Embalming 2: Lesson 1 - vessel selection

What is the standard term used for the process of vascular embalming?

Arterial embalming

What process is used to determine which vessel to raise for injection?

Case analysis

When considering accessibility for vessel selection, what are two factors related to the physical location of the vessel?

Whether it is superficial or deep, and its proximity to the aorta

Besides age and sex, name three patient-specific factors (out of the 14 listed) that influence vessel selection.

Weight (corpulence), adipose (fat) distribution, and disfigurations

What colors are assigned to arteries, veins, and nerves respectively for identification?

Arteries are off-white, blood-filled veins are bluish, and nerves are silvery white

Which of the three structures (artery, vein, or nerve) does not have a lumen?

Nerve

How do the walls of an artery behave differently than a vein when rolled between two fingers?

Artery walls roll between the fingers, whereas vein walls do not roll

What happens to the structure of an artery versus a vein when it is cut?

An artery stands open when cut, while a vein collapses

Which structure features visible vasa vasorum?

Artery

What defining feature is present in veins but absent in arteries and nerves?

Valves

Define 'Anatomical Guide' as used in vessel selection.

A descriptive reference for locating arteries and veins by means of identifiable anatomical structures

What is a 'Linear Guide'?

A line drawn or visualized on the surface of the skin to represent the approximate location of some deeper-lying structure

Define 'Anatomical Limits'.

Points of origin and termination in relation to adjacent structures used to designate the boundaries of arteries

What is the primary use of the Linear Guide during the vessel raising process?

To help locate the place of incision

How is the anatomical guide used differently than the linear guide?

The anatomical guide is used to locate the artery and vein after the incision is made

What technique is used to move through superficial fascia, deep fascia, and adipose tissue?

Blunt dissection

Why is it recommended to ligate vessels loosely after cleaning them?

To mark the vessels for easier identification

According to the transcript, which vessel incision is considered the most common method?

Transverse Incision

Name the vessel incision that is described as 'triangular'.

Wedge Incision

Besides 'T' and Transverse, what are two other types of vessel incisions listed?

Diagonal Incision and Longitudinal Incision

What instrument is inserted into the artery for injection?

Cannula (arterial tube)

What two tools can be used to secure a cannula in the artery?

Ligature or arterial fixation forceps

What two drainage instruments can be inserted into the vein?

Drain tube or angular spring forceps

In which direction should a drainage instrument be directed within the vein?

Toward the heart, specifically the right atrium if possible

List three specific arteries mentioned that may be used for injection in the next lesson.

Common carotid, facial, and subclavian

What are the four types of embalming mentioned in the lecture?

Arterial (vascular), hypodermic, surface, and cavity.

Which type of embalming is the standard starting point for the embalming process?

Arterial or vascular embalming.

In vascular embalming, the embalmer must raise the artery or arteries for injection and which other vessel for drainage?

The vein.

What tool or process does an embalmer use to determine which vessels will be selected?

Case analysis.

When are the three times an embalmer analyzes the case for vessel selection?

Before, during, and after the embalming.

What two specific things are determined during the case analysis before the embalming begins?

What vessel to use and what solution will be used.

What might be adjusted during the embalming process based on the case analysis?

Raising additional arteries for injection or adjusting the embalming solution.

What is determined after the embalming process is complete?

If there is a need for hypodermic or surface embalming.

What does the term 'superficial' mean regarding vessel depth?

Easy to access and close to the surface.

What does the term 'deeply seated' mean regarding vessel depth?

Far below the surface and more difficult to access.

Why should an embalmer be careful not to cut the sternocleidomastoid muscle when raising the common carotid?

It gives a particular shape to the neck, and cutting it reduces a natural form.

Which vessel is considered the center of circulation for the body?

The aorta.

Why are larger vessels like the common carotid or femoral artery preferred for whole-body embalming?

They allow for enough fluid injection at a particular rate of flow and pressure to achieve good distribution.

What is a primary disadvantage of using smaller vessels for injection?

They cannot withstand as much pressure and will take much longer to embalm the body.

If an incision is made in a viewable area, what techniques should be used to conceal it?

Restorative art techniques or particular suture techniques.

What is the concern regarding posing the body in relation to vessel incisions?

The incision should not be in a place where tension will compromise the integrity of the closure.

Which two veins are considered the best choices for taking drainage?

The jugular vein and the femoral vein.

Between the jugular and femoral veins, which provides better drainage?

The jugular vein.

What can occur to the color of the body if blood is not sufficiently removed during injection?

The body can turn a gray color, known as embalmer's gray.

What reaction causes 'embalmer's gray'?

Formaldehyde in the embalming fluid reacting with leftover blood in the body.

What condition common in older individuals may make the femoral artery a poor first choice for injection?

Arterial obstruction or occlusion due to the artery being sclerotic.

Which artery is usually not affected by sclerosis even when the femoral artery is?

The common carotid artery.

