midterm Flashcards
embalming is the chemical treatment of the dead body to reduce the presence and growth of microorganisms, to temporarily inhibit organic ___ , and to restore the dead human body to an acceptable physical appearance
decomposition
reverence for the dead is the basic ___ axiom of the funeral service profession
ethical
___ published The American Way of Death, a savage and relentless attack on the profession, causing a counterattack on Mitford herself by America’s funeral directors
Jessica Mitford
without a body present, an essential element of the ___ process is missing
grieving
viewing and touching a dead human body is the ___ way for the bereaved to overcome any death denial feelings
best
___ is a pioneer in the study of grief management
Erich Lindemann
___ is a pioneer in psychology who saw human psychological life as a universal phenomenon whereby identification with what he termed the “collective conscious” linked all humanity together
Carl Jung
it is important for the embalmer to conduct a ___ at the beginning, during, and following the preparation
case analysis
today ___ allows the fallen military hero to be transported from a distant foreign field or waters to the hometown often with the possibility of the viewing of the remains
arterial embalming
the work done at the mortuary affairs located at ___ houses the largest and only port mortuary under the united states department of defense within the continental united states
dover air force base
in ancient Egypt, the dead were embalmed according to ___ custom
religious
“show me the manner in which a nation or community cares for its dead and I will measure with mathematical exactness the tender sympathies of its people, their respect for the laws of the and, and their loyalty to high ideas” - this quote was spoken by
William Evart Gladstone
the practice of embalming allows bereaved families to have ___ to make important decisions, deal with all that has happened, organize and participate in funerals
time
all personal information about a deceased (ex. cause and manner of death and condition of the body) are strictly ___
confidential
embalming must be authorized by the expressed or written permission ___ the performance of the procedure
before
the embalmer is responsible for maintaining the proper ___ of the body throughout the various stages of preparation and until the time of final disposition
identification
it is the ethical responsibility to maintain a clean and sanitary work environment, offer ___ to any person allowed access to the preparation room, restrict entry to unauthorized persons, and maintain coverage of sheltered human remains
personal protective equipment (PPE)
authorized photographs must be digitally and physically safeguarded to ensure confidentiality. it is wise and prudent for the embalmer to secure permission from the ___ prior to taking photographs
authorizing agent
when handling human remains, funeral practitioners must ensure the dignity of the deceased and ___ are strictly observed
universal precautions
embalmers can be responsible for the transmission of recognized classical and/or opportunistic pathogens
all of the above
(from human remains to the embalmer, from the embalmer to their family, to the families and friends of the deceased)
preventing the transmission of recognized classical and/or opportunistic pathogens is a reasonable public health ___ on the part of the embalmer
expectation
implementing minimum professional practice standards in embalming is necessary to provide a standard of ___ control and assurance in preserving and disinfecting human remains
quality
a process to promote and establish conditions that minimize or eliminate biohazards
sanitation
(1) something that preserves or has the power of preserving; (2) an additive used to protect against decay, discoloration, or spoilage; (3) chemicals that inactivate saprophytic bacteria, render unsuitable for nutrition the media upon which such bacteria thrive, and that will arrest decomposition by altering enzymes and lysins of the body as well as converting the decomposable tissue to a formless susceptible to decomposition
preservative
obtaining food by absorbing dissolved organic material especially obtaining nourishment from the products of organic breakdown and decay
saprophytic
separation of compounds into simpler substances by the action of microbial and/or autolytic enzymes
decomposition
to prevent or retard an unwanted alteration of a physical state. slowing the onset of the changes of decomposition by the use of refrigeration, dry or wet ice, and the injection of chemicals or non formaldehyde containing fluids
stabilize
(1) the decomposition of organic matter; (2) the typically anaerobic splitting of proteins of bacteria and fungi with the formation of foul smelling incompletely oxidized products; (3) decomposition of proteins by the action of enzymes from anaerobic bacteria
putrefaction
decomposition of proteins by enzymes of aerobic bacteria; to undergo destructive dissolution; implies a slow change from a state of soundness
decay
which of the following is an external factor of decomposition
strength and volume of embalming solutions
there are too many variables associated with embalming to provide ___ regarding the degree or length of time that preservation of the embalmed body can be maintained
assurances
embalming preservatives and germicides interact primarily with body proteins - creating ___ - that can no longer be easily broken down by bacterial or autolytic body enzymes
embalmed tissue
one of a class of complex nitrogenous compounds that are synthesized by all living organisms and yield amino acids when hydrolyzed
