ブロック重要ポイント(5th Nov)Q&A.Eng

Contents

1 Anatomy
2 Physiology
3 Biochemistry
4 Histology

Anatomy

A key finding for splenic injury is the presence of fluid in the S____________ fossa, observed during an abdominal ultrasound.
The splenorenal ligament contains the S____________ artery and vein, which reach the hilum of the spleen.
During splenectomy, it is necessary to clamp the S____________ ligament to control blood flow.
The splenic vein joins the superior mesenteric vein to form the P____________ vein.
The splenic artery divides into more than 5 branches within the spleen, and A____________ zones exist between these branches, allowing for partial splenectomy.
The left gastro-omental artery and short gastric artery are branches originating from the S____________ artery in the hilum of the spleen.
The infundibulum of the gallbladder is adjacent to the gallbladder N____________, where stones may become impacted.
During cholecystectomy, the C____________ duct must be ligated.
Calot’s triangle is formed by the common bile duct,
the visceral surface of the liver, and the C____________ duct, containing the cystic artery.
The cystic artery is typically a branch of the R____________ hepatic artery.
In the functional division of the liver, the region medial to the gallbladder and its fossa is known as liver S____________ V.
Venous blood from the liver is drained directly into the inferior vena cava through the H____________ veins.
The caudate lobe (Segment I) of the liver receives blood from both the right and left H____________ arteries, while other segments are usually supplied by a single hepatic artery.
The R____________ sagittal fissure divides the right lobe of the liver into anterior and posterior parts.
C____________ line extends from the gallbladder to the inferior vena cava, dividing the liver into right and left lobes.
The hepatic artery supplies the liver with O____________ blood and typically branches from the common hepatic artery, which is a branch of the celiac trunk.
The liver has a dual blood supply: 20-30% from the hepatic artery and 70-80% from the P____________ vein, which is nutrient-rich but oxygen-poor.
The notches of the spleen are located on its anterior and S____________ borders, distinguishing it as a unique structure.
The superior pancreaticoduodenal artery is a branch of the G____________ artery, which supplies blood to the duodenum and pancreas.
The spleen is located in the left hypochondrium, between the 9th and 11th ribs.
The H____________ recess is a gravity-dependent area in the abdominal cavity where fluid tends to accumulate.
The bare area of the liver is separated from the diaphragm by the C____________ ligament.
The right and left sagittal fissures are connected centrally by the P____________, through which the portal vein, hepatic artery, and bile ducts pass.
The caudate lobe of the liver has a slender, papillary process located behind the P____________, in the posterior part of the liver.
Segment V is also known as the A____________ medial segment and is located in the right lobe of the liver.
The bile duct runs along the posterior surface of the head of the pancreas and joins the P____________ duct to open into the duodenum.
The main arterial blood supply of the middle part of the bile duct primarily comes from branches of the R____________ hepatic artery.
The cystic duct contains spiral valves, which help regulate the flow of B____________.
Submucosal esophageal veins drain into the azygos vein or the L____________ gastric vein, which connects to the portal vein system and may cause esophageal varices.
The superior mesenteric vessels run anterior to the neck of the P____________, providing a landmark for surgical and diagnostic procedures.
The primary blood supply to the body and tail of the pancreas comes from branches of the S____________ artery.
The arterial arcade of D____________ is a complex network of arteries that supplies blood to the small intestine.
The foregut ends at the descending part of the D____________, where the midgut begins.
The ileum, the third part of the small intestine, ends at the I____________ junction.
The first part of the duodenum, also known as the duodenal bulb or ampulla, is the only part of the duodenum that exhibits a M____________.
The ampulla of Vater is where the common bile duct and pancreatic duct merge and open into the major D____________ papilla of the duodenum.
The jejunum is characterized by long straight vessels known as V____________ recta, thick walls, and large circular folds.
The C____________ chyli is an enlarged structure that collects lymph from the intestinal trunk and continues into the thoracic duct.
The appendix is a small, tube-like projection arising from the P____________ aspect of the cecum.
S____________ fascia is the membranous layer of deep subcutaneous tissue located beneath Camper’s fascia.
The L____________ alba is a fibrous structure extending from the xiphoid process to the pubic symphysis along the midline of the abdomen.
The internal oblique muscle originates from the anterior part of the I____________ crest.
The thoraco-abdominal nerves, which supply the abdominal wall, are derived from the anterior rami of spinal nerves T____________ to T11.
The artery that supplies the anterior abdominal wall and originates from the external iliac artery is the I____________ epigastric artery.
The medial inguinal fossa, also known as H____________ triangle, is located between the medial and lateral umbilical folds.
During fetal development, the S____________ plays an important role as a hematopoietic organ, producing blood cells, especially red blood cells.
The spleen is connected to the stomach by the G________________ ligament and to the left kidney by the S________________ ligament.
The spleen receives its blood supply from the S____________ artery, which branches off the celiac trunk.
The splenic vein joins with the superior mesenteric vein to form the H____________ portal vein.
The spleen is composed of soft S____________ tissue, which makes it fragile and prone to rupture.
The left kidney is located immediately P____________ to the spleen.
Nerve supply to the spleen comes primarily from the C____________ plexus, which runs along the splenic artery.
The spleen is located between the 9th and 11th ribs on the left side of the body.
The pancreas functions as an accessory digestive gland with both E____________ and endocrine functions, secreting digestive enzymes and hormones like insulin and glucagon.
The head of the pancreas receives its blood supply primarily from the anterior and posterior superior P_________________________ arteries.
Nerve supply to the pancreas is mediated through the C____________ plexus and the superior mesenteric plexus.
The tail of the pancreas lies anterior to the left kidney and is closely related to the S____________ hilum and the left colic flexure.
The uncinate process of the pancreas is part of the pancreatic head and lies posterior to the S____________.
The pancreas is primarily located at the vertebral levels L____________ and L2, reflecting its position between the duodenum and the spleen.
The accessory pancreatic duct usually opens into the minor D____________ papilla in the duodenum.
The inferior vena cava (IVC) lies posterior to the head of the P____________.
The liver is located primarily in the right hypochondrium and E____________ regions, extending slightly into the left hypochondrium.
The B____________ area of the liver is the only region not covered by peritoneum, where the liver contacts the diaphragm directly.
The falciform ligament divides the right and left lobes of the liver anatomically, while the R____________ ligament is a remnant of the umbilical vein from fetal circulation.
