Science section Bootcamp

3 positioning levels are suggested for decedent

• The highest level is the head

• The middle level is the chest (anterior thoracic wall)

  • The lowest level is the abdomen (anterior abdominal wall) 

scalpel

• A knife with a small, sometimes detachable blade

• Used to make incisions to raise vessels

  • Also used to make excisions

formaldehyde advantages

• Inexpensive

• Bactericidal

• Inhibits yeast/mold growth

• Rapidly destroys autolytic enzymes

  • Inhibits tissue decomp

HCHO disadvantages

• Rapidly coagulates blood

• Constricts capillaries

• Dehydrates tissues

• Unpleasant odor

  • Eye, nose, skin, and throat irritant

preservatives

•  chemical substances that inactivate saprophytic bacteria of the body. Alter the tissues to make them less susceptible to decomposition 

paraformaldehyde

• Polymer of formaldehyde

• Usually used in powdered form for hardening compounds. It’s essentially formaldehyde with the water removed with distillation leaving a powder

  • Harsh odor

phenol

• AKA carbolic acid

• Can be used as a cauterant or bleaching agent

• Germicide

• Strong odor

• More expensive compared to HCHO

  • Because it’s a strong mold inhibitor it’s ideal for use in anatomical cases

trioxane

• Prepared through evaporation and distillation processes like paraformaldehyde (results in a white powder) 

• Also used in hardening compounds

• Smells like chloroform 

  • Very expensive 

glutaraldehyde

• Can treat protein structures over a wide pH

  • When it combines with proteins/tissues, it makes them less susceptible to decomp (works better than HCHO) 

• A better disinfecting alternative

• Very expensive 

distribution of fluids

• Ascending aorta/aorta are the center of arterial distribution

• The arch of the aorta is a continuation of the ascending aorta which begins at the left ventricle

• As embalming solution enters the left ventricle of the heart, the ascending aorta fills up and causes the aortic semilunar valve to close

  • Once the semilunar aortic valve closes, the arteries of the body begin to fill with embalming solution

pressure filtration

•  caused by intravascular pressure/considered one of the most important passive transport mechanisms

osmosis

• - passive transport involved with liquid/solvent movement. It involves the passage of solvent (aka water) through a semipermeable membrane from a dilute to a concentrated solution. 

  • Embalming solutions and interstitial fluid are separated by the walls of the capillaries which are semipermeable 

dialysis

• - the mechanism responsible for the diffusion of the dissolved crystalloid solutes of a solution through a semipermeable membrane

  • Crystalloids: very small solutes (salts, preservatives, germicides) 

stomach trocar guide

•  direct the trocar point toward the intersection of the 5th intercoastal space and left midaxillary line

cecum trocar guide

• direct the trocar a point of ¼ of the distance from the right anterior superior iliac spine to the pubic symphysis

agonal algor

• cooling/decrease in body temp before death (common when death is slow, metabolism/circulation is slow) 

agonal fever

• - increase in temp before death, common with infection and elevates microbial growth

algor mortis

• - postmortem cooling of body over time 

decompostion order

1. Carbs

2. Soft proteins - proteins that line gastrointestinal tract, and proteins that form the liver,brain and kidneys

3. Fats

4. Hard proteins - collagen, keratin, muscle proteins

   1. Bones 

amino acids

building block of proteins, increases HCHO demand

rigor mortis

• Postmortem stiffening of the body muscles by natural body process

• Not uniform

  • Begins in the eyelids

ID for unembalmed remains

• head/showders of decedent should be elevated when placed in cooler

• Should receive permission to do minimum care such as setting features of unembalmed decedent

• What can be done without permission on an unembalmed person?

  • Comb hair, clean nails, disinfect decedent 

removal before embalming

• feeding/air passageway tubes

• Tracheotomy tubes

  • Urinary catheter

remove before/after embalming

• Abdominal feed tubes

• Surgical drains

  • Colostomy

remove after embalming

• Intravenous catheters 

• Temporary metal sutures

• Radioactive seeds (brachytherapy) should be removed by

  • Medical professionals

plastic pants

• - plastic garments covers the torso, from the lower abdomen to the upper thigh: use for decubitus ulcer, anal purge

coveralls

• - plastic garments covers the trunk from the upper thigh to the axillary space: use decubitus ulcer, anal purge (use: vertebral recovery) 

stockings

•  plastic garments are used to cover the legs/feet of the dead:( use for femur/tibial donor, edematous leg)

sleeves

•  plastic garment is used to cover the upper arm to the wrist of the dead

shirt jacket

•  plastic garment is used to clever the upper torso from the neck to the waist, including the arms.( Use leakage of proximal humerus and scapular donor)

capri pants

•  plastic garment is a combo of pants/stockings

unionalls

• - plastic covers the entire body except for the head, neck, and hands. Use skin donors (use for vertebral recovery, skin donors) 

clothing colors for those who have jaundce

• Peach

• Pink

• Maroon

• Gray 

  • AVOID - blue, green, or violet

Colors and cosmetizing

Most difficult background for a cosmetized body

• White 

Suggested color for normal skin color after makeup

• Gray 

refrigeration for decedent temps

 35 to 45 degrees fahrenheit (1.6 to 4.4 C) 

• If decedent is being stored for delayed viewing check on them every 3-4 days

air tray

•  casketed remains

  • The casket bed should be at its lowest position with the feet at the furthest end of the casket

