MOR 340 Embalming II Lesson 5.1

After embalming, how could one use gravity as a method of treating edema of the head, face, and neck?

We can place the body on a cot for several hours with the head end fully elevated and the foot end fully lowered. This would allow edema to gravitate from the head, face and neck.

Secondary dilution

Weakening of the strength of the arterial solution by vascular and interstitial fluids.

Under what physiological conditions is edema said to be established?

When there is a 10% increase in total body water.

List five types of "body cavity" edema and describe where they occur.

1. Ascites of the abdominal cavity, 2. Hydrothorax of the pleural cavity, 3. Hydrocephalus of the cranial cavity, 4. Hydropericardium of the pericardial sac surrounding the heart, and 5. Hydrocele in the saclike cavity in the tunica vaginalis testes of the male scrotum.

Regarding generalized edema, what are the two main objectives of the embalmer?

1. Inject a solution of sufficient strength and volume to counteract the secondary dilution that occur in the tissues, and 2. Remove as much edema from the tissues as possible.

What are three general body sites where edema can be found?

1. Intracellular, 2. Intercellular and 3. Within the body cavity.

In a normal 160 lbs. adult male, what percentage of body weight does total body water constitute?

55% to 60% of total body weight.

Pitting (Intercellular) edema

Condition in which interstitial spaces contain such excessive amounts of fluid that the skin remains depressed after palpation.

Briefly describe how Epsom salts work on edema.

Epsom salts create a hypertonic solution. This hypertonic solution sets up an osmotic gradient that draws the edema from the tissue spaces toward this concentrated salt solution in the capillaries.

Desiccation

Extreme dehydration often resulting in post-embalming discolorations.

Anasarca

Generalized edema in subcutaneous tissue.

In what situation does the Epsom salt solution work best? In what situation does it NOT work well?

In accompanying average to strong arterial solutions for generalized edema, on facial tissues when edema is recent, such as recent surgeries, heart or aortic surgery. It does not work well when the edema has been present for a long period of time in cases such as trauma cases, drug therapy cases.

How is ascites affected by the arterial solution and blood drainage?

No secondary dilution will occur as the arterial solution will not reach the body cavities. It is recommended to make a small incision to remove fluids from the cavity.

Hypostasis

Process of blood and/or other fluids settling to the dependent portions of the body; can occur in the antemortem, agonal, or postmortem periods.

Cellular (Solid) edema

The type of edema that does NOT respond to embalming treatments and is frequently seen in facial tissues when corticosteroids have been administered.

List some recommended treatments that will maintain moisture or add moisture to dehydrated bodies.

1. Use a moderate arterial solution, 2. Slowly inject arterial solution, 3. Use co-injection fluid with arterial solution, 4. Use humectant co-injection, 5. Run large amounts of fluid through body, 6. Intermittent or alternative drainage, 7. Apply massage cream, 8. Avoid excessive massaging of hands, neck and face, and 9. Avoid air currents.

List five of the six types of arterial solutions recommended in treating edema.

1. Very large volume or mild/average arterial solution, 2. Very strong/astringent arterial solution, 3. Special purpose, high index fluid designed specifically for edema, 4. Addition of dehydrating co-injection chemicals, and 5. use of Epsom Salts in the arterial solution.

Hydrocephalus

Abnormal accumulation of cerebrospinal fluids in the ventricles of the brain.

Hydrothorax

Abnormal accumulation of fluid in the thoracic cavity.

Hydropericardium

Abnormal accumulation of fluid within the pericardial sac.

Hydrocele

Abnormal accumulation of fluids in the scrotal sac.

Define Edema.

Abnormal accumulation of fluids in tissue or body cavities.

Edema

Abnormal accumulation of fluids in tissue or body cavities.

Ascites

Accumulation of serous fluids in the peritoneal (abdominal) cavity.

Describe Pitting Edema.

An imprint will remain when the area is pushed on by the embalmer. The fluid is in the interstitial spaces or between the cells and can be gravitated.

What is another term for generalized edema?

Anasarca

Why is cavity embalming important in cases of renal failure?

Because there would usually have bleeding occurring in the gastrointestinal tract and the cavity embalming provides an excellent treatment for the likely bacterial growth and rapid decomposition. It's highly likely their renal failure condition caused formation of gas which cavity embalming would remove.

Which type of edema does NOT respond to embalming treatments and is frequently seen in facial tissues when corticosteroids have been administered?

Cellular (Solid) Edema

Describe the appearance of desiccated lips and fingertips.

Desiccated lips appear black, very wrinkled and shrunken and teeth can be exposed. Fingertips become parchment like and turn a yellow brown.

What is another term for extreme dehydration?

Desiccation

What is the theory behind using a very large volume of a mild or average (standard) arterial solution to treat generalized edema?

It ensures good distribution, large amount of preservative, washes out a good portion of edema.

Discuss the effect of water temperature on embalming fluid reaction.

It impacts surface tension. As temperatures rise the surface tension value of a solution decreases. The warmer the water the more the solution would be expected to expedite penetration, preservation and fixation of tissues. The colder the water the slower the formaldehyde reaction which allows for better distribution/diffusion throughout the body.

Why should one avoid excessive massaging of the hands, neck & face on a dehydrated body?

It not only draws additional fluid into these areas but also removes tissue and arterial solution from these areas.

What is one of the leading causes of a postmortem loss of moisture?

Refrigeration, gravitation, and desiccation.