MORS 11 Lecture- vocab and additional notes Flashcards
A non-toxic disinfectant suitable for use on animal tissue.
Antiseptic
Freedom from infection and from any form of life- sterility
Asepsis
An agonal bacterial invasion of the body, usually by the putrefactive bacterial, usually confined to the colon, migrating into the blood vascular and skeleton system.
- presence of bacteria in the blood
Bacteremia
Destructive to bacteria.
Bactericidal
Destruction of bacteria by action of certain chemical substances.
Bacteriolysis
Agent that has the ability to inhibit or retard bacterial growth; no destruction of viability of the microorganism is implied.
Bacteriostatic Agent
Removal of infectious agents by scrubbing and washing, as with hot water, soap, or suitable detergent.
Cleaning
An agent, usually chemical, applied to inanimate objects or surfaces for the purpose of destroying disease-causing microbial agents, but usually not bacterial spores.
Disinfectant
The destruction and or inhibition of most pathogenic organisms and their products in or on the body.
Disinfection
An agent, usually chemical, applied either to inanimate objects or surfaces or living tissues for the purpose of destroying disease-causing microbial agents, but usually not bacterial spores.
Germicide
An agent, usually chemical, that possesses disinfecting properties when applied to a pre-cleaned object or surface.
Sanitizer
A process that renders a substance free of all microorganisms.
Sterilization
Formulated by the action of pure phenol on pure cultures of Bacillus typhosus or other similar bacteria. The relative germicidal value of other disinfectants is determined by comparing their germ killing power with that of phenol under identical conditions.
- Less killing power is less than 1.0
- More killing power is greater than 1.0
Phenol- Coefficient
The process in which a gaseous agent is used to destroy rodents and insects. Some are:
- Hydrogen cyanide
- Sulfur dioxide
- HCHO gas (formaldehyde gas)
Fumigation
An agent which is destructive to insect larvae (maggots are primary larvae), such as:
- Malathion
- Diazinon
- Chlordane
Larvacide
A chemical agent capable of destroying saprophytic or pathogenic fungi such as mold. (Fungi are more resistant than bacteria to chemical agents and can easily survive on an embalmed body.)
Fungicide
Is a poor, almost useless fungicidal agent.
Formaldehyde
Has fungicides built into them.
Preservative jelly, such as Postene (phenol)
- Mucor
- Aspergillis
- Penicillium
Common, most troublesome molds that the embalmer must face
- Carbolated Vaseline
2. Paradichlorobenzene
The fungicides most commonly used by embalmers
A substance able to destroy lice. Example: Rid
Pediculicide
An agent destructive to adult forms of insect life; same chemicals as larvicide.
Pesticide (Insecticide)
The metabolic entity of growth, reproduction and locomotion.
Life
A group of cells will form a tissue, groups of tissue will form organs, groups of organs will form systems, and groups of systems will form an:
- Heart
- Lungs
- Brain
Individual Organism
- Heart
- Lungs
- Brain
Tripod of Life
The irreversible, total cessation of metabolic activity.
- Necrobiosis
- Necrosis
Death
The death of certain groups of cells and their subsequent replacement by new cells in the normal course of bodily activities.
Necrobiosis
The pathological death of certain cells or tissues of a still living body.
- Gangrene
- Dry gangrene
- Wet Gangrene
- Gas Gangrene
Necrosis
Antemortem cellular death.
Gangrene
The result of a blockage or degenerative condition of the arteries (arterial obstruction).
Dry Gangrene
The result of a blockage or a degenerative condition of the veins ( venous obstruction).
Wet Gangrene
Caused by an organism called clostridium perfringen (bacillus welshii).
Gas Gangrene
Life = Gas gangrene
Death =
Tissue Gas
The antemortem development of a bed sore into necrotic tissue which may become fatal.
Decubitus Ulcers
The period just prior to death.
- Death rattle
- Death struggle
- Instantaneous rigor mortis (cadaveric spasm)
Moribund (dying period, agonal period)
A noise made by a moribund person which is caused by air passing through a residue of mucus in the trachea and the posterior oral cavity.
Death Rattle
The semi-convulsive twitches which often occur before death; It is caused by death of the nervous system.
Death Struggle
The last act in life is preserved in death (anything involving sudden or over production of sarcolactic acid. I.e., combat, sports, automobile accidents.
Instantaneous Rigor Mortis (Caderveric spasm)
The condition in which the manifestations of life are feebly maintained.
- Suspended animation
- Catalepsy
Apparent Death
A temporary condition of apparent death with cessation of respiration.