protein
arterial embalming is also called
vascular embalming
the solution in the embalming machine replaces the ___ in the vascular system
blood
direct treatment of the contents of three body cavities: thoracic, abdominal, and pelvic. applied in two phases: aspiration of the cavity contents and injection of undiluted cavity fluid
cavity embalming
the ___ vein is customarily selected as the primary source of blood drainage
internal jugular vein
preservation of tissues by direct contact. preservative chemicals are applied to a cotton compress of inlay that makes contact with the tissues, or the chemical applied directly to the skin surface. considered a supplemental embalming procedure
surface embalming
the ___ is the structural mediator through which the injected preservative chemicals are delivered to the receptive tissue sites
capillary
the contents of hollow organs must be removed to make room for the introduction of cavity fluid (process called ___) also removes fluids and gases from between the organs that have accumulated ante- or post- mortem
aspiration
a ___ is inserted through the abdominal wall near the umbilicus (belly button) to pierce the hollow organs to drain accumulated fluids and makes channels in the solid organs
trocar
the preservative solution flows through the arteries, capillary, and venous routes similar to the ___ in the living body
blood circulation
KNOW WHO YOU ARE EMBALMING - identify all bodies throughout ___ phases of care
all
this form must be completed in lieu of an embalming report for each deceased human body brought into the care of a funeral or an embalming facility. a copy of the report must accompany the body being shipped or transported to another funeral facility
decedent care report
this form provides permission for embalming the body and indemnification of the funeral home
embalming authorization
results from John Hopkins University study concluded that funeral home employees who worked as embalmers had a greater exposure to ___ than funeral home employees who did not embalm bodies
tuberculosis
___ is a pathogenic bacterial staph infection that causes over 100k hospital infections a year. it can be found on the skin, in the nose, in blood and urine, and in exudates or fluid from an infected site. this infection is spread by direct physical contact or contact with contaminated objects
MRSA
___ is a fatal disease caused by a prion. the causative agent is very difficult, if impossible to destroy. the causative agent appears to be concentrated in cerebrospinal fluid
Creutzfeldt-Jakob disease
exhaust ventilation should draw fumes ___ the embalmer
away from
embalmers should keep ___ closed on the embalming machine when not in use
rate of flow valve
used to provide personal and public health protection; should be examined and maintained or replaced on a regular basis; two primary areas of consideration are adequate ventilation and proper plumbing
engineering controls
in the united states, the practice of embalming is regulated primarily by the ___. responsibilities include, but are not limited to, overseeing the care and disposition of dead human remains; also the regulating and licensing of funeral homes, funeral directors and embalmers
individual states
since 1987, the US environmental protection agency has recognized formaldehyde as a potential ___ for tumors in the lung, nasopharynx, and nasal passages
carcinogen
four divisions of ___ directly affect the funeral establishment: general rule, hazard communication standard, formaldehyde rule, and blood borne pathogen rule
OSHA
the funeral home must include on the ___ selected statement “…you do not have to pay for embalming you did no approve if you selected arrangements such as direct cremation or immediate burial. if we charge for embalming, we will explain why below”
itemized statement of funeral goods and services
the funeral home must disclose on ___ in immediate conjunction with the price shown for embalming: “except in certain special cases, embalming is not required by law. embalming may be necessary, however, if you select certain funeral arrangements, such as a funeral with a viewing”
general price list
the funeral home cannot represent that ___ requires that a deceased person be embalmed when such is not the case…nor can it fail to disclose that embalming is not required by law, except in certain special cases
state or local law
this OSHA rule directly applies to occupations and professions where employees are exposed to infectious agents. compliance with this rule is accomplished through applying universal precautions, engineering contours, and work practice controls
blood borne pathogen rule
___ must be made available to all employees who have occupational exposure to infectious agents (and at no cost to employees)
hepatitis B vaccine
rule of thumb for protective garments is that the embalmer should have no ___ skin
exposed
this OSHA rule requires that employers communicate to employees the dangers that exist in the workplace as a result of hazardous substances or materials. it also directs employers to train employees in the safe use and handling of hazardous substances or materials. under this rule, any chemical or a mixture of chemicals that expose employees to a health or physical risk are considered to be hazardous
hazard communication standard
studies have shown that exposure to ___ at certain levels will likely cause employees to experience eye, nose, throat, and upper respiratory tract irritation
formaldehyde
exposure that is time weighted over an established period. it allows the exposure levels to be averaged generally over an 8 hour period
