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Embalming
Final Qtr 1
| Question | Answer |
|---|---|
| The art and science of disinfecting, temporarily preserving, and restoring to a normal appearance a dead human body | Embalming |
| Destruction or inhibition of pathogenic organisms and their products in or on the body | Disinfection |
| Chemical treatment of the body so as to delay the decomposition of the body for a limited time | Temporary Preservation |
| Care of the deceased to recreate natural form and color | Restoration |
| Name the 4 types of embalming | Arterial (Vascular), Cavity, Hypodermic, Topical (Surface) |
| Type of embalming that uses the circulatory system; basic embalming procedure | Arterial/Vascular Embalming |
| Direct chemical treatment other than by arterial embalming of the contents of the body cavities and the lumina of the hollow viscera; done with a trocar | Cavity Treatment/Embalming |
| Injection of embalming chemicals directly into the tissues using a syringe, hypodermic needle, or trocar; done as needed | Hypodermic Embalming |
| Direct contact of internal or external tissues or body surfaces with embalming chemicals; use a cotton pack as needed | Surface/Topical Embalming |
| What is the main cause of decomposition? (produced by bacteria and our own cells) | Enzymes |
| Relationship based on trust | Fiducial Relationship |
| The study of death | Thanatology |
| The cessation or extinction of life manifested by the absence of heartbeat and respiration, and characterized by the absence of metabolism and total lack of irritability. The cessation of all vital functions without the possibility of resuscitation. | Death |
| The irreversible cessation of total brain function | Death |
| The irreversible cessation of all body functions | Death |
| Condition in which the heartbeat, respiration, body warmth, and other manifestations of life are very feably maintained | Apparent Death |
| Sound sometimes made by the dying caused by labored breathing through air passages partly filled with mucus | Death Rattle |
| Semi-convulsive series of movements and facial twitches which may occur before death | Death Struggle |
| Period of time immediately before death, however the time period can vary between a few seconds and a few days | Agonal State/Period |
| Someone in the agonal state | Moribund |
| Someone facing death | In Articulo Mortis |
| The body of a deceased person including skeletal remains or a body in any stage of decomp | Human Remains |
| Dead body embalmed in a special manner for the study of anatomy or dissection | Cadaver |
| Those elements of a dead human body remaining after cremation | Cremated Remains |
| Dead human body | Corpse |
| Ratio of the number of deaths over a given period of time to the population of a given area | Mortality Rate (Death Rate) |
| Ratio of the number of cases of specific diseases over a period of time to the population of a given area | Morbidity Rate |
| Death of the whole organism; the body is an autonomous unit and it is the point when cooperation between body systems break down | Somatic Death |
| Name the two parts of somatic death | Clinical Death (Legal Death) & Biologic Death |
| Cessation of heartbeat & respiration, lasts about 5-6 minutes before brain death occurs, can be reversed if you can get the heart started before the 5-6 mins | Clinical Death (Legal Death) |
| Irreversible cessation of total brain function, follows clinical death and this is the last part of somatic death | Biologic Death |
| Name the 3 modes of somatic death | Syncope, Asphyxia, Coma |
| Name the organs in the Tripod of Life | Lungs, Heart, Brain |
| Death beginning at the heart; can be caused by penetrating wounds, loss of blood volume, myocardial infarction, heart failure | Syncope |
| Death beginning at the brain; can be caused by penetrating/crushing wounds, tumors, stroke, blockage of vessels, loss of blood volume | Coma |
| Death beginning at the lungs; can be caused by blood clots, choking, cancer, emphysema, pneumonia, TB, drowning, smoke inhalation, paralysis of the diaphragm | Asphyxia |
| Death of the individual cells of the body, always follows somatic death | Cellular Death |
| Name the cause of cellular death | Anoxia (absence of oxygen) |
| The gradual loss or reduction of oxygen | Hypoxia |
| Death of cells and replacement of new cells of the same type; body's way of self replacement; normal process of cellular death | Necrobiosis |
| Pathological death of certain cells or tissues in a still living body; 2 types: gangrene & decubitous ulcers | Necrosis |