Why is raising a femoral artery more difficult in obese individuals?

Because of the layer of adipose tissue on top of the muscle.

What is the danger of putting too much tension on an artery while trying to pull it to the surface in an obese body?

The danger of snapping the artery in two.

What effect does trauma, such as a motor vehicle accident, have on vessel selection?

Vessels may be severed or dissected from their normal anatomical locations.

How does organ and tissue procurement typically affect an embalmer's work?

It disrupts circulation from the aorta, potentially requiring a six-point injection.

Which medical treatment is noted for being very hard on the vascular system?

Chemotherapy.

What three types of structures must an embalmer be able to distinguish between before an incision is made?

Arteries, veins, and nerves.

Proper drainage can only be taken from which type of vessel?

A vein.

Does an artery have a lumen?

Yes.

How is the color of an artery described?

Off-white or creamy colored.

How is the color of a vein described when it is filled with blood?

Bluish.

How is the appearance of a nerve described?

Silvery, shiny, white color.

What are 'vasa vasorum'?

Little blood vessel looking specks or lines visible on the outside of an artery wall.

Which structure is solid and lacks a lumen?

A nerve.

Describe the difference in vessel wall thickness between an artery and a vein.

The artery has a thick vessel wall; the vein has a thin vessel wall.

What is the 'noodle' test for identifying an artery?

The vessel walls of an artery will roll between two fingers, feeling much like a noodle.

Why doesn't a vein roll between the fingers?

It lacks enough thickness or structure.

What happens to an artery when it is incised?

It will stand open.

What happens to a vein when it is incised?

It will collapse.

How do nerve fibers react when they are cut?

They fray like a rope.

Which of the three structures (artery, vein, or nerve) contains valves?

The vein.

Are arteries usually filled with blood?

No, they are usually not blood filled.

What is an anatomical guide?

A descriptive reference for locating arteries and veins by means of identifiable anatomical structures.

What is a linear guide?

A line drawn or visualized on the surface of the skin to represent the approximate location of deeper lying structures.

What are anatomical limits?

Points of origin and termination in relation to adjacent structures used to designate the boundaries of arteries.

What is the purpose of anatomical limits?

To designate the boundaries of the arteries.

What should be done if the vessel to be raised is in a particularly hairy area?

The area may be shaved.

What is the difference between an aneurysm hook and an aneurysm needle?

The aneurysm needle has a hole in the end of the hook for threading ligature, while the aneurysm hook does not.

What is a common length used for cutting ligature for ligation?

$6$-$8$ inches.

Which technique is used to move through superficial and deep fascia?

Blunt dissection.

Describe the motion used for blunt dissection with aneurysm hooks.

A slow side-to-side, back-and-forth motion using the pointer fingers for control.

Why must vessels be 'cleaned' after they have been isolated?

To prevent them from being too constricted for instrument insertion and to allow for better movement.

What is the best practice for securing ligature around a vessel during raising?

Have two pieces of ligature loosely secured around each vessel.

What does ligation allow for during the procedure?

It allows the vessel to be tied above and below the incision to protect against fluid leakage.

Which vessel incision type is considered the most common?

The transverse incision.

Where is a transverse incision made on a vessel?

Across the vessel, often from the side to approximately the middle.

What can happen if a vessel is cut too far during incision?

The vessel may separate and retract into the body.

Why shouldn't an incision in an artery be made larger than necessary?

It weakens the artery and may compromise its integrity to remain intact.

How is a T incision made?

By making a horizontal and vertical incision that meet in the center to form a capital T.

What is the difference between a T incision and a double T incision?

A double T is shaped like a lowercase 't' with the vertical incision extending above and below the horizontal one.

What is a longitudinal incision?

A vertical incision made in the middle of the artery.

How is a wedge incision performed?

By cutting a V-shape or triangular wedge out of the side of the artery.

What is the maximum recommended depth for the apex of a wedge incision?

Approximately $\frac{1}{3}$ of the width from the side.

How is the arterial tube secured once inside the artery?

By ligature or arterial hemostats (fixation forceps).

What is another name for arterial hemostats?

Arterial fixation forceps.

Why must the arterial tube be secured?

To keep it from sliding out once the embalming solution is flowing under pressure.

Which vein is best for drainage because of its access to the right atrium?

The jugular vein.

What is likely the most common drainage instrument used in the industry?

Angular forceps.

What is a primary benefit of using a drainage tube over angular forceps?

The ability to close drainage to build pressure.

How does building pressure with a drainage tube help the embalming process?

It forces arterial solution through the vascular system and helps force out clots.

How does a drainage tube reduce exposure to bloodborne pathogens?

By directing drainage through a hose and into a drain or channel.

Where can a student find examples of vessel incision types?

In the textbook and on slides $12$ through $14$.

What will be covered in the week two lesson?

Specific anatomical guides, limits, and linear guides.

Why is it important to recite information according to the lecture?

If you read it, write it, and recite it, you are more likely to retain it.