1. What is the liver? Describe the anatomy and morphology of the liver.

Liver is the largest and the most complex organ of the body. Most of it lies in the right upper side of the abdomen. Liver in average adult weights about 1,5 kilos. It is covered by a fibrous capsule. The liver is composed of up to 100 000 branched and interconnected sells (lobules). Liver gets blood supply from 2 vessels – hepatic portal vein (carrying the blood from the organs of abdominal cavity. the products of digestion are absorbed by capillaries in the intestinal wall and carried into the hepatic portal vein to capillares within the liver. ) and hepatic artery (carrying newly oxygenated blood). Each lobule is surrounded by capillaries from hepatic portal vein and the hepatic artery. The blood lives along the hepatic vein to join the inferior vena cava and pass to the heart.

2. What are the principle physiological functions of the human liver?

carbohydrates(glucose and glikogean formation), protein(syntesis and dehydratation) lipid(cholesterol syntesis) ,

production of coagulation factors (thrombopoetin),

break down the insuline,

recycle various substances such as hemoglobin,

destroys many poisonous substances.

Bile salts and bilirubin are formed in the liver and pass into bile ducts to be excreted to the duodenum or stored in the gall-bladder.

All metabolic processes produce considerable amount of heat that helps to maintain body’s normal temperature.

Stores fat-soluble vitamins.

Produce albumine.

In a fetus – blood-forming function.

3. What factors may cause liver diseases?

The liver is a complex organ that can be disrupted by number of disorders, of which the major causes include infection, poisoning, excessive alcohol, metabolic abnormalities, obstruction, and deficiency diseases. Many diseases can not produce any symptoms until it reach the advanced stage.

4. Name and define the liver diseases you know.

Cirrhosis – type of permanent and progressive liver damage characterized by the formation of fibrous scars and nodules that connect to involve the larger areas of the liver, significant loss of liver cells.

Acute hepatitis – inflammation of the liver characterized by panlobular infiltration of mononuclear cells, hepatic cell necrosis, hyperplasia of Kupher cells, cholestasis.

Cholestasis, alcohol damage, hepatitis type a,b,c,d,e, hepatoma, fatty liver.

5. What are the symptoms of liver disorders?

Many diseases can not produce any symptoms until it reach the advanced stage.

The main symptoms of liver diseases include: dull ache in the upper part right part of the abdomen main symptom – jaundice (bilirubin accumulates in the blood)

ABDOMINAL SWELLING (ASCITES)

Varicose veins in the lower end of the esophagus which can burst = blood vomiting and blood in feces (melena) (obstruction of the hepatic portal vein)

Generalized itching

Pale stools and dark urine

Fatigue, bruising, easy bleeding

6. What is the cirrhosis? What may cause the cirrhosis? What are its types?

Cirrhosis – type of permanent and progressive liver damage characterized by the formation of fibrous scars and nodules that connect to involve the larger areas of the liver, significant loss of liver cells.

The 2 most common causes of cirrhosis are alcohol abuse and viral hepatitis or cholangitis. Other less common causes are: autoimmune diseases, some rare inherited diseases (wilson’s disease, haemochromatosis), some drugs or chemicals such as carbon tetrachloride.

Most types of cirrhoses can be classified as(clinical classification with some morphological or etiological factors):

Laennec’s (alc.abuse)

Postnecrotic

Biliary (primary or secondary) chronic impairment of bile excretion. Destruction centred about the intrahepatic bile ducts

Haemochromatosis\

Cardiac or congestive

Rare and nonspecific

7. What are the symptoms of the cirrhosis?

Early symptoms include weakness, feeling of tiredness, loss of appetite, nausea and vomiting of blood, constipation or diarrhea. Symptoms of advanced cirrhosis – jaundice, broken blood vessels, hard liver, swollen abdomen, swollen ankles(evidence of fluid retention), spider angiomas, palmar erythema, finger clubbing, itching. Some men experience enlargement of their breasts, loss of pubic hair and shrinking of the testicles

8. What is the treatment for the cirrhosis?

Treatment of cirrhosis based on the underlying cause.symptomatic. If cirrhosis caused by autoimmune disease steroids and immunosuppressive drugs may be prescribed. Specialized care over a long period. Reduse consumption of alcohol, eat healthy food. To reduse the ascitis – restriction of salt, water, diuretics prescribed. In severe cases – transplantation.

9. What is the difference between the hepatitis A and hepatitis B (etiology, incubation period, transmission, contagious rate)?

Traditionally viral hepatitis had been classified into 2 epidemiologically distinct types: infectious hepatitis (A) and serum hepatits(B). this distinctions were based on earlier observations that hepatitis A had a shorter incubation period, high contagious rate, and usually fecal-oral way of transmission., while hepatitis B had a longer incubation period, less contagious and thought to be transmitted only by the parenteral route. This viruses now are distinguished vy their antigenic properties but are known to produce clinically similar disease.

10. What are the histological and morphological lesions of the hepatitis?

The typical morphological lesion consis of panlobular infiltration with mononuclear cells, hepatic cell necrosis, cell dropout, balooning of cells, acidophilic degeneration of hepatocytes, hyperplasia of Kupffer cells, variable degrees of cholestasis. With this lesion one finds “bridging” between lobules because the necrauses leads to large the area of hepatic cell dropout (bridge consist of condensed reticulum, inflammatory debris, degenerating cells). Hepatic cell regeneration is also present

11. Describe the clinical picture of the acute hepatitis and its treatment.

Causes: viruses, bacteria, fungy, candida… consumption of alcohol, autoimmune, drugs (antituberculosis), ischemic hepatitis.

Symptoms: malaise, anorexia, nausea and vomiting, fatigue, headache, fotofobia, changes in taste and smell, fever (38-40), dark urine, light stools, abdominal discomfort, enlargement and tenderness of the liver, rare pine in the right upper part of the abdomen, hepatomegaly, spider angiomas.

Treatment: diet, interferon, hepatoprotectors

12. What organs does the urinary system consist of? Describe their anatomy and morphology.

Urinary system consist of 2 kidneys, 2 ureters, urinary bladder, urethra. Tne main organ – kidneys – been-shaped organs situated retroperitonealy, on the both sides of vertebral colon in the lumber region of the span. Kidneys situated in the adipose tissue, surrounded by fibrous connective tissue for protection. The kidney consist of outer cortex region and inner medulla region.

2 ureters – muscular tubes lined with mucose membrane membrane which pass urine from kidney to urinary bladder. urinary bladder – hollow muscular distensible sac. Temporary store urine

Urethra – tube in which urine is discharged

13. What are the kidneys? What is the anatomy and morphology of the kidneys? (location, structure).

Tne main organ – kidneys – been-shaped organs situated retroperitonealy, on the both sides of vertebral colon in the lumber region of the span. Kidneys situated in the adipose tissue, surrounded by fibrous connective tissue for protection. The kidney consist of outer cortex region and inner medulla region. Grossly, these structures take the shape of 8 to 18 cone-shaped renal lobes, each containing renal cortex surrounding a portion of medulla called a renal pyramid (of Malpighi).^[6] Between the renal pyramids are projections of cortex called renal columns (of Bertin). Nephrons, the urine-producing functional structures of the kidney, span the cortex and medulla.The kidneys receive blood from the renal arteries, left and right, which branch directly from the abdominal aorta. Despite their relatively small size, the kidneys receive approximately 20% of the cardiac output