FSE-212: Embalming Theory II FINAL EXAM

What kind of fluid helps with a yellowing color of the skin/eyes (jaundice)?

-Specialty jaundice fluids which may or may not contain formaldehyde -Pre-injection, which clears the vascular system -Bleaching co-injection -Cavity fluid

How do we treat purge?

Aspiration, packing of the orifices

Where should proper ventilation be placed in a prep room?

At or near floor level, due to the fact that formaldehyde is heavier than air

Purge from this area may have a white semisolid appearance Lung Brain Stomach Anus

Brain

How do we aspirate the brain?

By inserting a trocar through the cribriform plate of the ethmoid bone by way of the left or right nostril

This is an anaerobic bacterium which can cause intense gas in the tissues accompanied by a foul odor. Methanethiol Dimethyl disulfide Clostridium perfringens Dimethyl trisulfide

Clostridium perfringens

Extreme dehydration causes what condition of the body?

Desiccation

This is a commonly prescribed synthetic opioid similar to morphine, yet 50-100 times more potent. Hydromorphone Tramadol Fentanyl Tapentadol

Fentanyl

How do you treat the walls of the cavity in an autopsy case?

Hypodermic embalming, surface embalming

What does ascites do to cavity fluid?

It dilutes it

This type of burn can be classified as deep, affecting the posterior dermal layer of the skin and may cause blisters to develop. First Degree Burn Second Degree Burn Third Degree Burn Fourth Degree Burn

Second degree burn

Which of the following is categorized as an extravascular irregularly shaped blood discoloration that often appears on the arms and back of the hands? Livor Mortis Postmortem Stain Senile Purpura Hematoma

Senile purpura

Which of the following is not a commonly transplanted organ? stomach pancreas small bowel liver

Stomach

When embalming a decedent who has undergone a cranial autopsy, the embalmer must clamp vessels inside the cranium to ensure distribution to the face. These vessels make up which of the following? The Cranial Circle The Neuroarterial Circle The Superior Thyroid Arteries The Circle of Willis

The Circle of Willis

Edema of the legs

Thighs and lower legs, sectional injection, surface packs

The Uniform Anatomical Gift Act is a state act that will differ by jurisdiction a local act that will differ by jurisdiction a federal act enforceable in every state a recommendation, but unenforceable

A federal act enforceable in every state

What are the procedures for shipping a body?

Complete the Embalming and Decedent Care Report, complete thorough embalming, pack orifices, use plastic garments, dress in hospital gown

Proteolytic enzymes do not break down proteins True False

False

Edema of the hands

In tissues of the backs of the hands, RCI, strong arterial solution

Describe the different plastic garments

Pants: covers torso from the lower abdomen to the upper thigh Coveralls: covers the trunk from armpit to upper thigh Stockings: covers entire leg to feet Sleeves: covers arm to wrist Shirt jacket: covers upper torso from neck to waist, and arms Capri pants: covers lower abdomen to feet Unionall: covers entire body besides head, neck, and hands

This type of jaundice causes obstruction of biliary drainage; bilirubin is not excreted by the kidneys resulting in hyperbilirubinemia. Prehepatic Intrahepatic Hepatocellular Posthepatic

Posthepatic

When should surface discolorations be treated, pre- or post-embalming?

Pre-embalming

What causes change in skin color when a body has undergone renal failure?

Waste products (urea, ammonia, uric acid) accumulate in the blood causing acidosis, presence of urochrome turns skin yellow or brown

What is waterless embalming?

Waterless embalming is a technique in which no water is added by the embalmer to the embalming solution

How many ounces are in a standard bottle of arterial solution?

16 oz.

It has been estimated that ____ times more preservative chemical is needed to preserve tissues of bodies dead from complications of renal failure. 2 3 4 6

6

For a partial thickness skin harvest, what instrument is used in the harvesting process? dermatroph dermatome dermashaver dermablade

Dermatome

What chemical treats dehydration?

Humectant

Where is the heart located?

In the thoracic cavity, between the lungs in the middle of the chest

Can rigor mortis recur once it has passed?

Naur

When suturing an autopsied body, the embalmer should begin suturing at the: pubic symphysis left side of the Y incision middle of the Y incision right side of the Y incision

Pubic symphysis

I have finished embalming a decedent that has an exposed stoma due to a colostomy. Which suture method would be effective in closing the exposed area of the stoma? Single Intradermal Suture Double Intradermal Suture Baseball Suture Purse String Suture

Purse string suture

What is the best practice for removing a transdermal opioid patch from a decedent? Remove the patch with a gloved hand Remove the patch with a paper towel Remove the patch with an instrument such as forceps Dispose of the patch in a standard biohazard container

Remove the patch with an instrument such as forceps

What are the properties of cautery chemicals?

-Basically phenol (carbolic acid) -Contain about 2-5% of phenol -Rapid drying affect -Reducing and constricting -Germicidal

What neutralizes formaldehyde?

Ammonia, urea, waste products, nitrogenous wastes

How do we receive drainage in autopsy cases?

