Chapter 9 Embalming Vessel Sites and Selections

Arterial scissors

incise a vessel, some styles cut needle injector wires

Supraclavicular (anterior lateral) incision

incision made along clavical near sternoclavicular articulation and is directed laterally. Cutting along surface of bone allows to not damage underlying vessels.

split injection

injection from one site and drainage from another

arterial tube

inserted into artery for injection of embalming solution

drain tube or angular spring forceps

inserted into vein for drainage of blood and fluids

the location of the femoral artery compared to femoral vein

is superficial and lateral to the fem. vein, near inguinal ligament.

Femoral artery and vein advangates

large in diameter, possible even distribution to face

advantages of common carotid artery

leads directly to face, center of fluid distribution, center of drainage

characteristics of veins

lumen bluish when filled with blood collapses when cut vaso vasorum not visible when rolled infeingers, edges not felt generally contains clotted blood or clotted material

characteristics of arteries

lumen creamy white thick walls; edges easily felt when rolled in fingers vasa vasorum visible remains open when cut generally empty

anterior horizontal incision

made at base of neck from point on SCM and directed posteriorly, can be visable w collarless shirt or low necklines.

Surgical scissors

make incisions, cut ligatures, incise the artery or vein

scalpel

make incisions, superifcal disection, incise the artery or vein

iliofemoral

near the inguinal ligament, is the exact point where the external iliac artery extends and the femoral artery beings.

popliteal artery place of incision

posterior medial aspect of thigh, superior to the popliteal space

If a body part has been mutilated, which of the following embalming procedures is recommended?

sectional embalming

arterial hemostat

secures arterial tube in artery

Technique for raising vessels

shave areas if needed, select instruments and ligature, locate incision location using liner guide, make incision on one pass, blunt dissection thru superficial fascia, fat and deep fascia, clean off blunt dissection and ligate (tie) vessels loosely.

characteristics of nerves

solid structure, silvery white solid structure demonstrated when nerve is rolled between two fingers vasa vistorium present nerve fibers fray when cut has no valves, does not roll, not blood filled

T-incision

A combination of the transverse and longitudinal incisions.

six point injection

A multipoint injection of the body in which six areas are separately injected. May become 12 point if artial tube injects fluid away from trunk and toward trunk.

vasa vasorum

A network of small blood vessels that provide sustaining blood supply to large blood vessels

transverse incision

A vascular incision made at 90 degrees to the long axis of the vessel.

Diagonal incision

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

one point injection

An artery and a vein at one location are used for injection and drainage

ANV acronym

the acronym is helpful to describe relationship of common carotid, vagus nerve, and internal jugular vein from medial to lateral.

restricted cervical injection

the embalming process in which the injection of one common carotid artery is accomplished while the other common carotid is occluded.

Posterior vertical (parallel)

the incision posterior to the sternocleidomastiod muscle. 2 in below the lobe of the ear and directly downward toward the base of the neck.

wedge incision

triangle cut out from the artery

why would we use a small artery for injection of the entire body?

tried a larger artery and had to shoot into tributary / bifurcations due to sclerosis/issues, religious back rounds and needs modesty.

femoral artery and vein disadvantages

vessels are deep seated in obese cases, condition of vessel (arteriosclerosis), drainage sometimes difficult to establish and maintain

which incisions are not recommended to open sclerotic arteries

wedge and longitudinal incisions

sectional embalming

Embalming of a large area of the body

9 questions asked in considering an artery as an injection point

How superficial or deep is the artery? What other structures surround artery? How close is the artery to the aorta? What is the diametric size of the artery? Will selection of the artery interfere with body positioning? can the incision be easily consealed when clothing does not cover incision? Can drainage be taken from the companion vein? In which direction will the arterial clots move during injection? Is arteriosclerosis present in the artery?

Longitudinal incision

Incision into a vessel that's parallel to the long axis of the blood vessel

common carotid artery precautions

Incision may be visible after dressing Tubes may leave a mark on face Face may be over injected

multipoint injection

Inject from 2 or more arteries

advantages of using the largest vein for blood drainage

Larger in diameter and allows easy removal of blood and coagula, direct drainage of applicable location

Strap Line incision

Made approx. 2 inches lateral to the base of the neck on the line where the strap of the undergarments crosses the shoulder. Adaptable to the embalming of females

describe where the incisions are made for raising the radial and ulnar arteries

Radial: on the lateral side of the wrist (thumb) Ulnar: on the medial side of the wrist (pinky)

Two arteries most commonly used for arterial embalming

Right common carotid and the femoral artery

6 incisions that can be used to raise the common carotid artery

Supraclavicular (anterior lateral) Anterior vertcal (parallel) Posterior vertical (parallel) Anterior horizontal Semilunar (flap incision) Strap line

Anterior vertical (parallel)

The incision is made from a point near the sternoclavicular articulation and is directed upward on the sternocleidomastoid muscle. Muscle serves as a structural guide for the cutting instrument.

location of the common carotid artery compared to the internal jugular vein

artery is deep and medial to vein

double T- incision

bi-directional

axillary artery and brachial artery (basilic vein) advantages

close to face, close to drainage and distribution, vessels are superficial

axillary artery disadvantages

danger over injecting face, anomalies of both artery and vein are common, if arm is not treated properly does not appear natural in casket.

why would using multiple injection sites achieve optimal embalming?

direct access to larger variety of areas in the body, however not everyone needs that.

aneurysm hook

dissects fat and fascia; elivates and secures vessels

Separator

elivates and secures vessels

grooved director

expands vein for insertion of drainage device or guides an arterial tube into an artery

semilunar (flap incision)

extends from a point lateral and slightly superior to SCM articulation, crosses the upper chest in an arc. Resembles the letter U or inverted C. Ideal when embalming right and left common carotids. Also relieves tissue gas cases.