Lecture Notes - Exam 3 MORS 113 Flashcards
1
Q
The sum total of those considerations given the case at hand, beginning before the embalming procedure is begun and continuing throughout the operation.
A
Case Analysis (Embalming Analysis)
2
Q
- Pre-embalming analysis
- Analysis during arterial embalming
- Analysis after arterial embalming
A
Case Analysis Will Occur in Three Overlapping Stages (List Question)
3
Q
- Should be documented in report form.
- Should be stored in a 3-ring binder - O.S.H.A.
- If the body is being shipped, no matter where, a duplicate copy of the report should accompany the embalmed body.
- Translation to a foreign language may be required when shipping internationally.
A
The Case Analysis Should:
4
Q
If the organs were returned or not in these cases should be included in the case report.
A
Autopsy
5
Q
To perscribe and apply the proper embalming technique.
A
Purpose of Embalming Analysis
6
Q
- General condition of the body after death
- Effects produced by disease processes
- Effects produced by drugs or surgical procedures
- Effects that occur during postmortem interval
A
4 Major Factors the Embalmer Must Consider in Making a Pre-embalming Analysis
7
Q
The time lapse between death and embalming or to disposition.
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Postmortem Interval
8
Q
It can take weeks or months for this to happen.
A
To Move the Body to Another Country
9
Q
Occur within the body.
A
Intrinsic Factors
10
Q
- Cause and manner of death
- Bodily conditions
- Presence or absence of postmortem discolorations or stains.
- Postmortem chemical or physical change
- Pharmaceutical agents including illegal drugs - antemortem exposure
- Age
- Gender
- Weight
A
Intrinsic Factors
11
Q
- Pathological conditions
- Microbial influence
- Moisture content
- Thermal influences - fever
- Nitrogenous waste products
- Gase in tissues or cavities
A
Bodily Conditions (Intrinsic)
12
Q
IV needles (illegal drugs) are known for:
- Transmitting HIV
- Transmitting Hepatitis C
A
Pharmaceutical agents including illegal drugs- antemortem exposure (Intrinsic)
13
Q
An example would be that females typically have more adipose tissue.
A
Gender (Intrinsic)
14
Q
Emaciated, obese, condition of the muscles.
A
Weight (Intrinsic)
15
Q
Occur outside the body, have direct influence on the condition of the body.
A
Extrinsic Factors
16
Q
- Environmental
- Postmortem interval
- Embalmer
A
Extrinsic Factors
17
Q
- Atmospheric conditions - climatic (Humid, moist, dry).
- Thermal influences (Ideal temp. for bacteria = 98.6oF
- Microbial influences
- Vermin and insects
- Humidity
A
Environmental (Extrinsic)
18
Q
Aptitude and attitude.
A
The Embalmer (Extrinsic)
19
Q
This is the very foundation of professional embalming.
A
Case Analysis
20
Q
In a case analysis, cause of death is not as important as this.
A
Manner of Death
21
Q
Circumstances surrounding the body at the time of death.
A
Manner of Death
22
Q
- Cause and manner of death
- Bodily conditions
- The presence or absence of pathological discolorations.
- All of the postmortem physical and chemical changes
- Age
- Weight
- Medication, drugs and other therapeutic agents
- Gender
A
Intrinsic Variable Factors
23
Q
Generally considered unreliable most of the time because the death certificate is often not obtained until after the embalming has been done and/or it is just stamped ASCVD or MI which is little help.
A
Cause and Manner of Death (Variable Intrinsic)
24
Q
Are much more important and will indicate what procedure the embalmer will follow.
- Pathological conditions
- Anaerobic bacterial influence
- Moisture content in tissues
- Thermal influence
A
Bodily Conditions (Variable Intrinsic)
25
Those conditions in which there has been damage to the tissue due to disease.
Pathological Conditions
26
Dependent on how much bacteria there is present in the colon (e-coli).
Anaerobic Bacterial Influence
27
* Edema
* Dehydration
* Average Case
Moisture Content in the Tissues
28
In this case, there is an abundance of moisture in the tissue and you would use a strong solution. (36 index, 1 or more bottles per gallon).
Edema
29
In this case, you would use a weak solution. (About 22 index, lanolin-based, 6 ounces to a gallon).
Dehydration
30
In this case, you would use a middle index fluid (20-25). This has medium firming capabilities, contains lanolin and active dyes (femoral vein is good to use).
Average Case
31
An example would be high fever produced by a febrile disease. There will be scanty and clotted drainage.
Thermal Influence
32
This is a reliable indicator of the degree of the postmortem changes:
* Green spot over the cecum
* Yellow Cast to the tissue
* Livor mortis or postmortem stain
* Golden yellow color
The presence or absence of pathological discolorations (variable intrinsic)
33
Caused by e-coli, anaerobic bacterial.