The liver receives 75-80% of its blood supply from the P____________ vein and 20-25% from the hepatic artery.
Deep lymphatics of the liver run alongside the P____________ triad, playing a crucial role in lymphatic drainage.
The perisinusoidal spaces of D____________ are important sites for lymph production within the liver’s microenvironment.
The bile duct is formed by the convergence of the common hepatic duct and the C____________ duct.
The bile duct is located in a groove behind the head of the P____________.
The proximal part of the bile duct receives its blood supply mainly from the C____________ artery.
Lymph from the bile duct first drains into the cystic lymph nodes, then to the hepatic and O____________ lymph nodes.
The cystic artery generally branches from the R____________ hepatic artery and is located within Calot’s triangle.
The fundus of the gallbladder is located near the tip of the right 9____________ cartilage.
The right P____________ nerve carries somatic sensory fibers that transmit pain caused by gallbladder inflammation.
The bile duct typically varies in length from 5-15____________ cm, depending on the individual.
The transversalis fascia of the abdomen corresponds to the internal S____________ fascia of the spermatic cord.
The lower thickened portion of the external oblique aponeurosis forms the I____________ ligament.
Muscle fibers of the internal oblique fascia transform into the C____________ fascia within the spermatic cord.
The medial boundary of Hesselbach’s triangle is formed by the R____________ sheath.
The hepatoduodenal ligament is part of the lesser omentum, connecting the liver to the D____________.
The neurovascular plane of the abdomen is located between the internal oblique and the T____________ abdominis muscles.
The abdominal cavity extends superiorly to the 4____________ intercostal space.
The F____________ fascia is the connective tissue layer containing the nerves and blood vessels of the descending colon.
A peritoneal ligament, such as the C____________ ligament, is a double layer of peritoneum that connects organs to each other or to the abdominal wall.
The iliohypogastric nerve, derived from the anterior ramus of L____________, supplies sensory innervation to the lower abdomen and perineum.
The ligament of C____________, also known as the pectineal ligament, is part of the inguinal ligament that attaches to the pecten pubis of the pelvis.
The omental foramen, located behind the free edge of the lesser omentum, connects the lesser sac with the G____________ sac.
The mesentery is a double layer of peritoneum that connects the V____________ peritoneum to the parietal peritoneum and anchors the intestines.
The O____________ bursa, also known as the lesser peritoneal sac, is a space located behind the stomach.
The layers of the abdominal wall, in order, include skin, Camper’s fascia, S____________ fascia, external oblique muscle, internal oblique muscle, transversus abdominis, preperitoneal fat, and parietal peritoneum.
The superficial epigastric artery supplies blood to the lower abdominal wall and the region around the U____________.
The transpyloric plane, an important anatomical landmark, is located at the level of the L____________ vertebra and the upper border of the pylorus.
The ligament of G____________ is part of the inguinal ligament and attaches to the upper margin of the pubis.
The right iliac region contains structures such as the external iliac artery, ileum, cecum, and the genitofemoral nerve, but the inferior mesenteric artery is located on the L____________ side and supplies the large intestine.
The gallbladder is located in the R____________ upper quadrant of the abdomen.
The G________________________ ligament is a peritoneal ligament that connects the stomach to the spleen.
The iliopubic ligament is a thickened lower border of the transversalis fascia located in the I________________ region.
The deep inguinal ring is located superior to the middle part of the inguinal ligament and lateral to the inferior E________________ artery.
The median umbilical fold contains the remnant of the U____________, running from the apex of the bladder to the umbilicus.
The bladder is classified as a S________________ organ, as it is located below the peritoneum and not fully covered by it.
The conjoined tendon is formed by the aponeurotic fibers of the internal oblique muscle and the T________________________ muscle.
The A____________ line is where the posterior wall of the rectus sheath transitions from aponeurosis to transversalis fascia.
The short gastric artery branches from the S____________ artery and supplies the upper part and fundus of the stomach.
The frenula of the I________________ valve are folds inside the cecum that contribute to the function of the ileocecal valve.
The transverse M________________________ is a fold of peritoneum that attaches the transverse colon to the posterior abdominal wall.
The transverse mesocolon divides the abdominal cavity into the supracolic and I________________ compartments.
The pyloric antrum is located between the body of the stomach and the pyloric canal, but the narrowest part of the stomach is the P____________ sphincter.
The right gastro-omental artery is a branch of the gastroduodenal artery and supplies the right side of the greater curvature of the S____________.
The superior pancreaticoduodenal artery is a branch of the gastroduodenal artery and supplies the proximal part of the D____________, near the bile duct opening.
The splenic artery is one of the major branches of the C____________ artery.
The left gastroepiploic artery branches from the splenic artery and supplies the greater curvature of the S____________.
The superior mesenteric artery (SMA) branches from the abdominal aorta at the level of L____________.
The transverse colon is located R________________________ as one of the retroperitoneal organs.
The inferior mesenteric artery (IMA) branches from the abdominal aorta at the level of L____________ and supplies the lower part of the colon.
The P____________ canal is the narrowest part of the stomach, controlling the passage of stomach contents into the duodenum.
Sympathetic fibers to the jejunum and ileum arise from the thoracic spinal segments T____________ to T10 and regulate bowel movement and blood flow.
The T____________ lies anterior to the esophagus and is often damaged simultaneously if the esophagus is injured.
Tumors located in the middle part of the esophagus often metastasize to the T________________________ lymph nodes.
The gastroduodenal artery supplies the part of the duodenum proximal to the opening of the B____________ duct.
The superior mesenteric vein joins the splenic vein behind the neck of the pancreas to form the P____________ vein.
The O____________ bursa is located between the posterior surface of the stomach and the pancreas.
The veins in the lower third of the esophagus drain into the P____________ vein, contributing to the formation of esophageal varices.
The thoracic esophagus is located approximately 22.5____________ cm from the incisors and is crossed by the left main bronchus.
The main arterial supply to the abdominal esophagus comes from the L____________ gastric artery.
The jejunum is characterized by long V____________ recta and fewer large arterial arcades.
The jejunum has thick walls, large circular folds, and fewer P________________________ patches compared to the ileum.
The celiac artery branches from the abdominal aorta at the level of T____________.
The A________________________ incisure marks the boundary between the body and the pyloric region of the stomach.
The T________________________ coli are thickened bands of longitudinal muscle running along the entire length of the large intestine.