| How does cause of death affect the onset and duration of cellular death? | Healthy Person--> slow onset, long duration Someone with chronic, lengthy illnesses--> rapid onset, short duration |
| How does the condition of the body affect the onset and duration of cellular death? | Young--> slow onset, long duration Old--> fast onset, short duration Obese--> Longer duration Thin--> Shorter duration |
| How do the environmental conditions affect the onset and duration of cellular death? | Cold--> slower onset, longer duration Warm/Hot--> rapid onset, short duration |
| How do the medications taken before death affect the onset and duration of cellular death? | Medications that help/build up cells--> slower onset, longer duration Medicines that are cytotoxic--> faster onset, shorter duration |
| Sensible manifestations that indicate the absence of life in a human body | Signs of Death |
| What is the #1 most reliable sign of death? | Decomposition |
| Name the signs of death | Cessation of Heartbeat & Respiration, Algor Mortis, Rigor Mortis, Livor Mortis, Dehydration, Changes in the eye, Decomposition |
| Postmortem adjustment of body temperature to that of the surrounding medium | Algor Mortis |
| Temporary stiffening of the voluntary & involuntary muscles as a result of chemical changes in a dead body | Rigor Mortis |
| Settling of the blood to the dependent parts of the body | Livor Mortis |
| Loss of moisture from tissues by direct convection from the skin | Dehydration |
| Complete/extreme dehydration; tissues become hard & black like wood; occurs in the lips, fingers, toes, eyelids, tip of the nose | Dessication |
| Complete and rapid dehydration | Mummification |
| Name the changes in the eye that occur after death | Surface becomes dull; lens, iris, cornea become white/milky (clouding of the cornea); eyes start sinking into the sockets |
| Name the 5 signs of decomposition | Appearance of a green discoloration in the lower right quadrant, purge, gas distention, skin slip (desquamation), odor |
| Any procedure used to verify a sign of death | Tests for death |
| What are the 2 types of tests for death? | Expert & Common (Inexpert) |
| Stethoscope Test, Dye Injection Test, Electrocardiograph (EKG), Electroencephalograph (EEG), Opthalamoscope Test | Expert Tests |
| Heartbeat & Respiration Test, Pulse Test, Ligature Test, Ammonia Injection Test | Common Tests |
| Changes in the appearance of the deceased before somatic death | Agonal Changes |
| What are the implications of agonal period on embalming? | The disease has more time to cause more damage, more secondary (opportunistic) infections, allows more changes to occur |
| Is it true that the longer the agonal period the greater the liklihood the number and extent of changes will occur? | Yes, true **These make embalming difficult |
| Lowering of body temperature before death; often seen in elderly patients | Agonal Algor |
| Increase in body temperature before death; due to febrile diseases | Agonal Fever |
| Settling or movement of blood to the dependent parts of the body due to the pull of gravity before death | Agonal Hypostasis |
| Slowing of bloodflow or restriction of bloodflow can allow clotting to occur in blood vessels | Agonal Coagulation |
| Capillaries open/expand in an attempt to get more blood and oxygen before death; can lead to edema | Agonal Circulatory Expansion |
| Increase of moisture in the body before death | Agonal Edema |
| Decrease of moisture in the body before death; common for long drawn out diseases, febrile diseases | Agonal Dehydration |
| Collapse of the immune system before death allows intestinal bacteria to migrate into other tissues of the body; leads to gas gangrene | Agonal Translocation of Bacteria (Agonal Invasion; Bacterial Migration) |
| Number of changes in facial appearance of those in the agonal state | Facies Hippocratica |
| Name the changes in facies hippocratica | Pallor, gradual sinking of eyes, darkening of the skin around the eyes, collapse of the sides of the nose, lower jaw drops, deepening of facial lines, expressionless look |
| Changes in the body from the molecular to the systemic level that take place after biologic death | Postmortem Changes |
| Passage of time between biologic death and the start of the embalming process | Postmortem interval |
| Is it true that the longer the postmortem interval the more changes will appear and the more severe and noticable they become? | Yes, true |
| Type of postmortem change that involves a change in location or the physical state of matter | Physical Change |
