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Liver - Coggle Diagram
Liver
function
carbohydrate metabolism
protein metabolism
fat metabolism
bile production
immune function
biotransformation
toxin metabolism with cytochrome p450
specialized centrilobular hepatocyte (zones 3)
produce coagulation factors
toxicoses
copper toxicosis
Cu-carrying protein mutation
reduced Cu excretion
sheep
decreased capacity to excrete copper in bile
copper accumulation
hepatocytes release copper into blood
lysis of RBCs
hemoglobinuric nephrosis
gun-metal grey-brown liver
intrinsic toxins
predictable dose-dependent toxin
idiosyncratic toxins
rare
unknown
unpredictable effect
examples
mycrocystin
mushroom
blue-green algae
benzodiazepine
aflatoxin B1
carbon tetrachloride
medications
acetaminophen
dose-depenent in dogs and cats
carprofen
idiosyncratic rxn in some dogs
massive liver necrosis
centrilobular hepatocytes most suceptible
pyrrolizidine alkaloids
crotalaria
senecio
necrosis
injury
leads to hepatobiliary disease
regeneration
can occur if CT is intact (scaffolding)
if CT damaged, fibrosis
cirrhosis
pathophysiological consequences
biliary obstruction
reduction of functional parenchyma
portal hypertension
causes
chronic toxicity
chronic cholangitis/ obstruction
chronic congestion
disorders of metal metabolism
Fe
Cu
chronic hepatitis
idiopathic
aka "end stage liver"
diffuse fibrosis and conversion of normal liver architecture to abnormal nodules
liver will not increase in size
proliferations
response to sustained injury
functionally deficient
random hepatocellular degeneration/necrosis
single cell necrosis
multifocal areas
typical of many viruses
gross
tan
dark red
discrete foci ranging in size
centrilobular degeneration and necrosis
most common form of zonal necrosis
receives least oxygenated blood
greatest enzymatic activity
causes
severe, acute anemia
chorinc passive congestion
toxins
massive necrosis
necrosis of an entire hepatic lobule/acinus
regeneration does not occur
repaired by fibrosis
gross appearance varies
cholestasis
cholelith
in horses
green sheen liver
impaired bile flow
accumulation of bile in blood
bile acids
conjugated bilirubin
cholestrol
can be intra- or extrahepatic
icterus
infections
viral
herpesvirus
equine rhinopneumonitis
bovine rhinotracheitis
puppies <4w
gross
multifocal acute necrosis with eosinophilic intranuclear inclusions
infectious canine hepatitis
young dogs
replicated in oral lymphoid tissues
enlarged, hemorrhagic liver with centrilobular pattern
rare; vaccine available
adenovirus-1
bacterial
hepatic necrobacillosis
Fusobacterium necrophorum
facultative anaerobe
necrosis wherever they settle, with microabcesses
sepsis
Bacillary hemoglobinuria
Clostridium haemolyticum
hemolysis
clostridial spores in Kupffer cells
produce hemolyzing toxins
Tyzzer's Diseae
Clostridium piliforme
fecal-oral
colonize GI
move to liver through portal venous system
"shower"
acute multifocal to coalescing necrotizing/necrosuppurative hepatitis
"pick-up sticks" appearance
be able to define
hepatits
cholangitis
cholangiohepatitis
chloecytitis
how they get there
penetrating trauma
adjacent perionitis
hematogenous via hepatic artery
ascending common bile duct
migrating nematodes
structure
hepatocyte
higly active
numerous mitochondria + other organelles
phagocytosis
long life span
ito cells
"hepatic stellate cell"
regulate sinusoid blood flow
vit A sotrage
express GF
macro
lobule
acinus
penetrating vessels
zones 1-3
bile cannuliculi
metabolic disease
hepatic accumulations
hemosiderin
Fe accumulation in Kupffer(macrophage) cells
hepatic lipidosis
excess entry of fat
enhanced fatty acid synthesis/
decreased fatty acid oxidation
due to abnormal hepatocyte function
increased esterification of fatty acids and triglycerides
response to increased glucose and insulin
prolonged increase in chylomicrons
decreases apoportein synthsis
impaired lipoprotein secretion
ex.
bovine fatty liver
peak lactation
feline fatty liver
enlarged, pale, soft
amyloidosis
friable liver with waxy consistency
inflammatory
hemochromatosis
tropical birds
systemic Fe overload
enterocytes with high Fe uptake
accumulation in hepatocytes and Kupffer cells
fibrosis
bile duct proliferation
loss of hepatocytes
gross
heaptomegaly
hyperpericardia
pulmonary edema
developmental anomalies
biliary cysts
incidental
breeds
Cairn
west highland white terriers
persian cats
capsule fibrosis
"milk spots"
resolved periotonitis or nematode migration
circulatory disease
passive congestion
enlarged firm fibrotic
nutmeg pattern
centrilobular hepatocyte loss
periportal lipidosis
anemia
circulatory disturbance
portosystemic shunts
congential
extrahepatic
intrahepatic
acquired
primary
socondary
hyperplasia of muscular arteries
liver will be abnormally small
neoplasms
epithelial
hepatocellular adenoma/hepatoma
dogs mostly affected
increased size of affected lobe
hepatocytes w/o portal triades
usually singular
hepatocellular carcinoma
affects dogs more often
can be one lobe or widespread
can be metastatic to LNs and/or lungs, but not common
chonlagiocellular/biliary adenoma/cystadenoma
rare in dogs
difficult to differentiate from congenital biliary cysts
cholangiocellular/biliary carcinoma
more often in cats
can be in one lobe or widepsread
metastases arecommon
may arise from chronic cholangitis