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PIMS path 2 > week 7 for embalming 1 > Flashcards

week 7 for embalming 1 Flashcards

1
Q

what is in embalming fluid? (6)

A
  1. preservatives
  2. disinfections
  3. modifying agents (buffers, anticoagulants, surfactants, humectants, and antiemetics)
  4. dyes (active and inactive)
  5. vehicles
  6. perfuming agents
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2
Q

concentrated preservative chemicals used primarily for arterial embalming

A

arterial fluid

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3
Q

mixture of arterial fluid and water used for arterial injection with possible inclusion of supplemental fluid

A

arterial solution

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4
Q

fluids injected for purposes other than preservation and disinfection that will enhance the actions of the arterial solution

A

supplemental fluids

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5
Q

methylene bridge subcategories (3)

A
  1. amines
  2. amides; peptide
  3. aldehyde action
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6
Q

purpose of embalming fluid (3)

A
  1. “fixes” or coagulates proteins so they cannot further decompose and so they are no longer a source of food for bacteria
  2. this is done by cross linking those proteins at a methylene bridge
  3. this is based on the tendency of aldehydes to react with nitrogen
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7
Q

organic compound containing nitrogen with the general formula of R-NH2

  • proteins are chemically linked via a reaction with formaldehyde (also forms water)
  • cross- linking of two proteins or protein-like substances is done via the methylene bridge
A

amines

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8
Q

derivative of carboxylic acids in which a hydroxyl group is substituted with an amine or ammonia having the general formula of R-CONH-R’

  • protein chains join together by reacting with multiple formaldehyde units via a methylene group
  • aldehydes can bridge many peptide sites along a protein chain
  • allows for tissues to be tightly linked but also cause tissues to be too firm
A

amides (peptides)

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9
Q

elements in the methylene bridge (4)

A
  1. oxygen (highly electronegative, valence of 6)
  2. nitrogen (moderately electronegative, valence of 5)
  3. carbon (moderately electronegative, valence of 4)
  4. hydrogen (moderately electronegative, valence of 1)
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10
Q

methylene bridge formation (3)

A
  1. nitrogen in a protein is bound to two carbons and a hydrogen
  2. aldehyde molecule enters the body
  3. nitrogen loses a hydrogen and bonds with the aldehydes carbon
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11
Q

aldehyde action (2)

A
  1. cross link reaction between aldehydes and proteins results in dehydration, firmness of tissue, and ultimately preservation
  2. because of the elongated structure of glutaraldehyde specifically, it doesn’t bridge every peptide linkage along the protein chain
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12
Q

bacteria killing elements (4)

A
  1. alcohol
  2. phenol
  3. bleach (sodium hypochlorite)
  4. quaternary ammonium compounds
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13
Q

an organic compound containing one or more hydroxyl (-OH) groups

  • disinfectant and antiseptic as well as humectant qualities
  • alcohols can denature proteins in bacteria
  • efficacy increases in the presence of water
  • able to remove water in the bacteria
A

alcohol

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14
Q
  • disinfectant, antiseptic, anti fungal, antiviral
  • cauterizing agent, bleaching agent, sometimes used in cavity fluids
  • denatures proteins and can get through non polar lipid membranes that protect bacteria
A

phenol

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15
Q
  • oxidizes cell membranes of bacteria leading to cell lysis
  • reacts with proteins in blood
  • mixing this and embalming chemicals will create noxious gas
A

bleach (sodium hypochlorite)

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16
Q

surface disinfectants that are generally used for disinfection of skin, oral and nasal cavities, and instruments

  • target the cytoplasmic membrane in bacteria
  • degrade proteins and nucleic acids
A

quaternary ammonium compounds

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17
Q

preservatives (3)

A
  1. aldehydes
  2. dialdehydes
  3. phenol
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18
Q
  • formaldehyde is sold as formalin and is very soluble in water
  • 37% formaldehyde gas by mass in water or in water/methyl alcohol
  • paraformaldehyde - precipitant
  • trioxane; another polymer of formaldehyde
A

aldehydes

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19
Q

dialdehydes (2 subcategories)

A
  1. glyoxal

2. glutaraldehyde

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20
Q
  • contains small amounts of ethylene glycol, glycolic acid, formic acid, and formaldehyde
  • tends to stain tissue yellow
  • optimal pH range of 9-10
A

glyoxal (dialdehydes)

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21
Q
  • mild odor, light color
  • reacts by cross linking proteins
  • wide pH range
  • liquid at room temperature
A

glutaraldehyde (dialdehydes)

