Test 2 Material Flashcards
- Gangrene wet and dry
- Jaundice (Icterus)
- Addison’s Disease
- Leukemia
- Tumors
- Meningitis
- Peritonitis
- Lupus vulgaris
Pathological Discolorations (Types)
Antemortem discolorations which occur during the course of certain diseases.
Pathological Discolorations
Antemortem or postmortem discolorations which occur prior to or during embalming due to the deposit of a foreign substance on the body surface.
Surface Discoloring Agents
- Adhesive tape
- Blood
- Grease
- Ink
- Iodine
- Mercurochrome
- Metaphen
- Mold
- Oil
- Paint
- Tincture of benzene
- Tobacco tars
- Varnish
Surface Discoloring Agents (Types)
This can be removed with cold water.
Blood
This can be removed with lemon juice.
Tobacco Tars
Always remove these kinds of discolorations before embalming.
Surface Discolorations
May be present before embalming but has become more intense, changed in hue, or may have evolved due to embalming; post embalming.
Postmortem Discoloration
- Razor burns (desiccation marks)
- Formaldehyde gray
- Embalmed jaundice bodies that turn green
- Eye enucleation bruises
Postmortem Discolorations (Types)
- Countered by active dyes and good drainage
- People with dark complexions are the most suspectible to this.
Formaldehyde Grey
Lead to discoloration and are also called unnatural conditions.
Non-pathological Conditions
- Refridgerated
- Hanging
- Burns
- Poisons
- Mutilation
- Gunshot
- Carbon monoxide poisoning
- Drowning
- Exsanguination
- Electrocution
Non-Pathological (Unnatural) Conditions (Types)
Also called hyperemia.
First Degree Burns
May include swelling and blisters.
Second Degree Burns
Charred tissue.
Third Degree Burn
Total eviseration of the tissue.
4th Degree Burns
Is cherry red in color, starts antemortem and goes into postmortem.
Carbon Monoxide Poisoning
Has two demarcations, one entry mark and one exit mark.
Electrocution
- Atheroma
- Arteriosclerosis
- Varices
- Clots
- Emboli
- Plebitis
- Thrombosis
- Hemorrhage
- Endocarditis
- Tuberculosis
- Febrile diseases
- Tumors
- Freezing
- Gangrene
- Mutilation
- Severances
- Corrosive poisons
- Asphyxiation
- Pneumonia
- Burns
- Syphilis
- Leukemia
- Hanging
- Shock
- Advanced decomposition
Conditions Predisposing to Vascular Difficulties
These are most likely to occur in veins.
Emboli
These are most likely to occur in arteries.
Thrombosis
Likely to cause blood clots.
Febrile Diseases
Likely to see petechial hemorrhages.
Asphyxiation
Causes damage to the lining of the arteries.
Syphilis
- Hydrocephalus
- Edematous cases
- Peritonitis
- Burns
- Gangrene
- Mutilations
- Advanced pregnancy
- Febrile cases
Conditions Predisposing to Decomposition
Most likely to occur in children.
Hydrocephalus
Causes maceration from the amniotic fluid.
Advanced Pregnancy
- Hardening compound
- Deodorant powder
- Deodorant spray
- Sealer
- Reducing and bleaching agents
- Disinfecting chemicals
- Preservative powder
Special Chemicals to deal with Decomposition
Good to use on wet gangrene.
Hardening Compound
Good to use on dry gangrene.
Preservative Powder
- Phenol
- Gluteraldehyde
Common Disinfecting Chemicals found in the Embalming Room
Gluteraldehye and QUATS
Cold Sterilants
- Hemorrhage
- Febrile Diseases
- Tuberculosis
- Burns
- Refridgeration
Conditions Predisposing to Dehydration
- Phlebitis
- Heart Failure
- Cirrhosis of the liver
- Nephritis
- Lymph vessel obstruction (cancer, parasites)
- Carbon monoxide poisoning
- Burns
- Alcoholism
Conditions Associated with Edema
Generalized edema.
Anasarca
Edema in the abdominal or peritoneal cavity.
Ascites
Edema in the plural cavity.
Hydrothroax
Intracranial edema.
Hydrocephalus
Edema in the pericardial cavity.
Hydropericardium
Testicular edema.