答え

Splenorenal
Splenic
Splenorenal
Portal
Avascular
Splenic
Neck
Cystic
Cystic
Right
Segment
Hepatic
Hepatic
Right
Cantlie’s
Oxygenated
Portal
Superior
Gastroduodenal
Hepatorenal
hepatorenal
coronary
porta
portal vein
anterior
pancreatic
right
bile
left
pancreas
splenic
Drummond
duodenum
ileocecal
mesentery
duodenal
vasa
cisterna
posteromedial
Scarpa’s
linea
iliac
T7
inferior
Hesselbach’s
spleen
gastrosplenic, splenorenal
splenic
hepatic
spleenic
posterior
celiac
endocrine
pancreatic
celiac
splenic
splenic artery
L1
duodenal
pancreas
epigastric
bare
round
portal
portal
Disse
common hepatic
pancreas
cystic
right
ninth
phrenic
centimeters
Scarpa’s
inguinal
cremasteric
rectus
duodenum
ilium
ilioinguinal
fascia
falciform
1
Cooper
greater
visceral
omental
superficial
umbilicus
L1
G
left
right
gastrosplenic
inguinal
epigastric
urachus
subperitoneal
transversalis
arcuate
splenic
ileocecal
mesocolon
inferior
stomach
splenic
celiac
stomach
L2
retroperitoneal
L3
pyloric
T7
T10
trachea
tracheobronchial
bile
portal
omental
portal
cm
gastric
vasa
Peyer’s
T12
angular
taenia

Physiology

A____________ is caused by impaired peristalsis of the esophagus and failure of the lower esophageal sphincter to relax, associated with damage to the myenteric plexus.
Chronic gastritis can lead to reduced production of intrinsic factor by the parietal cells, resulting in malabsorption of V____________ B12 and potentially leading to pernicious anemia.
Severe celiac disease can cause malabsorption of V____________ D, leading to conditions such as osteomalacia.
Peptic ulcers most commonly occur on the L____________ curvature of the stomach.
Pyloric obstruction can result in retention of gastric contents, leading to persistent vomiting of acidic material and causing M____________ alkalosis.
Motion sickness is triggered by overstimulation of receptors in the V____________ labyrinth of the inner ear, which is responsible for sensing balance and body position.
G____________ is a condition characterized by excessive gastrin secretion, leading to hyperacidity and the development of peptic ulcers.
U____________ colitis is an inflammatory condition affecting the colon, marked by widespread ulceration and inflammation.
B____________ salts aid in the digestion and absorption of fats by making cholesterol more water-soluble; however, bile does not contain enzymes or iron, and the bilirubin present is unconjugated.
The liver is the primary site for the synthesis of A____________, a major plasma protein.
Hemolysis results in the release of large amounts of U____________ bilirubin into the bloodstream, which can lead to jaundice and darker-colored urine.
Liver dysfunction can lead to symptoms such as G____________ (enlargement of male breast tissue), bleeding tendencies, and elevated levels of unconjugated bilirubin.
However, an increased albumin-to-globulin ratio is not typically a consequence of liver dysfunction. In fact, liver dysfunction usually causes a D____________ in this ratio due to reduced albumin synthesis and relatively increased globulin levels.
S____________ secretion increases when mechanoreceptors in the oral cavity are stimulated.
O____________ inhibits gastric acid secretion by blocking the H-K ATPase pump in parietal cells.
C____________ causes contraction of the gallbladder and relaxation of the sphincter of Oddi.
The secretions of the small intestine contain enzymes that hydrolyze D____________ into simpler sugars.
Pancreatic juice contains enzymes that break down triglycerides into G____________ and fatty acids.
C____________ suppresses gastric acid secretion by blocking H2 receptors.
Hydrochloric acid (HCl) is secreted by the P____________ cells located in the gastric fundus.
Thick, alkaline mucus secreted by mucous cells protects the gastric lining from H____________ acid.
The stomach relaxes when food enters to prevent an increase in gastric pressure, a process known as R____________ relaxation.
Bile salts are A____________ molecules that aid in the emulsification of fats.
Glucose absorption in the small intestine is facilitated by S____________ co-transport.
Urobilinogen is converted to U____________ when exposed to air, giving urine its dark color.
After a significant portion of the intestine is resected, malabsorption can lead to weight loss and reduced hemoglobin levels, while fecal F____________ content increases.
Glucose absorption depends on a C____________ mechanism within the cell membrane, distinct from that used by fructose.
More than 99% of the end products of protein digestion are absorbed as A____________ acids.
The basic chemical reaction in digestion is H____________, where large molecules are broken down by the action of water molecules.
S____________ potentials are true action potentials that occur when the membrane potential exceeds -40 mV.
The Meissner’s plexus is located in the S____________ and regulates local blood flow and secretions in the gastrointestinal tract.
The E____________ nervous system, located in the muscular and submucosal layers, independently controls gastrointestinal motility and secretion.
The sacral parasympathetic nerves (S2-S4) innervate the rectum and A____________ sphincter. Parasympathetic stimulation generally promotes gastrointestinal activity, while sympathetic stimulation inhibits it.
The E____________ reflex is a neural reflex that originates in the intestines and travels via the brainstem to inhibit gastric motility and secretion in response to stimuli such as intestinal acidity.
S____________, secreted by the S cells of the duodenum, stimulates bicarbonate secretion from the pancreas to neutralize acid.
C____________, secreted by the I cells of the small intestine, stimulates gallbladder contraction and pancreatic enzyme secretion.
The L____________ of the Gut describes the law of peristalsis, where peristaltic reflexes move intestinal contents in the direction of the anus through coordinated contractions.
G____________, secreted by the G cells of the stomach, promotes gastric acid secretion.
M____________, or chewing, is primarily controlled by the trigeminal nerve (CN V).
Resection of the duodenum results in rapid gastric emptying but reduces the secretion of S____________ and CCK.
The lower E____________ sphincter prevents the reflux of gastric contents into the esophagus.
The G____________ reflex causes the ileum to empty its contents into the cecum after a meal.
The defecation reflex, facilitated by the gastrocolic reflex, often occurs after a meal due to increased activity in the gastrointestinal tract, which causes the colon to contract and push stool into the rectum, promoting D____________.
In the large intestine, M____________ is secreted to aid the movement of stool.
M____________ movements are strong peristaltic contractions in the colon that move large portions of contents at once.
During defecation, the internal anal sphincter relaxes, and the rectum contracts to facilitate stool E____________.
P____________ lipase is the main enzyme that breaks down triglycerides and is essential for fat digestion.
P____________ is an inactive precursor that is converted into the active enzyme pepsin by hydrochloric acid (HCl), aiding in protein digestion.
The secretion of pepsinogen is primarily regulated by A____________ and gastrin.
Pepsin, secreted by chief cells, digests C____________, breaking down connective tissue in meat to allow further protein digestion by other enzymes.
L____________ helps emulsify fats and plays an important role in fat digestion.
The pyloric glands secrete M____________ and gastrin in the pyloric region of the stomach.
H____________ is secreted by enterochromaffin-like cells (ECL cells).
The absorption of glucose in the small intestine primarily occurs via sodium-glucose cotransport, which involves the cotransporter protein S____________.
S____________ is secreted during the intestinal phase and stimulates the pancreas to secrete water and bicarbonate ions.
Amino acids like alanine are taken up into intestinal epithelial cells by sodium-dependent C____________ transport.
T____________ is secreted by the pancreas and activates other proteolytic enzymes like chymotrypsin and carboxypeptidase, initiating protein digestion.
Glucose is absorbed through sodium-dependent cotransporters, while fructose is absorbed through G____________, using a different mechanism.
Cholera toxin activates chloride secretion channels in the crypt cells of the intestines, leading to D____________.
Bile acids are reabsorbed in the small intestine through E____________ circulation.
S____________, commonly known as table sugar, is broken down into fructose and glucose.
The parotid gland secretes S____________ α-amylase, initiating the digestion of carbohydrates.
In infants, defecation after a meal is caused by the G____________ reflex, where gastric distension stimulates colonic movement.
The gastrocolic reflex travels through the P____________ sympathetic ganglia before returning to the gastrointestinal tract.
N____________ is released during sympathetic stimulation, reducing blood flow to the gastrointestinal tract.
B____________ is a vasodilator that increases blood flow during gastrointestinal activity.
When oxygen levels decrease, the increase in A____________ causes vasodilation, leading to increased blood flow.
G____________ inhibitory peptide (GIP) stimulates insulin secretion in response to carbohydrate and fat intake and is secreted by the K cells in the duodenum and jejunum.
Sensory information that initiates the pharyngeal phase of swallowing is transmitted by the T____________ nerve (CN V) and the glossopharyngeal nerve (CN IX).
Motor control of the pharyngeal phase of swallowing involves the trigeminal nerve (CN V), glossopharyngeal nerve (CN IX), vagus nerve (CN X), and H____________ nerve (CN XII).
R____________ relaxation is the phenomenon where the stomach relaxes in anticipation of food before it arrives from the esophagus, regulated by myenteric inhibitory neurons.
The E____________ reflex slows gastric emptying when the duodenum is overloaded, allowing time for digestion and absorption.
P____________ rush is the powerful, rapid peristaltic movement in the small intestine that occurs in response to infection or irritation, quickly moving contents into the colon.
The I____________ sphincter reflex inhibits ileal peristalsis and closes the ileocecal valve in response to pressure or chemical irritation in the cecum, controlling the entry of material into the large intestine.
The V____________ reflex is triggered by bladder stimulation and inhibits intestinal activity.
The P____________ reflex is activated by peritoneal irritation, leading to strong inhibition of intestinal activity and possibly causing intestinal paralysis.

