Discolorations(Exam 2) Flashcards
(244 cards)
1
Q
Only those which normally are removed during routine embalming procedures and those which may be altered sufficiently during routine embalming procedures
A
Discolorations
2
Q
A discoloration which appears on the human body during life
A
Antemortem Discoloration
3
Q
A discoloration which makes its appearance on the human body only after the death of the body
A
Postmortem Discoloration
4
Q
The fact that it may remain after life is extinct will not cause change of its classification
A
Antemortem Discoloration
5
Q
Discoloration resulting from changes in blood composition, content, or location
A
Blood Discoloration
6
Q
List the Classifications of discolorations according to occurrence
A
Antemortem
Postmortem
7
Q
Easily removed by vascular injection and drainage
A
Intravascular Blood Discolorations
8
Q
Not substantially reduced by vascular injection and drainage
A
Extravascular Blood Discolorations
9
Q
Occurs within the vascular system
A
Intravascular Blood Discoloration
10
Q
List the Antemortem Intravascular Blood Discolorations
A
Hypostasis
Carbon Monoxide Poisoning
Capillary Congestion
11
Q
Occurs during the agonal period which results in a bluish purple; most noticeable in the elderly
A
Hypostasis
12
Q
A cherry red blood discoloration on the body surface
A
Carbon Monoxide Poisoning
13
Q
Blood will lose its ability to coagulate
A
Carbon Monoxide Poisoning
14
Q
Blood tends to be in a liquid state causing the cherry red blood discoloration to be more intense
A
Carbon Monoxide Poisoning
15
Q
If not embalmed soon after death, hypostasis will turn to hemolysis, causing postmortem stain
A
Carbon Monoxide Poisoning
16
Q
List the progression from Hypostasis to Postmortem Stain
A
Hypostasis - Livor Mortis - Hemolysis - Postmortem Stain
17
Q
Occurs during the agonal period, just prior to death
A
Capillary Congestion
18
Q
Occurs when the arterial supply to an area of the body is increased
A
Active Capillary Congestion
19
Q
Occurs when venous drainage from an area is decreased
A
Passive Capillary Congestion
20
Q
Livor Mortis is what
A
A postmortem intravascular blood discoloration
21
Q
The most common postmortem intravascular blood discoloration
A
Livor Mortis
22
Q
Livor Mortis is also called
A
Cadaveric Lividity
23
Q
Occurs outside the vascular system
A
Extravascular Blood Discoloration
24
Q
List the antemortem Extravascular Blood Discolorations
A
Purpura
Ecchymosis
Petechia
Hematoma
25
Weak, diseased Vascular System
Purpura
26
Bruise from trauma
Ecchymosis
27
Extravasation of blood under the surface tissue
Ecchymosis
28
Pinpoint bleeding
Petechia
29
AKA Hemorrhagic Effusion
Petechia
30
A blood filled swelling
Hematoma
31
A collection of blood in a tumor like mass
Hematoma
32
A blood blister
Hematoma
33
Hemoglobin Decomposition
Postmortem Stain
34
AKA Laking
Postmortem Stain
35
If the postmortem interval is long enough and the blood remains liquid, especially aided by refrigeration, the body will from from livor mortis to this much faster
Postmortem Stain
36
How do you determine the difference between intravascular and extravascular blood discolorations?
Palpation - If the color changes at touch, it is intravascular; if not, it is extravascular
37
For an intravascular blood discoloration, _______ the vascular system of the discolored blood
Flush
38
To ensure the correct type and strength of the injection chemical to clear an intravascular blood discoloration, use
Anticoagulants
39
The quantity of the injection chemical to clear an intravascular blood discoloration should do this
Fill and flush all parts of the vascular system
40
You do not want the injection chemical to do this
Cause rupture of the vascular system, converting the intravascular discoloration to an extravascular
41
How is clearing an intravascular blood discoloration accomplished?
Low flow and low pressure
42
List the two things that will assist in increasing the flow to the discolored area and to assist the drainage from the discolored area
Raise and lower the part
| Manually massage
43
The direction of the massage should always be
Towards the heart
44
If the discoloration is localized, this may be used
Sectional Arterial injection and venous drainage
45
This may be used to ensure vascular filling of injection chemicals
Increased pressure and Limited Drainage
46
This may aid in the removal of the blood
Distention of the vessels
47
Not removed without special treatment
Extravascular Blood Discolorations
48
These may help drain the discolored area of blood
Operative Aids during embalming
49
When the discolored areas are swollen, it may be
Incised directly or punctured and channeled
50
Channeling the discolored area will induce this
The direct outflow of extravasated blood and accumulated serums
51
___________________ of chemicals designed to bleach and preserve may be necessary
Sectional or local hypodermic injection
52
What chemical can be used to bleach and preserve the discolored areas of extravascular blood discolorations?
