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Physiology · Gastrointestinal: hepatic arterial buffer response
Sample itemIn a patient with portal vein thrombosis, hepatic arterial flow increases. What is the mechanism?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
B. Reduced portal flow lets adenosine accumulate, dilating the hepatic artery
Adenosine is washed out of the space of Mall by portal blood flow. When portal flow falls, adenosine accumulates and relaxes hepatic arterial smooth muscle, which partly compensates and maintains total hepatic flow. This is the hepatic arterial buffer response.
Option by option
A. Direct sympathetic vasodilatation of the hepatic artery
The response is local and does not depend on sympathetic vasodilators.
B. Reduced portal flow lets adenosine accumulate, dilating the hepatic artery (correct)
Correct. Reduced washout of adenosine dilates the hepatic artery.
C. Increased pressure in the hepatic veins
Hepatic venous pressure is not the signal for this response.
D. Rising portal oxygen content
Portal oxygen content falls when flow is reduced, not rises.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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