A green spot over the cecum
34
This is due to dehydration (not to be confused with jaundice yellow).
A yellow cast to the tissue
35
This is due to hemolysis or hemostasis. The colors tend to be red, purple, blue.
Livor Mortis or Postmortem Stain
36
Associated with hepatic failure causing jaundice.
Golden Yellow
37
Infant, child, adult, elderly- will demand different embalming procedures- injection sites, drainage sites, strength, quantity, and chemical mixture of fluids- posing features, etc.
Age
38
Emaciated, obese, musculature (muscle development), will demand different embalming procedure- posing features, injection and drainage sites, strength, quantity, and chemical mixture of fluids.
Weight
39
* This factor is of limited value in case analysis because the embalmer is unaware of the chemicals involved prior to death.
* Many drugs used in surgery will impact the embalming process negatively.
* I.E., Chemotherapeutic agents are toxic to the body and will have an adverse effect on tissue structure.
Medication, drugs and other therapeutic agents
40
Injection and drainage sites, exposure of incisions as they relate to burial garments, and texture of surface tissue which may demand milder strength solutions.
Gender
41
* Environmental Conditions
* The postmortem Interval
* The Embalmer
Extrinsic Variable Factors
42
* Atmospheric Conditions: Such as humidity
* Thermal Influence: Such as Temperature
* Bacterial Influence
* Vermin and Insects
Environmental Conditions (Variable Extrinsic)
43
May reduce dehydration but it will favor early decomposition because heat and moisture are favorable for rapid bacterial growth.
A high atmospheric humidity
44
Will extract moisture from the body causing early dehydration (and may lead to mummification) but it will deter decomposition. It will however, cause problems with cosmetics due to discolored surface tissues.
A low atmospheric humidity
45
Will deter early decomposition, but extreme cold will cause the tissue to burn, as in freezer burn where the tissues will be dark, discolored and crusty (fingertips, earlobes, chin, tip of nose, lips- lips are first).
Cold
46
Will hasten decomposition, but in extreme cases, will alter the growth of the bacteria.
Heat
47
This will depend on the amount of aerobic bacteria in the air causing early decay.
Bacterial Influence
48
Will affect the surface tissues of the body and may require restorative artwork.
Vermin and Insects
49
This is, with all things being equal, the most important variable factor in case analysis. It is the time lapse from death to embalming, and it is during this time that the postmortem physical and chemical changes occur. **It is the most significant factor determining the embalming chemistry and technical procedure**.
The Postmortem Interval (Variable Extrinsic)
50
* Reverent respect for the dead because they can no longer demand it for themselves.
* Education in the field of embalming including continuing education courses throughout their careers.
* Patience- problem solving
* Lifestyle free from fatigue, depression, and anxiety.
* Pride in workmanship
The Embalmer (Variable Extrinsic, list question)
51
In this, we have what could be called a "hypothetical normal case" having the best set of characteristics at death.
Case Analysis
52
* No mutilations
* No blood coagulation
* No antemortem or postmortem discoloration
* No comminucable disease
* No blockages or breaks in the blood vascular system
* No excessive rigidity
* No cardinal signs of decomposition
* Minimum physical and chemical postmortem changes
Hypothetical Normal Case
53
No breaks or destruction of any internal or external surface which would require special treatment restorative art. Example- surgery.
No Mutilations
54
Free flowing drainage- clot free.
No Blood Coagulation
55
Which lead to postmortem stain.
No Antemortem or Postmortem Discoloration
56
That could cause danger to the embalmer. Example: C.J.D.
No communicable Disease
57
Example: ASCVD
No Blockages or Breaks in The Blood Vascular System
58
Rigor Mortis
No Excessive Rigidity
59
* Color
* Odor
* Purge
* Desquamination (skin slip)
* Accumulated gas
No Cardinal Signs of Decomposition (list question)
60
In case analysis, these factors in operative embalming are the most important.
Variable and Fixed Factors
61
This is the greatest single problem encountered in operative embalming. It is because of this that no single inflexible embalming procedure can be expected to produce satisfactory results in more than a very small percentage of the cases involved.
Variation
62
* The remains
* The operator
* The instruments and equipment
Variable Factors Involved in Case Analysis
63
These are of primary importance. It is the degree to which the protein of the body has been broken down into amino acids; it is further complicated by the degree to which the amino acids are broken down into amines and other by-products of putrefaction.
* It is the extrinsic factor (postmortem interval) in case analysis that must be on the mind of the embalmer.
The remains (Variable factor)
64
His or her ability varies according to:
* Educational background
* Natural, inborn ability
* Attitude towards this art
* Degree of efficiency
The Operator (Variable Factor)
65
These are of third most important importance. It is poor economy to attempt to operate an embalming room with those that are obsolete or insufficient. The per-case cost is the cheapest expenditure of the funeral home.