答え

Achalasia
Vitamin
Vitamin
Lesser
Metabolic
Vestibular
Gastrinoma
Ulcerative
Bile
Albumin
Unconjugated
Gynecomastia
Decrease
Salivary
Omeprazole
Cholecystokinin
Disaccharides
Glycerol
Cimetidine
Parietal
Hydrochloric
Receptive
Amphipathic
Sodium
Urobilin
Fat
Carrier
Amino
Hydrolysis
Spike
Submucosa
Enteric
Anal
Enterogastric
Secretin
Cholecystokinin
Law
Gastrin
Mastication
Secretin
Esophageal
Gastroileal
Defecation
Mucus
Mass
Expulsion
Pancreatic
Pepsinogen
Acetylcholine
Collagen
Lecithin
Mucus
Histamine
SGLT1
Secretin
Cotransport
Trypsin
GLUT5
Diarrhea
Enterohepatic
Sucrose
Salivary
Gastrocolic
Prevertebral
Norepinephrine
Bradykinin
Adenosine
Gastric
Trigeminal
Hypoglossal
Receptive
Enterogastric
Peristaltic
Ileocecal
Vesicointestinal
Peritoneointestinal

Biochemistry

A____________ dehydratase (ALAD) is an enzyme that converts 5-aminolevulinic acid (ALA, δ-aminolevulinic acid) into P____________, playing a crucial role in the heme biosynthesis pathway.
The formation of H____________ is a critical step in the heme biosynthesis pathway, requiring four molecules of P____________ linked head-to-tail to form hydroxymethylbilane.
P____________ are cyclic compounds consisting of four pyrrole rings linked by methyne bridges (-CH=) to form a ring structure.
Hydroxymethylbilane spontaneously cyclizes to form U____________ III in the heme synthesis pathway.
The enzyme involved in acute intermittent porphyria (AIP) is P____________ deaminase, also known as Uroporphyrinogen I synthase.
Congenital erythropoietic porphyria (CEP, also known as Günther’s disease) is caused by a defect in U____________ III synthase, leading to photosensitivity and increased uroporphyrin levels in urine, feces, and red blood cells.
Porphyria cutanea tarda (PCT) is characterized by a deficiency in U____________ decarboxylase, resulting in photosensitivity and increased uroporphyrin in the urine.
Uroporphyrinogen I synthase functions in the C____________ (cytosol), not in the mitochondria or other cellular compartments.
Protoporphyrinogen oxidase is an enzyme that functions in the M____________, facilitating reaction 7 in heme synthesis.
A____________ dehydratase works in the cytosol and catalyzes the synthesis of porphobilinogen from ALA (aminolevulinic acid).
X-linked sideroblastic anemia is caused by a defect in A____________ synthase, an enzyme that initiates heme biosynthesis in the erythroid precursor cells of the bone marrow, leading to impaired red blood cell maturation and reduced hemoglobin production.
P____________ is caused by the accumulation of porphyrin molecules in the skin, which, when exposed to ultraviolet light, generate reactive oxygen species, leading to skin damage.
The type of porphyria that leads to cytochrome P____________ production after heme depletion, potentially increasing harmful heme precursors, is drug-induced porphyria.
The predominant form of bilirubin excreted in bile in mammals, when conjugated bilirubin abnormally exists in the plasma, is B____________ monoglucoronides.
R____________ hyperbilirubinemia refers to a condition where excessive bilirubin production occurs, and the body cannot metabolize and excrete it properly, leading to elevated levels of particularly unconjugated bilirubin.
U____________ bilirubin can cross the blood-brain barrier and enter the central nervous system, causing encephalopathy due to its lipophilic nature.
H____________ coproporphyria is classified as a hepatic porphyria and is caused by a deficiency in coproporphyrinogen oxidase in the liver.
P____________ is an erythropoietic porphyria caused by a deficiency in ferrochelatase, mainly affecting red blood cell precursors and leading to photosensitivity.
A____________ dehydratase deficiency is classified as a hepatic porphyria, characterized by abdominal pain and neuropsychiatric symptoms due to reduced enzyme activity in the liver.
V____________ porphyria is caused by a defect in protoporphyrinogen oxidase, affecting the seventh step in heme synthesis, leading to photosensitivity, abdominal pain, and neuropsychiatric symptoms, and is classified as a hepatic porphyria.
C____________-Najjar Type I syndrome is characterized by the complete loss of UDP-glucuronosyltransferase activity, causing severe unconjugated hyperbilirubinemia and potentially leading to neurological damage in newborns.
L____________ poisoning inhibits ALA dehydratase, disrupting the heme synthesis pathway and causing porphyria-like symptoms such as abdominal pain and neurological issues.
G____________ syndrome causes mild unconjugated hyperbilirubinemia and is typically discovered incidentally without significant liver dysfunction. It may temporarily worsen due to stress or infection.
A____________ intermittent porphyria (AIP) presents with symptoms such as abdominal pain, neuropsychiatric disturbances, and increased urinary porphyrins. It can be triggered by hormonal changes or medications, especially in women.
C____________ is a key enzyme that breaks down hydrogen peroxide into water and oxygen, protecting cells from oxidative stress.
T____________ 2,3-dioxygenase (also known as tryptophan pyrrolase) is involved in tryptophan catabolism, converting it into niacin and other metabolites.
The C____________ P450 enzymes are essential for the metabolism of xenobiotics, performing various chemical modifications to increase the water solubility of drugs and chemicals.
C____________ oxidase is an enzyme involved in the final stage of the electron transport chain, located in the inner mitochondrial membrane.
M____________ is a heme protein responsible for storing oxygen within muscle tissue.
The pentose phosphate pathway’s main importance lies in the production of N____________ and ribose-5-phosphate. NADPH is necessary for reducing reactions in the cell, fatty acid and steroid biosynthesis, and maintaining reduced glutathione.
G____________ acid is an intermediate in the uronic acid pathway and acts as a precursor in the synthesis of proteoglycans, crucial for the structure and function of connective tissue.
G____________ kinase is the enzyme that catalyzes the phosphorylation of galactose to form galactose-1-phosphate, an early step in galactose metabolism.