| Name the physical changes that occur postmortem | Algor Mortis, Livor Mortis, Dehydration, Increase in blood viscosity |
| Type of postmortem change that changes the identity of the chemicals involved | Chemical Change |
| Name the chemical changes that occur postmortem | Decomposition, Rigor Mortis, Change in body pH, Postmortem Stain, Postmortem Caloricity, Hydrolysis |
| Small buildup of heat in the body due to active cells still working after death | Postmortem Caloricity |
| Is it true that postmortem caloricity may not occur after death? | Yes. It may not occur if there was agonal algor before death |
| Is it true that the trunk cools slower than the skeletal tissues? | Yes |
| What is the rate of body temperature loss after death? | 4*F per hour for the first few hours, 1.5*F after that until environmental temp is reached |
| How does the size of the body affect agonal algor? | Taller--> cools slowly Short--> cools faster |
| How does the weight of a body affect agonal algor? | Obese--> cools slowly Thin--> cools faster |
| How does the age of a body affect agonal algor? | Very young/Very old--> cools faster Adult/Prime of Life--> cools slower |
| How does cause of death affect agonal algor? | Febrile Diseases--> cools slower Debilitating/Wasting Diseases--> faster cooling Sudden Death--> slow onset, slow cooling |
| How does the clothing affect agonal algor? | More Clothing--> slower onset, slow cooling Less Clothing--> quicker onset, faster cooling |
| How does environmental temp/humidity affect agonal algor? | Closer to body temp--> slower onset, slower cooling *Bodies cool fastest in cooler temps |
| Name the AKAs of Livor Mortis | Postmortem Lividity, Passive Congestion, Cadaveric Lividity, Cadaveric Ecchymosis, Hypostatic Congestion |
| Extravascular discoloration that occurs when blood cells break down and the hematin mixes with the plasma and then leaks into the surrounding tissues | Postmortem Stain |
| Name the conditions that accelerate postmortem dehydration | Refrigeration, Hypostasis of blood and other fluids, Air Currents, Agonal Dehydration |
| How do you prevent post-embalming dehydration? | Keep body away from drafts, use cream cosmetic, or cover the body with plastic |
| The degree of thickness of liquid compared to water, and how close the molecules are to one another | Viscosity |
| Temporary reduction in the viscosity of the blood | Hypinosis |
| How does the blood become more viscous? | Water evaporates and the solid parts of the blood get thicker and stickier. Also if the temp around the body is close to body temp it will speed up coagulation. |
| Name the 3 different blood clots that occur postmortem | The Cruror, The Chicken Fat Clot, The White Fibrin Clot |
| Describe the Cruror Clot (The Red Currant Jelly Clot) | Soft, jelly-like, fragile, easily movable, most common type |
| Describe the Chicken Fat Clot | The white and red cells in the blood seperates, the white cells clump together, much stickier than cruror, grayish in color |
| Describe the White Fibrin Clot | Caused by the fibrin in the blood sticking together, stick to the vessels and are hard to remove |
| The chemical breakdown of complex molecules into simpler ones, caused by enzymes | Decomposition |
| Decomposition results in simple compounds that cannot be broken down by any other chemical means, what are these called? | End Products |
| Name the 4 types of decomposition | Proteolysis, Sacchrolysis, Lipolysis, Autolysis |
| Decomposition of proteins | Proteolysis |
| Describe the process of proteolysis | Proteins--> Amino Acids--> Amines+CO2+H2O-->Ammonia, Mercaptans, Sulfuric Acid, Phosphoric Acid, Methane, Hydrogen, etc... *All of this is triggered by Enzymes |
| Name the 4 Amines (Ptomaines) produced during proteolysis | Putrescine, Cadaverine, Indole, Skatole |
| What are the 2 types of proteolysis? | Putrefaction & Decay |
| Bacteria that live off dead tissue | Saprophytic Bacteria |
| Putrefaction is caused by what type of bacteria? | Anaerobic Bacteria |
| Decay is caused by what type of bacteria? | Aerobic Bacteria |
| Sacchrolysis occurs by what type of decomposition? | Fermentation (decomp of sugars into carbohydrates, carbs into organic acids + CO2 + H2O) |
| Where does fermentation mainly occur in the body? | In the intestines |
| Lipolysis is the decomposition of what? | Decomp of body fat by lipases Fats--> Fatty Acids + Glycerol |
| If a body is directly buried into moist, slightly alkaline soil, what will happen? | Adipocere (Grave Wax) will form *soft, whitish-gray/yellow, crumbly, greasy, sweet/rancid smell |
| The formation of adipocere is called..... | Saponification |
