Embalming-Linear and Anatomical Guides
Posterior tibial linear guide
A line drawn from the center of the popliteal space to a point midway between the medial malleolus and calcaneus bone
Common carotid linear guide.
A line drawn from the sternoclavicular articulation to anterior surface of lobe of ear.
Subclavian linear guide
A line drawn from the sternoclavicular junction to the lateral border of the first rib.
Axillary Vein
Accompanying vein of axillary artery: Relative location-Medial and superficial to the axillary artery
Common iliac artery
Accompanying vein-Common iliac vein
External iliac artery
Accompanying vein-External iliac vein
Femoral artery
Accompanying vein-Femoral vein. Relative location: Medial and deep to artery.
Aorta
Accompanying vein-Superior and Inferior Vena cava-Left ventricle to level of 4th lumbar vertebrae
Factors governing selection of vessel to be injected
Age, sex, weight, disfigurations, disease, local obstruction, disease, local obstruction, mutilation, medial/legal requirements (autopsy), cause of death, religion
Brachial place of incision
Along linear guide-From the center of the base of the axillary space to center of the forearm just below bend of elbow (cubital fossa)
Common carotid anatomical guide
Along medial (inner) border of sternocleidomastoid muscle
Axillary place of incision
Along the anterior margin of the hairline of the axilla.
anterior tibial place of incision
Along the lateral margin of the inferior third of the crest of the tibia
Femoral place of incision
Along the linear guide for artery and below the inguinal ligament.
Dorsalis Pedis place of incision
Along the superior one-third of the linear guide
Subclavian place of incision
Along the upper margin of the clavicle about one-third of the distance from the shoulder and root of the neck
Linear guide
An imaginary line drawn on the surface of the skin to represent the approximate location of some deeper lying structure
External iliac
Anatomical guide-medial border of the psoas major muscle
medial malleolus, calcaneus tendon
Anterior Tibial place of incision: Midway between the ___________ __________ and the ___________ __________
tibia
Anterior tibial anatomical guide: the anterior and outer edge of the ______________
patella, ankle
Anterior tibial linear guide: From the lateral border of the _________ to the anterior surface of the _________ joint
third, tibia
Anterior tibial place of incision: Along the later margin on the inferior __________ of the crest of the _____________
axillary space, upper extremity
Axillary Linear guide: through the center of the base of the _____________ ______________ and parallel to the long axis of the ____________ ________________ when abducted.
first rib, teres major
Axillary anatomic limits. Begins at the later border of the _________ ________ and extends to the inferior border of the tendon of the __________ _________ muscle.
caracobrachialis
Axillary anatomical guide: Just behind the medial borer of the ___________________ muscle.
axilla
Axillary place of incision: Along the interior margin of the hairline of the _________________.
Left Common Carotid anatomical limits
Beginning at the level of second costal cartilage and extends to upper border of thyroid cartilage
Femoral anatomical limits
Begins at point behind the center of the inguinal ligament and terminates at the opening of the adductor magnus muscle
Axillary anatomical limits
Begins at the lateral border of the first rib and extends to the inferior border of the tendon of the teres major muscle.
Right Common Carotid anatomical limits
Begins at the level of sternoclavicular articulation and extends to level of superior border of thyroid cartiliage
Left Subclavian anatomical limits
Begins at the level of the second costal cartilage and extends to the outer border of the first rib (left)
Popliteal anatomical limits
Begins at the opening of the adductor magnus muscle and terminates at the lower border of the popliteus muscle (about one inch below knee joint).
Right subclavian anatomical limits
Begins at the sternoclavicular articulation and extends to the outer border of the first rib (right).
Ulnar place of incision
Between the tendons on the flexor carpi ulnaris and flexor digitorum superificialis. (just above the wrist a half inch in from the medial side). Linear guide at the wrist.