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22
Q
  • preservative and germicide
  • penetrates skin easily and is absorbed by proteins
  • strong irritant
  • preserves by penetrating the phospholipid bilayer of the cell and dissociating in the cytoplasm of the cell
A

phenol (presevative)

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23
Q

modifying agents (

A
  1. buffers
  2. humectants
  3. anticoagulants
  4. surfactants
  5. dyes
  6. anti-endemics
  7. perfuming agents
  8. vehicles
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24
Q
  • substances capable of maintaining a constant pH by neutralizing both acids and bases
  • borates (stabilize formalin, reduce hardening and graying affects of formalin (sodium borate (borax) and boric acid)
  • sodium phosphate, citrates, sodium salt of EDTA
  • carbonates (sodium carbonate, magnesium carbonate)
A

buffers

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25
Q

chemicals that increase the capability of tissues to retain moisture

  • work by coating formaldehyde molecules, coating sheds off as the tissues become saturated
  • glycerol
  • sorobitol, glycol
  • emulsified oils (lanolin, silicon)
  • aloe
  • gums (vegetable or synthetic)
A

humectants

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26
Q

alcohol that increases germ killing capabilities of other chemicals

A

glycerol

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27
Q

loses water at a slower rate than glycerol, soluble in water

A

sorbitol, glycol

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28
Q

not water soluble

A

emulsified oils (lanolin, silicon)

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29
Q

swell and retain moisture when added to water helping to fill out tissues and overcome emaciated appearance

A

gums (vegetable or synthetic)

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30
Q

chemical agents that retard the tendency of the blood to become more viscous

  • keep blood in a liquid state, reduce water hardness, create an alkaline environment
  • borates - stabilize formaldehyde as well as reduce coagulation
  • EDTA
  • Magnesium sulfate, sodium chloride, sodium sulfate, sodium phosphorite, sodium citrate
A

anticoagulants

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31
Q

chemicals that will reduce the molecular cohesion of a liquid and thereby enable it to flow through smaller openings

  • before embalming fluid can circulate throughout the body, any liquid remaining in the capillaries must be cleared
  • capillary attraction is the force that holds liquid in the capillary tubes
  • if surface tension is lowered, the liquid flows out of the capillaries easily
A

surfactants (surface tension reducer, wetting agent, penetrating agent)

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32
Q
  • chemical structure features one side of the molecule that has a strong affinity for water and another side that has an affinity for non aqueous solutions
  • this allows for components like oil and water to mix together more easily
  • lowering the surface tension allows the preservative to flow readily and rapidly through the capillaries and into the tissues
  • reducing the capillary attraction for blood and other body liquids allows a quick clearing of blood from the capillaries
  • increase the ability of fluid to pass through semipermeable capillary walls
A

surfactants cont’d

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33
Q
  • function best in low concentrations
  • sodium laurel sulfate, sulfonates
  • anionic surfactants are compatible with other anionic surfactants and nonionic compounds
  • cationic surfactants are inactivated by anionic compounds
A

surfactants cont’d

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34
Q
  • cosmetic (active) ___ are those that color tissues or can serve to trace diffusions
  • non cosmetic (inactive) ___ are those that do not impart color to tissue
  • natural
    • cuber - purplish red
    • carmine, cochineal - bright red
  • synthethic - mostly coal tar derivatives
A

dyes

35
Q
  • draw excess fluid from edematous bodies
  • called desiccants in chemistry
  • do the opposite of what humectants do
A

anti-edemics

36
Q
  • synthethic essential oils blended with harsh preservatives
  • contain floral compounds like wisteria, rose and lilac
  • spicy, fruity, or minty aromas
A

perfuming agents

37
Q

liquids that serve as solvents for the components of embalming fluids and solutions

  • must be a solvent that keeps the active substances in a stable and uniform state
  • include glycerine, sorbitol, glycols, or alcohols in addition to water
A

vehicles

38
Q

fluids injected for purposes other than preservation and disinfection that will enhance the actions of the arterial solution

  • enhance the effectiveness of the preservative
  • may be injected prior to the solution or mixed with the solution
  • pre injection, co-injection, water conditioners
A

supplemental fluid

39
Q
  • designed to prepare the circulatory system for injection
  • clears blood discolorations, adjusts the pH of the tissues to prevent graying, reduces coagulation, improves distributions and drainage, and minimizes the harsh effects of formaldehyde
  • generally diluted with water and contain no preservative
  • over injection can Waterloo the tissue
A

pre-injection fluid ; also called primary injection fluids and capillary washes

40
Q
  • combined with the arterial fluid
  • water corrective, chemicals, dyes, humectants, edema reducing chemicals
  • tissue gas co-injection fluid is germicidal and designed to act specifically on clostridium perfringens
  • interal bleach and stain removers can help to lighten discolorations
A

co-injection fluid

41
Q

any chemical used in the preparation of human remains that is not injected into the arterial system or cavities

