Lab Manual Packet Flashcards
The center of embalming circulation
The arch of the aorta
Since the arch of the aorta is the center of embalming circulation, it is imperative to
Select an injection site as close as possible to the arch
The center of venous drainage
The right atrium of the heart
Medial
Going toward the middle of the body; toward the midsagittal plane
Lateral
Going away from the middle of the body; away from the midsagittal plane
Superficial
Going toward the surface of the body
Superficialis
Noting a superficial artery, vein, nerve or other structure near the body surface.
Deep
Going toward the center of the body well below the body surface
Anterior
Situated at or directed toward the front of the body
Posterior
Situated at or directed toward the back of the body
Bifurcate
To divide into two branches (equal sizes)
Superior
Going toward the head
Inferior
Going toward the feet
Abut
To touch or contact as with the tarsal plates of the closed eyelids.
Articulation
Place of union between two or more bones
Subcutaneous
Situated or occurring beneath the skin
Buccal cavity
Vestibule of the oral cavity; the space between the lips, gums, and teeth
Canalization
Formation of new channels in a tissue
Lumen of a vessel
The hollow space within an artery, intestine, or anatomical, tubelike structure. Will decrease in diametric size as they distance themselves from the aorta and vena cava.
Cachexia
General deterioration of the body; a state of ill health, malnutrition, and wasting. May occur in many chronic diseases as certain malignancies and advanced pulmonary tuberculosis.
Desiccation marks
May occur in the area of right common carotid artery caused by instruments at this injection site; occur from damage to the surface of the skin
The external iliac vein becomes the_________ as it passes through the ilium bone
Femoral vein
Anatomical guide
Any surface, prominence, or structure which is used to establish the location of adjacent structures or prominence. A descriptive reference for locating arteries and veins by means of anatomical structures which are known.
Anatomical limits
The point of origin and termination of a vessel as expressed in relation to adjacent structures or prominences. Used to designate boundaries of arteries.
Linear guide
Imaginary line drawn on the surface of the skin which represents the approximate location of a deeper lying structure or prominence
Another word for brachiocephalic artery
Innominate
The right common carotid artery is a terminal branch of the
Brachiocephalic artery
The ______________ is the first branch off the arch of the aorta
Brachiocephalic artery
The _____________ is the second branch off the arch of the aorta
Left common carotid artery
Linear guide of the common carotid artery
A point from the sternoclavicular articulation to the anterior surface of the lobe of the ear.
The carotid artery lies along the medial border of the
sternocleidomastoid muscle
The left common carotid artery is _______ than the right common carotid artery
Longer
Right common carotid artery begins at…
The level of sternoclavicular articulation
The right common carotid artery terminates at….
The level of the superior border of the thyroid cartilage
The left common carotid artery beings at…
The level of the second costal cartilage
The left carotid artery terminates at…
The superior border of the thyroid cartilage
Supraclavicular incision
Along the superior boarder of the clavicular bone (limit to three inches)
Most funeral homes prefer the incision to be along the…
Inferior border of the Medial 1/3 of the clavicle bone
An incision on the surface of the skin to raise the common carotid arteries is made along the….
Superior border of the medial 1/3 of the clavicle.
Parallel incision
An incision made along the posterior boarder of the inferior sternocleidomastoid muscle. (Not used in embalming)
Restricted clavicle method (incision)
Involves utilization of both common carotids and both internal jugular veins. Recommended for difficult cases.
Considerations (pros) of the restricted cervicle method
- direct distribution to the face
- close to center of venous drainage
- close to center of embalming circulation
- fluid will enter the head from vertebral arteries
- has no branches except it’s terminal branches
Precautions (cons) of restricted cervicle method
- incision may be visible after dressing
- tubes may leave mark on face
- face may be over injected on the left side when using right common carotid as an injection site and vice versa
Internal and external carotid arteries originate…
At the bifurcation of the left and right common carotid arteries at the superior boarder of thyroid cartilage
Bifurcation of internal and external carotid arteries occur _________ not ___________
Front to back, not side to side
External carotid artery: anterior branch
Primary blood supply to the face
Internal carotid artery: posterior branch
Primary blood supply to the brain.
The accompanying vein to the internal carotid artery
Internal jugular vein
The internal jugular vein lies
Lateral and superficial to the common carotid artery
The common carotid artery will lie….
Medial and deep to the internal jugular vein.
The external facial artery is also called the
Maxillary artery
External facial/maxillary artery
Branch off the external carotid artery that supplies blood to the cheeks and lips
The external facial/maxillary artery runs along the___________ border of the mandible just anterior to the ________________________
inferior, angle of the mandible.
Place of incision for the external facial/maxillary artery
Along the anatomical guide, not more than one inch in length, directly over the mandibular notch.
