Embalming II 2405.2 - Exam 2

one-point injection

type of injection that embalmers hope to achieve; injection and drainage from a single location; customarily selected as the primary injection technique

- R common carotid artery and R internal jugular vein

- R femoral artery and R femoral vein

- R axillary artery and R axillary vein

the most frequently selected vessels for one-point injection include:

split injection

injection of solution from one site with drainage from a different site; this method reduces short-circuiting of the solution and establishes a uniform distribution

- right internal jugular vein (drainage)

- right femoral artery (injection)

the most frequently used combination of vessels in the split injection method:

multi-point injection

injections from two or more sites; an additional site is identified to supplement the primary injection site when arterial solution cannot reach a particular area or when the area is insufficiently preserved

multi-point injection

autopsied cases are always __________-_________ cases

restricted cervical injection

raising both right and left common carotid arteries for injection; allows for the head to be injected separately

restricted cervical injection

beneficial when swelling of the face is a concern

internal jugular vein

normally the _________ __________ vein is used for drainage during restricted cervical injection

sectional embalming

type of multi-point injection; different sections/regions of the body are embalmed separately using specific arteries

sectional embalming

beneficial for difficult cases (ex: decomp)

pressure

the action of a force against an opposing force; a force applied or acting against resistance

whatever pressure is necessary to overcome vascular resistance and properly distribute embalming solution to all areas of the body

the recommended pressure when embalming:

gravity injection

provides a slow, steady method of injection that allows the body to accept the embalming solution at a slower rate; historical/antequated method of injection

percolator

large glass reservoir that has a delivery hose attached to the bottom of the bowl

foot

approximately, one-half (0.43) pound of pressure is obtained for each ________ of height the device is raised above the injection point

.5

when estimating, used ____ pounds instead of the more precise .43 pounds

hand pump

this method is historical and consists of utilizing a hand-operated pump and tubing; this apparatus can be used for aspiration as well (but it would be very slow)

bulb syringe

historical method; the simplest form of injection apparatus; consists of a bulb-type rubber syringe and tubing (think of a baby’s nose sucker)

air pressure

works like a hand pump but is mechanical/electric; historically, these machines were very dangerous to use and difficult to operate; not commonly used in the US

centrifugal force machine/pump

the most commonly used method of creating injection pressure today; this is the modern embalming machine

- pulsating - fluid is injected in spurts

- non-pulsating (direct) - fluid is injected on a continuous basis

- automatic pressure control

three common types of centrifugal force pumps:

rate-of-flow

the speed at which fluid/solution is injected

ounce per minute

rate-of-flow is measured in:

potential pressure

indicated by the injector gauge needle when the embalming machine is running, and the rate-of-flow is closed (what you want the pressure to be)

actual pressure

indicated by the injector gauge needle when the arterial tube is open, and the arterial solution is flowing into the body (what the pressure actually is when you start injecting)

differential pressure

difference between potential and actual pressure

drainage

the other half of standard arterial embalming

1. drain tube

2. angular spring forceps

3. trocar (for heart tap)

the three drainage instruments:

(primary)

- alternate

- intermittent

- concurrent

(other/last resort)

- direct heart drainage

the four drainage methods:

alternate drainage

with this method, arterial solution is never injected while drainage is done; alternate between injecting and draining but never do both at the same time

intermittent drainage

injection is done continuously, but drainage is only taken at certain intervals; compromise between alternate and concurrent; helps prevent short circuiting

concurrent drainage (continuous)

injection and drainage proceed at the same time throughout the entire embalming procedure; the least effective drainage method

direct heart drainage (aka heart tap)

drainage method in which a trocar is inserted (from the normal entry point) directly into the right atrium of the heart and drainage is taken through the trocar; recommended only in special situations where a vein cannot be used for drainage

alternate drainage

the most effective drainage method:

• Select a large vein

• Select a large drainage instrument

• Use pre-injection when possible

• Use manual massage during injection

• Increase rate-of-flow and/or injection pressure

• Select an alternate drainage site if needed

• Use intermittent or alternate forms of drainage (restricting drainage is beneficial and creates vascular pressure)

7 ways to improve drainage:

blood, blood clots, interstitial fluid, lymphatic fluid, embalming solution

drainage is composed of:

- rigor mortis

- gas in the cavities

- contact pressure

- tumors and swollen lymph nodes

- bandages

- skeletal edema

extravascular influences affecting injection pressure include:

- condition of the vessels (normal/schlerotic)

- local congestion or coagulation of blood

intravascular influences affecting injection pressure include:

primary dilution

strength of the arterial solution mixed in the embalming machine

C x V = C^1x V^1

to determine strength of the primary dilution, we can use the equation:

unmixed arterial fluid in the bottle

the left side of the primary dilution equation represents:

mixed solution in the embalming machine

the right side of the primary dilution equation represents:

secondary dilution

decrease in concentration of arterial solution by vascular and interstitial fluids

concentration

the "C" variables stand for:

volume

the "V" variables stand for:

16

____ ounces in a standard embalming fluid bottle

128

_____ ounces in a gallon

3

most embalming machines hold ___ gallons

hypotonic solution

solution having a lesser concentration of dissolved solute than the solution to which it is compared

hypertonic solution

solution having a greater concentration of dissolved solute than the solution to which it is compared

isotonic solution

solution having an equal concentration of dissolved solute as the solution to which it is compared

pressure filtration

passive transport system enabling the passage of arterial solution from the capillary to the tissue fluid; movement from an intravascular to an extravascular position

osmosis

passage of pure solvent from a solution of lesser concentration to one of greater solute concentration when the two solutions are separated by a semipermeable membrane

dialysis

separation of substances in solution on the basis of differences in their ability to pass through a semipermeable membrane

gravity filtration

extravascular settling of preservative fluids by gravitational force to the dependent areas of the body; occurs naturally and without action of the embalmer

hypotonic

a _______________ solution will move toward the more concentrated solution – to try and create a state of balance/equilibrium between the two

hypertonic

a ________________ solution will not move. Instead, the other solution will move toward it to create the balance/equilibrium

hypotonic

hypertonic

isotonic

• Distention of superficial vessels

• Large volume of blood drainage

• Reduction of intravascular blood discolorations

• Dye tracing (dye seen in tissues)

• Loss of tissue elasticity (firming)

• Drying of the tissues

• Rounding and distention seen in the lips, fingertips, and toes

• Bleaching/mottling of the tissues

(8) signs of distribution and diffusion:

• Increase rate-of-flow

• Increase injection pressure

• Inject using the pulse function

• Restrict drainage (to increase vascular pressure)

• Massage the body

• Inject a greater total volume of solution

• Relieve any extravascular pressure

(7) ways to improve distribution and diffusion:

distribution

the movement of embalming (arterial) solution from the point of injection throughout the arterial system and into the capillaries

diffusion

the movement of embalming (arterial) solution from within the vascular system through the capillary walls and into the tissue spaces