Axillary vein
Brachial accompanying bein: Relative location-medial and superficial to the brachial artery.
biceps brachii
Brachial anatomical guide: lies posterior to the medial belly of the __________ __________ muscle
teres major, antecubital fossa
Brachial anatomical limits: begins at the inferior border of the tendon of __________ _________ muscle and extends to a point inferior to the ______________ ___________
axillary space, forearm, bend of elbow
Brachial linear guide: from the center of the base of the __________ ________ to the center of the ___________ just below _________ _____ _________ (cubital fossa)
base, center, below
Brachial place of incision: From the center of the ______ of the axillary space to the ______ of the forearm just ________ bend of elbow (cubital fossa)
Considerations of axillary
Close to face. Close to center of circulation. Close to center of venous drainage. vessels are relatively superficial.
Internal jugular
Common carotid accompanying vein. Relative location: Lateral and superficial to the common carotid artery
sternocleidomastoid
Common carotid anatomical guide: Along medial (inner) border of ___________________________ muscle.
sternoclavicular articulation, lobe of ear
Common carotid linear guide: a line drawn from _____________ ____________ to anterior surface of ________ ___ ______.
Precautions of Axillary
Danger of over-injecting the face and partially if there is any obstruction present in the other trunk arteries of the body. The abnormalities of both artery and vein are common. If the arm is not treated properly, it does not appear natural when body is placed in casket. Numerous branches
ankle, first big
Dorsalis pedis linear guide: From the center of the anterior surface of the __________ joint to a point between the ________ __________ to and adjacent second toe
one-third
Dorsalis pedis place of incision: Along the superior __________ - __________ of the linear guide
sartorus, adductor longus
Femoral anatomical guide: Through the center of femoral triangle bounded laterally by the ____________ and medially be the ____________ ___________ muscle
inguinal, adductor magnus
Femoral anatomical limits: begins at the point behind the center of the ____________ ligament and terminates at the opening of the ____________ ________ muscle.
inguinal, medial condyle
Femoral linear guide: On surface of the thigh from center of _____________ (femoral) ligament to center point of ____________ __________ of femur
inguinal
Femoral place of incision: along the linear guide for the femoral artery and below the _______________ ligament.
Dorsalis pedis linear guide
From the center of the anterior surface of the ankle joint to a point between the first big toe and adjacent second toe
Brachial linear guide
From the center of the base of the axillary space to the center of the forearm just below bend of elbow (cubital fossa).
Anterior tibial linear guide
From the lateral border of the patella to the anterior surface of the ankle joint
Precautions of common carotid
Incision may be visible after dressing. Tubes may leave mark on face. Face may be over injected.
Considerations of common carotid
Insure direct distribution to the face. Close to center of venous draining and better blood removal of face is assured. Close to center of circulation. Face possibly can be embalmed with mild fluid while remaining portion of body can be injected with more preservative solution. Has no branch except terminal branches
Axillary anatomical guide
Just behind the medial border of the caracobrachialis muscle.
Radial anatomical guide
Just lateral to the tendon of the flexor carpi radialis muscle
Radial place of incision
Just lateral to the tendon of the flexor carpi radialis muscle (just above wrist and a half inch from lateral side). Linear guide at wrist.
Femoral considerations
Large in size. Lower portion of body can be embalmed without concern of distention of face. Arms can be placed in natural position and allowed to remain there. Equal distribution of fluid to head.
costal cartilage, thyroid cartilage
Left common carotid anatomical limits: Beginning at the level of second ____________ ______________ and extends to level of upper border of _____________ _____________.
costal cartilage, first rib
Left subclavian anatomical limit: Begins at the level of the second _________________ _____________ and extends to the outer border of the ___________ _________ (left).
Ulnar anatomical guide
Lies in groove between tendon of the flexor digitorum superficialis muscle and the tendon of the flexor carpi ulnaris muscle
Brachial anatomical guide
Lies posterior to the medial border of the belly of the biceps brachii muscle
incision
Make proper ___________ through skin, superficial fascia and deep fascia
Anatomical guide
Method of locating structure by reference to an adjacent known or prominent structure
Posterior tibial place of incision
Midway between the medial malleolus and the calcaneus tendon
Femoral linear guide
On surface of the thigh from center inguinal (femoral) ligament to center point of medial condyle of femur
Ulnar linear guide
On the surface of the forearm from the center of the antecubital fossa to a point between the 4th and 5th fingers.