  • used in addition to vascular and cavity embalming fluids
  • most are applied to the body surface directly
A

accessory chemicals

42
Q
  • either a thin gel or a more viscous gel
  • might be poured over the viscera returned from an autopsy
  • may also be applied directly to a visceral surface or the walls or a cavity
  • may be applied as a surface park for pathologists such as a decubitus ulcer or necrotic areas
  • may be used to bleach areas, cauterize and/or deodorize as well
  • always cover in cotton or plastic
A

autopsy (surface) gels

43
Q
  • phenol based liquids
  • can be applied to areas where skin is removed (skin slips, blisters, abrasions, burns)
  • fast acting
  • can also be injected hypodermically to bleach out tissues
  • always wear eye protectant when using these chemicals
A

cautery chemicals

44
Q
  • injected into sunken areas of the face and hands to help restore a more natural contour and appearance
  • contains nitrocellulose and alcohols
  • don’t overfill as it is almost impossible to remove tissue builder once it is injected
A

tissue builder

45
Q
  • general solvent is used for cleaning the skin, surface, scalp, and hair if necessary
  • tissue builder solvent (methyl alcohol) is used to clean hypodermic syringes and needles used for injection of tissue builder
  • acetone is used to dissolve glue and take off nail polish
A

solvents

46
Q
  • blends of powdered chemicals used to dry out tissues
  • may contain preservatives, disinfectants, and deodorants
  • used to treat cavities and viscera in autopsied bodies
  • also often placed in plastics to absorb moisture and odor
  • often contain plaster of Paris, paraformaldehyde, aluminum chloride, and wood powder
A

hardening compounds

47
Q
  • similar to hardening compounds but are designed specifically for use on exposed tissues within the body cavities
  • absorb excess moisture, preserve, firm and sanitize
  • not reduced by the cremation process and cannot be separated from the cremated remains; a larger urn may be necessary in some cases and minimal use is recommended if the final disposition is cremation
A

autopsy compounds

48
Q
  • preservative tissues but don’t absorb moisture

- primarily paraformaldehyde based

A

embalming preservative powder

49
Q
  • usually a topical gel or a spray
  • generally phenol or thymol based
  • refrigeration will slow down most mold growth but will not stop it entirely
  • if you are removing mold, wear proper PPE
A

mold inhibitors

50
Q
  • can be applied internally or externally
  • internal products are placed into the incision prior to suturing (powders and mastic compounds)
  • external agents are things like adhesives and glues and are brushed or sprayed on after suturing
A

incision sealing agents

51
Q
  • designed to flush mild jaundice discolorations and stop them from getting worse where possible
  • contain little to no formaldehyde
  • generally also contain buffers to prevent pH changes that could cause bilirubin to biliverdin
A

jaundice fluids

52
Q
  • to insure that the contents of the hollow viscera and body cavities are perfused
  • to prevent the formation of any products of decomposition in the body cavities or hollow organs
  • to prevent putrefactive changes in tissues within the body cavities
A

cavity treatment purpose

53
Q

removal of gas, fluids, and semi-solids from body cavities and hollow viscera by means of suction with an aspirator and a trocar

A

aspiration

54
Q

direct treatment of the contents of the body cavities and the lumina of the hollow viscera; usually accomplished by aspiration and injection of chemicals using a trocar

A

cavity embalming

55
Q

Chronological order of cavity aspiration (5)

A
  1. aspiration
  2. injection of cavity chemicals into body cavities
  3. closure of the trocar point of entry
  4. washing and drying of the body
  5. possible re-aspiration or re-injection if necessary
56
Q
  • when abdomen is tightly distended with gas or edema, pressure should be relieved prior to arterial injection
  • edema can result in ascites or gases in the abdomen that causes extravascular resistance
  • can be done by inserting a drainage tube or the trocar
A

partial aspiration

57
Q
  • long, hollow needle with a removable sharp point
  • used to withdraw contents of organs and residual fluid and also to introduce disinfectant/ preservatives solution into the internal organs
  • frequently clogs when masses of material are aspirated
  • if trocar is completely clogged, water will reverse flow and the body cavities will fill up with water
A

trocar

58
Q

-designed for cavity treatment in infants but can also be used for hypodermic injection of fluid

