What can immediate allergic reaction to a drug cause?
tissues appear swollen, discolored skin surface, possible skin eruptions
What can result from liver failure?
edema (ascites); edema of lower extremities
increase in ammonia in the tissues (neutralizes formaldehyde)
purges caused by rupture of esophageal veins
gastrointestinal bleeding; fluid loss; possible purge
hair loss
jaundice
What can result from renal failure?
increase in ammonia in the tissues
edema of tissues
gastrointestinal bleeding
pulmonary edema
congestive heart failure
discoloration of the skin (sallow color)
uremic pruritus of the skin
What can result from damage to blood vessels?
skin hemorrhage (ecchymosis aka bruise, purpural hemorrhage)
What can result from damage to the walls?
breakdown of the skin; skin-slip often present
What can cause difficult tissue firming?
protein degeneration
ammonia buildup in the tissues which neutralizes formaldehyde
presence of edema
Gas Causing Distension: Subcutaneous emphysema
Cause: puncture of lung or pleural sac
Treatment: gas will escape through incisions; establish good arterial preservation; channel tissues after arterial injection to release gases
Gas Causing Distension: True Tissue Gas
Cause: Anaerobic bacteria
Treatment: Use of special "tissue gas" arterial solutions; localized hypodermic injection of cavity fluid; channel tissues to release gases
Gas Causing Distension: Gas Gangrene
Cause: Anaerobic bacteria
Treatment: strong arterial solutions; local hypodermic injection of cavity chemical
Gas Causing Distension: Decomposition
Cause: bacterial breakdown of body tissues; autolytic breakdown of body tissues
Treatment: proper strong chemical in sufficient amounts by arterial injection; hypodermic and surface treatments; channel to release gases
Gas Causing Distension: Air from embalming apparatus
Cause: air injected by embalming machine
Treatment: channel after arterial injection to release gases
Contents of Hollow Viscera that must be Treated: Lungs, Trachea, Bonchi
blood, edema, purulent material, gases
Contents of Hollow Viscera that must be Treated: Stomach
hydrochloric acid, undigested food, blood, gases
Contents of Hollow Viscera that must be Treated: Small Intestine
gases, undigested foods, partially digested foods, blood
Contents of Hollow Viscera that must be Treated: Large Intestine
gases, fecal material, blood
Contents of Hollow Viscera that must be Treated: Urinary bladder
urine, pustular material, blood`
Contents of Hollow Viscera that must be Treated: Gallbladder
bile
Contents of Hollow Viscera that must be Treated: Pelvis of the kidney
urine, pustular material, blood
Contents of Hollow Viscera that must be Treated: Heart
blood
Contents of Hollow Viscera that must be Treated: Inferior vena cava, portal veins
blood
Types of Purge:Stomach
from: nose/mouth
description: liquids, semisolids, dark brown "coffee ground" appearance, odor, acid pH
Types of Purge: Lungs
from: nose/mouth
description: frothy; any blood present is red in color, little odor
Types of Purge: Brain
from: nose/ear/eyelids
description: gases can move into tissues of the eye, fractures can cause blood to purge from the ears, creamy white semisolid brain matter may exit through a fracture or the nasal passage
Nine Abdominal Regions
Right Hypochondriac, Epigastric, Left Hypochondriac
Right Lumbar, Umbilical, Left Lumbar
Right Inguinal (Iliac), Hypogastric, Left Inguinal (Iliac)
Preservative Demand of the Muscle Tissues During Rigor
Prerigor - great adsorption of preservative
Rigor - little absorption of preservative
after rigor - great preservative demand
Side effect of body in rigor
degree of rigor varies in the different muscle groups (more muscle = harder rigor)
tissue pH varies throughout the body
there is a lack of uniform distribution of fluid
tissues vary in preservative demand
Antemortem blood discolorations: Intravascular
hypostasis (blue-black discoloration)
result of carbon monoxide poisoning (cherry red coloring)
capillary congestion (hypostatic, active, or passive)
Antemortem blood discolorations: Extravascular
ecchymosis (large bruise caused by escape of blood into tissues)
purpura (flat medium-sized hemorrhage beneath the skin surface)
Petechia (small pinpoint skin hemorrhage)
Hematoma (swollen blood filled area within the skin - blood blister)
Postmortem blood discolorations: Intravascular
livor mortis
Postmortem blood discolorations: Extravascular
postmortem stain
tardieu spots
Unnatural Conditions Related to Discolorations: Burns
first degree - redness of skin
second degree - blistering and redness
third degree - charred tissue
Postmortem blood discolorations: CO Poisoning
bright red color to the blood
low blood viscosity, intense livor
