Embalming Chapter 22
When can you lessen the index strength of injection fluid on a diabetic?
1st gallon should be milder than the subsequent ones
How can you relieve external resistances from visceral weight?
Above and below heart injection and drainage points can be employed.
Define polycythemia Vera.
An increase in red blood cells.
What should you use as a drainage instrument? Why?
Angular Spring Forceps, to help pull coagula.
Describe the negative influences that can affect the heart valves.
Any one or any combination of those valves can be affected by the same degenerative diseases that affect the arteries, they can also be attacked by bacteria and damaged irreparably or slugger a congenital malformation, therefore altering substantially, the circulation of blood and of preservative fluid.
When encountering sclerosis, what type of rate of flow should you use during initial injection? Why?
Begin with a very slow rate of flow, and then adjust if necessary. This prevents blowout.
What are some complications of end stage congestive heart failure?
Blood congestion in the right side of the heart, neck veins are engorged, dark facial tissues, lips, ears, and fingers are cyanotic, pitting edema, ascites, blood may be more viscous and salt retain in the body fluids.
How an you relieve external resistance from ascites?
By draining prior to or during arterial injection.
Should you use stronger or weaker solutions when you encounter arteriosclerosis?
Can be increased if distribution is poor or slow, and use of stronger solution ensures that sufficient preservative reaches the tissues even if a large amount of solution cannot be injected.
Describe treatment for pulmonary edema.
Cavity treatment and nasal packing.
What is an extreme concern of post mortem arterial coagula?
Coagula will move and block distribution of embalming solution.
When you believe you will encounter vascular problems such as sclerosis or other obstructions, what artery should be used as a primary injection site? Why?
Common Carotid. It rarely exhibits arteriosclerosis and the size of the lumen allows easy tube insertion.
What type of ulcer does diabetes cause and what are the treatments?
Decubitus Ulcers. Surface packing/injected directly after disinfecting them.
Describe common problems with patients who suffer from diabetes?
Distribution issues due to arteriosclerosis, subject to increased bacterial and mycotic infections, abnormal pH values, gangrene in fingers, and decubitus ulcers.
How can you relieve external resistances from hydrothorax?
Drainage may be possible prior to inaction but can be difficult.
What are some procedures you can use to increase distribution on a diabetic or to trace where fluid is going?
Dyes as tracers, co-injection and humectant, and massage.
How can you relieve external resistances from tumors?
Excise, with permission, if absolutely necessary. Sectional injection may be necessary.
What are some common problems associated with surgical repair of the aorta when you have an aortic aneurysm?
Extreme facial edema can accompany it.
Which artery is the most likely to be affected by arteriosclerosis?
Femoral.
When using a multi-site injection, what type of pressures/rate of flow should you use in comparison to a single point? What should you do when circulation is established?
Higher pressure and pulsation. Once circulation is established, pressure and rate of flow can be reduced.
If you inject via the carotid, what arteries might you block due to coagula? If you inject the femoral?
If you inject the carotid, you might block the femoral. If you inject the femoral you may block the common carotid.
What are the three layers of an artery? Of what type of cells/tissues are they composed of?
Intima, Media and adventitia. They are composed of endothelial cells.
What is a complication of an obstructed lumen?
It can decrease or stop flow of arterial fluid.
What is a benefit of an enlarged liver in the congestive heart patient?
It improves drainage because of a low clotting factor.
Is venous coagula as serious a problem as arterial coagula?
It isn't as seriously, unless they don't move and can create a blockage but massage helps move it a long.
Describe the necessity of thorough aspiration in the congestive heart patient.
Its best to reaspirate and reinject several hours later after first treatment (due to edema)
List and describe all 4 major valves of the heart.
Left atrioventricular/mitral valve allows blood to pass from the left atrium to the left ventricle. Right atrioventricular/tricuspid valve opens the right atrium into the ventricle. Pulmonary semilunar/a tricuspid valve opens to allow blood to flow from the right ventricle into the lungs via the pulmonary artery. Aortic semilunar/a tricuspid valve opens into aorta from the left ventricle.