time weighted average
legal limits established by OSHA to which workers can be exposed continuously for a short period without damage or injury. these exposures should not be longer than 15 minutes and not repeated more than four times per day
short term exposure limit
OSHA has a ___ standard that must be followed when respirators are put into use in the preparation room. employees must be fit tested to see if a respirator is appropriate for them
respirator
under the ___, employers must introduce employees, who have occupational exposure, to safety data sheets. employers must identify methods by which employees will have access to the information
formadlehyde standard
an agent, usually chemical, applied either to inanimate objects/surfaces or living tissue for the purpose of destroying disease causing microbial agents, but usually not bacterial spores
germicide
a process that renders a substance free from all microorganisms
sterilization
an agent, usually chemical, applied to inanimate objects/surfaces for the purpose of destroying disease causing microbial agents, but usually not bacterial spores
disinfectant
examples of engineering control for compliance with the formaldehyde standard are essentially the same as for biological hazards. the formaldehyde standards requires employee information and training before their being exposed to ___
hazardous substances
a blunt instrument used for tissue dissection and determining the location and elevation of arteries and veins. it has an “eye” in the hook portion of the instrument, which could be used for passing ligatures around the vessel
aneurysm needle
similar to aneurysm needle but has a sharp pointed tip. the handle is designed to function as a separator
aneurysm hook
curved cutting instrument that cuts from the inside outward. some embalmers prefer this type of instrument for opening arteries and veins. it also can be used for the excision of tissues
bistoury knife
there are many varieties of this instrument and they can be used to clamp leaking vessels. they also can be used for packing orifices or handling contaminated bandage dressings. the ends of this instrument may be curved or straight, serrated or smooth, or plain or rat toothed
hemostat
this instrument is used to hold an incision open during blunt dissection and raising of vessels
incision spreader
sharp cutting instrument used for making incisions. they can be purchased with a permanent blade, or the handles can be purchased and disposable blades used
scalpel
used to keep vessels elevated above the incision. can be made of hard rubber, bone, or metal
separator
an instrument used for grasping and holding tissues. the limbs may be straight, curved, or angular. the tips of forceps may be serrated, smooth, or rat toothed
spring forceps
used to close autopsy incisions as well as incisions made to raise vessels for injection
suture needles
temporarily hold skin flaps together so the embalming can suture an incision
tissue gather forceps
carry blood away from the heart. elastic, deep, and well protected. cream color. feels like a large rubber band. stand open when incised
arteries
carry blood toward the heart. they are blue in color and may be superficial. collapse when incised
veins
a small branch of an artery leading into capillaries
arterioles
middle layer of an artery composed of smooth muscle; functions in dilation and constriction of blood vessels
tunica media
the heart is surrounded by a sac called___
pericardium
the first branch off the arch of the aorta is the
brachiocephalic artery
a large artery that carries oxygenated blood to the head, face, neck; left and right arteries; the right artery bifurcates (divides) two divisions (internal and external)
common carotid artery
a major artery that supplies oxygenated blood to the head, neck, chest, and arms; located below the clavicle on both sides of the neck; left and right arteries; they receive blood from the aortic arch
subclavian artery
a large blood vessel that supplies to the lower body; carries oxygenated blood to the lower limbs of the limb; passes through the thigh and divides into a deep branch and a superficial branch near the knee
femoral artery
a blood vessel of the lower limb that carries oxygenated blood to the dorsal surface of the foot; sits on the top of the foot, running over the tarsal bones then down towards the sole of the foot
dorsalis pedis artery
admittance to the preparation room is by ___. the preparation room is kept strictly private during body preparation
authorization
which is an example of someone who would not have a viable reason to be in a preparation room
members of the community and neighborhood
preparation room signage must be in compliance with the applicable laws and regulations; strictly private area and signs with required ___ warnings
OSHA
the preparation room must be ___ and should not be located so that it becomes a passage to other building areas
secured
in order to maintain the dignity of the remains, the deceased must be properly ___, and provided a modesty cloth for genital areas
identified
embalmers and others working in the preparation room must maintain the highest ethical and moral standards of care and ___
confidentiality
the preparation room must be properly maintained to create a clean and healthy environment. it is important to perform and ___ regular maintenance and cleaning of the preparation room
document
maintain an ___ supply of chemicals and associated sundry items necessary for embalming and decedent care, restorative, and cosmetology treatments
adequate
maintain an adequate number of tables and positioning devices per case ___
volume
