columnar epithelium Exocrine Pancreas: Histology pyramidal secretory acinus basal basophilia cell (rough ER) merocrine secretion (exocytosis) zymogen granules centro- condensing acinar golgi vacuoles cells blood vesicles vessel intercalated duct rough nerve endoplasmic golgi reticulum apparatus interlobular zymogen duct granules Pancreas: Histology INTERCALARY DUCTS AND CENTROACINAR CELLS intercalary duct centroacinar cell intercalary duct PANCREATIC EXOCRINE SECRETORY CELL zymogen granules centroacinar cell CELL BIOLOGY OF PANCREATIC SECRETION 1. SYNTHESIS 2. SEGREGATION 14C -leucine + tRNA mRNA for chymotrysinogen ribosomes 14C -amino-acyl tRNA ribosomes mRNA polypeptide chymotrysinogen 6. DISCHARGE RER cisterna 3. INTRACELLULAR TRANSPORT exocytosis RER transitional elements 5. INTRACELLULAR 4. CONCENTRATION STORAGE zymogen golgi granules H2O apparatus H2O golgi vesicles condensing vacuoles ISLET OF LANGERHANS alpha cell (glucagon) vascular pole (secretion by exocytosis) acinus beta cell beta cell (insulin) alpha fenestrated cell capillary blood capillary INSULIN- increases membrane promotes glycogenesis decrease blood glucose levels permeability to glucose GLUCAGON - promotes glycogenolysis increases blood glucose levels “ ANTAGONISTIC HORMONES” Pancreas: Histology Pancreas: Histology ISLET OF LANGERHANS Pancreas: Histology ISLET OF LANGERHANS - TEM STAINED ALPHA AND BETA CELLS ALPHA CELLS BETA CELLS Pancreas: Histology INTERCALARY DUCTS AND CENTROACINAR CELLS intercalary duct centroacinar cell intercalary duct Pancreas: Histology Gallbladder = 8–10 cm (~3–4 in) long, nested in a shallow area on posterior aspect of right liver lobe , muscular sac storing, concentrating, and, when stimulated, propelling bile into duodenum via common bile duct, divided into 3 regions: 1.fundus = widest portion, tapering medially into 2.body, which in turn narrows to
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