G____________-6-phosphate dehydrogenase deficiency can lead to hemolytic anemia in response to certain foods (e.g., fava beans) or medications (e.g., sulfonamides).
H____________ fructose intolerance is caused by a deficiency of aldolase B, an enzyme crucial for fructose metabolism. This deficiency leads to the accumulation of fructose in the body, causing metabolic disturbances.
In patients with hereditary fructose intolerance, X____________ is excessively produced due to the disruption of fructose metabolism caused by aldolase B deficiency.
In patients with diabetes, elevated blood glucose levels lead to the accumulation of S____________ in the lens, attracting water and causing lens swelling, which promotes cataract formation.
The most common form of G____________, an inherited disorder of galactose metabolism, is caused by a deficiency in galactose-1-phosphate uridyltransferase (GALT), resulting in the harmful accumulation of galactose in the body.
The U____________ pathway provides glucuronic acid, which is essential for the conjugation of drugs and toxins in the liver, increasing their water solubility for excretion.
G____________ peroxidase is a selenium-containing enzyme that breaks down hydrogen peroxide (H2O2) into water and oxygen.
T____________ is an enzyme in the pentose phosphate pathway that transfers a three-carbon dihydroxyacetone fragment, forming ketose (such as fructose-6-phosphate).
In the oxidative phase of the pentose phosphate pathway, R____________ 5-phosphate is generated, along with NADPH, which is used in reductive biosynthesis and other cellular processes.
L____________ is the enzyme that breaks down lactose, and its deficiency leads to symptoms such as bloating, nausea, cramps, and diarrhea due to lactose intolerance.
P____________ kinase catalyzes the final high-energy phosphate transfer reaction in glycolysis, converting phosphoenolpyruvate (PEP) to pyruvate and generating ATP.
G____________ 3-phosphate dehydrogenase catalyzes the conversion of glyceraldehyde-3-phosphate to 1,3-bisphosphoglycerate during glycolysis, utilizing inorganic phosphate and generating NADH.
G____________ is the metabolic process in which glucose is synthesized from non-carbohydrate precursors such as amino acids, glycerol, and lactate, primarily occurring in the liver and kidneys.
S____________ amylase (also known as ptyalin) is the enzyme in the oral cavity responsible for breaking down starch.
After a meal, the rise in blood glucose stimulates the secretion of I____________, which helps cells take up glucose, storing the excess as fat or glycogen to normalize blood sugar levels.
During fasting, the liver initially uses G____________ (glycogenolysis) to produce glucose, supplying glucose from glycogen stores when dietary glucose is unavailable.
Once glycogen stores are depleted, the body switches to G____________ to generate glucose from non-carbohydrate precursors.
During fasting, skeletal muscles primarily use F____________ acids as an energy source.
S____________ (Sodium-Glucose Linked Transporter 1) is the primary transporter responsible for the uptake of glucose and galactose into intestinal epithelial cells.
Glycogen storage disease type I (Von Gierke disease) is caused by a deficiency of G____________-6-phosphatase, impairing glycogen breakdown and glucose release from the liver, leading to hypoglycemia and glycogen accumulation.
During fasting, G____________ stimulates the expression of enzymes that promote gluconeogenesis, including phosphoenolpyruvate carboxykinase (PEPCK), which converts pyruvate to phosphoenolpyruvate, a key intermediate in glucose synthesis.
The C____________ cycle involves the conversion of lactate to glucose in the liver, playing an essential role in maintaining blood glucose levels during anaerobic conditions.
G____________-6-phosphate dehydrogenase (G6PD) deficiency is a genetic disorder seen more frequently in males of Mediterranean or Afro-Caribbean descent, leading to reduced resistance to oxidative stress in red blood cells and resulting in hemolytic anemia.
The pentose phosphate pathway has two phases: the O____________ phase, which produces ribose-5-phosphate, CO2, 2 NADPH, and 2 H+, and the nonoxidative phase.
The activity of P____________ (phosphoenolpyruvate carboxykinase) increases during fasting and in patients with diabetes, promoting gluconeogenesis.
Not all glycolytic reactions are freely reversible during gluconeogenesis. Irreversible steps in glycolysis require B____________ enzymes to bypass them in gluconeogenesis.
The P____________ phosphate pathway generates NADPH, which is essential for fatty acid and steroid biosynthesis, as well as maintaining reduced glutathione, without producing ATP.
Essential P____________ is a rare genetic disorder caused by a deficiency in xylulose reductase, leading to increased excretion of xylulose in the urine.
G____________-2 is a bidirectional glucose transporter found in the liver, pancreas, kidneys, and intestines, enabling the rapid uptake or release of glucose depending on blood sugar levels.
G____________-1 is the primary glucose transporter in red blood cells, brain, colon, and kidneys, and it functions independently of insulin.
G____________-3 is found in tissues with high glucose demand, such as the brain and placenta, and has a high affinity for glucose.
G____________-4 is insulin-dependent and primarily facilitates glucose uptake in muscle, cardiac tissue, and adipose tissue.
G____________-5 is primarily found in the small intestine and is responsible for fructose transport.
The liver contains an isozyme of hexokinase called G____________, which efficiently metabolizes glucose during postprandial hyperglycemia.
G____________-kinase catalyzes the phosphorylation of galactose to galactose-1-phosphate, using ATP as the phosphate donor.
Ketone bodies are synthesized in the L____________ during fasting and are used by the brain and muscles, but red blood cells, which lack mitochondria, cannot utilize them as an energy source.
Glucose uptake in adipocytes is promoted by I____________ and not glucagon, while gluconeogenesis primarily occurs in the liver, not in muscle tissue.
During fasting, fatty acids released from adipocytes become the primary metabolic fuel for many tissues.