___ decedent care activities for every decedent in the care of the facility through the use of embalming decedent care reports and the applicable forms
document
OSHA prescribes in detail the physical and ___ requirements that employers must meet to provide a safe workplace. these requirements are enforced through workplace inspections, warnings, and citations
environment
OSHA right to know laws provide workers with direct access to information about the health risks of ___ used in the work place
chemicals
posting requirements for this information is ___
mandatory
new construction and facility remodeling requires a ___
building permit
used for decedent care activity purposes other than arterial embalming; also called a holding or staging area
dressing room
the ___ can be the most logical and least costly location of a preparation room when space allows
first floor
the ___ of a facility is often where space is most readily available. however, ceiling height can be limited in this area due to overhead plumbing lines and ducts for heating, ventilation, and cooling systems
basement
___ coatings provide a seamless and nonslip surface that is easy to clean and disinfect. they can be used over cement, tile, wood, and other types of flooring
epoxy
___ tile is also seamless, resilient to cleaning products, and comfortable to stand on for hours at a time
vinyl
when selecting windows for a preparation room, ___ must always be ensured in the preparation room. window glass cannot be transparent and allow visibility into a preparation room
privacy
when selecting doors for preparation room, remember that they must be secured to deny access to unauthorized persons. ___ locking devices require only a code; the code can be readily changed when the need arises
touch pad
wall material must be wipeable and readily ___ upon contamination or soiling
disinfected
OSHA required emergency safety device providing a steady stream of water for flushing the eye
eyewash station
device that uses a motor to create a suction for the purpose of aspiration
electric aspirator
specialized equipment connected to the water supply: creates suction for trocar aspiration of the body cavities
hydro aspirator
multipurpose instrument (size can vary) used in the embalming process (ex. as a drainage instrument)
angular spring forceps
used to inject embalming fluid solution into the blood vascular system
arterial tube
has many openings so as to be “non clogging”. it is used to aspirate blood and arterial fluid from the cavities of autopsied bodies
autopsy aspirator
screws onto the cavity fluid bottles. when the device is inverted, cavity fluid flows through the trocar into the body cavities
cavity fluid injector
used to expand a vein to help guide a drain tube or drainage device into a vein for drainage
grooved director
creates a vacuum when water is running through the mechanism
hydro aspirator
designed for hypodermic treatments. it is not used for aspiration but rather for injection
hypo valve trocar
used to attach the delivery hose from the injection device to the arterial tube. can be used to maintain and stop the flow of fluid into the arterial tube
stopcock
long hollow needle used to aspirate and inject body cavities and hypodermic injection treatments
trocar
developed for the embalming of autopsied bodies. it allows the embalmer to embalm both legs and arms or sides of the head at the same time
y-tube
which of the following is not a postmortem physical change
rigor mortis
temporary rise in body temperature after death
postmortem caloricity
progression is realized once the body loses ability to sustain physiologic and metabolic activity
somatic death
occurs when spontaneous respiration and heartbeat irreversibly cease
clinical death
“grave wax”; the final product of fat decomposition
adipocere
stiffening of the muscles after death; creates extravascular resistance, body positioning and feature setting challenge for the embalmers; tissue distention during arterial injection; increases preservative demand; pH changes affect chemical reaction of embalming solution
rigor mortis
postmortem evacuation of any substance from an external orifice of the body as a result of pressure
purge
thin, smooth, flat polyethylene boards, are strong, non absorbent, and easily cleaned; placed under the body to move the body
body transfer board
sloughing off of the epidermis, wherein there is a separation of the epidermis from the underlying dermis
desquamation (skin slip)
a gurgling, or rattling in the throat caused by the accumulation of mucous and axacerbated by loss of the cough reflex
death rattle
anaerobic, saprophytic, spore forming bacterium, responsible for tissue gas, referred to as a gas bacillus
clostridium perfringens
embalming machine that uses motorized force; pulsating and non pulsating types available
centrifugal pump
the irreversible phase of somatic death and represents the cessation of simple body processes. the organs in the body no longer function
biological death
which of the following is not a postmortem chemical change
livor mortis
extravascular discoloration, not cleared during arterial injection alone; gray discoloration when reacting with embalming chemicals; sign of delay between death and embalming
postmortem stain
used to insert a “barb” into the mandible and maxilla to hold the lower jaw in a closed position
needle injector
the antemortem interval is known as the ___ as the person is said to be actively dying during this stage
agonal period
used to draw excess swelling and to displace moisture under the skin
electric spatula
holds skull bones in place after autopsy
calvarium clamp