Suspended animation
A condition in which there is a waxy rigidity of the body and the vital phenomena of life are feebly maintained; body does not respond to stimuli.
Catalepsy
The body of the deceased human being including the cremated remains of a person.
1- Cadaver
2- Cremains
3- Thanatology
Human Remains
A dead human body preserved and especially used for dissection. (inject onlys here at school)
Cadaver
Cremated remains; those elements remaining following the cremation of a body.
Cremains
The study of death.
Thanatology
The death of the whole organism, specifically the death of the heart, brain and lungs.
Somatic Death
1- Is the qualitative expression of dying marked by the cessation of cardiac and respiratory activity.
- The period is brief, not more than 5-6 minutes
- The highly specialized cells of the nervous system are dying quickly due to the lack of oxygen (anoxia)
- It is possible during this period to mechanically restore some form of existence, not exactly life, but a state between somatic death and complete cellular death.
Clinical Death (Legal Death)
- The tissue and organs have undergone irreversible changes so that restoration of normal life function is impossible.
- Highly specialized cells are already dead and the remaining cells are dying.
- Complete cellular death has not occurred yet, and the muscles still respond to electrical shock.
- The tissue is becoming acid, and rigor mortis is developing in the muscle tissue.
- Autolysis which is the digestion of tissue cells by their own enzymes is beginning (simply, self-digestion)
- Saprophytic organisms are starting to infiltrate into the bloodstream and skeletal tissue (systems that attract e.coli) from the intestinal tract.
Biological Death
- Asphyxia (apnea)
- Coma
- Syncope
- Anemia
- Astenia
Modes of Somatic Death
Death beginning at the lungs.
Asphyxia (apnea)
Death beginning at the brain.
Coma
Death beginning at the heart.
Syncope
Cardia failure due to an insufficient blood supply. (ischemia)
Anemia
A weakness or feebleness of any organ to function.
Astenia
Examples:
- Syncope by anemia
- Syncope by asthenia
- Coma
- Asphyxia (apnea)
Most postmortem findings are the results from the modes of somatic death.
- Heart contracted and empty vascular breakdown with probable ruptured aneurysm.
- No blood discolorations on the surface indicating massive internal hemorrhage.
- To embalm you will need a six pointer most likely.
Syncope by anemia
- Blood stopped in its course and found to be plentiful in both arteries and veins.
- Numerous agonal clots (antemortem, clot formation occurring during the agonal stage).
- Vascular system still intact.
- To embalm, usually one point injection with two points of drainage.
Syncope by asthenia
- Blood in the arteries of the brain, spinal cord and the meninges.
- Hemorrhages are common to the ears and nostrils.
- Distention and discoloration in the eyelids.
- Possible gas in the cranium due to putrefaction (bulging eyeballs).
- Rapid migration of organisms causing early decomposition.
Coma
- Raise both common carotids, open both jugular veins
- Inject left common carotid downward to arch of the aorta and clamp off right common carotid and nick it above the clamp to:
- Look for fluid
- Let out gasses and clots
- Fluid will enter the head from back to front because of the vertebral arteries which originate from the subclavian arteries.
Restricted Cervical Method (to embalm comas)
For bulging eyeballs, possible decomposition in cranial cavity.
Instant Tissue Fixation (Head Freeze)
- Hook Y into both common carotids, aiming upward
- One 16oz bottle of 30 index or better fluid.
- One bottle full of hot water (acts as a catalyst to embalming fluid).
- Use wet towel over machine to seal it; turn off pressure, minimize flow
- Up both carotids, try to get all 32oz in head unless you see swelling.
Cranial Cavity Decomposition- Instant Tissue Fixation (Head Freeze)
- Meningitis
2. Creutzfeldt-Jacob Disease
Beware of these things- Head Freeze (cranial cavity decomposition)
- Pack left nostril with petroleum jelly; insert a small-barrel trocar into it; the trocar will butt the cribriform place of the ethmoid bone (at posterior nasal cavity).
- Smack the trocar to pierce bone and aspirate.
- After aspiration, inject 3-4oz of straight cavity fluid (with hypodermic needle) through hole into brain case and then plug with batting cotton and incision sealer and petroleum jelly.
Aspirate brain- Cranial Cavity Decomposition
Always secondary to coma or syncope.
Asphyxia
- Main arteries and veins are empty
- Cyanosis of the body surface is discoloration due to an extreme congestion of the superficial capillaries with deoxygenated blood.
- Blood discoloration usually dark purple except for drowning and carbon monoxide poisoning when blood will be cherry red.
