Embalming 2 Exam 2 Flashcards
When is the determination of which vessels to raise for injection done?
During case analysis (pre-embalming)
Determining which vessels to raise for injection is done during THE case analysis
Selection of arteries
Considerations and precautions (advantages/disadvantages)
Factors governing selection of arteries for injection
Proper technique for raising vessels
TYPES OF INCISION & CLOSURES
Selection of arteries
Considerations and precautions (advantages/disadvantages) based upon:
- Accessibility (easy to get to vessels)
2. Arterial occlusion (blockage/hardening of arteries through calcium)
- Accessibility (easy to get to vessels)
Superficial or deep Surrounding structures Size (diameter) Proximity to aorta Accessibility for drainage from corresponding vein
Superficial or deep (closer to surface -thicker fat in femoral area vs neck area)
Surrounding structures (scar tissue/tough or large growth/restructured parts are reason to avoid area)
Size (diameter) - use appropriate size tube (the larger the tube to allow fluid to flow & correct amount of pressure & rate of flow for better results)
Proximity to aorta (center of embalming is the arch of aorta into brachocephalus, left common carotid, left subclavian)
Accessibility for drainage from corresponding vein (all blood clots come to right atrium & can be removed with drainage tube to retard decomp)
Arterial occlusion (blockage/hardening of arteries through calcium)
1
Factors governing selection of arteries for injection
- Age:
- Weight (corpulence)
- Disfiguration
- Disease
- Edema
- Obstruction
- Trauma
- Medico - legal requirements
- Cause and manner of death
Age:
Infant (dissect below belly button & inject thru descending abdominal aorta & drain from IVC (lies lateral right to DAA, same size as adult brachial) vs. adult
Weight (corpulence) fatter heavier people have more fatty tissue in femoral area
Disfiguration - scar tissue, arthritis
Disease - can be caused by trauma, cancer, goes hand in hand with disfiguration, etc.
Edema - excessive fluids, inject more stronger fluid
Obstruction - arterial vascular or extravascular blood clots (should happen within 1st 2 Gal, more blood removed better disinfection & distribution)
Trauma - wound or injury ie. cut off limb
Medico - legal requirements
Cause and manner of death (could be related to medico-legal requirements, if sepsis catch drainage material in separate container)
Proper technique for raising vessels
- Shave area if necessary (not shave over sharp edges to avoid razor burns
- Select instruments and prepare ligature or necessary instruments.
- Locate place of incision using linear guide.
- Make incision through skin, superficial fascia (yellow fat tissue) and deep fascia (surround blood vessels) used instruments in same direction as incision in blunt dissection
- Use blunt dissection through superficial fascia and deep fascia, and adipose tissue (fatty tissue).
- Locate vessels by use of anatomical guide (know structure used to locate vessels).
- Clean vessels by blunt dissection and ligate (tie off) vessels.
- Make incision in vessel.
TYPES OF INCISION
Incision can be made with Artery-Vein scissors, SS Scissors, scapula
- Transverse incision (perpendicular 90degree)
- Diagonal incision (oblique)
- “T” incision
- Double “T” incision
- Wedge incision (triangular)
(cut is perpendicular 90 degrees)
- most common method employed to open the artery or vein. Wide enough to insert tube. Cut is made from the edge of the vessel to the center of the vessel.
Transverse incision (perpendicular 90degree)
Cutting at an oblique angle
Diagonal incision (oblique)
used for drain tube from neck, short perpendicular horizontal & long parallel vertical
“T” incision
2 “Ts” width perpendicular not as wide or close to edge
Double “T” incision
used on sclerotic artery cuz does least damage to walls of vessels that are diseased
Wedge incision (triangular)
Suture for closure
A Baseball
B Intradermal
Single needle
C Lock stitch
D Whip or roll stitch
E Draw stitch (purse string)
F. Basket weavemost common stitch, named cuz if done properly looks like a baseball stitch.
Baseball
least leak poof, form least common ridge, hidden stitch under the skin except last end - used on viewable lesions or cut on the face or hand that can be seen in casket
Intradermal
Single needle ( single intradermal suture) double needle (use 2 different needles start from different ends/ear ie autopsy bald head)
most leak proof suture, used on spinal autopsy & organ donation case
Lock stitch
continuous suture, used to close long incisions, prevent leakage of fluids from body cavities during transfer from hospital to funeral home
Whip or roll stitch
(purse string)
Draw stitch
reinforcing anchor for restorative wax
Basket weave
Other methods of closing the incision:
A Adhesives (erin alpha or topical sealants on dry small areas ie. Face or wrist)
B Surgical staples
Terms associated with vascular injection
One point injection
Split injection/drainage
Multi-point injection
Restricted cervical
One location is used for both injection and drainage.
Most common sites
Common carotid artery & Internal jugular vein
Femoral artery & vein
One point injection
Injection from one location and drainage from a separate location.
Most common site
Injection - right femoral artery
Drainage - right internal jugular vein
Split injection/drainage
Inject from two or more arteries
This procedure ensures better distribution throughout the body.
Most common site
Autopsy case aka 6 point
Multi-point injection
Both common carotid arteries are raised.
Allows the head to be injected separately.
Extension/swelling of face, head trauma for restorative procedures
Restricted cervical