Blood pools into the cavities and is removed by an autopsy aspirator

Hydrothorax

Edema in the thoracic cavity, aspiration and injection of the lungs

Hydrocephalus

Edema of the cranial cavity

Hydropericardium

Edema of the pericardial cavity

Hydrocele

Edema of the scrotum

Drainage in a full autopsy case should be taken where? the iliac vein the jugular vein the basilic vein the cavity

The cavity

Contact with contaminated instruments may expose a decedent to tissue gas True False

True

This plastic garment is ideal for autopsy cases, as it covers the entire body with the exception of the neck and head. Capri Unionall Coverall Plastic shirt

Unionall

The principal manifestations of diabetes include all of the following except: hyperglycemia glycosuria ketosis emaciation

Emaciation

Which document must accompany all bodies being prepared and shipped to another funeral facility? Cremation Authorization Embalming/Decedent Care Report Death Certificate Airline Letter of Guarantee

Embalming/decedent care report

When embalming a decedent who passed due to complications of alcoholism, the embalmer should expect poor drainage, even within a reasonable time of death. True False

False

What does index mean when referring to arterial fluid?

Percentage of aldehyde in the concentrate, amount of formaldehyde gas, measured in grams, dissolved in 100 mL of solution

Characteristics of the different types of purge

1. Stomach: brown, resembles coffee grounds, foul odor 2. Lung: frothy, light pink/red, no odor 3. Esophageal varices: bloody liquid 4. Brain: white semisolid 5. Anal: semisolid/liquid 6. Embalming solution: arterial fluid 7. Cavity fluid: cavity fluid, blood

What are the three layers of the artery and the vein?

1. Tunica intima (inner lining) 2. Tunica media (middle layer) 3. Tunica externa/adventitia (outer layer)

The fluid strength for an autopsy is generally going to be higher. This is due to The amount of time in refrigeration The delay between death and embalming Possible trauma/decomposition All of the above

All of the above

Chemotherapeutic agents may include all of the following except: alkylating agents antimetabolites corticosteroids aminoglycosides

Aminoglycosides

What types of sutures work best for different scenarios?

Baseball: lengthy incisions Inversion, worm: cranial autopsy Continuous, whip: temporarily close lengthy incisions

This type of bacteria is commonly found in the mouth, intestinal tract, and vagina of healthy individuals: Candida Aspergillus Histoplasma capsulatum Cryptococcosis

Candida

What cause of death would cause a cherry-red discoloration, bright red color to blood, intense livor mortis, rapid post mortem staining, and petechiae? Drowning Carbon Monoxide Poisoning Electrocution Exsanguination

Carbon monoxide poisoning

What type of suture is used to temporarily close incisions?

Continuous/whip suture

Due to their small size, all infants must be embalmed using mild solutions and low-index arterial solutions. True False

False

This is a fatal disease caused by contamination of a wound infection by a toxin-producing, spore-forming, anaerobic bacterium. True Tissue Gas Gas Gangrene Aspergillosis Histoplasmosis

Gas gangrene

The classic colors of discoloration associated with dehydration in the tissue of the body include all of the following except: Yellow Green Black Brown

Green

Which of the following is not a consideration when treating a body exposed to radiation: Protection Time of Exposure Distance from the body Height/Weight of the body

Height/weight of the body

Facial edema

In facial tissues, strong arterial solutions, hypodermic embalming, plastic, gravitation, puncture and drain

Pulmonary edema

In the alveoli of the lungs, sectional injection, strong arterial solution

Pitting edema

In tissue spaces between cells, treated with strong arterial solution

Short term refrigeration is necessary in some cases, and can provide several advantages to the embalmer. Which of the following would not be an advantage of short term refrigeration? The slow progression of rigor mortis in the body Increased capillary permeability for diffusion The maintaining of blood in a liquid state A slower rate of decomposition

Increased capillary permeability for diffusion

This embalming method is recommended for extreme cases to minimize tissue swelling and provide maximum preservation. Restricted Cervical Injection Instant Tissue Fixation Six Point Injection Hypodermic Injection

Instant tissue fixation

How do you prepare a casket for shipping?

Line the inside of the casket with plastic, reverse casket pillow and elevate head, place cotton around head to avoid shifting, secure decedent with straps, avoid placing live flowers in the casket which will create moisture, secure items placed in casket, make sure nose or forehead of decedent does not touch casket lining, LEAVE CAP OFF, write at the head end: decedent's name, names, addresses, and phone numbers of both funeral homes, place burial transit permit, dc, and embalming and decedent care report in the envelope

This organ is the main detoxification center of the body: Spleen Appendix Pancreas Liver

Liver

Solid edema

Located within the body cells, must be excised

These drugs are commonly used for pain relief and anesthesia. Tranquilizers Opioids Sedatives Corticosteroids

Opioids

Which of the following medical devices must be removed prior to cremation? Colostomy bag IV needle Pacemaker Metal hip replacement

Pacemaker

Which medical devices must be removed for cremation?

