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Embalmin 3 random
| Question | Answer |
|---|---|
| Common Carotid Artery Accompanying vein | Internal jugular vein |
| Common Carotid Artery Linear guide | a line drawn on the surface of the skin from a point over the sternoclavicular articulation to the anterior surface of the lobe of the ear |
| Common Carotid Artery Anatomical guide: | along medial border of sternocleidomastoid (SCM) muscle |
| Anatomical limits: Right Common Carotid | - begins at the level of sternoclavicular articulation and terminates at the level of the superior border of the thyroid cartilage |
| Anatomical limits: Left Common Carotid | - begins at the level of second costal cartilage and terminates at the superior border of the thyroid cartilage |
| Facial Artery Anatomical guide | along the inferior border of the mandible just anterior to the angle of the mandible |
| Subclavian Artery Accompanying vein | Subclavian vein |
| Subclavian Artery Anatomical guide | Clavicle bone |
| Anatomical limits: Right Subclavian - | begins at the sternoclavicular articulation and terminates at the lateral border of the first rib |
| Anatomical limits: Left Subclavian | begins at the level of the second costal cartilage and terminates at the lateral border of the first rib |
| Axillary Artery Accompanying vein: | Axillary vein |
| Axillary Artery Linear guide: | through the center of the base of the axillary space and parallel to the long axis of the upper extremity when abducted |
| Axillary Artery Anatomical guide: | along the medial border of the coracobrachialis muscle |
| Axillary Artery Anatomical limits: | begins at the lateral border of the first rib to the inferior border of the tendon of the teres major muscle |
| Brachial Artery Accompanying vein: | Basilic vein |
| Brachial Artery Linear guide | from the center of the base of the axillary space to center of forearm just below the bend of the elbow |
| Brachial Artery Anatomical guide | lies posterior to the medial border of the belly of the biceps brachii muscle |
| Brachial Artery Anatomical limits | : begins at the inferior border of the tendon of the teres major muscle and terminates at a point just inferior to the antecubital fossa (bend of the elbow) |
| Radial Artery Accompanying vein: | Radial vein |
| Radial Artery Linear guide: | on surface of the forearm from center of the antecubital fossa to center of base of the second digit |
| Radial Artery Anatomical guide | just lateral to the tendon of flexor carpi radialis muscle |
| Radial Artery Anatomical limits: | extends from one inch distal of antecubital fossa to the base of the thumb |
| Ulnar Artery Accompanying vein: | Ulnar vein |
| Ulnar Artery Linear guide | a line drawn on the surface from the center of the antecubital fossa to a point between the 4th and 5th digits |
| Ulnar Artery Anatomical guide | lateral to the tendon of the flexor carpi ulnaris muscle |
| Ulnar Artery Anatomical limits: | extends approximately one inch distal from the antecubital fossa to the medial palm of the hand |
| External Iliac Artery Accompanying vein: | External iliac vein |
| External Iliac Artery Anatomical guide | medial border of the psoas major muscle |
| Femoral Artery Accompanying vein | Femoral vein |
| Femoral Artery Linear guide: | on the surface of the thigh from the center of the inguinal ligament to the center point on the medial condyle of the femur |
| Femoral Artery Anatomical guide | through the center of the femoral triangle bounded laterally by the sartorius muscle and medially by the adductor longus muscle |
| Femoral Artery Anatomical limits | begins at a point posterior to the center of the inguinal ligament and terminates at the opening of the adductor magnus muscle |
| Popliteal Artery Accompanying vein: | : Popliteal vein |
| Popliteal Artery Linear guide: | a line from the center of the superior border of the popliteal space parallel to the long axis of the lower extremity to the center of the inferior border of the popliteal space |
| Popliteal Artery Anatomical guide | located between the popliteal surface of the femur and the oblique popliteal ligament |
| Popliteal Artery Anatomical limits: | extends from a point beginning at the opening of adductor magnus muscle to lower border of the popliteus muscle |
| Anterior Tibial Artery Linear guide | a line drawn from the lateral border of the patella (knee cap) to the anterior surface of the ankle |