Describe type 2 arteriosclerosis.
Lumen is quite reduced in size and pushed to one side of the artery.
How can you relieve external resistance from rigor mortis?
Manipulation prior to arterial injection.
How can you relieve external resistances from contact pressure?
Massage these areas.
What techniques can you employ to improve distribution of fluid in a sclerotic artery?
Massaging limbs, higher pressure and pulsation can be used (multi-site injection), co-injection, and dye so you can see where its going.
Why is cavity treatment important in the diabetic patient?
Mycotic infections are often found in the lungs of persons with diabetes.
Does arteriosclerosis only occur in old people? What is the average age of those who die from heart disease?
No, it can begin at 30. Mid-50's.
Is pre-injection fluid recommended when there is vascular obstruction or disease?
No, swelling could result.
Do gangrenous areas receive arterial solution during injection?
No, those areas should be treated hypodermically
Is lung purge a major concern to the embalmer?
No.
Should you raise a sclerotic femoral artery to the surface of the body? Why or why not?
No. It can break.
What is an atheroma?
Patchy or modular thickening of the Intima.
Define extravascular resistance?
Pressure on the outside of an artery or vein.
How can you relieve external resistance from in the cavities?
Puncture the abdomen and relieve gases prior to or during arterial injection.
How can you relieve external resistances from bandages?
Remove tight bandages prior to injection
What type of injection (single, multi, restricted cervical) allows for injection of milder solution into facial tissues?
Restricted cervical.
Describe what arteries to use for an aortic aneurysm, the strength of fluid, how to interpret drainage, and whether you should use dye.
Right common carotid, use strong arterial solution.
Describe the injection process for congestive heart failure in detail including fluid.
Right internal jugular vein for drainage, and restricted cervical injection. 1st gallon should be mild to clear blood congestion and discoloration. If edema is present, subsequent gallons should be stronger. If there's facial discoloration, drain from both jugulars.
How can you relieve external resistance from swollen lymph nodes?
Sectional injection may be necessary.
Why do you need to use an arterial tube that may be smaller than those normally used in a sclerotic artery?
So that it slips easily into the lumen.
Describe type 3 arteriosclerosis.
The artery is completely blocked/occluded.
Define Lumen.
The cavity (hole) of a vessel
Describe type 1 arteriosclerosis.
The inner wall is hardened and thickened but the lumen is well defined and large.
What is the result of the great strides made in the medical profession regarding infant mortality, infectious diseases, and better medical care?
They leave an older generation, more likely to die of degenerative diseases because of better medical care or better control over some diseases.
What type of ligature is recommended, why?
Thick cotton or an arterial hemostat (thin linen may separate and tear the vessel)
Describe vasodilation and vasoconstriction including how to diagnose the conditions and treatments.
Usually, when these are present there is an unequal distribution of arterial solution due to the fact that some vessels have undergone vasoconstriction causing the vessels on the other side of the body to undergo vasodilation to compensate for the lack of blood flow. Multi-site injection may be necessary, but in most bodies injection of a sufficient quantity of solution should overcome the issue. (Seen in stroke victims)
Describe where you should make an incision in a sclerotic femoral artery if you should need to use it.
Where the vessel is the softest.
It is possible to embalm a body from a single injection site if they have died of an aortic aneurysm?
Yes, but if drainage is bad and swelling occurs, you may need to change that.
Does heart or blood vessel disease affect the embalming procedure? If so, how much?
Yes, due to any degenerative change caused by it or even drugs taken for the medical problem.
Should you use co-injection solution when using arteriosclerosis or sclerotic veins?
Yes, may help distribute the preservative solution.
Do drug treatments affect the system more than the disease?
Yes.
What type or fluid strength should be used on a diabetic?
moderate to strong, along with a coinjection
