Final Study Guide
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| blood composition after death | 85% capillaries
10% veins
5% arteries
45% solid
55% liquid
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| reasons for blood drainage | 1. slow post-embalming decomposition
2. make room for arterial solution
3. permit disinfection
4. remove blood discolorations
5. reduce secondary dilution
6. remove a tissue that rapidly decomposes
7. remove bacteria present in the blood
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| most common/effective drainage method | alternate drainage
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| method of injection-drainage in which embalming solution is injected and then injection is stopped while drainage is open | alternate drainage
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| method of drainage in which the drainage is stopped at intervals while the injection continues | intermittent drainage
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| method of drainage in which drainage occurs continuously during vascular injection | concurrent drainage
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| which drainage methods are considered "restricted"? | alternate & intermittent
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| possible dangers of heart tap | might clog trocar & might damage arterial system
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| heart tap: aim trocar at the ____ ear lobe | right
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| dark red, soft & fragile rapidly-forming clot that forms before blood separates; most easily removed clot | Cruror/Red Currant Jelly clot
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| yellowish-white clot that forms when red & white blood cells separate; takes longer to form | Chicken Fat clot
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| clot found in the right atrium of the heart; fibrin separates out from blood and forms a sticky & hard clot; problematic during aspiration | White Fibrin clot
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| methods for assisting drainage | - anticoagulant
- massaging
- pre-injection
- hot/cold compresses
-drain tube
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| the direct treatment other than by arterial injection of the contents of the body cavities & the lumina of the hollow viscera | cavity treatment
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| purposes of cavity treatment | 1. weight of viscera prevents embalming of viscera via arterial injection
2. must remove decomposing material inside
3. must treat lumina of hollow viscera
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| 9 Regional Plan: upper right | right hypochondriac
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| 9 Regional Plan: upper left | left hypochondriac
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| 9 Regional Plan: upper middle | center epigastric
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| 9 Regional Plan: middle right | right lateral/lumbar
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| 9 Regional Plan: middle left | left lateral/lumbar
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| 9 Regional Plan: middle middle | center umbilical
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| 9 Regional Plan: lower right | right inguinal/iliac
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| 9 Regional Plan: lower left | left inguinal/iliac
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| 9 Regional Plan: lower middle | center hypogastric/pubic
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| main trocar guides | stomach, cecum, urinary bladder, heart
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| trocar guide: stomach | toward intersection of 5th intercostal space & left midaxillary line
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| trocar guide: cecum | toward 1/4th of the distance from right anterior superior iliac spine to the public symphysis
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| trocar guide: urinary bladder | toward the intersection of the midline & pubic bone
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| trocar guide: heart | toward the right ear lobe up until the diaphragm, lower to get under rib
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| cases requiring reaspiration | 1. ascites
2. blood infection
3. Crones disease
4. pulmonary infections
5. infectious disease of abdominal
6. obesity
7. shin-ins
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| the postmortem evacuation of any substance from any external opening of the body (including incisions) | purge
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| causes of purge | - pressure
- rupture
- gas buildup
- diseases in GI tract
- encephalitisis
- cerebra hemorrhage
- post-operative cases
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| brown colored purge with sour odor, coffee ground consistency, mostly liquid | stomach purge
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| white frothy odorless purge | lung purge
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| cream-colored sticky purge | brain purge
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| conditions predisposing to purge | 1. decomp
2. delay between death & embalming
3. drowning/asphyxia
4. ab, thoracic or cranial surgery
5. tissue gas
6. hydrothorax/ascites
7. peritonitis or blood infections
8. varices, GI tract ulcers, internal hemorrhages
9. warm environment
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| which arteries of the head must be clamped off for an autopsy? | internal carotids
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| which arteries should be ligated for an autopsy case? | 1. external iliacs
2. axillaries or subclavians
3. common carotids
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| attaching the calvarium: notches present | 1 notch on frontal bone, other notches on temporal bones
