Embalming II Chp. 21, 22, & 23

Proper moisture balance

A major objective of the embalming process should be to establish or to maintain ______________ in the dead human body

There are 3 moisture conditions:

1. Normal Body Moisture

2. Dehydration

3. Edema

For the average 160 lbs. male adult- the total body water:

Normal to obese: 55%- 60%

Thin bodies: Approx. 65%

Females: 10% less than males

Normal to obese: 45%-50%

Thin bodies: Approx. 55%

Dries

Formaldehyde _______ tissues- the embalmer must add moisture to the normal body. This is why so much water is used to dilute arterial fluid

For Dehydration:

1. Follow the dilution recommendations by the manufacturer. Strengths of 0.75% to 1.5% will add moisture

2. Use Intermittent drainage which will help to distribute and diffuse the arterial fluid

3. Slower injection- solution is better distributed and less tissue fluid is withdrawn

4. If refrigeration before embalming -cover with a Plastic Sheet to prevent dehydration

5. Use Non-absorbent cotton to set the features

6. Warm water solutions increase fluid reaction. Cool Solutions slow the formaldehyde reaction and allows for better distribution and diffusion

7. After embalming- Cover the body to prevent circulating air from dehydrating the surface

8. Massage cream & cream cosmetics help to reduce moisture loss to the atmosphere

9. If there is a long delay between embalming and viewing, do not excessively Do not excessively elevate the head during storage because the liquids will gravitate from the facial tissues

10. Using too much Humectant can have the opposite effect of drying the tissues

Cosmetics; Dyes

Darkened skin— corrected by ________ ; use fluid _______ to ensure fluid distribution

Massage cream; Cream cosmetics

Flaking skin— Apply _________ and then clean with a solvent to remove all loose skin; use _____________

Dyes

Firm skin— skin feels embalmed; use additional _______ to trace the fluid distribution

Wax; Tissue building; Opaque cosmetics

Desiccated lips, eyelids, or fingertips— May need correction with __________, ___________, and ___________

Opaque cosmetics ; Tissue builder

Dehydration of large facial areas from embalming and air flow over the body—- Use massage cream before cosmetics application; ___________ may be needed to cover discolorations; may need ____________

Desiccation; Not viewable

___________ is extreme dehydration. Desiccated bodies are ___________

More slowly

Dehydrated bodies decompose __________ and desiccation is a form of preservation

Desiccated

Desiccated lips appear black, very wrinkled, shrunken, drawn back and the teeth are exposed. The tips of the fingers turn yellow-brown. The thin areas, such as the ears, nose and eyelids, are easily:

Edema

The abnormal collection of fluid in tissue spaces, serous cavities, or both

Edema can be found in 3 body sites:

1. Intracellular — within the individual cells

2. Intracellular — within the spaces between the cells

3. Within the Body cavities

Edema can be local or generalized

Local— ex. heart surgery or aortic repair— the face and head can be grossly swollen, but the trunk and limbs may display no edema

Generalized (Anasarca) — swelling of the whole body

Solid; Strong arterial

_________ edema — within the cells; must be excised for reduction (but this is not recommended). Could be caused by an allergic reaction or extended use of corticosteroids. Use _________ solution with a co-injection

Pitting

_________ edema— between the cells; may be moved by gravity or punctured and drained; use strong arterial solution; hypodermic and surface embalming; and plastic garments

Anasarca

Generalized edema in all body tissues; treat the same as pitting edema

Edema of the face:

Restricted cervical injection; Strong arterial solution; may use salt solutions or high-index to reduce swelling; Elevate head, Channel the neck with trocar; surface Weights for eyes and lips; surface and hypodermic embalming

Edema of the hands

Possible leaking from I.V. punctures; Wrinkles after edema is removed; sectional injection using the Axillary artery; surface packs with cavity fluid; Bleach discolorations; Elevate to gravitate edema into the arm

Edema of the legs

Dilution of arterial solution & Leakage are problems; sectional injection from the Femoral or External Iliac arteries; Strong arterial solution; Salt solutions: hypodermic & surface embalming; Elevate to gravitate; puncture and drain; plastic stockings with embalming powders

