test 4 Flashcards
1
Q
pre embalming long bone donation cases
A
- clean/bathe the body as normal
- disinfect mouth, nose, and eyes as normal
- set features as normal
2
Q
embalming long bone donation option 1
A
- remove and open all procurement incisions
- remove prosthetic devices
- raise left and right carotid for head and trunk
- do not use pre injection and make arterial stronger for trunk and limbs
3
Q
embalming long bone donation - legs
A
- use femoral
- start as high on leg as possible
- clamp off vessels
- if femoral has been cut inject below the cut
- might use anterior/posterior tibial or even dorsalis pedis
- inject hypodermically if have to
4
Q
embalming long bone donation - arms and hands
A
- inject using axillary or brachial
- possibly use radial
- hypo if need be
5
Q
embalming long bone donation - trunk
A
- inject through femoral, subclavian, or carotid
6
Q
embalming long bone donation - head
A
- inject through carotids
- solution does not need to be as strong as solution for trunk and limbs
7
Q
embalming long bone donation - after injection
A
- allow body to sit and drain as long as possible
- dry all tissues
- replace prosthetics
- coat tissues with preservative and absorbent
- use tight suture (baseball)
- wash entire body
- cavity work as normal
- mortuary glue on incisions and cotton
8
Q
embalming long bone donation option 2 - before injection
A
- after features set, cleaned, disinfected, raise right common carotid
- make solution for trunk, arms, and legs stronger than normal
9
Q
embalming long bone donation option 2 - during injection
A
- do not use pre injection
- inject carotid down with strong than normal solution
- if not getting enough move to another artery lower down limb or hypo
- inject head through carotid using weaker arterial
10
Q
embalming long bone donation option 2 - after injection
A
- wash entire body
- cavity work as normal
- use trocar at bottom of incision to aspirate accumulation of fluids
- allow to sit/drain for long as possible
- suture and seal as usual
11
Q
eye enucleation procedure
A
- raise lid gently with aneurysm hook
- remove packing in socket
- dry socket with cotton
- swab socket with cotton soaked in drying agent then leave inside
- place eye cap over the cotton and close lid
- coat eye area in massage cream
- do not use pre injection
- use normal strength arterial
- use minimum pressure and rate of flow
- observe carefully during injection
12
Q
eye enucleation after injection
A
- remove cotton packing from socket
- dry socket and duplicate eye with cotton and place in socket
- place eye cap on top of cotton
- close eye (glue if necessary)
13
Q
if removal of just the cornea
A
- treat like enucleation except
- aspirate the fluid from eyeball before embalming
- drying and packing is done inside the empty eyeball instead of the socket
14
Q
embalming severed limbs
A
- each part of limb embalmed separately
- if blood vessels intact through arterial
- if not vessels hypo
- when done vessels should be ligated
15
Q
suturing severed limbs
A
- suture the muscles of both parts tightly
- suture skin entirely around limb
- suture line can be covered with sealer
- after sealer dries cover with cotton and second coat of sealer
16
Q
restoring length to severed limbs
A
- use four metal/plastic/wood rods
- straight section of metal hanger
- rods placed in each section of limb reproducing correct length
- rods covered with rolled cotton and sealer
- entire area taped
- tape should extend 4-5 inches past the cotton onto the skin to keep sections connected
17
Q
missing limb - arm and hand
A
- long sleeves recommended
- sleeve stuffed with soft material
- white glove can be stuffed
- glove then pinned to inside of sleeve
- can try and remake a hand out of mortuary mastic
- if remade hand, place it under the natural one in casket
18
Q
twisted limb
A
- may be necessary to sever the ligaments behind elbow or knee
- place in proper position and dry incision, seal it, and saturated
- metal splints can be used under knee for support
- may have to tweak casket interior to fit arthritic limbs
19
Q
decapitation embalming
A
- head and body embalmed separate
- embalm head using waterless solution (max preservation with minimum solution)
- tie off vessels and openings (esophagus)
- use a sealer to cover are on body and neck
- use dowel rod to reconnect head to body
- add extra rods around opening for stabilization
- liquid sealer on both had and opening
- suture (baseball stitch after attached)
20
Q
what is decomposition
A
separation of compounds into simpler substances by the action of microbial and/or autolytic enzymes
21
Q
proteolysis
A
breakdown of proteins
22
Q
autolysis
A
breakdown of self by self
23
Q
lipolysis
A
breakdown of lipids (fat)
24
Q
fermentation
A
breakdown of carbohydrates
25
Q
saccharolysis
A
breakdown of sugars
26
Q
signs of decomp - color
A
- along trunk there can be green discoloration in lower right quadrant of abdomen; large intestine will be identifiable
- vascular marbling in small superficial vessels
- livor mortis and stains in dependent areas
27
Q
signs of decomp - purge
A
putrefactive body fluids become forced out of body orifices
28
Q
signs of decomp - gas
A
- produced by chemical/microbial activity during decomp of solid wastes
- clostridium perfringens cause gas and leads to stomach and rectal purge
- heat/humidity increase likelihood of gas
- bloating, eyes and tongue can protrude
- distension of abdominal cavity can cause purge
29
Q
signs of decomp - odor
A
- autolysis and putrefaction products emit foul odor
- C. perfringens produce pungent odor
30
Q
signs of decomp - skin slip
A
- aka desquamation
- on hands, face, etc
31
Q
extrinsic factors that affect decomp
A
- temperature (higher = faster)
- moisture (more = faster)
- access of air
- animal activity
- pressure due to clothing or earth
- bacteria
32
Q
intrinsic factors that affect decomp
A
- internal moisture
- febrile diseases (infections)
- gas gangrene, moist gangrene
- bacteria in body
33
Q
mode of death that affects decomp
A
- drowning
- suicide like hanging, gun shot
- deaths that leave a lot of trauma to the body
34
Q
order of decomp of body
A
- liquid tissues (blood/lymph)
- soft tissues (parenchyma or organs/functioning material)
- firm tissues (muscle/stroma or organs)
- hard tissues (cartilage/bone)
35
Q
5 stages of decomp
A
- fresh (1-2 days)
- bloated (2-6 days)
- decay (5-11 days)
- post decay (10-25 days)
- dry (25+ days)
36
Q
possible problems with decomp
A
- discolorations: livor mortis, post mortem stain
- gas: distension from moisture and tissue gas
- skin slip: weakens superficial layer of skin, gas moves easily causing blisters
- maggots: if body found in 50 degree or more
37
Q
embalming complications with decomp
A
- fluid distribution will be poor
- coagula in arterial system
- drainage poor from decomposed vessels
- swelling of tissues
- ammonia and nitrogenous products which neutralize formaldehyde
- require higher preservative demand
38
Q
embalming a decomp case
A
- multi point injection and RCI
- strong solution
- hypo areas if needed
- perfuming agents or kitty litter for smell
- cauterize agent/drying agent on areas needing wax and cosmetize work