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| attaching the calvarium: notches not present | 1. suture through temporalis muscles
2. calvarium clamps
3. drill holes in calvarium & temporal bones
4. superglue
5. plaster of paris
6. needle injector wires
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| autopsy: arteries to inject lower extremities | ideal: common iliac
backup: external iliac
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| autopsy: arteries to inject upper extremities | ideal: subclavians
backup: axillaries
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| other arteries to clamp off (autopsy case) | 1. vertebral
2. internal thoracic
3. internal thyroid
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| desquamation | skin-slip
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| separation of the upper layer of skin (epidermis) from the deeper dermal layer | skin-slip
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| cause of skin-slip | decomposition of rete mucosum
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| sloughing off of the epidermis, wherein there is a separation of the epidermis from the underlying dermis | skin-slip (desquamation)
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| postmortem accumulation of gas in tissues or cavities brought about by an anaerobic gas-forming bacillus, Clostridium perfringens | tissue gas
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| the formation of cavities in an organ or tissue | cavitation
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| "rice krispies" feel | crepitation
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| cavitation is frequently seen in some _________ cases | tuberculosis
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| cases predisposing to stomach purge | 1. GI tract diseases
2. stomach cancer
3. colitis
4. peritonitis
5. ulcerations
6. intestinal obstructions
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| cases predisposing to lung purge | 1. tuberculosis
2. pneumonia
3. lung cancer
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| cases predisposing to brain purge | 1. encephalitis
2. meningitis
3. cerebral hemorrhage
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| bacteria that causes tissue gas | Clostridium perfringens (Clostridium welchii)
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| cases that predispose to tissue gas | 1. antemortem infection
2. compromised immune system
3. intestinal perforation, ulceration or hemorrhage
4. intestinal carcinoma
5. appendicitis/peritonitis
6. septicemia
7. gun shot/stab wounds
8. intro of bacteria from outside source (trauma)
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| conditions that predispose to skin-slip | 1. edema
2. heat blisters
3. frost bite
4. burns
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| conditions that predispose to dehydration | 1. hemorrhage
2. febrile diseases
3. high or chronic fever
4. chronic or exhausting diseases that interfere with hydration
5. vomiting/diarrhea
6. burns
7. refrigeration
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| embalming treatment: dehydrated case | - slow rate
- large volume
- mild fluid
- restricted drainage
- pulse
- humectant
- anticoagulant (co-injection)
- massage cream
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| dropsy | edema
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| abnormal accumulation of a plasma-like fluid (mostly water) in the cells, intercellular tissue spaces, and/or cavities of the body | edema
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| water invades the cells themselves, causing hardening of the cell & reduction of intercellular space | solid edema
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| condition in which interstitial spaces contain such excessive amounts of fluid that the skin remains depressed after palpation | pitting edema
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| abdominal edema | ascites
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| hydroperitneum | ascites
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| edema in the chest; between lungs & lung covering | hydrothorax
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| pleurisy | hydrothorax
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| increase of pericardial fluid | hydropericardium
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| water/fluid in the cranial cavity | hydrocephalus
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| water/fluid in the scrotum | hydrocele
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| general (widespread) edema | anasarca
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| causes of edema | 1. congestive heart failure
2. renal failure/insufficiency
3. arteriosclerosis
4. hyperthemia (1st & 2nd degree burns)
5. alcoholism/cirrhosis of liver
6. carbon monoxide poisoning
7. chemotherapy
8. lymphatic damage/obstruction
9. lung diseases
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| embalming problems caused by edema | 1. distention
2. increased secondary dilution
3. increased preservative demand
4. skin-slip
5. early & extensive decomposition
6. skin too soft
7. arterial constriction
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| embalming treatment: generalized edema | - no preinjection
- strong unmodified hydroscopic fluid
- 3-5% minimum
- edema fluid coinjection
- astringent
- low pressure
- low rate
- massage/squeeze & release
- hypodermic injection
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| embalming treatment: dependent edema | - sectional embalming
- inject affected part separately
- body gets normal arterial
- hypodermic injection (95% phenol/cavity/cauterant)
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| when moisture is retained by the cell, or abnormal amounts of moisture are allowed to pass into the cell | solid edema
