Lesson 1.1 Study Guide

Foramina in the area of the eye, serves as a pathway for what

Gas that affects the eye surrounding tissues, include the optic formaen, superior orbital fissure, inferior orbital fissure, inferior orbital fissure, infraorbital fissure, supraorbital foramen, anterior ethmoidal foramen, and posterior ethmoidal foramen.

List and number the areas of the abdomen using the 9-region method (right to left and top to bottom)

(1) Right Hypochondriac (2) Epigastric (3) Left Hypochondriac (4) Right Lumbar (5) Umbilical (6) Left Lumbar (7) Right Inguinal (iliac) (8) Hypogastric (9) Left Inguinal (iliac)

Using the four main trocar guides, which organ will you pierce if you move the trocar along a line from the left anterior-superior iliac spine and the right earlobe and depressing the point after you have passed through the diaphragm?

Guide for the right side of the heart.

Describe dividing lines of the four region plan

Horizontal line is drawn from left to right through umbilicus. A vertical line is drawn down the midline of the body. This establishes upper right and left quadrants and lower right and left quadrants.

Instrument installed on a water line that uses water to create a vacuum for cavity aspiration?

Hydro aspirator

Two commonly used types of instruments used to create a vacuum?

Hydro aspirator & Electric aspirator

What are two period during which cavity aspiration and injection can take place?

Immediately (or shortly) after arterial injection and delayed cavity treatment 8-12 hours.

In relation to arterial embalming, when does cavity embalming occur?

Immediately (or shortly) after arterial injection.

List some advantages of aspirating shortly after arterial injection

Large number of microbes that can easily multiply and accelerate decomposition are removed as soon as possible. Removal of the microbes prevents or minimized the possible production of gases that could cause purge. Immediate aspiration removes materials that could purge if sufficient gases were generated during the delay. Removal of the contents of the hollow viscera and cavities eliminates a bacterial medium.

List the 4 sections of the colon (large intestine) in anatomical order

Ascending colon, transverse colon, descending colon, sigmoid colon. (ATDS)

Type of purge that originates in the stomach

Liquids, semisolids, dark brown "coffee ground" appearance, odor, acid pH.

Largest glandular organ in the human body

Liver

Purge that is frothy with possible red blood and very little odor would emanate from which source?

Lungs

Solid organs that are treated by cavity embalming

Lungs, trachea, bronchi, stomach, small intestine, large intestine, urinary bladder, gallbladder, pelvis of the kidney, heart, inferior vena cava, portal veins.

Describe how a cavity fluid injector is used.

Attached directly to the 16-ounce bottle of cavity fluid. Hose connect the injector to the trocar. Higher the bottle is raised, the faster the fluid flows into the body. Small openings on the side of the gravity injector allows air to flow into the cavity fluid bottle. By placing a finger over this opening, the embalmer stops the flow of cavity fluid.

One occasion when cavity treatment is not employed?

Autopsy Cases

Why is a complete disinfection/sterilization of the trocar important?

Microorganisms have been transferred from one body to another via the trocar.

Besides the trocar, name two other types of aspiration instruments

Nasal tube aspirator & autopsy aspirator

Aspiration also creates more "surface area" within the thorax and abdomen, what is the significance of this?

Cavity treatment increase the surface area of the internal organs which increase the amount of tissue upon which the cavity fluid can act.

The bony plate/bone through which the trocar is pushed to aspirate the cranial cavity.

Cribiform plate of the ethmoid bone.

List the 3 sections of the small intestine in anatomical order

Duodenum, jejunum, ilieum. (DJI)

What items are required to accomplish the process of aspiration?

Pointed trocar, tubing, device to create a suction or vacuum. After aspiration, a gravity injector or other injection device is connected with tubing to the trocar to inject the disinfectant/preservative chemicals. To close the opening in the body wall, a needle and ligature or trocar button and inserter are used. A disinfection try is needed for cleaning and disinfecting the trocar.

What is the aspiration procedure and subsequent perfusion with cavity fluid designed to do?