Hydrocele
- Distension of tissue
- Secondary dilution of fluid
- Desquamination- skin slip
- Distortion of body contour
- Possible leakage
Embalming Complications Associated with Edema
- Hydrocephalus
- Paralytic conditions
- Tumors
- General decomposition
- Hanging
- Mutilations
- Corrosive poisonings
- Burns
- Arthritis
- Congenital conditions
- Fractures
- Crushing
Conditions causing deformities and malformations
- Hepatitis
- Tuberculosis
- Pneumonia
- Influenza
- Meningitis
- Syphilis
- Scarlet fever
- Poliomyelitis
- Rabies
- Diptheria
- AIDS
- Herpes
- Legionnaires disease
- Crutzfeldt-Jacob disease
Common contagious or infectious Diseases
- Cobalt 60
- Iodine 131
- Phosphorus 32
- Radium 226
- Gold 198
- SR89
Radiation: Substances used in diagnosis and treatment
- Close and seal all incisions
- Treatment of all orifices
- Terminal disinfection of the body
- Leakage precautions- plastic protectors- coveralls
- Stabilizing techniques in the casket or shipping case
- Embalming report
Post Embalming Preparation of a Case to be Shipped
Edema in this case typically occurs in the ankles and lower legs.
Heart Failure
This kind of shipping container is used for uncasketed remains.
Combination (combo) Tray
This kind of shipping container is used for casketed remains.
Air Tray
Antemortem or Postmortem
Classifications of Discolorations According to Occurrence
A discoloration which appears on the human body during life. The fact that it may remain after life is extinct will not cause change of its classification.
Antemortem Discoloration
A discoloration which makes its appearance on the human body only after the death of the body.
Postmortem Discoloration
- Hypostasis (Not really a discoloration)
- Carbon Monoxide Posioning
- Capillary Congestion
- Active capillary congestion
- Passive capillary congestion
Types of Antemortem Discolorations
Occurs during the agonal period which results in a bluish purple blood discoloration most noticeable in the elderly.
Hypostasis
A cherry red blood discoloration on the body surface. The blood will lose its ability to coagulate: thus it tends to be in a liquid state causing th cherry red blood discoloration to be more intense. If not embalmed soon after death, hypostasis will turn to hemolysis causing stain.
Carbon Monoxide Poisoning
Occurs during the agonal period just prior to death. Can be hypostatic active or hypostatic passive.
Capillary Congestion
Occurs when the arterial supply to an area of the body is increased.
Active Capillary Congestion
Occurs when venous drainage from an area is decreased.
Passive Capillary Congestion
- Livor Mortis
- Postmortem Stain
Types of Postmortem Discolorations/Stain
The most common postmortem intravascular blood discoloration. It is the reddish-blue discoloration resulting from postmortem hypostasis.
Livor Mortis (Postmortem Lividity, Cadaveric Lividity)
Occurs outside of the vascular system (stain). Can be antemortem or postmortem.
Extravascular Blood Discoloration
- Purapura
- Ecchymosis
- Petechia
- Hematoma
Types of Antemortem Extravascular Blood Stain
Caused by blood cells leaking into the skin or mucous membranes. Frequently seen with persons using blood thinners. (Being easily bruised). Larger than petechia.
Purapura
Bruise from trauma (suggulation same thing); extravasion of blood under the surface tissue.
Ecchymosis
Pinpoint bruises. Often can occur from strangulation.
Petechia (Hemorrhagic Effusion)
A blood filled swelling; a collection of blood in a tumor-like mass: simply a blood blister.
Hematoma
Hemoglobin Decomposition.
If the postmortem interval is long enough and the blood remains liquid, especially aided by refridgeration, the body will go from livor mortis to this at a faster rate.
Postmortem Stain (Laking)
Using your finger, press on the area.
- If the color lightens, it is livor mortis
- If nothing happens, it is postmortem stain
Testing to see if Discoloration is Livor Mortis or Postmortem Stain
- Flush the vascular system of the discolored or discoloring blood by varying the type, strength and quantity of injection chemical.
- To assist in increasing the flow of injection chemicals to the region of the discoloration and to assist the flow of venous blood drainage from the part, certain mechanical aids may be used.
- If the discoloration is localized, sectional arterial injection and venous drainage may be used in that part.
- Increased pressure and limited drainage may be used to ensure vascular filling of injection chemicals. The resulting distension ofthe vessels may aid in the removal of blood (however, distension of tissue is bad).
Treatment of Intravascular Discolorations (Blood)
- Type and strength should be such that the blood will not be further modified to “set” the discoloration.
- This is carried out by anticoagulants and water conditioners.
- Quantity should be such as would fill and flush all parts of the vascular system but would not cause rupturing of the vascular system to convert the intravascular discoloration to an extravascular type. This is accomplished by slow rate of flow and pressure.
