Fourth Quarter Final Exam Flashcards
Postmortem Changes
- Algor mortis
- Dehydration
- Hypostasis
- Livor mortis
- Increased blood viscosity
- Endogenous invasion of microorganisms
Postmortem Changes (Chemical)
- Postmortem caloricity
- Change in body pH
- Rigor Mortis
- Postmortem stain
- Decomposition
Complications from time delay between death and embalming
- Nonuniform distribution
- Tissues easily swell
- Increased preservative demand
When to use hypotonic solutions
- Dehydrated cases
- to prevent livor from staining
When to use hypertonic solutions
Edematous cases to reduce moisture
When to use high-index solution
-Delayed embalming
-Extended refrigeration/frozen
-Extensive drug treatments
-Trauma
-Decomposition
-Gangrene/Tissue Gas
-Edema
-Obese
-Renal failure
-Difficulty firming
-Bloodstream infections
Instant Tissue Fixation
- Embalming technique that uses a very strong arterial solution (often waterless)
- The solution is injected under high pressure in spurts into a body area
- This technique is used to limit swelling
Rigor Mortis Definition
- Postmortem stiffening of the body muscles by natural processes
- Begins 2-4 hours after death
- Fully established 6-12 hours after death
- Passes 36 hours after death
What are the three stages of rigor mortis?
- Primary Flaccidity: the period in which the rigor develops and is hardly noticeable
- Active Period: muscles noticeably stiffen
- Secondary Flaccidity: rigor has passed from the body
What causes rigor mortis?
- Rigor mortis is a natural process that occurs in all the dead
- It affects all muscles in the body (unequally)
- Begins when the body cannot replenish adenosine triphosphate (ATP)
What are the complications associated with rigor mortis?
- Higher preservative demand if embalmed during rigor
- Body absorbs little preservative
- Higher strength solutions will be needed to compensate for the poor absorption
- Positioning challenges
- Difficult setting features
- Poor fluid distribution
- Poor drainage
- Tissues easily swell
- Tissues may not firm well after the passage of rigor due to poor absorption during rigor and lack of sufficient volume of arterial solution injected
- Tissue firmness caused by rigor can be a false sign of tissue fixation by the preservative
Classifications of Discolorations According to Cause
- Blood discolorations
- Drug and therapeutic discolorations (pharmaceutical agents)
- pathological discolorations
- Surface discoloring agent discolorations
- Reactions to embalming chemicals on the body
- Decomposition changes
Classifications of Discolorations According to Time of Occurrence
- Antemortem
- Postmortem
Intravascular Discolorations
- Discoloration of the body within the blood-vascular system
- These discolorations can be removed through arterial injection and drainage
Extravascular Discolorations
- Discoloration of the body outside the blood-vascular system
- These discolorations can not be removed through arterial injection; must be bleached and cosmetized over
Antemortem, Intravascular Blood Discolorations
- Hypostasis of blood (blue-black discoloration)
- Carbon Monoxide (CO) poisoning (cherry-red color)
- Capillary congestion (hypostatic, active or passive)
Antemortem, Extravascular Blood Discolorations
- Ecchymosis: large bruise caused by the escape of blood into the tissues
- Purpura: flat, medium-sized hemorrhage beneath the skin
- Petechia: small pinpoint skin hemorrhages
- Hematoma: swollen blood-filled area within the skin
Postmortem Intravascular Blood Discolorations
Livor Mortis: (Cadaveric Lividity) red-blue discoloration resulting from hypostasis of blood
Postmortem Extravascular Blood Discolorations
- Postmortem Stain: blood discolorations as a result of hemolysis
- Tardieu Spots: Tiny petechial hemorrhages result from small vessel ruptures as blood pools in dependent body areas; accompanies livor mortis
Formaldehyde Gray
- A gray discoloration that occurs after embalming due to the creation of methemoglobin (HCHO and blood)
- Can be intravascular or extravascular
What are the signs of embalming diffusion?
- Dye in tissue
- tissue firming
- drying of tissue
- rounding of fingertips, tips and toes
- mottling of tissue (bleaching)
Anaerobic Bacteria
bacteria that do not need oxygen; involved with putrefaction
Aerobic Bacteria
Bacteria that do need oxygen; involved in decay
Desquamation
- “Skin Slip”
- The separation of the superficial layer of the skin (epidermis) from the deeper dermal layer
- Can be a sign of early decomposition
Restricted Cervical Injection
- Method of injection where both the common carotid arteries are raised
- Recommended to use when varied solution strengths need to be used for the face and trunk
- Recommended to give better control over the fluid entering the face
Skin
- The cutaneous layer of tissue forming the natural outer covering of the body
- Two Layers:
1. Epidermis: superficial layer
2. Dermis: inner layer
Treatments for Skin Discolorations
- Intravascular discolorations are resolved through thorough arterial embalming and drainage
- Extravascular discolorations are resolved through the use of hypodermic and surface embalming (bleaching)
Different Types of Embalming
- Arterial Embalming
- Cavity Embalming
- Surface Embalming
- Hypodermic Embalming
Jaundice
- A condition characterized by an excessive concentration of bilirubin in the skin and tissues and a deposition of excessive yellow bile pigment throughout the body
Pharmaceutical Discolorations
- Antemortem discolorations as a result of continued use of pharmaceutical and chemotherapeutic drugs
- Wet Gangrene: bright red to black
- Dry Gangrene: dull reddish to black
- Jaundice: yellow
- Addison Disease: bronze darkening
- Leukemia: skin hemorrhages
- Meningitis: reddish purple rash of petechia and purpura
- Tumors: local discolorations
- Lupus: malar butteryfly rash over the bridge of the nose and cheeks
Treatments for Jaundice
- Jaundice Fluid
- Pre-Injection
- Mild Arterial Solution
- Non-formaldehyde Fluid
- Bleaching Co-Injection Fluid
- Cavity Fluid
Histoplasmosis
- Disease caused by Histoplasma capsulatum
- Infection can be flu-like to severe
- 4 types: acute pulmonary, chronic pulmonary, acute disseminated, chronic disseminated
Chronic Pulmonary Histoplasmosis
- Progressive form
- Can cause granulomatous inflammation and caseation necrosis and cavitation
- Usually misdiagnosed as pulmonary tuberculosis
- Can be deadly
Acute Disseminated Histoplasmosis
- Can be either benign or progressive
- Rapidly fatal
- Usually occurs in children or immunosuppressed adults
Chronic Disseminated Histoplasmosis
- Usually occurs in elderly healthy
- May be fatal
- The clinical features vary according to the organ most severely involved
Mycotic Infection
Fungal infections that can spread by direct contact
Stomach Purge
- Liquid/semi-sold
- Coffee grounds appearance
- Foul odor
- Acid pH
- Contents: stomach contents, blood, arterial solution
Lung Purge
- Frothy
- Blood remains red
- Little odor
- Contents: respiratory liquids, residual air, blood arterial solution