rapid postmortem staining
Postmortem blood discolorations: Drowning
low blood viscosity, intense livor
head faced downward, livor and stain
possible abrasions and bruising
Postmortem blood discolorations: Electrocution
point of contact, burn marks can bepresent
Postmortem blood discolorations: Gunshot Wounds
eyelids can show ecchymosis, swelling of eye area when injury is to face or head
Postmortem blood discolorations: Hanging
intensive livor in facial tissues; some capillary rupture showing petechial discolorations; no blood present in facial tissues
Postmortem blood discolorations: Mutilation
loss of blood - little livor mortis
ecchymosis and bruising at affected areas
Postmortem blood discolorations: Poisons
variable - from generalized conditions such as jaundice and cyanosis to localized discolorations such as caustic burns and petechiae
Postmortem blood discolorations: Refridgeration
low blood viscosity, intense livor
postmortem stain speeded
dehydration of mucous membranes and skin surface after long exposure to cold air
Problems Associated with Dehydration: darkened skin
corrected by cosmetic application; use fluid dyes to ensure fluid distribution to all body areas
Problems Associated with Dehydration: "flaking" or peeling of skin, especially in facial areas
apply massage cream and then clean with a solvent to remove all loose skin; mortuary cream cosmetics further reduce skin drying
Problems Associated with Dehydration: firm feel to the skin
skin feels embalmed; additional dye helps to trace the distribution of fluid
Problems Associated with Dehydration: desiccated lips, eyelids, or fingertips
may need correction with restorative waxes; tissue building; opaque cosmetics needed to hide discolorations
Problems Associated with Dehydration: thickened blood
may be diluted with a preinjection fluid; use right internal jugular as drainage point; inject from the carotids to push arterial coagula toward the lower extremities
Problems Associated with Dehydration: dehydration created by the embalmer; wrinkled lips, fingertips; facial areas
use correct dilutions for arterial and humectant fluids; areas may be filled out with tissue builder after embalming
Problems Associated with Dehydration: dehydration of large facial area from embalming and passe of air over body
use massage cream on exposed areas prior to cosmetic application; if skin is discolored, opaque cosmetics will be needed; cream cosmetics further reduce dehydration; fingertips and facial areas may also be treated with tissue builder to reduce dehydration
Types of Edema: ascites
edema of the abdominal (or peritoneal) cavity
treatment: aspiration and injection of undiluted cavity fluid; preembalming draining via trocar or drainage tube; reaspiration and reinjection
Types of Edema: hydrothorax
edema of the pleural cavity
treatment: aspiration; injection of cavity fluid; careful draining prior to arterial injection
Types of Edema: hydrocephalus
edema of the cranial cavity
treatment: drain in infant via ethmoid foramen; inject cavity fluid via ethmoid foramen
Types of Edema: hydropericardium
edema of the pericardial sac surrounding the heart
treatment: aspiration and injection of undiluted cavity fluid
Types of Edema: hydrocele
edema in the tunica vaginalis testis of the male scrotum
treatment: channel with trocar to drain into abdominal cavity; inject via trocar undiluted cavity fluid; surface coating with autopsy gel; use of plastic garments and embalming powder
Types of Edema: anasarca
generalized edema
treatment: strong arterial solutions; hypodermic and surface embalming; plastic garments; gravitation; puncture and drain
Types of Edema: pitting
edema in tissue spaces, between cells
treatment: may be gravitated; use strong arterial solutions; may be punctured and drained; use plastic garments to protect from leakage
Types of Edema: of hands or legs
use sectional embalming
Types of Edema: of face
use restricted cervical injection
Preservatives
aldehydes
Alcohols
-ol
Coal Tar Derivatives
Phenol
Phenol aka
Carbolic Acid
Inorganic Salts
Natron
Supplemental Germicides aka Disinfectants
Quaternary Ammonium Compounds - Zephiran aka Benzalkonium Chloride
aldehydes
-ols
Anticoagulates aka Water Conditioning Agents
sodium
Dyes
Eosine, Ponceau Red, and Erythrosine
Deodrants
Oils & Benzaldehyde
Oil of Wintergreen aka
Methyl salicylate
Vehicles
water & alcohol
Surfactants
sulf-
Humectans
Sorbitol, Glycerine, Glycol, & Lanolin (sheep fat)
Buffers
always exist in pairs, one acid and one base
Buffers
Sodium, Bo-, and Citrates
Mold Preventative Agents
para-
Hardening Compound
Plaster, Alum, Perlite (sawdust), clay, styrofoam
aneurysm
bulge in a blood vessel
what percentage of body weight does total body water constitute?