Phenol
53
What does phenol do?
Bleach and discolor
54
Discoloration may be lessened in intensity by applying surface compresses saturated with this
Phenol
55
A phenol saturated compress is also called
Surface Pack or Cavity Pack
56
Can you substantially reduce an extravascular blood discoloration?
NO
57
Examples of antemortem discolorations resulting from the administration of pharmaceuticals or chemotherapeutic agents include
Radium
Methylene Blue
Atabrine
Sulfa
58
Causes burns that will give red discolorations
Radium
59
Causes a distinct blue discoloration
Methylene Blue
60
How would the Methylene Blue discoloration be converted into green?
Too Strong Formaldehyde
61
Where will the Methylene blue discoloration first show if it is present in the vascular system?
In the sclera of the eye
62
Causes a brown discoloration
Atabrine
63
Causes a yellow discoloration, not jaundice
Sulfa
64
Drugs that affect or damage the liver will result in what?
Jaundice
65
Why would drugs affecting or damaging the liver result in jaundice?
Because of their toxicity
66
All drug discolorations are ___________
Antemortem
67
All drug discolorations are caused by
Specific drugs or dombinations of drugs
68
Most common drug discolorations
Jaundice over the entire body
| Hemorrhagic Discolorations on the arms
69
Antemortem discolorations which occur during the course of certain diseases
Pathological Discolorations
70
Necrosis of tissue cells that undergo bacterial decomposition
Gangrene
71
Caused by venous congestion
Wet Gangrene
72
The affected part becomes becomes moist, dark, and putried
Wet Gangrene
73
Has the Odor of rotting flesh
Wet Gangrene
74
This type spreads rapidly
Wet Gangrene
75
Caused by the interference of the arterial supply of the blood
Dry Gangrene
76
Can result in a bluish black discoloration
Dry Gangrene
77
Has little odor as the bacterial activity is limited by dryness of the tissues
Dry Gangrene
78
The most common form of dry gangrene
Senile Gangrene
79
Frequently seen in the extremities of the body
Senile Gangrene
80
If odor is present with Gangrene, use
Spray Disinfectant
81
With gangrene, undamaged or unaffected tissue requires this
Regular strength injection, regular venous drainage procedures
82
With gangrene, it is possible to inject strong solution utilizing high index fluid or injectable cavity fluid in the affected area through
Multiple Injection Sites or hypodermically
83
This should be used for Gangrene, over the entire area
Cavity or topical preservative jelly
84
A cavity pack should be of a higher index, and should never contain this
Active Dyes
85
What makes Cavity Fluid uninjectable?
Phenol
86
Always use these with a Gangrene case
PLASTICS
87
What is the primary treatment purpose of gangrene?
To preserve, prevent leakage, and the escape of odor
88
Results in a yellowish discoloration of the body
Jaundice
89
Where is jaundice first detected?
Sclera of the eye
90
The yellow stain of jaundice is due to the present of this in the bile
Bilirubin
91
What does a strong formaldehyde arterial solution do to the jaundiced body?
TURNS IT GREEN
92
A strong arterial solution converts the bilirubin to what?
Biliverdin
93
The higher the HCHO index is, the ____________
Greener the body
94
In the embalming of all jaundiced bodies, this takes precedence over clearing the discoloration
PRESERVATION
95
Jaundice chemicals are
low index
96
What kind of injection/drainage is used for Jaundice?
Restricted Cervical Method
97
With injecting a Jaundiced case, there is a minimum of
Two Drainage Sites
98
If preservation demand is high with a jaundice case, use this
Restricted Cervical Method
99
If preservation demand is low with a jaundiced case, what are the sites to be used?
Femoral artery as injection
| Right jugular and Right femoral for drainage
100
In which cases do you definitely not use the femoral artery?
Obese or Arteriorsclerosis
101
If you are using these chemicals, use the femoral artery
Active Dyes and Humectants
102
Excessive amounts of active dye are used to counter stain shades of
Green
103
Excessive amounts of active dye must enter these uniformly
Both Common Carotid Arteries
104
In a jaundiced case, this should be used to flush out as much blood drainage as possible
Pre-Injection
105
What kind of fluid should be used on a jaundiced case?