The production of K____________ bodies increases in the liver as fasting progresses.
P____________ (phosphofructokinase-1, PFK-1) is negatively regulated by high concentrations of ATP, inhibiting glycolysis.
In the uronic acid pathway, G____________ (glucuronate) functions as a precursor to proteoglycans, which provide structural stability, water retention, and cushioning in tissues. In the liver, glucuronate conjugates with drugs and hormones, enhancing their excretion by forming water-soluble glucuronides.
F____________ is a hexose (six-carbon sugar), not a pentose (five-carbon sugar).
The uronic acid pathway is the main source of G____________ and plays a crucial role in the conjugation of drugs and bilirubin in the liver.
Type 1 galactosemia is the most severe form and is caused by a deficiency in G____________-1-phosphate uridyltransferase (GALT), leading to liver damage and intellectual disability.
G____________ is an important component of glycolipids, proteoglycans, and glycoproteins, contributing to the carbohydrate chains of these complex molecules and playing a crucial role in cell-cell communication and signal transduction.
During prolonged fasting, amino acids released from muscle protein breakdown are converted to glucose via gluconeogenesis in the L____________, helping maintain blood glucose levels.
After a meal, the increase in portal blood glucose concentration suppresses G____________ secretion, allowing the body to lower blood sugar levels.
Excessive fructose intake is associated with hypertriglyceridemia, elevated cholesterol, and increased uric acid levels. This is due to the production of excess P____________ through fructose metabolism, promoting fatty acid synthesis.
P____________ carboxykinase plays a key role in gluconeogenesis, utilizing GTP as a phosphate donor, linking the citric acid cycle to gluconeogenesis.
G____________ peroxidase is a selenium-containing enzyme that reduces hydrogen peroxide (H₂O₂) to water, protecting cells from oxidative stress.
G____________ reductase reduces oxidized glutathione (GSSG) back to its reduced form (GSH), maintaining the cell’s defense against oxidative stress.
During gluconeogenesis, the activity of G____________-6-phosphatase increases, generating glucose to maintain blood sugar levels, particularly during fasting or in diabetes.
T____________ is an enzyme that transfers two-carbon units from a ketose to an aldose, playing a crucial role in the pentose phosphate pathway.
When carbohydrates are consumed, G____________ (gluconeogenesis) is suppressed, and the activity of phosphoenolpyruvate carboxykinase (PEPCK), a key enzyme in gluconeogenesis, decreases.
After carbohydrate intake, the availability of glucose reduces the need for gluconeogenesis, leading to a decrease in the activity of P____________ carboxylase, an enzyme important in the early stages of gluconeogenesis.
T____________ is an enzyme in the pentose phosphate pathway that transfers a three-carbon dihydroxyacetone unit, leading to the formation of fructose-6-phosphate.
In the citric acid cycle, acetyl-CoA and oxaloacetate combine to form C____________, a reaction catalyzed by citrate synthase.
The conversion of succinate to fumarate is catalyzed by S____________ dehydrogenase, which is located in the inner mitochondrial membrane and also functions in the electron transport chain, directly reducing ubiquinone.
The intermediate formed by the oxidative decarboxylation of isocitrate is A____________-ketoglutarate, catalyzed by isocitrate dehydrogenase, producing NADH and CO₂.
The conversion of succinyl-CoA to succinate in the citric acid cycle is the only substrate-level phosphorylation reaction, generating either G____________ or ATP.
The main purpose of the citric acid cycle is to oxidize acetyl-CoA and generate N____________ and FADH₂, which link to oxidative phosphorylation for ATP production.
O____________ leaves the citric acid cycle to serve as a precursor in gluconeogenesis, being converted into phosphoenolpyruvate (PEP).
I____________ dehydrogenase is inhibited by high concentrations of ATP, regulating the rate of the citric acid cycle.
F____________ acetate exerts its toxicity by inhibiting aconitase, causing an accumulation of citrate in the citric acid cycle.
S____________ dehydrogenase, while converting succinate to fumarate in the citric acid cycle, also interacts with the electron transport chain by providing electrons to ubiquinone via FAD.
A____________-ketoglutarate dehydrogenase catalyzes the oxidative decarboxylation of α-ketoglutarate to succinyl-CoA, producing CO₂ and NADH in a crucial step of the citric acid cycle.
M____________ dehydrogenase catalyzes the oxidation of malate to oxaloacetate, generating NADH and regenerating oxaloacetate in the final step of the citric acid cycle.
The oxidation of acetyl-CoA in the citric acid cycle produces C____________ as a waste product.
C____________ can be transported to the cytosol, where it serves as a precursor for fatty acid synthesis and is cleaved into acetyl-CoA and oxaloacetate.
The decarboxylation of isocitrate to α-ketoglutarate is facilitated by M____________ ions, which promote the reaction.
The citric acid cycle occurs within the M____________ matrix.
Glycolysis takes place in the C____________ of the cell.
A____________-ketoglutarate dehydrogenase is subject to feedback inhibition by its product, NADH.
Pyruvate is converted to oxaloacetate by pyruvate carboxylase in an anaplerotic reaction, replenishing intermediates of the citric acid cycle.
R____________ (vitamin B2) is required in its FAD form as a coenzyme for succinate dehydrogenase.
The citric acid cycle is considered A____________ because it participates in both catabolic and anabolic processes.
Oxaloacetate can be produced via a transamination reaction from A____________.
S____________ dehydrogenase is inhibited by the accumulation of oxaloacetate.
P____________ dehydrogenase is inhibited by the accumulation of NADH.
Vitamin B1 (thiamine) is required as thiamine pyrophosphate (TPP) for the activity of P____________ dehydrogenase.
V____________ is one of the amino acids that generates succinyl-CoA during its metabolism.

