Lecture Notes- Continued MORS 113 Flashcards
- Disinfection of oral and nasal cavities
- Remove and record all clothing and personal effects
- Disinfection of clothing when necessary
- Remove all medical dressing and devices
- Bathe- external disinfection
Initial Treatment of The Body
These medical devices are removed after embalming.
Intravenous
Should be documented in a permanent file.
Removed clothing and personal belongings
- Materials and proper procedure- aerosols sprays, topical jelly and cavity packs
- Cleaning and disinfecting agents
- Protect all identification tags and bands
Bathe - External Disinfection
This is something to be done prior to embalming.
Position the Body
Body should be placed on a table with the head elevated _____ the rest of the body.
Above
Be sure the body is ______ on the table.
Straight
The head should be placed on the ______ in such a way that it will not interfere with the distribution of fluid and drainage.
Headrest
The face may be tilted to the right, no more than ____ degrees, which is the generally preferred casketing position.
15
The _____ must be aligned in such a way that there will be no interferences with distribution of fluid and drainage.
Neck
_____ should be placed in a desirable position. (Left over right)
Hands
____ may need to be elevated or otherwise posed for effective positioning of the hands.
Arms
________ may need to be elevated to effect proper neck alignment.
Shoulders
The use of additional _____ ______ _____ may be necessary in special situations for proper body positioning.
Impermeable Posing Devices
Be sure ________ do not abrade surface tissue causing desiccation marks.
Instruments
- Shaving
- Prepare the face with cream or oil (optional)
- Closing the mouth
- Closing the eye
- Positioning the arms and hands
- Positioning the head
- Prepare face and hands- massage cream
- Raise artery and vein- begin embalming process
- Wash and dry hair
- Pack external orifices
- Bathe entire body
- Fingernails cleaned
- Hair cut and styled
- Prepare to dress and casket
Posing the Features to Create Feature Naturalness
The application of this at this time may have the following effects:
- Cleanse tissue pores
- Retard dehydration
- Base for further massage
- Base for cosmetics
- Stimulate circulation
Massage Cream or Oil
Will fill the pores of the skin and prevent the face from soaking in cosmetics.
Massage Cream- Base for Cosmetics
- Excessive manipulation of the lip tissue can cause distension (swelling).
- Sharp teeth can cause personal injury to the operator.
Precautions of Closing the Mouth
- Relieve rigor mortis
- Disinfect and cleanse oral and nasal cavities
- Remove, cleanse and disinfect dentures
- Observe normal overbite
- Observe points of natural expression
- Secure the mandible
Starting Procedure- Mouth Closure
Run copious amounts of water through the nostrils, then use the nasal aspirator to remove excess water.
Disinfect and Cleanse Oral and Nasal Cavities
Use a small, stiff brush. As for the dentures at the place of death if possible.
Remove, Cleanse and Disinfect Dentures
- Natural teeth
- Dentures - 90% accuracy
- Mouth formers
Observe Normal Overbite
- Five arcs of lip closure (hunting bow)
- Protrustion of the upper lip
- Natural facial lines and acquired facial lines
- Corner of the mouth slightly raised
Observe Points of Natural Expression
Shape of the mouth
Horseshoe
Shape of the line of closure of the lips.
Hunting Bow
- Naso-labial fold
- Philtrum
Natural Facial Lines
- Labial sulci
- Naso-labial sulcus
Acquired facial lines
To make the deceased look restful and peaceful.
Raise the corner of the mouth slightly
- Print name
- Social security number
- Date of birth
- Date of death
- Name of funeral home
- address
- phone number
- The tag must have protected laminate (encased impermeable plastic).
Maryland requires that identification tags be attached to a long bone after embalming.
- Needle Injector
- Muscular suture or tie
- Mandible suture or tie
- Wire through the bones
Acceptible Methods of Securing the Mandible
This is only used in special situations, usually trauma. The mandible is wired to the maxilla after small holes are drilled with a dremel (acceptible).
Wire Through the Bones
- Chin rest
- Dental Tie
- Hypodermically injecting the masseter muscle
- The tack and thread method
- Drywall adhesive
Outdated, unreliable and in some cases, unethical methods of mouth closure
Outdated. The mouth is closed and a head-block, bottle or nose-chin clamp is positioned. Both carotids are raised and the head is over-embalmed. These positioning devices are left in place until the facial tissue and muscles are firm, then they are removed. The theory is that the tissue is fixed and firm sp that the mouth won’t open, but this method seldom works and the devices leave marks on the face.
Chin-Rest Method
Most elderly people have no teeth, making this method useless from the start. This method consists of fastening a strong ligature or fishing line around one of the upper incisors and allowing the free end to hand loose. A similar ligature is placed around the corresponding lower incisor and then both loose ends of the ligature are tied together. The biggest fault is that most people have an overbite.
Dental Tie Method
This is the muscle of mastication; the grinding of the mandible against the maxilla.
Masseter Muscle
Injection of high index cavity fluid, via small syringe, into the masseter muscles (loacted at the rear of the mouth behind the teeth). The mandible is then put in a closed position until the muscles firm. A problem that may arise is a circular burn mark in the cheek from the cavity fluid. This method seldom works.
Hypodermically Injecting the Masseter Muscles
- This method is unprofessional
- This is the predecessor of the needle injector method.
- One carpet/upholesterer’s tack is driven with a light tack hammer into the mandible between the roots of the teeth. The second tack is driven into the maxilla between the roots of the teeth, the mandible is positioned and with a fine suture, the two tacks are tied together. After ligation, the tack heads are counter-sunk with a punch.
The Tack and Thread Method
A controversial method deemed unprofessional by many embalmers, but effect as a mouth closure method. It is the application of the adhesive to top or bottom teeth. The mandible is positioned, the adhesive sets in fifteen minutes and the mouth is permanently closed. The method is useless if the deceased has no teeth. Same problem as a dental tie. Applied with a caulking gun in conjunction with replaceable adhesive tubes.
Drywall Adhesive- Liquid Nail
- Muscular Suture
- Mandibular Suture
- Needle injector or tack gun method
- Wire through the bones
Relible Methods of Mouth Closure
You suture the mentalis muscle of the chin to the septum of the nose.
- Half moon needle and single, find strand of suture.
- Needle is passed through the mentalis muscle just inferior to the frenulum in as wide of an arc as possible (about 1 inch)
- Done on the opposite side as the viewing side
Muscular Suture
Suturing around the mandible and through the septum of the nose.
- J-shaped needle and single strand suture.
- Needle is passed behind the gum through the floor of the mouth aimed to a point lateral to the chin, then reinserted through the same hole in front of the gum, aiming for the nasal passage. (then through the septum)
- A small dab of wax may be necessary to cover the hole in the chin.
Mandibular Suture
This is the best method for false teeth (dentures) because it helps hold the teeth in place when you tie the bottom plate to the gum.
Mandibular Suture
Packing the mouth with cotton between the dentures.
Another way to help keep dentures in place
The attachment of the mandible to the maxilla by wires attached to barbs and inserted mechanically into the gums.
- Injector is held at a right angle to a central point near the frenulum of the mandible and maxilla, a barb is injected at the roots of the teeth into the gums.
The needle injector or tack gun method
Used only in cases with disease or trauma involving the head. A small hole is bored through both the mandible and maxilla at the root of the teeth. A wire is then passed through the holes, the mandible is positioned ad the wires are twisted together.
- Good method for suicide and gun shot wounds.
- A dremel with a narrow bit is most effective.
Wire Through the Bones