Jaundice Fluid
106
Often called two-step fluids augmented with an abundance of active dye
Bleaching Co-Inejection
107
What active dye is usually added to a bleaching co-injection
Eosin
108
These may be necessary to conceal discolorations
Opaque Cosmetics
109
A bronze discoloration resulting from loss of function of the adrenal glands
Addisons Disease
110
What is the treatment for Addisons Disease?
Low index or specialized arterial fluid
111
What would a high index fluid do to a body with Addisons Disease?
turn surface tissue dark
112
Chronic or acute disease of unknown etiology characterized by unrestrained growth of leukocytes
Leukemia
113
The embalming problem with leukemia is
Capillary Congestion and extensive Thrombosis
114
The capillary congestion and thrombosis involved with Leukemia is a problem because they may
limit drainage
115
Start with the right carotid artery and jugular, followed by multiple injection and drainage sites when necessary with this disease
Leukemia
116
With leukemia, this is not recommended because of the risk of water logging
Pre-Injection
117
What strength fluid should be used on a leukemia case?
Stronger with co-injection
118
Why use a co-injection on a leukemia case?
To assist distribution of fluid solution
119
Inflammation of the peritoneum due to the invasion of infectious organisms
Peritonitis
120
A bright red color is characteristic of the infected peritoneum lining the abdominal cavity
Peritonitis
121
The embalming problem for peritonitis?
Hypostasis to hemolysis will occur rapidly
122
Because of bacterial invasion, what was going on with the blood of a peritonitis case antemortem?
Unable to coagulate
123
Describe the blood of a peritonitis case?
Odor and dark in color
124
What injection method should be used for a peritonitis case?
Restricted Cervical Method
125
Utilization of this may be necessary for peritonitis
Multiple injection and drainage sites
126
For the national board, what is the cavity fluid formula?
1 16 oz bottle per 50 lbs
127
The Historical formula for Arterial fluid is...
1 Gallon per 50 lbs
| 1% index
128
Today's standard for Arterial fluid is...
No set volume
2% index
70% tissue saturation
129
When should you aspirate a peritonitis case?
Immediately
130
What kind of cavity fluid should be injected immediately after aspiration for a peritonitis case?
Undiluted
131
Prior to dressing a peritonitis case, what should you do?
Re-aspirate and inject additional undiluted cavity fluid
132
If areas are not receiving fluid for a peritonitis, what should be done?
Hypodermic injection of strong solutions
133
What should be used to cover any surface discolorations
Opaque Cosmetics
134
This should be avoided with a peritonitis case
Pre-injection
135
What should you do instead of preinjection of a peritonitis case?
Use strong solutions and co-injections
136
Each time you re-aspirate, what should you do?
Add fresh cavity fluid
137
Tuberculosis of the skin
Lupus vulgaris
138
Characterized by patches which break down and ulcerate, leaving scars
Lupus Vulgaris
139
In some cases, a red butterfly rash may appear across the nose and cheeks
Lupus Vulgaris
140
Ulcers may be contagious to the embalmer
Lupus Vulgaris
141
Routine arterial injection of a lupus vulgaris case would have little effect on what?
Ulcers
142
An infectious contagious disease which causes an inflammation of the membranes of the spinal cord and/or brain
Meningicoccal Meningitis
143
A clear danger to the embalmer who should follow proper procedures for contagious and infectious diseases
Meningicoccal Meningitis
144
Pathological discoloration of Meningicoccal Meningitis may be in what form?
Rash
145
What kind of treatment is involved for meningicoccal meningitis
Opaque Cosmetics
146
Pathological discoloration will vary in both benign and malignant tumors
Tumors
147
This may be a problem if the tumor is necrotic
Odor
148
The tumor will seldom be preserved by this
Arterial Injection
149
The tumor must be ________ completely
Excised
150
How would an excised tumor area be preserved?
Topical Jelly, Cavity Pack, and/or hypodermically treated
151
A sallow yellow color to the skin
Chronic Renal Failure
152
What causes the sallow yellow color from Chronic Renal Failure
The presence of urochrome in the tissues
153
Chronic Renal Failure often accompanies this
Diabetes Mellitus
154
Diabetes Mellitus adversely affects what?