TABLE 31-2 Summary of Major Findings in the Porphyrias (Fill in the blanks)

Enzyme Involved	Type, Class, and OMIM Number	Major Signs and Symptoms	Results of Laboratory Tests
1. ____ synthase 2 (ALAS2), EC ____	X-linked sideroblastic anemia (erythropoietic) (OMIM ____ )	____	Red cell counts and hemoglobin ____
2. ALA dehydratase, EC ____	ALA dehydratase deficiency (____) (OMIM 125270)	____ pain, neuropsychiatric symptoms	Urinary ____ and coproporphyrin III increased
3. ____ synthase, EC 2.5.1.61	Acute intermittent porphyria (____) (OMIM 176000)	____ pain, neuropsychiatric symptoms	Urinary ____ and ____ increased
4. ____ synthase, EC 4.2.1.75	Congenital erythropoietic porphyria (erythropoietic) (OMIM 263700)	____	Urinary, fecal, and red cell ____ increased
5. ____ decarboxylase, EC 4.1.1.37	Porphyria cutanea tarda (____) (OMIM 176100)	____	Urinary ____ I increased
6. Coproporphyrinogen oxidase, EC ____	Hereditary coproporphyria (hepatic) (OMIM ____ )	Photosensitivity, abdominal pain, ____ symptoms	Urinary ALA, ____, coproporphyrin III, and fecal ____ III increased
7. Protoporphyrinogen oxidase, EC ____	____ porphyria (hepatic) (OMIM 176200)	Photosensitivity, abdominal pain, ____ symptoms	Urinary ALA, ____, coproporphyrin III, and fecal ____ IX increased
8. ____ EC 4.99.1.1	Protoporphyria (erythropoietic) (OMIM 170000)	____	Fecal and red cell ____ IX increased

TABLE 31-2 Summary of Major Findings in the Porphyrias

Enzyme Involved	Type, Class, and OMIM Number	Major Signs and Symptoms	Results of Laboratory Tests
1. ALA synthase 2 (ALAS2), EC 2.3.1.37	X-linked sideroblastic anemia (erythropoietic) (OMIM 301300)	Anemia	Red cell counts and hemoglobin decreased
2. ALA dehydratase, EC 4.2.1.24	ALA dehydratase deficiency (hepatic) (OMIM 125270)	Abdominal pain, neuropsychiatric symptoms	Urinary ALA and coproporphyrin III increased
3. Uroporphyrinogen I synthase, EC 2.5.1.61	Acute intermittent porphyria (hepatic) (OMIM 176000)	Abdominal pain, neuropsychiatric symptoms	Urinary ALA and PBG increased
4. Uroporphyrinogen III synthase, EC 4.2.1.75	Congenital erythropoietic porphyria (erythropoietic) (OMIM 263700)	Photosensitivity	Urinary, fecal, and red cell uroporphyrin I increased
5. Uroporphyrinogen decarboxylase, EC 4.1.1.37	Porphyria cutanea tarda (hepatic) (OMIM 176100)	Photosensitivity	Urinary uroporphyrin I increased
6. Coproporphyrinogen oxidase, EC 1.3.3.3	Hereditary coproporphyria (hepatic) (OMIM 121300)	Photosensitivity, abdominal pain, neuropsychiatric symptoms	Urinary ALA, PBG, coproporphyrin III, and fecal coproporphyrin III increased
7. Protoporphyrinogen oxidase, EC 1.3.3.4	Variegate porphyria (hepatic) (OMIM 176200)	Photosensitivity, abdominal pain, neuropsychiatric symptoms	Urinary ALA, PBG, coproporphyrin III, and fecal protoporphyrin IX increased
8. Ferrochelatase, EC 4.99.1.1	Protoporphyria (erythropoietic) (OMIM 170000)	Photosensitivity	Fecal and red cell protoporphyrin IX increased