Flushing the Vascular System by Varying the type, quantity and stength of the injection chemical
- Alternately raise and lower the part
- Manual massage with proper skin lubrication
- Massage towards the heart
- Exception: Finger tips
- Massage towards the heart
Assisting in Increasing the Flow of Injection Chemicals and Venous Blood Drainage
Either antemortem or postmortem, are not reduced without special treatment.
Extravascular Stains
- Operative aids during aterial embalming may help drain the discolored area of blood. Especially when the discolored areas are swollen, it may be incised directly or punctured and channeled to induce the direct outflow of the extravasated blood and accumulated serums.
- Sectional or local hypodermic injections of chemicals designed to bleach and preserve the discolored areas may be necessary. (phenol)
- The discoloration may be lessened in its intensity by applying surface compresses saturated with a proper bleaching agent. Colodian based chemicals. (carbolic acid)
Treatments for Extravascular Stain
Antemortem discolorations resulting from the administration of pharmaceuticals or chemotherapeutic agents.
Pharmaceutical Agents
- Radium
- Methylene Blue
- Atabrine
- Sulfa
- Drugs
Examples of Pharmaceutical Agents
Causes burns that will give red discolorations.
Radium
Causes a distinct blue discoloration which will be converted into green discoloration in the formaldehyde solution used to embalm the body is too strong; will show in the sclera of the eye if present in the vascular system.
Methylene Blue
Causes a brown discoloration.
Atabrine
Causes a yellow discoloration (not jaundice)
Sulfa
That affect or damage the liver will result in jaundice because of their toxicity; usually occurs just prior to death. (First appears in the sclera of the eyes).
Drugs
All of these are antemortem and are caused by specific drugs or combinations of drugs. Most common are jaundice over the entire body and hemorrhagic discolorations usually on the arms.
Drug Discolorations
Antemortem discolorations which occur during the course of certain diseases.
Pathological Discolorations
- Gangrene
- Wet gangrene
- Dry gangrene
- Senile gangrene
- Gas gangrene
- Jaundice
- Addison’s Disease
- Leukemia
- Peritonitis
- Lupus Vulgaris
- Meningicoccal Meningitis
- Tumors
- Chronic renal failure
Examples of Pathological Discoloration
Necrosis of tissue cells that undergo bacterial decomposition.
Gangrene
Caused by venous congestion where the affected part becomes moist, dark, putrid and has the odor of rotting flesh. This type of gangrene spreads rapidly.
Wet Gangrene
Caused by the interference of the arterial supply of the blood. Can result in a bluish-black discoloration with little odor as the bacterial activity is limited by dryness of the tissues.
Dry Gangrene
The most common form of dry gangrene and is frequently seen in the extremities of the body.
Senile Gangrene
Clostridum perfringes that causes gas buildup in the tissues antemortem.
Gas Gangrene
- If odor is present, use disinfectant.
- Undamaged or unaffected tissue requires regular strength injection and regular drainage procedures.
- Injection of excessively strong solutions utilizing high index arterial fluid or injectable cavity fluid driectly into the area through multiple injection sites or hypodermically with a narrow barreled trocar.
- Cavity (surface) pack or topical preservative jelly should then be applied to the entire area.
- Protective plastic garments contining preservative powder or hardening compound should be utilized prior to dressing and casketing.
Treatment for Gangrene
To preserve, prevent leakage and the escape of odor.
Primary Treatment Purposes (for gangrene)
Results in a yellowish discoloration of the body which is first detected in the sclera of the eye. The yellow stain is due to the presence of bilirubin pigmentation which adversely colors the bile. Strong formaldehyde arterial solutions adversely affects bilirubin and converts the yellow discoloration to green, changing bilirubin to biliverdin. The higher the HCHO index of the solution, the greener the body.
Jaundice
In embalming of all _____ bodies, preservation takes precedence over clearing of the discoloration.
Jaundiced
- High Index
- Acid pH of arterial solution
Two Causes of Biliverdin
- Jaundice chemicals- low index
- Injection- Restricted cervical method (Higher index down, lower index up)
- Injection- Minimum two drainage sites
- Pack applications bleaching chemicals (because jaundice often has edema)
- Opaque Cosmetics- airbrush
- Torchiere lamps
Treatment for Jaundice
If preservation demand is high, use __________: Strong solution to preserve the torso especially if edema is present; milder or special jaundice solutions for the head and hands.
