Lab Manual - Origins and guides of arteries and veins Flashcards
- Accessibility
- Proximity of the aorta
- Diametric Size of the Vessel
- Effect on posing the body
- Location of the exposed area
- Practicability of establishing good drainage from corresponding veins
Consideration and Precautions for each artery and vein are based upon these things.
- Superficial or deep
- Relationship of the artery and vein to surrounding structures
- Presence or absence of branches of vessels which may be disturbed or blocked by its use.
- All incisions in arterial injection should be limited to no more than 3”.
Accessibility
- Injection site as close to arch of the aorta as possible (center of embalming circulation).
- Center of venous drainage is the right atrium of the heart
Proximity to the aorta
The lumen of a vessel, artery, and vein will decrease in diametric size as they distance themselves from the aorta and vena cava.
Diametric size of the vessel
Some injection sites may adversely affect the positioning of the body.
- Cachexia - Femoral may be inaccessible
- Desiccation marks - Right common carotid by instruments
Effect on posing the body
After suturing an injection site, sutures may be visible.
Location of the exposed areas
Because of certain anatomical structures, bones, tendons, muscles, cartilage, etc., good drainage is often difficult to establish and maintain.
- The external iliac vein as it becomes the femoral vein when it passes through he ilium bone.
Practicability of establishing good drainage from corresponding veins
Begins at the level of the sternoclavicular articulation and terminates at the level of the superior border of the thyroid cartilage.
Right common carotid Artery
Begins at the level of the second costal cartilage and termites at the superior border of the thyroid cartilage.
Left common carotid artery
An incision is made along the posterior border of the inferior 1/3 of the sternocleidomastoid muscle. The incision is thus parallel to the muscle and vessel itself.
- An incision on the surface of the skin to raise the common carotid arteries. It is made along the posterior border of the inferior 1/3 of the sternocleidomastoid muscle.
- Note: There is no logical reason to use this incision in embalming. The problems generated by this incision outweigh the benefits.
Parallel incision
This method of incision involves the utilization of both common carotid and both internal jugular veins.
- Recommended for difficult cases
- Method of injection wherein both common carotid arteries are raised.
- Inject the right, clamp the left
- Half moon incision used historically, most embalmers prefer two separate three inch supraclavicular incisions.
Restricted Cervical method (Incision)
- Direct distribution to the face
- Close to center of venous drainage
- Close to center of embalming circulation
- Face possibly can be embalmed using the restricted cervical method with a mild solution, while remaining portion of body can be injected with a stronger solution- fluid will enter the head from vertebral arteries.
- Has no branches except its terminal branches
Considerations of the common carotid arteries
- Incision may be visible after dressing
- Tubes may leave mark on face
- Face may be over-injected on the left side when utilizing the right common carotid as an injection site and visa versa.
Precautions of the common carotid arteries
Originate at the bifurcation of the left and right common carotid arteries at the superior border of the thyroid cartilage.
- The bifurcation will occur front to back not side to side.
Internal and External Carotid Arteries
Anterior branch: Primary blood supply to the face.
External Carotid Artery
Posterior Branch: Primary blood supply to the brain.
Internal Carotid Artery
The internal Jugular vein will lie later and superficial to the common carotid artery. Therefore, the common carotid artery will lie medial and deep to the internal jugular vein.
Accompanying vein to the carotid artery
Branch of the external carotid artery that supplies blood to the cheeks and lips.
The external Facial Artery (Maxillary Artery)
Along the inferior border of the mandible just anterior to the angle of the mandible.
Anatomical Guide: External Facial Artery
Along the anatomical guide, not more than one inch in length, directly over the mandibular notch.
Place of incision: External Facial Artery
The left and right of these have different origins.
- Only raised in autopsy cases
Origin of the Subclavian Artery
- Arises from the right brachiocephalic artery
- Begins at the sternoclavicular articulation
- Terminates at the lateral border of the first rib
Anatomical limits: Right Subclavian Artery
- Arises directly from the arch of the aorta as the third branch.
- Begins at the level of the second costal cartilage
- Terminates at the lateral border of the first rib.
Left Subclavian Artery
Which is longer, the left or right subclavian artery?
Left
Gives off 4 Branches:
- Left and right Vertebral
- Left and right internal mammary
- Left and right costocervical
- Left and right thyrocervical
Branches of the Subclavian Arteries
It is imperative that the left and right subclavian arteries be injected on these cases so that these eight arteries carry arterial fluid to the shoulders and back of the head. Of the eight arteries, the left and right vertebral are of primary importance.
Autopsy Cases
Originates from the left and right subclavian arteries and terminates by forming the basilar artery in the foramen magnum.
Left and right Vertebral Arteries
Along the inferior border of the lateral one-third of the clavicle bone, exposing the vessel near its point of termination.
Place of incision: Subclavian Artery
A continuation of the subclavian artery and terminates by becoming the brachial artery.
Axillary Artery - Origin
The arm pit.
Base of the Axillary Space
Established by drawing a line along the fold of skin which envelopes the lateral border of the pectoralis major muscle.
Anterior border of the Axillary Space
Established by drawing a line along the fold of skin which envelopes the lateral border of the latissimus dorsi muscle.
Posterior Boundary of the Axillary Space
Established by drawing a line which connects the two points where the pectorals major and the latissimus dorsi muscles blend into the chest wall.
Medial Boundary of the Axillary Space
Established by drawing a line which connects the two points where the pectoralis major and latissimus dorsi muscles blend into the arm.
Lateral Boundary of the Axillary Space
A vertical line drawn from the center of the medial border of the base of the axillary space.
Mid- Axillary Line
Through the center of the base of the axillary space and parallel to the long axis of the upper extremity when abducted.
Linear guide: Axillary space
Posterior to the medial border of the coracobrachialis muscle.
Anatomical guide: Axillary space
- Begins at the lateral border of the first rib
- Terminates at the inferior border of the tendon of the teres major muscle.
Anatomical Limits: Axillary Space
Along the anterior margin of the hairline of the axilla. (arm pit)
Place of incision: Axillary Space
- Close to the face
- Close to the center of circulation
- Close to the enter of venous drainage
- Vessels are relatively superficial
Considerations of the Base of the Axillary Space
- Danger of over injecting face, particularly if there is any obstruction present in the other trunk arteries of the body.
- Anomalies of both artery and vein are common
- If the arm is not treated properly, it does not appear natural when the body is placed in the casket.
- Numerous branches
Precaution of the Base of the Axillary Space
Axillary Vein
Accompanying vein for the axillary artery
Medial and superficial to the axillary artery: therefore the axillary artery will lie lateral and deep to the axillary vein.
Relative location of the Axillary Vein
- A continuation of the axillary artery
- Terminates at the elbow where it bifurcates to become and ulnar and radial arteries.
Brachial Artery: Origin
From the center of the base of the axillary space to the center of the forearm just below the end of the elbow.
Linear Guide: Brachial Artery
Lies posterior to the medial border of the belly of the biceps brachii muscle.
Anatomical Guide: Brachial Artery
Begins at the inferior border of the tendon of the teres major muscle and terminates at a point just inferior to the antecubital fossa (elbow)
Anatomical Limits: Brachial Artery
In front of the elbow/ in the end of the elbow.
Antecubital