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| sequence of postmortem color change | 1. postmortem hypostasis (begins at death)
2. livor mortis (begins 20 mins after death)
3. postmortem stain (6 hrs after death)
4. formaldehyde grey (after embalming)
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| discoloration: Addison's disease | bronze
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| discoloration: leukemia | petecheae
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| discoloration: jaundice | yellow (bilirubin)
green (biliverdin)
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| discoloration: sulpha drugs (penicillin) | bruise-like
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| discoloration: atabrine | yellow (bilirubin)
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| discoloration: methylene blue | blue
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| separation of compounds into simpler substances by the action of microbial and/or autolytic enzymes | decomposition
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| signs of decomposition | 1. color changes
2. odor
3. purge
4. gases
5. desquamation
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| end products of lipid decomposition (lipolysis) | glycerol & fatty acids
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| end products of carbohydrate decomposition (fermentation) | organic acids, then carbon dioxide & water
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| end products of protein decomposition (putrefaction) | amino acids
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| hardening/calcification of arteries | arteriosclerosis
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| softening of arteries | atheroma/atherosclerosis
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| hardening of veins | phlebosclerosis
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| clot attached to the lumen | thrombus
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| clot that moves through the lumen | embolus
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| weakening in the wall of an artery that causes a bubble & eventually breaks | aneurysm
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| embalming treatment: decomposition case | - 3-5% at least
- firming fluid
- avoid humectant/cosmetic fluid
- 6 point injection
- low pressure
- low rate
- hypodermic injection
- possibly waterless
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| any fetus that dies prior to delivery | stillborn
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| any infant weighing less than 5 pounds at birth or born prior to the 37th week of gestation | premature (preterm)
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| from birth to 18 months old | infant
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| 18 - 48 months old (1 1/2 - 4 years) | toddler
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| 4 years old - puberty | child
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| arteries for infant embalming (non-autopsy) | 1. common carotid
2. femoral/external iliac
3. abdominal aorta
4. ascending aorta
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| arteries for infant embalming (autopsy) | 1. common carotid
2. iliac
3. subclavian
4. axillary
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| methods for embalming stillborns | 1. osmosis method
2. paraformaldehyde in lidded box
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| peach fuzz hair | lanugo
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| arteries/structures for premature infant embalming | 1. carotid
2. abdominal aorta
3. ascending aorta
4. arch of aorta
5. arterial umbilical vessel (can be problematic)
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| arteries for embalming 4 - 12 year olds (unautopsied) | 1. common carotid
2. femoral
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| arteries for embalming 4 - 12 year olds (autopsy) | 1. common carotid
2. external iliac
3. internal iliac
4. subclavian
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| organs of infants requiring special attention during aspiration | liver & brain
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| tuberculosis: modes of transmission | 1. ingestion
2. inhalation
3. casual contact
4. broken skin
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| tuberculosis: symptoms | 1. emaciation
2. fever
3. cavitation/tubercles
4. dehydration
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| candidates for tuberculosis | the fatigued and those with low resistance or compromised resistance
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| tuberculosis: embalming problems | 1. dehydration
2. purge
3. clotting
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| tuberculosis: cause | mycobacteria
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| painful cutaneous skin lesions with nodular appearance, usually on the face & neck; caused by tuberculosis | lupus vulgaris
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| embalming treatment: purge | - begin at suspected source as soon as it occurs
- allow purge to continue
- protect skin from acidic burns
- treat after arterial injection
- cavity treatment
- cranial aspiration
- penetrate cribriform plate of ethmoid bone
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| embalming treatment: tissue gas | - high index
- special fluid
- 55% cavity fluid
- hypodermic injection of cavity fluid into gas-filled area & surrounding area & underneath
- reinjection if tissue gas appears after embalming
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| preferred artery for arteriosclerosis case | femoral artery in sitiu
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| incision size for infants | 1/2"
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