Distribution and diffusion of arterial fluid solution
155
Poor peripheral circulation with Chronic Renal Failure leads to this
Gangrene of the lower limbs
156
Poor peripheral circulation with Chronic Renal Failure also converts urea in the bloodstream to this
Ammonia
157
What is the problem with ammonia?
Neutralizes Formaldehyde
158
This should be completely avoided with cases of Chronic Renal Failure
Pre-injection
159
What kind of solution would be used in chronic renal failure cases
Strong solutions with co-injection
160
How many injection and drainage sites will be necessary for chronic renal failure cases
Multiple
161
If an area does not receive arterial fluid solution in a chronic renal failure case, what should be done?
Hypodermic Injection
162
What should be used to offset the sallow yellow color of a chronic renal failure case?
Co-injection with an active dye
163
Antemortem or postmortem discolorations which occur prior to or during embalming due to the deposit of matter on the body surface
Surface Discolorations
164
What mechanical method of removal is used to remove a surface discoloration
Using an abrading device and washing with suitable cleaning agents
165
What side of the sponge should be used to clear a surface discoloration?
SOFT SIDE
166
Why should the soft side of the sponge be used to clear a surface discoloration
Danger of desiccation marks
167
If the surface discoloration cannot be cleared mechanically, what should be done
Proper solvent and waterless hand cleaner or dry wash
168
Why should a surface discoloration be removed before embalmed
They may conceal signs of fluid distribution or diffusion
| Most are more difficult to remove after tissues have firmed
169
Caused by the dehydrating effects of the air to damaged epidermis
Razor Burns
170
Razor burns have what kind of discoloration
Reddish brown
171
Razor burns become progressively __________
worse as time passes
172
The chemical combination of formaldehyde with hemoglobin results in the formation of a substance called methemoglobin, or
Formaldehyde Grey
173
Formaldehyde Grey is a bigger threat to whom?
People of darker complexion
174
With the passage of time, the skin color changes from pink to a dark slate grey
Formaldehyde Grey
175
Fluid burns due to excessively strong solutions
Desiccation Marks
176
Desiccation Marks are what color
Reddish-brown
177
Desiccation marks are usually seen where?
On the face
178
How can a discoloration be counteracted?
Complete flushing of the venous system
179
Describe how the body should be positioned while flushing out the venous system?
Heep the head elevated above the chest, and the chest elevated above the stomach
180
What should be used to impart a more life-like appearance
Active Dyes
181
This is a commonly used active dye
Eosin
182
Results from high formaldehyde index solutions converting bilirubin to biliverdin in a jaundiced body
Green Discoloration
183
Sometimes caused by an acidic environment
Green Discoloration
184
What is the primary concern with embalming a jaundiced case?
Preservation
185
Result from damage to tissue and capillaries during the enucleation
Eye Enucleation Bruises
186
How would you correct Eye Enucleation Bruises
Cavity fluid pack with bleaching cavity fluid followed by opaque cosmetics
187
Postmortem discolorations which are due to the action of bacterial and/or autolytic enzymes on the body tissues
Decomposition Changes
188
May be progressive color changes in the tissues if these are not inhibited
Enzymes
189
Describe the decomposition discolorations
Yellow to light green to dark green to blue black to marbling
190
Signs of Decomposition
```
Color
Odor
Purge
Skin Slip
Accumulated Gases
```
191
Seen in the sclera of the eye due to postmortem dehydration
Tan Discoloration
192
Associated with livor mortis eventually followed by postmortem stain
Red to Purple
193
Decomposition of the arterial system causing the vasa vasorum to deteriorate changing the artery to this color
Maroon
194
A spot about the size of a silver dollar will appear over the cecum indicating the activity of E. Coli
Green
195
What is the only true sign of death?
Decomposition
196
Any sign of decomposition, what kind of arterial fluid should be used?
High Index
197
If not properly embalmed, what will happen to the green discoloration?
It will spread over the entire body
198
Any traumatic or pathological change in the structure of the skin
Skin Lesions
199
The skin lesion must first be disinfected. How?
Phenol gel, cavity pack, bleaching agents
200
To prepare a lesion for post embalming restorative treatment, what must be done?
Dry it!
201
For the purpose of embalming, what are the four classifications of skin lesions?
Skin unbroken but discolored
Skin scaling as in exanthematous disease
Skin broken separated from the body
Pustular or ulcerative Lesion
202
Examples of the skin unbroken but discolored lesion includes
Allergic Reaction, Trauma, Tumors
203
Recommended treatment for an unbroken but discolored skin lesion?