答え

Aminolevulinic dehydratase (ALAD)
Hydroxymethylbilane
Porphyrins
Uroporphyrinogen
Porphobilinogen
Uroporphyrinogen
Uroporphyrinogen
Cytosol
Mitochondria
Aminolevulinic
Aminolevulinic
Photosensitivity
Drug-Induced
Bilirubin
Retention
Bilirubin
Hereditary
Protoporphyria
ALA
Variegate
Crigler-Najjar
Lead
Gilbert
Acute Intermittent
Catalase
Tryptophan
Cytochrome
Cytochrome C
Myoglobin
NADPH
Glucuronate
Galactokinase
Glucose-6-Phosphate
Hereditary
Hereditary
Sorbitol
Galactose-1-Phosphate
Glucuronate
Glutathione
Transketolase
Ribulose-5-Phosphate
Lactase
Pyruvate
Glyceraldehyde-3-Phosphate
Gluconeogenesis
Salivary
Insulin
Glycogenolysis
Fatty Acids
Sodium-Glucose
Von Gierke’s
Phosphoenolpyruvate
Cori
G6PD
Glucose-6-Phosphate
Phosphoenolpyruvate
Pentose
Essential
GLUT2
GLUT2
GLUT1
GLUT3
GLUT3
GLUT4
GLUT5
Glucokinase
Galactokinase
Ketone
Fatty Acids
Ketone
Phosphofructokinase-1
Glucuronate
Pentose
Uronate
Galactose-1-Phosphate
Galactose
Amino Acids
Glucagon
Fructose
Phosphoenolpyruvate
Glutathione
Glutathione
Glucose-6-Phosphatase
Transketolase
Carbohydrate
Gluconeogenesis
Pyruvate
Transaldolase
Citrate
Succinate
Alpha
GTP
NADH
Oxaloacetate
Isocitrate
Fluoroacetate
Succinate
Alpha
Malate
CO2
Citrate
Magnesium
Mitochondrial
Cytosol
Alpha
Anaplerotic
Riboflavin
Amphibolic
Aspartate
Succinate
Pyruvate
Pyruvate
Valine

Histology

When in contact with other organs, the outer layer of the digestive tract is called the A__________.
M______________ is found in the hard palate and gingiva.
The M______ contains the lamina propria, forming the connective tissue.
M________________________ are found as simple columnar epithelium in the stomach and intestines.
P____________ are lymphoid tissues located especially in the ileum of the small intestine.
The M_____________________ is part of the mucosa and helps in its movement.
The space of Disse contains I__________ cells, hepatocyte microvilli, and unmyelinated nerve fibers, but not elastic fibers.
The connective tissue layer of the gallbladder is composed of D__________ irregular collagenous connective tissue.
D_________ refer to serous cells capping mucous cells.
Most of the gallbladder is covered by S________ while part is covered by adventitia.
C___________ P450 enzymes are primarily found in the smooth ER and are involved in drug detoxification.
T___________ are most commonly found in the circumvallate papillae at the back of the tongue.
The small intestine is lined by S____________________________ epithelium, which aids in digestion and absorption.
T_____________ coli are longitudinal muscle bands found in the large intestine.
P_____________ cells in the small intestine secrete antimicrobial peptides.
The esophagus contains S_____________ muscle in its upper third.
Absorptive cells in the small intestine convert absorbed lipids into T______________, which are transported into lymphatic vessels.
E__________ cells in the intestine secrete hormones basally, while goblet cells secrete mucus into the lumen.
Abnormal primary teeth may suggest a problem with D__________, which is formed from neural crest-derived cells.
In patients taking long-term medications, smooth endoplasmic reticulum (SER) expansion occurs due to increased D___________ and metabolism of drugs.
Pancreatic Z__________ are secreted in an inactive form to prevent self-digestion of pancreatic tissue.
C______________ cells are specific to the exocrine pancreas and are part of the acinar structure.
B____________ are located between adjacent hepatocytes and are sealed by junctional complexes to prevent bile leakage.
The gallbladder secretes M________ to maintain the viscosity of bile and protect its mucosal lining.
The S______ of Disse is found between hepatocytes and hepatic sinusoids, facilitating nutrient exchange.
J__________ is caused by the accumulation of bilirubin in the bloodstream, often due to liver dysfunction.
In the parotid gland, S__________ ducts primarily function in Na+ reabsorption.
V____________ disease results from a deficiency of glucose-6-phosphatase, leading to glycogen buildup in hepatocytes.
The M______ of the gastrointestinal tract is the innermost layer, consisting of epithelium, lamina propria, and muscularis mucosae.
P_____________ patches are lymphoid tissues found in the ileum, playing a key role in immune defense.
F___________ papillae are distributed across the tongue but lack taste buds.
The esophagus is lined by N____________________________ stratified squamous epithelium.
A__________ plexus, located in the muscularis externa, controls peristalsis in the gastrointestinal tract.
The P__________ gland is the largest salivary gland and is located near the posterior mandible.
A P__________ lobule is defined as a triangular area with the central veins of adjacent hepatic lobules at its corners.
The P__________ triad consists of the portal vein, hepatic artery, and bile duct.
Hepatocytes utilize C___________ P450 enzymes in the smooth ER for drug detoxification.
I______________ ducts begin in the acini and play a critical role in adding bicarbonate ions (HCO₃⁻) to the initial secretions.
Intercalated ducts begin in the A_________ and add bicarbonate ions (HCO₃⁻) to the initial secretion.
Striated ducts are involved in the reabsorption of N__________ and chloride ions but do not directly supply bicarbonate.
The G__________ is a pear-shaped organ capable of storing 30-50 mL of bile.
The gallbladder wall is composed of mucosa, muscularis, and external A___________ or serosa.
P____ cells in the pancreas inhibit exocrine pancreatic secretion.
Z__________ granules, pancreatic acini, and acinar cells are all involved in the secretion of digestive enzymes.
The H__________ acinus of Rappaport is a diamond-shaped region that includes portions of adjacent liver lobules.
The functional unit of a salivary gland is the S________, composed of acini, intercalated ducts, and striated ducts.
H__________ sinusoids are specialized capillaries that allow for efficient exchange between hepatocytes and blood.
K__________ cells, located within hepatic sinusoids, are specialized macrophages responsible for breaking down old red blood cells.
Hepatocytes contain abundant rough and smooth endoplasmic reticulum and G__________ apparatus for protein synthesis and detoxification.
The gallbladder lacks a S__________, unlike many other digestive organs that contain this layer of connective tissue.
E__________ is an enzyme secreted by the duodenal mucosa, responsible for activating trypsinogen into trypsin.
C__________ is a hormone that promotes gluconeogenesis in the liver, especially during fasting or stress.

答え

Adventitia
Masticatory
Mucosa
Mucous
Peyer’s patches
Muscularis
Ito cells
Dense irregular
Demilunes
Serosa
Cytochrome
Vallate
Columnar
Teniae coli
Paneth
Striated
Triglycerides
Basal
Dentin
Smooth
Zymogens
Centroacinar
Junctional
Mucosa
Disse
Bilirubin
Sodium
Von Gierke
Mucosa
Ileum
Filiform
Non-keratinized
Auerbach’s
Parotid
Portal
Triad
Smooth
Intercalated
Acinus
Sodium
Gallbladder
Adventitia
PP
Zymogen
Hepatic
Salivon
Hepatic
Kupffer
Golgi
Submucosa
Enterokinase
Cortisol