A

infant trocar

59
Q
  • apparatus that utilizes a water supply to create suction and is used to aspirate the contents of the body’s cavities
  • on the supply line for cold water usually
  • vaccuum is created when water supply is turned on
  • vaccumm breaker prevents backflow
A

hydroaspirator

60
Q
  • stand alone motorized device

- recommended for when there is low water pressure

A

electric aspirator

61
Q
  • dual purpose hand held device used for both arterial solution injection and cavity aspiration
  • historical
A

hand pump

62
Q
  • clear plastic or rubber tubing

- 6-8 feet in length

A

tubing

63
Q
  • instrument used to aspirate the throat by means of the nostrils
  • used on oral and nasal cavities
  • inserted into the nares to reach the nasal cavity and back of the throat
  • clogs very easily
A

nasal tube aspirator

64
Q

used for aspiration of the trunk cavities of the autopsied body
-flat tip that can be placed on the floor of the cavity for passive operation

A

autopsy aspirator

65
Q

other tools used in the prep room (2)

A
  1. cavity injector

2. gravity injector

66
Q

what does cavity embalming treat? (4)

A
  1. contents of hollow viscera
  2. walls of visceral organs
  3. space between the visceral walls of the cavities
  4. solid organs; pancreas, spleen, kidneys, liver, lungs, brain (if applicable)
67
Q

what does cavity treatment move through the lungs, trachea, and bronchi (4)

A
  1. blood
  2. edema
  3. purulent material
  4. gases
68
Q

what does cavity treatment move through the stomach? (4)

A
  1. hydrochloric acid
  2. undigested food
  3. blood
  4. gases
69
Q

what does cavity treatment move through small intestine (4)

A
  1. gases
  2. undigested food
  3. partially digested food
  4. blood
70
Q

what does cavity treatment move through the large intestine (3)

A
  1. blood
  2. gases
  3. fecal matter
71
Q

what does cavity treatment move through the urinary bladder (3)

A
  1. urine
  2. pustular material
  3. blood
72
Q

what does cavity treatment move through the gallbladder (1)

A
  1. bile
73
Q

what does cavity treatment move through the pelvis of the kidney (3)

A
  1. urine
  2. blood
  3. pustular material
74
Q

what does cavity treatment move through the heart

A

blood

75
Q

what does cavity treatment move through inferior vena cava, portal veins

A

blood

76
Q

concentrated embalming chemical injected into the cavities of the body following the aspiration of the body
-not diluted

A

cavity fluid

77
Q
  • volume is determined by the mass of tissues being treated
  • relative to body size and weight
  • 32-48oz of undiluted cavity chemical is recommended for the 3 cavities in the average adult
A

amount of cavity fluid

78
Q

what purge contents come from where and exit from where?

-stomach

A
  • exits from nose and mouth
  • liquid, semiliquid
  • dark brown “coffee ground” resemblance
  • usually associated with an odor
  • usually acidic
79
Q

what purge contents come from where and exit from where?

- lungs

A
  • exits from nose and mouth
  • frothy sometimes contains some blood
  • little odor
80
Q

what purge contents come from where and exit from where?

-brain

A
  • exits from nose, ears, and eyes
  • creamy white semisolid mixture
  • sometimes contains brain matter
  • gases or liquids can move into eye and cause swelling
  • fractures can cause bloody purge from ears
81
Q
  • trocar should ve inserted 2 inches to the left and 2 inches superior to the umbilicus
  • aspirate prior to suturing incisions from arterial injection
  • gases are usually found in the anterior portions of the cavities
  • liquids gravitate to the posterior portions of the cavities
  • “fanning” around the cavities from right to left and at each level or depth will remove materials
A

general info for aspirating

82
Q

-allows for intravascular pressure to assist the diffusion of arterial solution from the capillaries into the interstitial space

A

time delayed aspiration

83
Q
  • removes microbes before they are able to further multiply and/or move into other tissues
  • prevents gases from causing purge and removes substances expelled in purge
  • takes away the medium for bacteria
  • removes blood that could mix with formaldehyde and cause a gray discoloration
  • can decrease swelling
A

immediate aspiration

84
Q
  • in case of excessive gas
  • tissue gas
  • advanced decomposition
  • if viscera appears soft in texture
  • death by drowning
  • ship ins
  • ship outs
  • recent abdominal surgery
  • obesity
  • purge/purge prevention
  • death from a blood infection or an infection of the abdominal cavity
A

re-aspiration

PIMS path 2 (8 decks)

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