| Posterior Tibial Artery Linear guide: | from the center of the popliteal space to a point midway between the medial malleolus and calcaneal tendon |
| Dorsalis Pedis Artery Linear guide: | from the center of the anterior surface of the ankle joint to a point between the first and second digits |
| Cardiac circulation: | All blood returns to the heart and empties into the right atrium via the superior and inferior vena cavae. a. Blood from the head and upper extremities returns via the superior vena cava. |
| Cardiac circulation: | b. Blood from the trunk and lower extremities returns via the inferior vena cava. c. The right atrium is the center of drainage in a dead human body. 2. From the right atrium, blood flows inferiorly into the right ventricle. |
| Cardiac circulation: | 3. Blood exits the right ventricle via the pulmonary arteries and goes to the lungs. 4. Newly oxygenated blood returns to the heart and empties into the left atrium via the pulmonary veins |
| Cardiac circulation: | 5. From the left atrium, blood flows inferiorly into the left ventricle. 6. Blood is ejected from the left ventricle into the ascending aorta. 7. Blood enters the aortic arch, the center of fluid distribution in the dead human body: |
| The aortic arch has three branches (numbered in the diagram above): | 1. Brachiocephalic trunk (which then bifurcates into two major vessels): a. Right common carotid artery b. Right subclavian artery |
| The aortic arch has three branches (numbered in the diagram above): | 2. Left common carotid artery 3. Left subclavian artery |
| Theoretically, the entire body can be embalmed using ANY artery. | true |
| Most Frequently Used | Common Carotid Femoral External iliac if raised at inguinal ligament Axillary Brachial |
| Drainage Sites: Most Frequently Used | internal jugular vein RIJ is closest to right atrium: center of venous drainage Femoral vein Axillary vein Basilic vein (companion vein to Brachial artery) |
| Very thick walls Creamy white in appearance Vasa vasorum Latin for “vessels of the vessels” on surface of artery | Arteries |
| Lumen remains open and very visible when vessel is incised Very ELASTIC Clear fascia to elevate | Arteries |
| Thinner Bluish appearance when filled with blood Contain valves Prevent “backflow” Has a lumen but collapses when incised Funnel-like effect | Veins |
| Silvery white appearance Visible surface striations When incised, no lumen is present Frayed appearance Rope | Nerves |
| Supra-clavicular | Made on or above the clavicle (collar bone) |
| Anterior Parallel | Parallel to the SCM muscle (tendon) Omohyoid as anatomical guide! TC fav |
| Posterior Parallel (Vertical) | Below earlobe |
| When using both artery and vein at same site: Always raise the superficial vessel first | Internal jugular vein then common carotid artery |
| Insert instrument into the deeper vessel first Use arterial tube slightly smaller than lumen | true |
| Common Carotid Artery Regions supplied: | Injecting superiorly: face and head Injecting inferiorly: opposite side of face/head & remainder of body |
| Common Carotid Artery Considerations (Pros) | Large in diameter No branches Flexible (rarely sclerotic) Close to aortic arch (center of distribution) Supplies solution directly to head Accompanied by large vein (internal jugular) Inferior injection will push clots away from head |
| Common Carotid Artery Precautions (Cons): | Facial features can distend Instruments can indent/mark facial tissue Clothing may not conceal incision Leakage must be controlled Visible soiling |
| Internal Jugular Vein Leads directly to right atrium | Center of drainage Joins brachiocephalic veins which empty into the IVC Preferred drainage site Direct drainage from the face/head |
| Axillary Artery Continuation of subclavian artery Regions supplied: | Distal injection (towards hand): Arm and hand Proximal injection (towards trunk): Entire body |
| Axillary Artery Considerations (Pros): | Solution flows directly into arm and hand Close to face Superficial Close to aortic arch (center of distribution) |
| Axillary Artery Precautions (Cons): | Arm must be abducted (extended) for drainage Artery is too small for injection of entire body Vein is too small for drainage Numerous branches Facial tissues may distend |
| Originates at bifurcation of brachial artery | Radial Artery and ulnar |
| Small artery Leakage and/or incision may be visible | Radial Artery and ulnar |
| Second most commonly used vessel | Femoral Artery |