Radial linear guide
On the surface of the forearm from the center of the antecubital fossa to center of base of the index finger
Supraclavicular
Place of incision common carotid: Along superior border of medial one-third of clavicle
Parallel
Place of incision common carotid: Along the posterior border of the inferior one-third of the sternocleidomastoid muscle
Half Moon
Place of incision common carotid: From the center of one clavicle by dipping curve to center of the other clavicle.
Anatomical limits
Point of origin and point of termination in relation to adjacent structures
adductor magnus, popliteus muscle
Popliteal anatomical limits: Begins at the opening of the ________ _________ muscle and terminates at the lower border of the _________ ________ (about one inch below knee joint).
long axis
Popliteal linear guide: Through the center of the popliteal space parallel to the __________ __________ of lower extremity
posterior medial, popliteal
Popliteal place of incision: longitudinal incision of __________-_____________ aspect of the thigh just superior to the ________________ space
medial malleolus, calcaneus bone
Posterior tibial linear guide: a line drawn from the center of the popliteal space to a point midway between the _____________ ____________ and __________ ___________
flexor carpi radialis
Radial anatomical guide: Just lateral to the tendon of the __________ __________ _________ muscle.
antecubital fossa, index finger
Radial linear guide: On the surface of the forearm from the center of the ____________ _________ to center of base of the _________ __________.
flexor carpi radialis, wrist
Radial place of incision: Just later to the tendon of the _________ ___________ _________ muscle (just above ________ and a half inch from lateral side). Linear guide at wrist.
sternoclavicular articulation, thyroid cartilage
Right common carotid anatomical limits: Begins at the level of the _______________ ____________ and extends to level of superior border of____________ ________________.
sternoclavicular articulation, first rib
Right subclavian anatomical limit: Begins at the ________________ _________________ and extends to the outer border of the ________ _______ (right)
Brachial Considerations
Same as axillary-Close to face. Close to center of circulation. Close to center of venous drainage. vessels are relatively superficial.
Brachial precautions
Same as axillary. Danger of over-injecting the face and partially if there is any obstruction present in the other trunk arteries of the body. The abnormalities of both artery and vein are common. If the arm is not treated properly, it does not appear natural when body is placed in casket. Numerous branches
ligature
Select instruments and prepare ______________
clavicle
Subclavian anatomical guide: the _______________
sternoclavicular, first rib
Subclavian linear guide: a line drawn from the _________________ junction to the lateral border of the ____________ _______.
clavicle, shoulder, neck
Subclavian place of incision: Along the upper margin of the _____________ about one-third of the distance from the _____________ and root of the __________.
anterior tibial anatomical guide
The anterior and outer edge of the tibia
shaved
The area for raising a vessel should be ___________ before incision
Subclavian anatomical guide
The clavicle
Femoral anatomical guide
Through the center of femoral triangle bounded laterally by the sartorus and medially by the adductor longus muscle.
Axillary linear guide
Through the center of the base of the axillary space and parallel to the long axis of the upper extremity when abducted
Popliteal linear guide
Through the center of the popliteal space parallel to the long axis of lower extremity.
flexor digitorum superficialis, flexor carpi ulnaris
Ulnar Anatomic Guide: Lies in a groove between tendon of the ________ __________ _________ muscle and the tendon of the _________ __________ _________ muscle.
antecubital fossa, fingers
Ulnar Linear guide: On the surface of the forearm from the center of the __________ _________ to a point between the 4th and 5th ____________.
flexor carpi ulnaris, flexor digitorum superficialis
Ulnar Place of incision: Between the tendons of the ___________ __________ ___________ and ________ ___________ __________. (Just above wrist a half inch in from medial side). Linear guide at wrist.
Femoral precautions
Vessels are deep-seated in obese cases. Draining is sometimes difficult to establish and maintain.
Vessels of Trunk
accompanying vein- Innominate vein (old terminology): Brachiocephalic vein
Popliteal place of incision
longitudinal incision of posterior-medial aspect of the thigh just superior to the popliteal space