Pacemakers and other radioactive devices

When treating the cranial cavity, this set of muscles can be sutured to keep the calavarium in place frontal sternocledomastoid temporalis occipital

Temporalis

Which of the following is not considered a stage of rigor mortis. Primary Flaccidity Active Rigor Secondary Flaccidity Terminal Flaccidity

Terminal flaccidity

This is an infection of the lungs, the ears, the nervous system, and the intestinal tract caused by a fungus commonly encountered as a saprophyte or a contaminant. Aspergillosis Phycomycosis Candidiasis Cytosis

Phycomycosis

How do we safely pour fluids into the embalming machine?

Slowly and carefully! Keep a distance and avoid splashback.

These drugs as the most widely used class of drugs. Ibuprofen Antibiotics Antidiabetic Agents Corticosteroids

Antibiotics

This form of Histoplasmosis is progressive, forming granulomatous inflammation with caseation necrosis and cavitation. acute disseminated chronic disseminated acute pulmonary chronic pulmonary

Chronic pulmonary

What pathological condition will cause a dull reddish to black discoloration? Addison's Disease Icterus Dry Gangrene Wet Gangrene

Dry gangrene

What does edema do to the cavities of the body?

Edema may build up in the cavities which in turn may cause swelling, may impact arterial distribution and blood drainage, and may dilute cavity fluid

Ascites

Edema of the abdominal cavity, aspiration and injection of the abdominal cavity

Reasons for a medicolegal autopsy include all of the following except: determination of the cause of death family request of postmortem examination determination of the manner of death establishment of the time of death

Family request of postmortem examination

Anasarca

Generalized edema in all body tissues, gravitated, punctured and drained, strong arterial solution

What is the treatment for skeletal edema?

High injection pressures, manipulation, pulsation, massage, sectional embalming

How do we preserve the trunk in an autopsy case?

Hypodermic and surface embalming

Time delays between death and preparation can present several problems to the embalmer. Which of the following would NOT be considered one of the problems associated with delayed embalming? Nonuniform Distribution Of Fluids Swelling Of Tissues Increased Preservative Demand Lowered Blood Viscosity

Lowered blood viscosity

This is the second highest cause of preventable death in the United States Heart Disease Smoking Obesity Alcoholism

Obesity

Provide examples of extravascular resistance:

Rigor mortis, gas in the cavities, expansion of hollow viscera during injection, tumors and swollen lymph nodes, ascites and hydrothorax, contact pressure, visceral weight, bandages, skeletal edema, inflammation

The most frequently encountered gas condition is caused by: Gas Gangrene Subcutaneous Emphysema Tissue Gas Decomposition

Subcutaneous emphysema

Tissue donation is regulated by: The National Organ Procurement and Transplantation Network The Food and Drug Administration The United Network for Organ Sharing The U.S. Department of Health and Human Services

The Food and Drug Administration for some reason

What arteries can be used to distribute fluid to the face if the carotid artery is not an option?

The facial artery, which can be found by making an incision along the inferior border of the mandible, anterior to the angle of the jaw

What is the best method of suturing for a cranial autopsy?

The inversion or worm suture, in which the needle runs parallel to the incision and the incision is concealed

All of the following corrective treatments can be used for eye distension in cornea donors except: Tissue Builder Surface Compresses Surface Embalming Heat Spatula

Tissue builder

How much of an increase in body water is considered edematous?

10%

At birth, the body water present in infants is approximately ____ of total body weight. 22% 75% 78% 40%

75%

What are the different types of skin injuries?

Abscess: localized accumulation of pus Abrasion: antemortem injuries resulting from friction of the skin against a firm object causing removal of the epidermis Contusion: bruise Incision: a clean cut made with a sharp instrument Laceration: wound characterized by irregular tearing of tissue Lesion: any change is structure over the course of an illness or injury

This complication occurs as a result of altered carbohydrate metabolism leading to a buildup of lactic acid Atrophy Ecchymosis Acidosis Jaundice

Acidosis

These drugs can lead to dehydration, low protein levels, kidney dysfunction , and the retention of nitrogenous waste. Corticosteroids Stimulants Tranquilizers Sedatives

Tranquilizers

Super adhesive glues and bonding agents can be used for some closures instead of traditional sutures. True False

True

Why do we inject arteries instead of veins?

Veins have internal valves that prevent the backflow of blood, preventing arterial fluid from circulating

What is instant tissue fixation and what types of cases require it?

1. Instant tissue fixation is a method of arterial injection in which strong solution under high pressure is injected in a burst-suppression pattern, creating firming without swelling 2. Early decomposition when facial swelling is anticipated, facial trauma, when facial tissues must be dry and firm for restoration, when facial excisions are necessary, re-embalming

Describe the process of restricted cervical injection

1. Raise the right carotid artery and insert two tubes: one facing the trunk and the other facing the head 2. Drain blood from the jugular vein 3. Raise the left carotid artery and insert a tube facing toward the head, tie off other end of artery 4. Inject trunk first, allowing open tubes facing head to release excess fluid 5. Inject the left side of the head 6. Inject the right side of the head