The right subclavian artery arises from
right brachiocephalic artery
Right subclavian artery terminates at….
The lateral boarder of the first rib.
The Left subclavian artery arises from
the arch of the aorta as the third branch. Begins at the level of the second costal cartilage.
Left subclavian artery terminates at…
The lateral boarder of the first rib
The left subclavian artery is _______ than the right subclavian artery
Longer
Each subclavian artery gives off four branches:
1) left and right vertebral
2) left and right internal mammary
3) left and right costocervical
4) left and right thyrocervical
All incisions used in arterial injection should be limited to
No more than three inches
Left and right vertebral arteries originate from the
left and right subclavian arteries and terminates by forming the basilar artery in the foramen magnum.
Place of incision: subclavian artery
Along the inferior border of the lateral 1/3 of the clavicle bone, exposing the vessel near its point of termination
The axillary artery is a continuation of the_____________Artery and terminates by becoming the____________ artery
Subclavian, brachial
Anterior boundary of the axillary space
Established by drawing a line along the fold of skin which envelops the lateral border of the pectoralis major muscle
Posterior boarder of the base of the axillary space
Established by drawing a line along the fold of skin which envelops the lateral border of the latissimus dorsi muscle.
Medial boundary of the base 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 chest wall
Lateral boundary of the base 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
Mid-axillary line of the base of the axillary space
A vertical line drawn from the center of the medial boarder of the base of the axillary space
the axillary artery runs through the center of ____________________ and parallel to the _____________ of the upper extremity when abducted
the base of axillary space, long axis
the axillary artery is posterior to the __________ border of the _______________ muscle
medial border, coracobrachialis
The axillary artery begins at______________________
The lateral border of the first rib
The axillary artery terminates at __________________
The inferior border of the tendon of the teres major muscle
Place of incision for the axillary artery
Along the anterior margin of the hairline of the axilla
The vessels in the axillary space are relatively __________________(deep/superficial)
Superficial
The axillary artery will lie ___________and __________to the axillary vein
Lateral and deep
The brachial artery is a continuation of the _____________
Axillary artery
The brachial artery terminates at the __________ where it bifurcates to become the ___________and ___________arteries
Elbow, ulnar and radial
Brachial artery lies _________ to the medial border of the belly of the _________________ muscle
Posterior, biceps brachii
Brachial artery begins at the inferior border of the tendon of the __________________muscle
Teres major
Brachial artery terminates at the point just inferior to the ____________________
Antecubital fossa (elbow)
Brachial vein’s accompanying vein for drainage
Basilic vein
Basilic vein is _________and ___________]to the brachial artery
Medial and superficial
The brachial artery will lie _______and __________to the basilic vein
Lateral and deep
Radial artery originates at the
Bifurcation of the brachial artery
Radial artery is on the surface of the forearm from center of the Antecubital fossa to the center of the base of the _______________
second digit
Radial artery is just _________ to the tendon of the flexor carpi radialis muscle
Lateral
Ulnar artery originates at the bifurcation of the ____________ and is ____________ than the radial artery
Brachial artery, larger
Ulnar artery is on the surface of the forearm from the center of the Antecubital fossa to
A point between the fourth and fifth digits
Ulnar artery lies _____ to the tendon of the flexor carpi ulnaris muscle
Lateral
Volar arch
The same as deep & superficial palmar arch
Brachiocephalic artery is the first branch off of the __________ and is only on the _________ side
Aortic arch, right
Brachiocephalic artery is about ________inches long
2-3
Right brachiocephalic vein will lie _________and________to the right brachiocephalic artery
Lateral and superficial
Right brachiocephalic artery will lie _______and ________to the right brachiocephalic vein
Medial and deep
The aorta is divided into ____ parts
4
The 4 divisions of the aorta
1) ascending aorta
2) arch of the aorta
3) descending thoracic
4) descending abdominal
Ascending aorta arises from the
Left ventricle of the heart
Arch of the aorta continues from the __________________ and is the center of _________________
Ascending aorta, embalming circulation
Why is the heart excluded from embalming circulation?
Because at death the tricuspid valve as well as the bicuspid or mitral valve shut down
The descending thoracic and abdominal aorta runs along
The left side of the spine
The diaphragm (phrenic muscle) divides the
Descending thoracic aorta from the descending abdominal aorta
All major trunk trunk arteries arise or originate from
The descending aorta
In infants, the artery to raise for injection is the
Descending abdominal aorta or the femoral artery
Superior (from above) and inferior (from below) vena cava empty into the
Right atrium of the heart
All veins have valves except for the
Superior and inferior vena cava
All veins (except the portal veins) will eventually drain into the
Superior and inferior vena cava
Portal veins lead to the
Liver
Common iliac artery originates at
The descending abdominal aorta.