| Autolysis is caused by.... | The self destruction of the cell by the lysosome |
| How does the lysosome start to break down its own cell? | when the body becomes acidic after death the membrane around the lysosome breaks down and this allows the enzymes inside to start breaking down the rest of the cell |
| Odor is one of the signs of death, how does odor occur? | Odor is caused by anaerobic bacteria= Putrefaction |
| Evacuated material that exits from a natural opening of the body that is made up of the contents of the hollow organs | Purge |
| How does skin slip (desquamation) occur? | The two layers of skin are held together by rete mucosum, and rete mucosum decomposes quickly which leads to the separation of the 2 layers |
| Factors inside the body | Intrinsic |
| Name the intrinsic factors of decomposition | Age at death, Gender, Corpulence, C.O.D, Bacteria, Moisture levels, Thermal Conditions, Drugs/Therapeutic Agents |
| Factors that exist outside the body but affects what goes on inside the body | Extrinsic |
| Name the extrinsic factors of decomposition | Access to Air, Atmospheric Moisture, Temperature of the Environment, Bacteria, Pressure on the body |
| What is the optimum temperature for intestinal bacteria for decomposition? | 99.5*F |
| What are the max. & min. temps for intestinal bacteria for decomposition? | Max.: decomp slows gradually until 120*F Min.: Decomp gradually slows until 50*F then considerally slows until 32*F |
| What is the first organ to start decomposing? | Lining of the larynx and trachea |
| what is the last organ to start decomposing? | Blood vessels or non-pregnant uterus |
| What is the order of tissue decomposition? | Liquid Tissues--> Blood & Lymphatic Soft Tissues--> Organs Firm Tissues--> Muscles, tendons, stroma Hard Tissues--> Bones, cartilage |
| What is the order of decomposition for body compounds? | Carbohydrates (Fermentation) Proteins (Proteolysis) Fats (Lipolysis) Firm Proteins--> Muscle, ligaments Calcium Compounds--> Bones, Tooth Enamel |
| The same grade/degree of decomp is found in a body exposed to air for 1 week as to a body in water for 2 weeks as a body buried in eart for 8 weeks | Caper's Law 1:2:8 |
| After death the body turns acidic, as low as.... | 5.5 |
| What is the most variable of the postmortem changes and the most likely to cause embalming problems? | Rigor Mortis |
| Name the 3 stages of rigor mortis | 1)Primary Flaccidity 2)Onset, Duration, & Termination 3)Secondary Flaccidity |
| What can you do to reduce/eliminate rigor mortis? | Flex, Rotate, Extend, and Massage the muscles to "Break" rigor |
| When does rigor mortis begin to appear? | 8-20 hours after death |
| How long can rigor mortis last? | 10-72 hours after onset |
| Is it true that the sooner rigor appears, the sooner it disappears and the less intense it will be? | Yes |
| Is it true that the later rigor appears, the later it will disappear and the more intense it will be? | Yes |
| What ALWAYS happens with rigor mortis? | Cutis Anserina |
| When the little muscles in the skin around the hair follicles contract causing bumps and the hair to stand up | Cutis Anserina (Goose Bumps) |
| What causes the muscles to contract in rigor mortis? | The decomposition of ATP |
| What are the conditions that affect the onset, duration, and termination of rigor mortis? | Body or Environmental Temperature, Age, COD, Degree of muscular development |
| How does age affect the onset, duration, and termination of rigor mortis? | Infants & Elderly--> rapid onset, brief duration, weak rigidity Healthy Adolescents & Young Adults--> most intense |
| How does COD affect the onset, duration, and termination of rigor mortis? | *Exhausting/Wasting Diseases accelerate rigor *Sudden deaths of previously healthy individuals cause rapid onset, brief duration but intense stiffness |
| How does the degree of muscular development affect the onset, duration, and termination of rigor mortis? | The greater the development the slower the onset but the greater degree of rigidity and duration |
| What is the order of appearance and disappearance of rigor mortis? | Eyes & Eyelids Back/Nape of Neck Lower Jaw Face Front of Neck Chest Muscles Upper Extremities Trunk Lower Extremities |
| Name the conditions mistaken for rigor mortis | Heat Stiffening, Cold Stiffening, Catalepsy, Cadaveric Spasm |
| Permanent stiffening/coagulating of muscle tissue which occurs when tissue is exposed to very high temperatures; in burnt, scalded bodies | Heat Stiffening |
| Muscular rigidity while still living | Catalepsy |