| Continuation of external iliac artery Begins at inguinal ligament Iliofemoral region | Femoral Artery |
| Regions supplied: Femoral Artery | Regions supplied: Distal injection: leg and foot Proximal injection: entire body |
| Femoral Artery Considerations (Pros): | Large diameter Incision not visible Both sides of head receive distribution Dye and internal tissue building Accompanied by large vein (Femoral vein) c. Both sides of face/head receive distribution |
| Femoral Artery Precautions (Cons): | Arteriosclerosis common (atherosclerosis) Vessels deep in obese cases Solution reaches head uncontrolled Coagula pushed towards head b. Vessels may be deep in obese cases |
| Very difficult to raise due to location (Back of the knee) | Popliteal Artery |
| Largest artery in body May be used on autopsied cases | Aorta |
| More commonly used on infants (largest vessel) | Aorta |
| Passes beneath inguinal ligament More superficial than femoral artery | External Iliac Artery |
| Largest vein in the body | Inferior Vena Cava |
| Lies to the right of the descending aorta Posterior abdominal wall Used for drainage in full/partial autopsy | Inferior Vena Cava |
| Right Atrium of Heart 2” superior & 2” to (deceased’s) left of umbilicus Aim for right earlobe Depress tip of trocar as you puncture the diaphragm | Direct heart drainage “Heart tap” |
| Embalming Analysis Done within three time periods: | Before embalming (Pre-embalming) During embalming (Concurrent) After embalming (Evaluative) |
| Four steps of analysis: | Observation and evaluation Proposed method(s) of treatment Implementation Observation of results |
| Pre-Embalming Analysis: Factors | Condition of the body Age, weight, musculature, build Immediate cause/manner of death Effects of disease or trauma Effects of drugs/medications |
| Pre-Embalming Analysis: Factors | PM physical and chemical changes PM procedures Refrigeration, autopsy, tissue recovery, etc. PM interval Time from prep to disposition |
| Pre-Embalming Analysis: Treatments | Positioning of the body Method of eye/mouth closure Treatments for swelling or discolorations Treatments to raise sunken tissues |
| Pre-Embalming Analysis: Treatments | Vessels for injection/drainage Strength of solution Volume of solution Pressure and rate of flow Delayed or immediate cavity treatment? |
| Intrinsic Factors | Cause/manner of death Body conditions Pathological conditions Microbial influence Moisture content Thermal influences (fever) Nitrogenous waste Weight |
| Intrinsic Factors | Gas in tissues/cavities Age Presence of discolorations PM physical changes PM chemical changes Effects of drugs |
| Extrinsic Factors | Environmental Atmospheric conditions Thermal influences (temp.) Microbial influences Vermin Time intervals Death to embalming “Postmortem interval” Embalming to disposition |
| Intrinsic Conditions: Child/Infant | Arteries/veins will be very small Abdominal aorta often best option for infant Smaller instruments needed E.g. arterial tube, drainage device Milder solutions possibly needed Don’t go too weak! |
| Emaciated | Reduce solution strength (prevent over-embalming) Dehydration can cause problems with eye/mouth closure |
| Renal failure | Increase in ammonia (NH3) and nitrogenous wastes Neutralizes HCHO |
| purge If drainage is present | continue injecting! |
| purge If purge is arterial solution (and drainage continues) | continue injection to make up for solution being lost via purge. |
| purge NO DRAINAGE: | There is a rupture somewhere in the arterial system Start a six-point or sectional embalming immediately |
| Algor mortis Physical Change | Slows onset of rigor; keeps blood in liquid state |
| Dehydration Physical Change | Increases blood viscosity; darkens surface of body |
| Hypostasis Physical Changes | Responsible for livor mortis >>> post-mortem stain Increases tissue moisture |
| Livor mortis Physical Changes | Intravascular discoloration: CAN BE CLEARED with arterial injection |
| Increase in blood viscosity Physical Changes | Intravascular resistance; post-mortem edema; poor drainage |
| Translocation of microbes Physical Changes | Speeds decomposition in various body regions |
| Rigor mortis Chemical Changes | Extravascular resistance; positioning difficult; pH not conducive to good fluid reactions; false sign of preservation; tissues swell; increases preservative demand (due to protein breakdown) |
| Decomposition Chemical Changes | Color changes; odor; purge; skin slip (desquamation); gases; poor distribution; rapid swelling |