Descending abdominal aorta bifurcates into the
Right and left common iliac arteries
Common iliac vein lies directly ________ to the common iliac artery
Inferior
Common iliac artery lies directly ___________ to the common iliac vein
Superior
External iliac artery is an extension of the
Common iliac artery
External iliac artery lies along the medial borer of the
Psoas major muscle
The external iliac vein lies _________ and ________to the external iliac artery
Medial and deep
The external iliac artery will lie ________and_______to the external iliac vein
Lateral and superficial
Internal iliac artery originates from the
Common iliac artery
Internal iliac artery branches off approximately half way down the _____________ muscle toward the __________
Psoas major, pubic viscera
Internal iliac artery carries blood to the organs in the
Pubic cavity
Artery usually severed in autopsy cases
Internal iliac artery
Another name for the internal iliac artery
Hypogastric artery
Femoral artery is a continuation of
The external iliac artery
Femoral artery lies on the surface of the thigh from the center of the _____________ to the center point on the medial condyle of the __________ bone
Inguinal ligament, femur
Condyle
Rounded articular process of a bone
Femoral artery runs through the center of the ___________, bounded laterally by the __________muscle and medially by the _______________ muscle
Femoral triangle, sartorius muscle, adductor longus
Femoral artery begins at the point _________ to the center of the ____________
Posterior, Inguinal ligament
Femoral artery terminates at the opening in the _______________ muscle
Adductor Magnus
Incision sight for femoral artery would be along any portion of the _____________________ of the linear guide
Superior two thirds
Relative position of femoral vein _________ at the Inguinal ligament, progressing to immediately _________ at the apex of the femoral triangle.
Medial, posterior
In theory, when injecting humectants/ dyes you should always use the
Femoral artery
Femoral vein will lie ________and ________to the femoral artery
Medial and deep
Femoral artery will lie ________and________to the femoral vein
Lateral and superficial
Base of the femoral triangle
Inguinal ligament ( pouparts ligament )
Lateral border of the femoral triangle
Sartorius muscle
Medial border of the femoral triangle
Adductor longus
Apex of the femoral triangle
Adductor Magnus ( not part of femoral triangle)
Another name of femoral triangle
Scarpa’s triangle
Profunda femoris artery will bifurcate from the _________ aspect of the femoral artery w/in scarpa’s triangle
Anterior
Profunda femoris artery descends downward along the __________ aspect of the thigh
Lateral
Profunda femoris artery terminates at the
Knee
Popliteal artery is an extension of the
Femoral artery
Popliteal artery runs through the center of the _____________ parallel to the long axis of lower extremity
Popliteal space
Popliteal artery begins at the opening of the ____________ muscle
Adductor Magnus
Popliteal artery terminates at the _____________
Inferior border of the popliteus muscle
Anterior tibial artery originates at the
Bifurcation at the popliteal artery
Anterior tibial artery runs from the _________ border of the ________ to the anterior surface of the _________ joint
Lateral, patella, ankle
Place of incision of the anterior tibial artery
Along lateral margin of the inferior 1/3 of the crest of tibia bone
The peroneal artery is a branch off of the
Posterior tibial artery
Posterior tibial artery originates at the
Bifurcation at the popliteal artery
Posterior tibial artery runs from the center of the __________ space to a point midway between the _______________ and the calcaneus bone
Popliteal, medial malleolus
Place of incision for the posterior tibial artery
Midway between the medial malleolus and the calcaneus tendon
Dorsal is pedis artery is an extension of the
Anterior tibial artery
Dorsalis pedis artery runs from the center of the anterior surface of the ___________ to a point between the first and second ________
Ankle joint, digits (toes)
Place of incision of the dorsalis pedis artery
Along superior 1/3 of the linear guide-superficial.
Planters arch is formed at the base of the _______anteriorly by the ________________ artery and posteriorly by the __________________
Digits (toes), dorsalis pedis, posterior tibial artery
Other factors governing selection of arteries to be used for injection
1) age
2) sex
3) weight
4) fat distribution
5) disfigurations
6) disease
7) edema
8) location obstruction
9) trauma
10) medico-legal requirements
11) cause of death
12) manner of death
Difference between a medical examiner autopsy and a hospital autopsy
Hospitals need permission and they do not typically return viscera; medical examiners do not need permission, and they typically return the viscera.
N.A.S.H. Cause of death
N-Natural
A-Accident
S-Suicide
H-Homicide
Difference between a medical examiner and a coroner
Medial examiners investigate; coroners hold inquest
Blunt dissection
Separation and pushing aside of superficial fascia leading to blood vessels and the deep fascia surrounding blood vessels. Utilizing manual techniques or rounded ended instruments that separate rather than cut the protective tissues.