    • Flip pillow over/place heavy layers of cotton around the head/face of the dead

combination case

•  uncasketed remains 

  • The dead should be dressed in at least a hospital gown and wrapped in a sheet for easy removal

unembalmed remains for shipping

• May be shipped with dry ice or ice packs 

embalming infant techniques

• Use of aorta or ascending aorta

• Drainage can be taken from the right auricle of the heart (the small ear-like appendage of the right atrium of the heart) clip open the auricle to allow drainage

  • Use at least medium strength fluid for arterially embalming because of their high water content

formaldehyde standard

• 0.1 ppm - irritations to the mucosa of the eyes, nose, throat

• 100 ppm - immediately dangerous to life/health

• Action level - concentration of 0.5 ppm of HCHO calculated at an 8 hour TWA concentration as defined by OSHA

• STEL - 2 ppm which is the max exposure during a 15 minute period

• PEL - HCHO in the workplace is 0.75 part HCHO ppm as measured as an 8 hour TWA

  • 8 hour TWA should be monitored in the prep room during peak activities

    • The STEL for HCHO should be monitored during an actual embalming 

eye proportions

• The face is 5 eyes wide arch from zygomatic bone to zygomatic bone

• The distance between the eyes is = to the the width of 1 eye

  • The mouth is 2 eyes wide

nose proportions

• The face is 3 noses long

• The length of the nose is = to the length of the ear

  • The width of the nose at the wings is = width of an eye

ear proportions

• The superior border of the ear is on the same horizontal plane as the eyebrows

• The inferior border of the ear is on the same horizontal plane as the base of the nose

  • The face is 3 ears long

facial proportions that are all equal

• Ear passage to the tip of the nose

• Eyebrow to the base of the chin

• Hairline to the base of the nose

• Ear passage to ear passage

• Also the height of an adult is 7-8 heads tall

  • The width of the face is ⅔ the length of the face

hypodermic nose tissue building

bridge of the nose

inside the nose

hypodermic tissue building for ears

lobe and behind top of the helix

hand hypodermic tissue building

fingers

back of the hand

sides

cheeks hypodermic tissue building

• Behind the wing of the nose

• Corners of the mouth

• Outside the ear behind the lobe

• Inside the ear behind the tragus

  • Angle of the jaw

Lips tissue building

lateral corners at the end of the line of closure

behind the medial lobe

convex profile

• Forehead recedes posteriorly from the eyebrows, while the chin recedes from the plane of the upper lip (most common types) 

concave profile

• The forehead protrudes beyond the eyebrows, and the chin protrudes beyond the plane of the upper lip (least common) 

orange

warmest hue

blue

coolest hue

Adding achromatic colors to regular colors

• Tint - color + white

• Tone - color + gray

  • Shade - color + black

heart layers

• Endocardium - innermost layer

• Myocardium - muscular layer (responsible for pumping action) 

  • Epicardium - outerlayer (AKA visceral pericardium) 

pulmonary circulation

• Starts in right ventricle (poorly oxygenated blood) 

  • CO2 needing to be unloaded is taken to the lungs

• Ends in left atrium 

pulmonary circulation order

1. Right ventricle

2. Pulmonary semilunar valve

3. Pulmonary trunk 

4. Right/Left pulmonary arteries

5. Right/Left lungs

6. Right/Left pulmonary capillaries

   1. Unload CO2

   2. Load oxygen 

7. R/L pulmonary veins

   1. Left atrium 

systemic circulation

1. Begins in left ventricle

   1. Oxygen rich blood

2. Circulates through body nourishing cells, tissues, etc.

3. Picks up waste products

4. Ends in right atrium 

   1. Center of drainage in the dead human body 

order of systemic circulation

1. Left ventricle 

2. Aortic semilunar valve 

3. Ascending aorta

4. Systemic arteries

5. Arterioles

6. Capillaries

7. Venules

8. Systemic veins

9. inferior/superior vena cava

   1. Right atrium 

stages of rigor

1. Primary flaccidity (pre-rigor)

   1. Before the body experience rigor mortis

   2. Preferred time to embalm

2. Active rigor

   1. Seen 2-4 hours after death, fully established within 6-12 hours

   2. Body absorbs little preservative

   3. Preservative demand is higher 

3. Secondary flaccidity (post-rigor)

   1. Seen 36 hours after death

   2. After the body experience rigor mortis

      1. Preservative demand is highest

direct transmission of disease

• Physical contact

• Droplet infection

• Aerosol

  • Congenital

indirect transmission of disease

• Food 

• Fomite

• Water

• Soil

• Vectors: biological/mechanical 

fomite

• Any inanimate object that harbors disease agent and may serve to transmit it 

biological vector

• An infected arthropod in which the disease-causing organism multiples/develops within the arthropod prior to becoming infective (malaria - parasite develops in the female mosquito before it’s transferred to an animal) 

mechanical vector

• A vector in which the growth and development of an infective agent don’t occur. Housefly may transmit typhoid fever by picking up infectious agents, but doesn’t become infected

endemic

• a disease that’s always going to be present in a given population

epidemic

• higher than normal appearance of an infectious disease/condition within a given population

pandemic

widespread epidemic, possibly worldwide

mortality rate

• number of deaths in a given time or place/proportion of deaths to a population 

morbidity rate

•  - relative incidence of a disease in the population or number of cases in a given time in a given population