Alveoli

Pulmonary Edema — in the ________ of the lungs; creates purge; aspiration and injection of the lungs

Purge; Neck & Face; Facial Distention

Hydrothorax— may create _________; pressure can cause venous congestion of ________ and __________; dilution of cavity fluid; aspiration and injection of cavity fluid

Stomach; Anal purge; Pre-embalming

Ascites— can cause _________ and __________; dilution of cavity fluid; __________ drainage; aspiration and injection of undiluted cavity fluid; re-aspiration & reinjection recommended

Drainage problems

Hydropericardium—pressure can cause __________; dilution of cavity fluid; aspiration and injection of undiluted cavity fluid

Channel; Plastic garments; Embalming powders

Hydrocele— leakage; dilution of arterial solution; __________ with trocar; surface embalming; ________ and __________

Via the ethmoid foramen; inject cavity fluid

Hydrocephalus— can create purge in infant; drain ____________via the ethmoid foramen

Embalming Complications Associated with Renal Failure:

1. Decomposition occurs rapidly

2. Acidosis alters the reaction between proteins and the preservative

3. The body appears sallow (an unhealthy yellow or brown color) because of the altered reaction between the proteins and the preservative

4. Sites of gastrointestinal bleeding may be sites of Arterial Fluid Loss and sources of Purge

5. Edema dilutes the arterial fluid

6. Uremic wastes in the blood and tissues neutralize preservatives

7. Skin infections may be caused by uremic Pruritus

Burned Bodies

- Especially 2nd degree, bodies are often so grossly distended with Edema that the face is not recognizable

-Restricted cervical with drainage from the right internal jugular vein is recommended

-Waterless or Very strong arterial solution with dye should be used.

-Leakage is the major problem. Use hypodermic and surface embalming and allow to air dry before placing in a unionall with embalming powders

Blood Vascular

The ________ is the distribution route for the embalming solution. Any pathological or traumatic change that obstructs or breaks open this delivery system either completely blocks or reduces the flow of arterial solution to a body region

Arteries

_______carry arterial solution to the capillaries

Body cells; Cellular proteins

At the capillaries, some of the arterial solution will leave the vascular system to enter the interstitial spaces, where it will come into contact with the ________ and ________

Veins; Drainage

The solution remaining in the vascular system travels into the ______ and helps push the blood from the body in the form of _________

Arteries have 3 layers:

1. Intima— the inner lining of endothelial cells which lines the entire blood vascular system and composes the walls of the capillaries

2. Media— the middle layer composed of muscles cells and elastic tissue

3. Adventitia— The outer layer, composed mostly of connective tissue

2; Cardiovascular

In the United States, one in every ______ deaths is attributable to __________ disease

The embalmer encounters 3 types of arteriosclerosis:

1. The inner wall of the artery is hardened and thickened, but the lumen is Open and Large

2. The lumen is small and pushed to one side; a small arterial tube can be used

3. The artery is completely occluded and Cannot be used for injection

Embalming treatments for arteriosclerosis:

• Increase the Strength of the solution

• Use a Co injection chemical to aid in distribution

• Begin injection using a Very slow rate of flow

• When multipoint is required, use Higher pressure and Pulsation

• Lower the hands over the table and Gently massage to aid distribution

• Use the Common Carotid and Internal jugular for the initial injection & drainage

Fluid Distribution

A ruptured aortic aneurysm can seriously affect ________ in the un-autopised body

Embalming treatments for ruptured aortic aneurysm

• Use a Strong arterial solution with additional dye as tracer

• Inject Slowly

• If there is drainage, Continue to inject

• If there is no drainage and the abdomen beings to swell, Stop the injection and institute Multipoint injection

• If surgical repair of the vessel was performed, Extreme facial edema can often accompany this repair

Center of arterial fluid circulation

Because of the position of the aortic semilunar valve; the aorta is considered the ___________

Left atrium; Lungs

If the aortic semilunar valve and the mitral valve are damaged; the _______ would fill with arterial fluid and that fluid would pass through the pulmonary veins back into the capillaries of the _________

Lung purge

The volume and pressure created by the fluid from the heart and the fluid from the bronchial arteries may cause