the process during which individual cells die; may take a matter of hours depending on numerous variables
postmortem cellular death
presents as reflexive twitching of the muscles, marking the final efforts to sustain life
death struggle
brain death occurs in a sequence of events that are a function of time without oxygen. the first part of the brain to die, usually in 5-6 minutes is the ___
cerebral cortex
cooling of the body to the temperature of the surrounding environment
algor mortis
gravitation of blood and body fluids to dependent areas of the body
hypostasis
the ability of the cells to draw moisture from the surrounding area into themselves
imbibition
a supplemental fluid that may be injected before the injection of preservative arterial solution in order to expand the vascular system, promote drainage, and prepare the tissues for reception of preservative arterial solution
pre injection fluid
solution having a lesser concentration of dissolved solute than the solution with which it is compared
hypotonic solution
chemicals found in embalming arterial formulations having the capability of displacing an unpleasant odor or of altering an unpleasant odor so that it is converted to more pleasant one
perfuming agents
concentrated embalming chemical injected into the cavities of the body following the aspiration of the body; can also be used in hypodermic an surface embalming
cavity fluid
concentrated arterial fluid is added to water to form the arterial solution
primary dilution
a colorless gas at ambient temperature; has a strong, irritating odor and is very soluble in water; a naturally occurring substance; produced by every living organism and is essential to the functioning of the human body
formaldehyde
chemical compounds that changes a protein from a state in which it is easily decomposed to a state in which it will endure and not undergo putrefaction, for a temporary period to time
preservatives
amount of preservative (formaldehyde) required to effectively preserve and disinfect remains. this amount depends on the condition of the tissues as determined through analysis
preservative demand
an agent, usually chemical, applied to inanimate objects and/or surfaces to destroy disease causing microbial agents, but no bacterial spores
disinfectants
weakening of the strength of the arterial solution by vascular and interstitial fluids
secondary dilution
the embalmer must make final determination as to type of arterial fluids to use, strength of the arterial solution, and volume of arterial solution to inject. the strength and volume of the initial arterial solution is determined by
pre embalming analysis
coloring agents added to embalming fluids to produce an internal cosmetic effect within the tissues of the decedent
active dyes
primarily used to supplement and enhance the action of vascular (arterial) solutions; designed to enhance the distribution and effectiveness of the arterial solution
co injection fluid
control the rate of action of the main preservative chemicals of embalming formulations. many preservatives when used alone exert adverse effects that interfere with good embalming results. it is necessary to control the rate of fixation so that the firming action is delayed long enough to permit thorough saturation of tissue cells; delay the hardening effect of the aldehyde, and get more uniform distribution of the coloring or staining agent
modifying agents
liquid that serves as a solvent for embalming fluids. must be a solvent or mixture of solvents that keep the active substances in a stable and uniform state during transport through the circulatory system to all parts of the body - to maintain the proper density and osmotic activity, the proper chemical and physical balance of the formulation
vehicle
chemical that increases the capability of embalmed tissue to retain moisture. they wrap around the formaldehyde molecule thus keeping the formaldehyde from making direct contact with albuminous material (class of water soluble proteins) until the tissues are thoroughly saturated and bathed with the preservative solution
humectants
chemicals that reduces the molecular cohesion and surface tension of a liquid so it can flow through smaller apertures
surfactants
aqueous solution containing 37% formadehyde gas by mass in water (40% by volume), or in water and methyl alcohol
formalin
a polymer of formaldehyde; a white powdery solid containing 85-99% formaldehyde. this form is used where powdered preparations are involved, such as hardening compounds or used for “dusting” the body walls and viscera
paraformaldehyde
has many advantages to offer in embalming, the most important being relative imperviousness of reaction rate to pH changes, particularly in the alkaline range; will react with protein at higher pHs that would essentially render formaldehyde inactive
glutaraldehyde
also known as carbolic acid or hydroxybenzene; classified as a preservative as well as a germicide; it was one of the most found components of both arterial and cavity fluids in the early days of the fluid industry
phenol
employed in embalming fluids to stabilize the acid base balance of the fluids, also maintain the balance of the pH in the tissues when the embalming fluids react with the cellular proteins
buffers
solution having a greater concentration of dissolved solute than the solution with which it is compared
hypertonic solution
an important component of embalming fluids, especially arterial fluids because they are used to maintain blood in a liquid state and making it easy to remove from the circulatory system. such chemicals inhibit or stop the clotting of blood
anticoagulants
lend color to the fluid in the bottle
inactive dyes
