Lab Manual 2- Factors for selection of arteries, techniques Flashcards Preview

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Flashcards in Lab Manual 2- Factors for selection of arteries, techniques Deck (43):
1

- Age
- Sex
- Weight
- Fat distribution
- Disfiguration
- Disease
- Edema, anasarca
- Location obstruction (congestion)
- Trauma
- Medico-legal requirements
- Cause of death
- Manner of death

Other factors governing selection of arteries to be used for injection

2

- Infant: Descending abdominal aorta, femoral, topically.
- Adult: Varies

Age

3

Females- if low cut shirt, not the carotid

Sex

4

May be a problem with raising the femoral.

Fat Distribution

5

- Arthritis
- Tumors
- Cachexia (wasting syndome)

Disfiguration

6

Abnormal accumulation of fluids in tissue or body cavities.

Edema

7

Severe generalized edema.

Anasarca

8

A.S.C.V.D. - Arteriosclerosis cardio vascular disease

Local Obstruction (congestion)

9

A physical injury or wound caused by external force or violence.
- Mutilation
- Accident
- Surgery

Trauma

10

- Autopsy protocol
- Medical Examiner/ coroner

Medico-Legal Requirements

11

- Hospital
- Medical Examiner

Types of Autopsies

12

- Needs signed permission.
- Concerned with cause of death.

Hospital Autopsy

13

- Does not need permission.
- Concerned with manner of death.
- Concerned with cause of death.

Medical Examiner Autopsy

14

- Medical Doctor
- Investigates death

Medical Examiner

15

- Makes a report to the Medical Examiner.
- Holds official inquests

Coroner

16

- Anoxia
- Cancer, etc

Cause of Death

17

- Natural
- Suicide
- Homicide
- Accidental

Manner of Death

18

1. Shave area- if necessary
2. Select instruments and prepare ligature
3. Locate place of incision using linear guide
4. Make proper incision though skin, superficial fascia and deep fascia.
5. Blunt dissection though superficial fascia, fat, and deep fascia.
6. Find vessels by use of anatomical guide and relative position of the vein.
7. Clean off by blunt dissection and ligate vein loosely.
8. Clean off and ligate artery loosely.
9. Make an incision in vessels.

Proper technique for Raising Vessels

19

Preparation room item used with suturing needles to suture cuts and incisions.

Ligature

20

The separation and pushing aside of the superficial fascia leading to blood vessels and then the deep fascia surrounding blood vessels, utilizing manual techniques or round ended instruments which separate rather than cut the protective tissues.

Blunt dissection

21

To tie off an artery and vein upon completion of embalming.

Ligate

22

Lying at right angles to the long axis of the body.

Transverse vessel incision

23

A vascular incision made on vessels by cutting in an oblique or slanting direction.

Diagonal vessel incision

24

A vascular incision that is made length-wise on a vessel.

Longitudinal vessel incision

25

A vascular incision created by making a short transverse incision at a right angle to the long axis of the vessel; then with the point of the scissors inserted into the original opening, a second incision is made parallel to the long axis of the vessel.

T-shaped vessel incision

26

A vascular incision which is made by cutting a small triangular wedge from the wall of a vessel.

Triangular (wedge) vessel incision

27

- Triangular (wedge) incision
- T-shaped incision

Allows us to better be able to insert the cannula

28

- Avoid the use of veins which require the abrupt turning of a curve by the drain tube, as the rupturing of the vein may result.
- Be sure the tube is well lubricated to insure easy insertion and prevent the rupture of the vessel wall. Oiling the inside of the drain tube will help prevent blood coagulation within the tube.
- Always use the largest tube the vein will accommodate. This insures the most copious flow of both liquid blood and clots.

Precautions during insertion of the drain tube

29

The process of converting soluble protein into insoluble protein by heating or contact with a chemical such as an alcohol or an aldehyde. The solidification of a solution into a gelatinous mass. This is a specific form of agglutination.

Coagulation

30

1. The vessels are tightly ligated and the free ends of the ligatures are cut off with utility scissors.
2. The incision is dried with cotton.
3. The incision is cauterized
4. The incision is dried with cotton again
5. Powder incision sealer is used to inhibit subsequent leakage.
6. The incision is sutured with stitches

Closing the Incision

31

In most cases, this stitch will be employed, but other types of incision closure are also available for special purposes.
i.e.- adhesives and staples.

Baseball Stitch

32

- Single suturing needle with a non-cutting edge
- Used on exposed areas of the body
- Suturing needle is brought though the surface and directed through the subcutaneous tissue.
- Small needle and thin ligature
- Nothing should show in the surface
- Does not hold well if used through fatty tissue.

The single Intradermal, Subcutaneous suture, Hidden Stitch

33

Made in the same manner as the single intradermal stitch, except that a suturing needle is used on each end of the ligature (two suturing needles) and the ligatures are crossed at each stitch, using crisscross motion just like tying shoes. This suture gives more protection against leakage in comparison with the single intradermal stitch.

The double intradermal or double Subcutaneous Suture

34

- Type of incision used by the Egyptians
- Usually an S shaped needle with a cutting edge and a heavy ligature
- Stitch is made from beneath, up through the skin and the needle is crossed from side to side with each stitch.
- Strong closure, but pulls the tissues adjacent to the incision upward into a ridge.
- Keep the ligature taut after each suture.

Baseball Stich, Sail Stitch

35

- Tight, leakproof Suture
- Creates unsightly ridge on the surface of the incision
- Large, full curve suturing needle and thick ligature
- Anchor or tie the ligature at one end of the incision and pull up the ligature which is anchored.
- Needle passes through both sides of the incision from the outside.
- Always keep the ligature tight
- Lock the stitch by looping it through the ligature, which is being held, releasing the ligature long enough to complete the loop; then catch the ligature and pull it tight again.
- Repeated until the incision is closed.
- Suturing needle insertion is always made from the same side of the incision.

The lock stitch, Half stitch, or Blanket Stitch

36

- Anchor the ligature around pins
- Considered as a temporary suture
- Holds the lips of the incision together during operation
- Assist in a permanent closure when an adhesive or sealer is used inside the incision to seal it permanently.
- Normally only used on exposed areas

The figure Eight Suture

37

Have the same basic suturing patterns.

The draw stitch and the worm stitch

38

The same as the single intradermal suture, except this stitch penetrates completely though the skin.
- Got its name because it draws the sides of the incision together.

The Draw Stitch

39

The same as the single intradermal suture, except the stitches are made parallel to the incision.
- Easily waxed over if used on exposed areas of the body.
- Used to turn under excess margins of the skin
- The opposite of the draw stitch in regards to the exposed areas of the ligature.

The Worm stitch

40

Used by passing the ligature through both sides of the incision from the outside going from one side to the other as the incision is sutured.

The Whip Stitch, Continuous Glover Suture, Roll Stitch

41

Individual stitch knotted at the tissue edge. This suture is normally used as a temporary stitch. It may be applied prior to the embalming to align tissues.

Bridge Suture, Temporary Interrupted Suture

42

A suture used to close small punctures or holes. A series of small stitches are made through the skin around the circumference of the opening. The ends of the thread are then knotted.

Purse String Suture

43

- Liquid Adhesive
- Spray sealing compound
- Cream sealing compound

Other methods of closure not using sutures

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