Strong arterial solution and surface compress
204
Examples of skin scaling as in exanthematous disease skin lesions include?
Acidosis, seborrhea, eczema, psoriasis, healing sunburn, measles, chicken pox
205
Recommended treatment for a skin scaling skin lesion during arterial injection?
Heavy coat of massage cream or petroleum jelly over exposed areas, face and hands
206
Recommended treatment for skin scaling skin lesion after arterial injection?
Remove massage cream
Use dry wash
Remove scaling skin
Topical Phenol Jelly
207
Examples of the skin broken separated from body skin lesion?
Abrasions, blisters, desquamation
208
Example of Pustular or Ulcerative Lesions?
Boils, carbuncles, furuncles, ulcers, pustules, fever blisters
209
What is the most dangerous Pustular or Ulcerative Lesion?
Herpes, Decubitus Ulcers
210
Initially decubitus ulcers are aseptic. Eventially, what do they become?
Streptococcus or staphylococcus
211
If there is a blockage in the ARTERY, what would you use?
Preservative Powder
212
If there is a blockage in the VEIN, what would you use?
Hardening Compound
213
This is the most important goal in embalming ALL bodies
Preservation
214
Redness of the skin
First Degree Burn
215
First Degree Burn is AKA
Hyperemia
216
Blistering and redness
Second Degree Burn
217
Charred Tissue
Third Degree Burn
218
Disintegrated Tissure
Fourth Degree Burn
219
Initially intravascular but becomes extravascular quickly
Carbon Monoxide Poisoning
220
Bright cherry red color to the blood
Carbon Monoxide Poisoning
221
Low blood viscosity, intense livor mortis
Carbon Monoxide Poisoning
222
Rapid Postmortem Stain
Carbon Monoxide Poisoning
223
Low blood viscosity, intense livor mortis, head faced downward, livor and stain
Drowning
224
Point of contract, point of exit burn marks can be present
Electrocution
225
Blood will coagulate
Electrocution
226
Little livor mortis, paleness to skin surfaces
| No blood discoloration
Exsanguination
227
Eyelids can show ecchymosis, swelling of eye area when injury is to head or face
Gunshot Wounds
228
Intensive livor mortis in facial tissues; some capillary rupture showing petechial discolorations; No blood present in facial tissues
Instantaneous Rigor Mortis
Hanging
229
Loss of blood, little livor mortis
| Ecchymosis and bruising at affected areas
Mutilation - Trauma
230
Variable - from generalized conditions such as jaundice and cyanosis to localized discolorations such as caustic burns or petechial hemorrhage
Poisons
231
Low blood viscosity
Intense Livor Mortis
Postmortem Stain speeded
Dehydration of mucous membranes and skin surface after long exposure to cold air (circular)
REfrigeration
232
Because of medico-legal investigation, postmortem interval is usually longer. What are the 2 solutions recommended for these conditions?
Restricted cervical and drainage (non-autopsied)
| Special purpose high index arterial fluids (30-38 index)
233
In an autopsy case, what arteries are raised?
Carotids
Subclavians
External Iliacs
234
What is the difference between a medical examiner and a coroner?
A medical examiner looks at the cause of death to find the manner of death. A coroner just wants the cause.
235
What should NEVER be done to an autopsied case?
Pre-Injection
236
In an full autopsy case, much of the blood discolorations will disappear. Why?
Because of the Evisceration process
237
List the major problems caused by refrigeration
```
Hypostasis to hemolysis occurs rapidly
Fluid distribution and diffusion problems
Surface dehydration
Distension of the viscera, causing purge
Capillary rupture
```
238
Where is surface dehydration most severe?
Fingertips, lips, eyelids, nose
239
Formation of high moisture content in some body tissues because the serum portion of the blood leaves the blood vascular system and gradually makes its way to the surface of the body
Postmortem Edema
240
List the major characteristics of refrigeration
Postmortem Edema
Blood thickens and agglutinates
Slow reaction between body proteins and preservative solution
Solidify subcutaneous fatty tissues
Light pink color will occur resulting from hemolysis
Slows postmortem chemical and physical change
241
What should be used to thaw a cold body?
Cold water
242
Why should you never use hot water to thaw a cold body
It could cause coagulation of blood and desiccation marks
243
What injection method should be used for a refrigerated body?
Restricted Cervical Method
244
What index should be used for a refrigerated body?
High index