Reach substances/microbes found in spaces with the thoracic, abdominopelvic and sometimes cranial cavities. Hollow viscera and their contents/organs that may not have been reached by arterial injection. Cavity treatment increases the surface area of the internal organs which increases the amount of tissue upon which the cavity fluid can act.

Why is clear tubing helpful in the aspiration procedure?

So aspirated material can be observed.

In aspiration, the main guides are to reach what?

Stomach, cecum, urinary bladder, and the heart.

Main organs of the abdominal cavity

Stomach, liver, gallbladder, pancreas, spleen, kidneys, and intestines (small and large), ovaries (in female).

Why is it wise to suture incisions after aspiration?

Sutures off the advantage of a complete closure. A bow can be used to secure the suture. It can be easily opened if re-aspiration is necessary.

Why isn't the trocar inserted on the right side of the abdomen near the umbilicus?

The liver is on the right side of the body. At the location where the trocar is inserted, it is easier to move the instrument from point to point. If it were inserted on the right side, the trocar would be entangled in the solid tissues of the liver.

As a general rule, the text suggest keeping the trocar in constant motion, what is the exception?

The trocar is kept in motion to minimize blockages (such as the intestines which exhibit a "clingy" effect on the trocar). However, if the trocar is inserted into an area filled with liquid (or gas), the trocar should be kept in that position until the fluid (or gas) has been thoroughly drained and/or removed.

According to the text, what is the suggested order of cavity treatment

Thoracic, Abdominal, Pelvic

Main organs of the thoracic cavity

Trachea, bronchi, lungs, esophagus, heart and great blood vessels, thymus gland, lymph nodes, and nerves.

Long hollow needle with removable sharp point that's used to pierce wall of the abdomen and internal organs for purpose of remove contents of organs and fluid that has pooled in cavities

Trocar

Using the four main trocar guides, which organ will you pierce if you direct your trocar along the abdominal wall to the symphysis pubis, pull it back slightly and depress it while moving it forward

Trocar guide for the urinary bladder.

List conditions under which re-aspiration would be strongly advised

When prior to dressing trocar button is removed and noticeable amount of gas appears to be present in abdomen. If body is to be transported to another funeral home. If body is received from another funeral home. Decomposition present. In cases of recent abdominal surgery. When embalmer is dealing with an obese body. When purge is present. When death involved blood infection or infection of the abdominal cavity (sepsis, peritonitis, or pneumonia). In case of bodies with ascites.

As a rule, cavity treatment follow arterial embalming, what is one exception to this rule?

When the abdomen is tightly distended with gas or edema, this pressure should be relieved prior to or during arterial injection. The presence of fluid (as in ascites) or gas in the abdomen can be great enough to act as an extravascular resistance. This resistance may also interfere with drainage. Drainage may be difficult to establish until this extravascular pressure is relieved.

Describe the standard point of trocar entry

2 inches to the left of the deceased and 2 inches superior to umbilicus

Condition where there is a noticeable amount of gas in the tissues prior to embalming

Antemortem subcutaneous emphysema

What is the theory behind have a long delay prior to aspirating

Delaying aspiration maintains the pressure within the vascular system and allows a more thorough distribution of the arterial solution into the tissues. It may also cause portions of the body that didn't receive adequate distribution to become better embalmed. For example, legs of the deceased received very good distribution to the knee; below that is marginal at best. By delaying aspiration, the embalmer will often see a marked improvement of the distal portions of the legs due to the intravascular pressure that has been kept in tact (by not aspirating right away).

What is the trocar guide for the stomach?

Direct the trocar point toward the intersection of the fifth intercostal space and the left mid axillary line (established by extending a line from the center of the medial base of the axillary space inferiorly along the rib cage) continue until the trocar enters the stomach.

What is the trocar guide for the cecum?

Direct the trocar toward a point one-fourth of the distance from the right anterior superior iliac spine to the pubic symphysis, keep the point of the trocar well up near the abdominal wall until within 4 inches of the right anterior-superior iliac spine, then dip the point 2 inches and insert it forward into the colon.