Instruments and Equipment (Variable Factors)
66
This is the only fixed factor in case analysis.
The Concentrated Fluid Used
67
* All remains recieve the same chemical formulation (type and volume) including cavity treatment regardless of condition of the body.
* All remains recieve the same injection and drainage site- same artery and vein.
* All remains recieve the same mouth closure method.
* All embalmed remains recieve the same cosmetic- no variation whatsoever.
Characteristics of a Non-thinking Anacephalic- Robot Embalmer (List Question)
68
In case analysis, this basic principal is the most important.
How the Tissue is to be Saturated
69
* Arterial
* Cavity
* Hypodermic
* Surface
4 Basic Types of Embalming
70
Arterial and Cavity Embalming
Required Embalming
71
Hypodermic and surface embalming.
Supplemental Embalming
72
**There is no substitute for this**. Hypodermic and surface embalming are an adjunct to (or act of desperation following) this. Cavity treatment is a separate operation from arterial embalming but is of equal importance.
Arterial Embalming
73
During life, this is the center of blood circulation. In death, the arch of the aorta becomes the center of the arterial embalming process.
The Heart
74
The most effective type of supplemental embalming.
Hypodermic Embalming
75
The heart is ordinarily excluded as the center of embalming circulation because of the \_\_\_\_\_\_\_\_, which prevent the solution from entering the heart. The only tie arterial fluid solution will enter the chambers of the heart is when the valves of the heart are diseased.
Aortic Semi-Lunar Valves
76
Cause the blood vascular system to contract, forcing the blood into the capillary bed. Because of hypostasis, this blood will eventually fall into the veins in short time. (Articulo-Mortis)
Muscular Contractions at Death
77
* 85% of blood is in the capillaries
* 10% of blood is in the veins
* 5% of blood is in the arteries
Articulo-Mortis
78
The average capillary has a diameter of this.
1/3000 of an Inch
79
During life, the blood content is sufficient to fill only about ___ of the capillaries at any one time.
1/3
80
In life, the human body has a blood volume of 6 quarts (5.5 liters); in death, an embalmer can inject up to 20 quarts of arterial fluid solution without drainage loss or swelling because the surplus fluid will fall into the remaining 2/3 of the capillary bed.
Embalming Signifiance - Articulo-Mortis
81
In life is the congestion of blood within the superficial capillaries of the immediate area of an infection of irritation.
Hyperemia
82
In life is the congestion of blood in the superficial capillaries of the face and neck because of nervous or emotional tension.
Blushing
83
In embalming is the congestion of arterial fluid solution in the superficial capillaries during the embalming process. It is a cauliflower effect on the tissue, usually with staining as a result of arterial dye (active).
* Can be induced by clamping off the corresponding vein, creating a backpressure.
Mottling
84
The removal of blood drainage from the vascular system or even livor mortis, but not postmortem stain. As the arterial fluid solution is forced into the arterial system, it flows out to the capillaries. There it comes into contact with the congested blood and pushes it ahead into the veins and eventually out into the drainage.
Flushing
85
The removal of at least 1/2 of the blood volume from the vascular system as a result of pressure and rate of flow induced by injection of the arterial fluid solution.
Venous Drainage
86
The point of injection is not as significant as this.
The point or points of drainage
87
No matter where you inject from, the body will not begin to be embalmed until the _____ is filled with arterial fluid solution. The ____ must be filled from its origin in the left ventricle of the heart up, around, and down to the bifurcation of the decending abdominal ______ at the iliac arteries.
Aorta
88
One superior to the heart via the right axillary vein or the right internal jugular vein, and the other inferior to the heart via the femoral vein or the right common or external iliac vein.
It is Recommended That the Embalmer Establish Two Points of Drainage
89
Because veins have these, with the exception of the vena cava, it is necessary to insert a drain tube, forceps or drain hose far enough into the vein that all of these leading to the superior or inferior vena cava are bypassed.
Valves
90
The aorta is the main trunk artery, and the main trunk veins are \_\_\_\_\_\_\_\_\_. Minimum standard is one-point injection and two point drainage.
Inferior and Superior Vena Cava
91
It is the formaldehyde gas, liberated from the arterial fluid solution, that effects and fixes the tissue cell protoplasm, not the fluid itself. The fluid is mearly a vector (carrier), which carries the gas.
Tissue Structure
92
The arterial solution will pass through the thin capillary wall to unite with protoplasm of the tissue cells, changing this soluble hydrophilic (water attracting) or albumin into an insoluble compound called an \_\_\_\_\_\_\_, which is highly resistant to bacteria.
Albuminoid
93
CH2OÎ, HCHOÎ
| (the arrows refer to a gas)
Formaldehyde Gas
94
This forces the blood out and the arterial solution into the tissues.
Pressure