Restricted Cervical Method
If preservation demand is low, use _________. Use the femoral artery as injection site with two drainage sites: right internal jugular vein and right femoral vein.
Minimum Two Drainage Sites
Excessive amounts of ____ ____ are used to counter stain shades of green and must enter both common carotid arteries uniformly.
Active Dye (In Jaundiced cases)
- Use pre-injection solution to flush out as much blood drainage (bilirubin) as possible.
- Use special jaundice fluids especially manufactured for this purpose.
- Bleaching co-injection
- Opaque cosmetics
Chemistry- Jaundice
Often called the two-step fluids augmented with an abundance of active dye, usually eosin (red).
Bleaching Co-injection
May also be necessary to conceal discolorations. Special lighting in the reposing room or chapel may also be necessary.
Opaque Cosmetics
A bronze discoloration resulting from loss of function of the adrenal glands.
Addison’s Disease
Same as jaundice, low index or specialized arterial fluid. Danger high index may cause surface tissue to turn dark.
Treatment: Addison’s Disease
A chronic or acute disease of unknown etiology characterized by unrestrained growth of leukocytes.
Leukemia
Capillary congestion and extensive thrombosis which may severly limit drainage to only a few ounces of liquid which may not even resemble blood. Tissue may also have a putty-like cast on the surface.
Embalmng problem: Leukemia
Start with the right common carotid artery and right internal jugular vein followed by multiple injection and drinage sites where necessary to solve injection and drainage problems.
Treatment: Leukemia
- Pre-injection but be careful of “water logging”
- Stronger solutions with co-injection to assist distribution of fluid solution.
Chemistry: Leukemia
Inflammation of the peritoneum due to invasion of infectious organisms. A bright red color is characteristic of the infected peritoneum lining the abdominal cavity.
Peritonitis
Hypostasis to hemolysis will occur rapidly because the blood in its antemortem state was unable to coagulate because of bacterial invasion. The blood will have an odor and will be dark in color.
Embalming Problem: Peritonitis
- Restricted cervical injection method.
- Utilization of multiple injection and drainage sites if necessary.
- Immediate aspiration and injection of undiluted cavity fluid at least 2 bottles, 32% after arterial injection. (1 bottle per 50lbs)
- Reaspiration and injection of additional undiluted cavity fluid prior to dressing and casketing.
- Hypodermic injection of strong solutions to areas not receiving arterial solution.
- Opaque cosmetics to cover any surface discoloration.
Treatment: Peritonitis
Avoid pre-injection and use strong solutions and coinjection instead. Reaspirate adding fresh cavity fluid each time.
Chemistry: Peritonitis
Tuberculosis of the skin characterized by patches which break down and ulcerate, leaving scars. In some cases, a red butterfly rash may appear across the nose and cheeks. Ulcers may be contagious to the embalmer.
Lupus Vulgaris
- Routine arterial injection will have little affect on ulcers.
- Pack application undiluted cavity fluid.
- Topical Jelly- phenol base (preservative gels)
- Hypodermic injection of arterial fluid directly into problem areas.
Treatment- Lupus Vulgaris
An infectious and contagious disease which causes an inflammation of the membranes of the spinal cord and/or the brain. A clear danger to the emblamer who should follow proper procedures for contagious and infectious diseases. Pathological discoloration may be in the form of a rash.
Meningicoccal Meningitis
Opaue Cosmetics
Treatment: Meningicoccal Meningitis
Pathological discoloration will vary in both benign as well as in malignant tumors. Odor may also be a problem because this may be necrotic.
Tumors
The tumor will seldom be preserved by arterial injection. It must be excised completely and the area preserved with topical jelly, cavity pack, and/or treated hypodermically (with the written permission of the PRD). Restorative art procedures will be requred.
Treatment: Tumors
A “sallow yellow color” to the skin resulting from the presence of urochrome in the tissues. Often accompanies diabeties mellitus, which adversly affects distribution and diffusion of arterial fluid solution.
Chronic Renal Failure
Poor peripheral circulation leading to gangrene of the lower limbs and the conversion of urea in the bloodstream to ammonia and neutralizes formaldehyde.
Major Problems to the Embalmer: Chronic Renal Failure
- Avoid preinjection completely.
- Use strong solutions with co-injection of drainage chemicals.
- Multiple injection and drainage sites will be necessary.
- Hypodermic injection of areas that did not recieve arterial fluid solution.
- Use active dye to offset the “sallow yellow color”- coinject dye with solution.
Treatment: Chronic Renal Failure