| Post-mortem stain Chemical Changes | Extra-vascular discoloration – CANNOT BE CLEARED via arterial injection; can be bleached from surface; increased preservative demand (6 hours); false indication of fluid dye; can turn gray after embalming |
| Post-mortem caloricity Chemical Changes | Sets off rigor and decomposition cycles |
| Shift of body pH Chemical Changes | Interferes with fluid reactions; can cause dye to splotch |
| Generalized edema | (Anasarca) |
| cardiac muscle around the left ventricle is much thicker than anywhere else in the heart; this is because the left ventricle ejects the blood to the rest of the body | true |
| When the heart muscle contracts, the blood is forced into the ascending aorta (#9) and through the aortic arch. At this point, it can take one of the three branches (#10) of the aortic arch, | true |
| The third section of the aorta is the descending aorta, which is divided into two sections: the thoracic aorta and abdominal aorta. | true |
| The right and left internal jugular veins carry blood from the head back towards the heart. They empty into the L & R brachiocephalic veins (the right one is much shorter than the left), which then empty into the superior vena cava. | true |
| The internal jugular lies lateral and superficial to the common carotid artery and is the most common vessel for drainage during the embalming process. | t |
| Any surface, prominence or structure used in establishing the location of an adjacent structure or prominence is referred to as a/an | anatomical guide |
| Each artery is a continuation of the one before it (the exception being the radial and ulnar arteries, which are formed by the bifurcation of the brachial artery.) | t |
| Because the right common carotid is a branch of the brachiocephalic trunk, it "starts" higher (more superiorly) than the left common carotid. | t |
| As in the arm, each artery is a continuation of the one before it (with the exception of the posterior tibial, which arises from the bifurcation of the popliteal artery.) | t |
| The dorsalis pedis artery is represented by a line drawn from the center of the posterior surface of the ankle joint to a point between the first and second digits. | f ANTERIOR surface of the ankle. |
| The popliteal artery begins at the opening of the adductor magnus muscle. | t |
| Theoretically, the entire body can be embalmed using ANY artery. However, smaller vessels can't handle necessary pressure and rate of flow (RoF) to reach entire body. | t |
| The aorta is the largest artery in the body. This vessel may come in handy for a partial autopsy or organ donation | t |
| This vessel passes below the inguinal ligament and is more superficial than the femoral artery, making it a good alternate site for injection of the lower limb. | L. External Iliac artery |
| The inferior vena cava is the largest vein in the body. Like the aorta, this vessel may come in handy for a partial autopsy or organ donation. | t |
| The embalmer must consider four major factors when conducting the pre-embalming analysis: | General condition of the body 2. Effects of disease processes 3. Effects of drugs or surgical procedures 4. Time between death and embalming (referred to as the postmortem interval or PMI) |
| General Intrinsic Body Conditions | Age 2. Weight 3. Musculature 4. Disease processes |
| Postmortem Interval Three postmortem conditions that interfere most with distribution in the arterial system are: | Blood coagulation (exacerbated by time) 2. Rigor mortis 3. Decomposition |
| Here is where intermittent drainage is crucial: closing the drainage while still injecting creates intravascular pressure, which forces the solution into deeper, distal tissues that have yet received any. You will also want to | palpate (massage) these areas to stimulate flow of solution. |
| Considerations of Post-Embalming Analysis The benefit of delaying aspiration is to retain intravascular pressure (IVP) that was built up during arterial injection. This pressure can essentially continue to embalm the tissue for hours afterwards | Delaying aspiration is most effective when done in tandem with intermittent drainage. Stopping drainage during injection of the final half- to quarter-gallon greatly increases |
| Generalizations | Use a restricted cervical injection if you expect to inject a large volume of solution; this will minimize over-embalming of the face/head. 3. Always start with a slightly milder solution and increase strength as necessary. |
Created by:
jcowing