55 to 60%
Under what conditions is edema said to be established?
when there is a 10% increase in total body water
The term used to describe an agent having an affinity for metallic ions such as calcium and magnesium.
chelating agents
2 main classes of chemotherapeutic agents?
cytotoxic & antimetabolite
nephro
kidney
term describing the physical wasting with loss of weight and muscle mass caused by disease
cachexia
problem caused by use of corticosteroids
decrease in cell permeability - use pre-injection chemical
body's main center of detoxification
liver
term used to describe a blister filled with serous fluid which is usually caused by gas
bleb
with regard to renal failure, how much more preservative chemical than normal is needed to achieve preservation?
6
ideal rate of flow
10-15 minutes per gallon
general pressure setting
5-20 pounds
invasive devices should be left in during embalming because
swelling and discoloration of area can occur
anastomosis
connection of normally separated parts or spaces so they intercommunicate
In an autopsied case, what are the ideal vessels to use for injection of the lower extremities?
iliac
In an autopsied case, what are the ideal vessels to use for injection of the upper extremities?
subclavian
inject which side of head first
left
Regarding delayed embalming, what main factor brings about the body's increased fluid need?
breakdown of tissues
In cases of delayed embalming or decomposition, what is the recommended arterial fluid index?
25 or higher
What is one occasion when cavity treatment is not employed?
donation to medical school
What is bile?
A bitter, alkaline, brownish-yellow or greenish-yellow fluid that is secreted by the liver, stored in the gallbladder, and discharged into the duodenum and aids in the emulsification, digestion, and absorption of fats.
Order of digestion
stomach, pylorus, duodenum, jejunum, ileum,cecum, ascending colon, traverse colon, descending colon, sigmoid colon, rectum
What is the function of the kidney?
extract waste from blood, balance body fluids, form urine, and aid in other important functions of the body
C x V = C’ x V’ equation
...
Examples of sublimation
...
Hepatic vein continues as…
...
Vessels of Scarpa’s Triangle
...
Purpose of adding EDTA
...
OSHA Action Level
...
Time frame for hemolysis
...
Def of antisepsis
...
Type of gangrene with ischemic necrosis
...
What is ischemia?
...
OSHA PEL
...
Formation of aldehyde
...
Largest number of bones in vertebral column are classified as
...
Antipolymerization agent for formaldehyde
...
Bifurcation of the antihelix
crus
Polymerization of formaldehyde is inhibited by the addition of:
Methyl alcohol
Polymerization of formaldehyde is inhibited by the addition of:
H-CHO
buffers
Embalming chemicals that work to help stabilize acid-base balance within embalming solutions and in tissues.
gas gangrene
Necrosis in a wound; anaerobic, from Clostridium Perfringens.
Forms base of femoral triangle(anterior superior iliac spine to pubic tubercle).
inguinal ligament
TWA
.75ppm/8 hours
Hemolysis
Causes postmortem stain during the embalming process.
Carbohydrates
First body compounds to decompose.
Clauderus
Embalming without evisceration.
Syncope
death beginning at the heart
Malpighi
father of histology
Ruysch
father of embalming
Hunter
Adductor's or Hunter's Canal
holmes
Father of US Embalming
harvey
Credited with discovery of circulation.
amino acids
First products of decomposition.
gannal
Made embalming available to the public.
Hemolysis
Swelling and bursting of red blood cells.
normal blood pH range
7.3-7.4
acid pH range
1.3-6.1
base pH range
7.6-13.3
neutral pH range
7.0
putrefaction
the decomposition of anaerobic bacteria is
decay
the decomposition of aerobic bacteria is
postmortem caloricity
the temporary rise in body temp after death is called
rigor mortis is detrimental to the embalming process because it
retards fluid distribution
lining of the trachea and larynx
in the usual case the first organ to decompose is the
the anaerobic decomposition of proteins results in
putrefaction
The primary flaccidity stages of rigor mortis the pH of the muscular tissue is
alkaline pH