- To embalm: If ASAP- present no problem, use low pressure and flow and two points of drainage right interior jug and right femoral veins.
Asphyxia- Characteristics
Regardless of the basic cause of somatic death, the final cause of death is always an oxygen starvation (anoxia) of the tissue cells when the blood ceases to circulate.
Cellular Death (Molecular Death)
The aging process usually occurring in 14-year cycles.
Necrobiosis
- Wet gangrene
- Dry gangrene
- Gas gangrene
Necrosis
- Necrobiosis
- Necrosis
- Decubitus ulcers
Examples of antemortem cellular death
- Cause of death
- Condition of the body at the time of death
- Environmental conditions surrounding the body at the time of death (hot room= speeds up problem).
- Medication given to an individual before death and how it affects the embalming fluid.
Factors influencing the onset of postmortem cellular death
- Algor mortis
- Rigor mortis
- Livor Mortis (cadaveric lividity, postmortem lividity)
- General Decomposition
Later signs of death
The only positive sign of death.
General decomposition
The movement of the blood from the heart and arteries into the capillaries and veins which occurs at the moment of death. (bluing of body at the moment of death).
Articulo-Mortis
Immediately after death, the muscles are flaccid; the body is now in the stage of Primary Flaccidity (first stage). For two to three hours after death, the muscles lose all of their vital turgidity (shape and form) and remain flattened in areas pressed upon by body weight; there is general limberness.
Complete Muscular Relaxation
“Expression of, look of death.” These are facial changes that are associated with death, such as the expression of slackness in the eyes, the mouth opens and the jaw drops back. The lips are dry and shrunken, and the facial lines are accentuated.
Facies-hypocratica
The postmortem cooling of the body to the surrounding environmental temperature.
Algor Mortis
The postmortem temporary stiffening of the voluntary and involuntary muscles as a result of chemical changes in the dead body.
Rigor Mortis
- Livor Mortis
2. Postmortem Stain
Postmortem Discoloration
The postmortem gravitation of the blood into all the dependent areas of the body. (continuation of antemortem hypostasis).
Livor Mortis (Hypostasis, hypostatic congestion)
The postmortem condition in which congested blood undergoes a change in which the hemoglobin separates from the red blood cells and passes through the capillary walls into the tissues.
Postmortem Stain (Laking)
By pressing your finger on the discolored area.
- Lightens in intensity - livor mortis
- Stays the same color- Postmortem stain
How to tell the difference between livor mortis and postmortem stain
Which comes first? Postmortem stain or livor mortis?
Livor mortis will always occur before postmortem stain.
Procedures used to prove a sign of death.
Tests For Death
Tests for death which are employed only by doctors.
Expert Tests For Death
A delicate instrument for detecting almost inaudible sounds of the heart and the respiratory tract. (An expert test for death).
Stethoscope
An optical instrument which an accompanying light which makes it possible to examine the retina of the eye.
Ophthalmoscope
- Used to test the ciliary muscle (makes pupil contract in presence of light).
- If the pupil doesn’t constrict in the presence of light, the subject is probably dead.
- Also detects the flow of blood in the vessels of the retina.
Use of the Ophthalmoscope
Not the best expert test for death because the eye becomes paralyzed in some head injuries; also because of neurological conditions like tertiary syphilis.
Ophthalmoscope
An expert test of death where various dyes are injected into the body to determine whether or not a circulation of blood still exists.
- Flourescein commonly used and will show up in the sclera if life persists. (light green).
Dye Injection Test
- Expert test of death
- Powered by 4 flashlight batteries
- Attached to the patient’s forearm with electrodes which pick up and transmit otherwise imperceptible heart impulses to a magnetic indicator needle.
Electron Life Detection Devices
- E.E.G. - Electroencephalogram
- E.C.G. (E.K.G.) - Electrocardiogram
- A.B.R.- measures activity in the brain steam, an area that controls heart and respiratory function.
Most reliable electronic detection devices
Performed by a mortician, fireman, policeman, paramedic
Inexpert Tests For Death
- Inexpert test for death
- Ligate a finger
- If it becomes discolored and swollen, life is still present.
- If the person is dead, nothing will happen.
Ligature Test
- Inexpert test for death
- Inject some household ammonia hypodermically into the skin.
- Reddish reaction if life is present
- No reaction= person is dead
Ammonia Test
- Inexpert test for death
- Digital pressure can be applied to the radial artery, the common carotid artery, to feel for a pulse beat.
- In some cases, the dorsalis pedis artery
Pulse Test
- Inexpert test for death
- Examiner places his or her ear over the patient’s thoracic cavity.
