Question

1. Trace the pathway that a blood cell would follow from the anterior tibial vein to the anterior tibial artery.

Answer 1

1) Anterior Tibial vein to Anterior Tibial artery.

2) Liver receives blood from portal veins and send blood to the inferior vena cava (IVC) through hepatic veins. When cirrhosis develops, the vasculature is injured and is replaced by scar tissue. That is why the liver is not able to drain the blood into IVC. Output is very reduced but input i.e. blood flow from Portal system keeps on coming. This increases the pressure inside the sinusoids of the liver. This leaks out the blood into the liver parenchyma which is drained by lymphatics. When the leakage exceeds the drainage capacity of lymphatics, the fluid starts dropping out of liver capsule into the peritoneal cavity as ascitic fluid. This causes ascites.

Cirrhosis leads to portal hypertension (increased pressure inside the portal venous system) which can cause:

• Formation of portosystemic shunts: hemorrhoids(rectum), varices (gastroesophageal junction), retroperitoneum and falciform ligament of liver, caput medusae (abdominal wall collaterals appear as dilated subcutaneous veins extending from umbilicus towards rib margins).
• Splenomegaly.
• Spider angiomas.
• Malnutrition

Cirrhosis also can lead to Hepatic encephalopathy , palmar erythema, deficient synthesis of Albumin which disturbs the osmotic pressure and cause generalized edema in the body.