Ligate
To tie off an artery and vein upon completion of embalming
In case of blood borne pathogens, it is best to use the ________ artery because it is farther from your face
Femoral
5 different incisions
1) transvers
2) diagonal
3) longitudinal
4) T-shaped
5) triangular (wedge)
Coagulation
The process of converting soluble protein to insoluble protein by heating or contact with a chemical such as alcohol or aldehyde.
Coagulation is a specific form of ______________
Agglutination
Three different suture needles
1) half moon- neatest incision, most dangerous
2) J- shaped ( single curve)
3) S-shaped ( double curve)- safest, messy closure
Single, intradermal, subcutaneous suture ( hidden stitch)
Made with a single suturing needle with non-cutting edge, and is used on exposed areas of the body, particularly in plastic surgery operations
Double intradermal or double subcutaneous suture
Made in the same manner as single intradermal stitch, except a suturing needle is used on each end of the ligature (two suturing needles) and ligatures are crossed at each stitch using a crisscross motion like tying shoes. Gives more protection against leakage in comparison with the single intradermal stitch.
Baseball stitch or sail stitch
Type of stitch used on baseball covers and was the type of incision used by the Egyptians. Usually uses an s-shaped suture needle
Veins and arteries have _______ layers
3
Lock stitch, half stitch, or blanket suture
Makes tight, leak proof closure, but creates unsightly ridge on surface of incision.
Figure 8 suture
Anchor surface ligature around pins. Considered a temporary suture. Suggested use is to bring and hold lips of incision together before and during embalming operation until more permanent closure is made.
Draw stitch
Same as single intradermal suture except this stitch penetrates completely through the skin.
Worm stitch
Easily waxed over if used on exposed areas of the body. Used to turn under excess margins of the skin. Opposite of the draw stitch in regards to exposed areas of the ligature.
Whip stitch, continuos glover stitch or roll stitch
Used by passing ligature through both sides of the incision from the outside going from one side to the other as the incision is sutured.
Bridge suture, temporary interrupted suture
Individual stitch knotted at the tissue edge. Normally used as a temporary stitch, may be applied prior to embalming to align tissues
Purse string suture
Used to close small punctures or holes. A series of small stitches are made through skin around circumference of the opening. The ends of thread are then knotted.
Arteries have ______ heavy coats and are ______ walled
3, thick
Three layers of artery wall
1) tunica intima (inner layer)
2) tunica media ( middle layer)
3) tunica adventica ( outer layer)
Vasa vasorum
Blood vessels supplying nutrients to the larger arteries and veins. Distributed to the walls of the larger veins and arteries throughout the vascular system.
Veins have _____ coats and are _______ walled
3, thin
Arteries have ______ lumen
Small
Veins have ________ lumen
Large
Nerves have no _______ or __________
Lumen, vasa vasorum
Organs in the right hypochondriac region
Greater part of right lobe of the liver, hepatic flexure of the colon, part of the right kidney, gall bladder
Organs in the epigastric region
Greater part of the stomach including cardiac and pyloric orifices. Left lobe and part of right lobe of liver, greater part of the pancreas, duodenum, suprarenal capsules and parts of the kidneys.
Organs in the left hypochondriac region
Fundus of the stomach, spleen, tail of the pancreas, splenic fixture of the colon, part of the left lobe of the liver
Organs in the Right lumbar region
Ascending colon, lower part of the right kidney, part of small intestine
Organs of the umbilical region
Transverse colon, parts of both kidneys, parts of duodenum, jejunum, and ileum. Part of great omentum and mesentary,
Organs of the left lumbar region
Part of the left kidney, descending colon, part of the omentum, part of small intestine.
Organs of the right Inguinal (iliac) region
The cecum and vermiform appendix, part of ascending colon
Organs in the hypogastric region
Part of the small intestines, bladder in children and in adults if distended, uterus during pregnancy
Organs of the left Inguinal (iliac) region
Sigmoid flexure of colon and part of the descending colon
The trocar is inserted where?
The umbilical region, two inches to the left and two inches above the navel.
What will come out of the stomach during aspiration?
Brown coffee ground consistency with acrid or sour smell
What will come out of the cecum during aspiration?
Yellow fecal matter
What will come out of the urinary bladder during aspiration?
Yellow bubbles
What will come out of the right side of the heart when aspirated?
Dark red venous blood (atrium)
What will come from the lungs when aspirated?
Clear or red foam or frothy white; no odor
What will come from the brain during aspiration?
Clear fluid, may contain small specks of tissue with no odor. May be creamy white
Pubic symphysis
Fibrocartilage that joins the two pubic bones in the median plane
Anterior superior iliac spine
Hip bone
Father of US/ Modern embalming
Dr. Thomas Holmes
The right subclavian artery begins at
the sternoclavicular articulation