- If heart or lung sounds are perceptible, life is present.
Heart and Respiratory Sound Test
Considered unreliable:
- Not hearing a heart or lung sound in a moribund case does not establish the certainty of death.
- Heart and lung sounds are common in decomposing bodies usually due to accumulated gases, often visceral gas.
Heart and Respiratory Sound Test
Those changes occurring in the interval prior to somatic death.
Antemortem (agonal changes)
That period immediately preceding death. It is a variable period.
- Sudden accidental death, lingering illness
Agonal State
- Antemortem
- Agonal
- Postmortem
3 overlapping stages of bodily changes
- Thermal change
- Blood change
- Moisture change
- Bacterial Translocation
- Gas in tissue
- Therapeutic Agents
6 Changes in The Agonal State
Marked by decrease in recorded body temperature; noted in senile patients (mental and physical).
Agonal Algor
- A progressive reduction in the rate of metabolism.
2. A general slowing of the blood circulation.
Cause of Agonal Algor
Marked by an increase of recorded body temperature.
Agonal Fever
- Highly Infectious diseases (febrile diseases)
- Poisons and toxemia
- Progressive increase in the rate of bacterial and/or chemical action in the tissues.
Causes of Agonal Fever
- Agonal Algor
- Agonal Fever
Temperature changes
- Agonal Hypostasis
- Agonal Coagulation
Blood Changes
Settling of blood to the dependent parts of the body just prior to death.
Agonal Hypostasis
After hypostasis, the problems start. There is a settling out of blood cells, particularly the white corpuscles. The result is the formation of long, tough, laminated clots which, because of their yellow color, are called “chicken fat” clots.
Agonal Coagulation (congealing)
- Pre injection - no more than 1/2 gallon
- Low pressure - or else clots lodge on all bifurcations
- Low flow - or else clots lodge on all bifurcations
- At least two points of drainage
Treatment of “chicken fat” clots
- Agonal Exudation
- Agonal Edema
- Agonal Dehydration
Postmortem Moisture Changes
An outpouring of lymph into the peritoneal cavity.
- Amount of liquid is much less than that of pathological edema.
Agonal Exudation
- Vascular congestion
- Increased capillary permeability
- Altered osmotic pressure
Causes of agonal exudation
Decomposition could be accelerated and cavity fluid could be diluted.
Danger of agonal exudation
The escape of blood serum from an intravascular to an extravascular location, caused by prolonged venous and capillary congestion.
Agonal Edema
A progressive condition which begins during the preagonal state and continues through the agonal state and postmortem period. Agonal desiccation (same as dehydration) is most pronounced in the lips and membranes of the upper respiratory tract. May times this occurs on the surface as agonal edema occurs in viscera and deeper areas.
Agonal Dehydration
Bacterial infiltration and growth from the intestinal tract to the vascular and skeletal systems causing capillary permeability changes.
- It has been proven that the anaerobic spore-forming bacilli have reached the chambers of the heart from the colon within an hour of death.
Bacterial Translocation
- Antemortem subcutaneous emphysema
- Gas gangrene
Gasses in the tissues
The presence of free air or gas in the subcutaneous tissues. The air or gas may originate in the rupture of an airway or alveolus and migrate through the subpleural spaces to the mediastinum and neck.
- The face, chest and neck may appear swollen
- No bacteria are involved in causing this condition
- Most common cause is trauma and/or life support.
Antemortem Subcutaneous Emphysema (Aerodermectasis)
Causative agent is clostridium perfringens (clostridium welchii). A species of anaerobic gram-positive bacteria. The oval spores of bacteria are found in soil and in the intestinal tracts of humans and animals.
- Invasion of this bacteria into bodily tissues is almost always fatal.
Gas Gangene
A crackling sensation produced when gases trapped in tissue are palpated. Common to both subcutaneous emphysema and gas gangrene.
Crepitation
- Chemotherapeutic agents
- Blood thinner
- Antibiotics
- Vasodilator
Therapeutic agents
In the treatment of disease, the application of chemical reagents which are not harmful to the patient but which have a specific and toxic effect upon disease-causing microorganisms.
Chemotherapeutic Agents
Anticoagulants.
Blood Thinners
Any of variety of substances both natural and synthetic that inhibit growth of or destroy microorganisms.
Antibiotics
A nerve or drug which dilates the blood vessels actually causing complete relaxation of the blood vessels.
Vasodilator
Multiplication of bacteria in the blood.
Septecemia
Bacteria in tissue or in blood.
Sepsis
These are effective against spores while germicides are not.
Preservatives