| The last act of life is crystallized in death; seen in traumatic /violent/accidental death | Cadaveric Spasm |
| How does rigor make embalming difficult? | *Temp. slows decomp, this is when the body is most acidic *Restricts fluid distribution *Distorts appearance of body *Reduces ability of formalin |
| Decomposition of red blood cells | Hemolysis |
| How are livor mortis and postmortem stain different? | *Livor mortis is a physical change while pm stain is a chemical change *Livor mortis is an intravascular discoloration while pm stain is an extravascular discoloration |
| What are some conditions that can affect postmortem caloricity? | *If the person died of a febrile disease *If there was increased muscle activity before death *If normal heat regulating mechanisms of the body are disturbed during life |
| The breakdown of complex substances into simpler ones when one of the catalysts are water or elements of water | Hydrolysis |
| Absorption of water by any substance | Imbibition |
| Name the 2 types of edema | Antemortem Edema & Postmortem Edema |
| A dead body surrounded by water will undergo ________ | Maceration ex: an infant that dies in utero and is not expelled |
| Name the 3 purposes of embalming | 1) Disinfection 2) Temporary Preservation 3) Restoration |
| Name the purposes of the sanitary considerations of embalming | *Protect the public from disease or biohazard *Protect the embalmer & their family *Create a clean and sanitary body for the families *Protect the environment |
| Name the purposes of the moral considerations of embalming | *Show sacred and reverent respect for the deceased *Maintain highest ethical and professional standards |
| Name the purposes of the legal considerations of embalming | *To cooperate with all civil authorities *To obey all federal, state, and local laws regarding our profession *We are highly legally regulated |
| Provides information about hazardous chemicals that you may come into contact with; applies to every employer; failure to comply could lead to $10,000 fine for every violation | Hazard Communication Standard |
| What are the requirements for the Hazard Communication Standard? | *Creation/maintenance of an MSDS *Creation/maintenance of Hazardous Materials Labeling System *Employee Training and Info. Program *Creation of Written Comprehensive Communication *Formaldehyde monitoring program |
| Level of formaldehyde gas present in the air averaged over 8 hrs | Time-Weight Average (TWA) |
| Maximum amount of formaldehyde gas that is permissible in the air; .075 ppm (measured as TWA) | Permissible Exposure Limit (PEL) |
| Higher level of formaldehyde gas that an employee can be exposed to in a short amount of time; 2.0 ppm for 15 min, 4x in an 8 hr block | Short-Term Exposure Limit (STEL) |
| What is the action level as a TWA? | .5 ppm |
| For prep room design, which floor of the building would be ideal for the prep room? | Ground floor is ideal, the second floor is the second best |
| Which floor do you want to avoid putting your prep room? | The basement (b/c of moisture and piping issues) |
| For the size of the prep room, how many square feet is ideal per embalming table? | 120-150 sq. ft. |
| What is the ideal table to number of cases ratio for determining how many embalming tables to have? | 1 table for every 100-125 cases per year |
| For a ventilation system in the prep room, what is the ideal air movement from the system? | Old air should be pulled from the floor while the new air is being introduced from the ceiling. |
| How many foot candle power is recommended at table range? | 500-800 foot candle power |
| Name some positioning devices found in a prep room | Head Blocks, Shoulder Blocks, Arm/Foot Blocks, Rubber Bands |
| Scalpel with a curved blade for tissue excision | Bistouary |
| The piece of equipment that goes into the artery to inject arterial fluid | Cannula |
| Consideration given to the dead body prior to, during, and after the embalming procedure is completed with documentation recommended | Case Analysis |
| When closing the eyes during posing the features, how should the top lid be positioned? | Top lid should extend over the top 2/3 of the eyeball and should come just under the iris |
| What stitch is preferred for closing the embalming incision? | Baseball stitch |
| Where do you insert the drain tube/angled forceps during embalming? | Into the vein being drained, angled toward the heart |
| What are the two common ways to close the mouth while setting the features? | Using the needle injector and the muscular suture |
Created by:
sbarton
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