Embalming 2 Final

anatomical guide

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

linear guide

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

anatomical limits

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

linear guide

The _____________ ___________ helps you to locate the place of incision. It can and may be the actual place of incision, but that is not always the case

blunt dissection

Use _________ ________________ to get through the superficial fascia and deep fascia - as well as any adipose tissue

anatomical guide

Locate vessels by using the __________________ _________

transverse incision

what kind of incision is pictured here?

diagonal incision

what kind of incision is pictured here?

longitudinal incision

what kind of incision is pictured here?

"T" incision

what kind of incision is pictured here?

double "T" incision

what kind of incision is pictured here?

wedge incision

what kind of incision is pictured here?

transverse incision

the most common type of incision; made by cutting from the edge of the vessel to its center or slightly beyond the center

diagonal incision

more common method of incision; made by cutting at an angle from the edge of the vessel to its center or slightly beyond its center

sclerosis

the presence of ____________ in an artery makes the vessel more fragile and less elastic

longitudinal incision

begins at the center and runs parallel with the vessel; this method if favored for creating a large opening without compromising the vessel; NOT recommended for sclerotic arteries

T-incision & double T-incision

a combination of the transverse and longitudinal incisions

wedge incision

removed a wedge-shaped portion from the side of the vessel; this method allows the insertion of large diameter instruments; NOT recommended for sclerotic arteries

supraclavicular (anterior lateral)

what type of incision is picture here?

anterior vertical (parallel)

what type of incision is picture here?

posterior vertical (parallel)

what type of incision is picture here?

anterior horizontal

what type of incision is picture here?

semilunar (flap incision)

what type of incision is picture here?

strap line

what type of incision is picture here?

supraclavicular (anterior lateral)

incision is made along the clavicle (collar bone) from a point near the sternoclavicular articulation and is directed laterally

anterior vertical (parallel)

incision is made from a point near the sternoclavicular articulation and is directed superiorly along the sternocleidomastoid muscle

posterior vertical (parallel)

incision is made posterior to the sternocleidomastoid muscle, 2 inches below the lobe of the ear, and is directed downward toward the base of the neck

anterior horizontal

incision is made at the base of the neck from a point on the sternocleidomastoid muscle and is directed posteriorly

semilunar (flap incision)

incision extends from a point lateral and slightly superior to the sternoclavicular articulation and is directed inferiorly, crosses the upper chest in an arc, and is directed superiorly to the opposite articulation

strap line

incision in made approximately 2 inches lateral to the base of the neck on the line where the shoulder strap of a sleeveless garment crosses the shoulder

- common carotid

- femoral (or external iliac if raised by the inguinal filament)

- axillary (or brachial)

the three most common arteries raised for arterial injection:

smaller

__________ arteries are usually reserved for secondary injection sights

internal jugular vein

what vein is the companion to the common carotid artery?

femoral vein

what vein is the companion to the femoral artery?

axillary vein

what vein is companion to the axillary artery?

basilic vein

what vein is companion to the basilic artery?

internal jugular vein

which vein is most commonly used for blood drainage? (hint: it's close proximity to the right atrium of the heart makes it an ideal pairing with any artery selected)

nerves

solid structures lacking the lumen present in both arteries and veins; they have a silvery white appearance with visible striations; if incised, the edges fray similar to the ends of a cut rope

veins

thin walled vessels that contain a lumen; they have a blush appearance when filled with blood; opaque when not blood-filed; have internal valves to prevent backflow of circulating blood

lumen

the opening or inside space of the vessel or other tubular structure

vein

upon mistakenly injecting a _______, the telltale sign is that fluid will not distribute and instead flow back out from the vessel; it will collapse on itself when cut

arteries

thick walled vessels that contain a lumen; the lumen stands open and pronounced when cut; do not have valves which makes them suitable for injection in either direction of the vessel

vasa vasorum (vv)

"vessels on vessels"; tiny blood vessels that supply the large vessel walls with nutrients

case analysis

how do we determine which vessel to raise for injection?

injection; drainage

arteries are used for ______________ while veins are used for _____________

ligatures; fixation forceps

the cannula is placed into the artery and then secured with either ____________ or arterial _____________ _____________

heart; right atrium

desired drainage instruments should be inserted into the vein toward the __________; specifically the _________ ________ if possible

drain tube or angular fixation forceps

these two instruments may be used for drainage:

the right common carotid artery and the right jugular vein

the vessels most commonly used for arterial embalming are:

ANV

the acronym ______ is helpful to describe the relationship of the common carotid artery, vagus nerve, and internal jugular vein

opposite

when accessing the common carotid artery for arterial embalming, turn the head of the body in the direction _____________ that of the vessels bring raised

ligate

to tie off

facial artery

one of the eight branches of the external carotid artery; usually reserved for injection of the facial tissues when the common carotid artery is either damaged or unavailable

axillary artery

in the early years of embalming the __________ ________ was the preferred site to inject the entire body; now it's used principally as a secondary point of injection

right internal jugular vein

this vein is often used for blood drainage as the axillary vein is relatively small and may not evacuate clotted materials

90

when accessing the axillary artery for arterial embalming, the arm must be raised slightly less than ____ degrees from the trunk

brachial artery

continuation of the axillary artery and used principally as a secondary point of injection to reach the forearm and hand

radial artery

originates at the bifurcation of the brachial artery and supplies solution to the lateral side of the hand (thumb)

ulnar artery

originates at the bifurcation of the brachial artery and supplies solution to the medial side of the hand (little finger)

femoral artery

the second more frequently used vessel for arterial embalming; continuation of the external iliac artery and located superficial and lateral to the femoral vein

VAN

the acronym ______ is helpful to describe the relationship of the femoral vein, femoral artery, and femoral nerve

popliteal artery

continuation of the femoral artery and can be used as a secondary injection site when solution has not distributed below the knee

popliteal

the location and size of the _____________ vein makes it unsuitable as a drainage site

anterior and posterior tibial arteries

supply arterial solution directly to the portion of the leg below the knee into the foot

aorta

the largest artery in the body, traveling the length of the torso along the midline; may be selected for infant embalming when commonly used arteries are too small for injection

abdominal and thoracic aorta

either of these can be used for injection following partial autopsy or organ donation

external iliac artery

passes beneath the inguinal ligament and lies on the lateral side of the external iliac vein; supplies solution to the lower extremity and anterior abdominal wall

internal iliac artery

supplies embalming solution to the external genitalia, gluteal muscles and the peroneal regions; following a complete trunk autopsy, it may be accessible from within the pelvic cavity

inferior vena cava

the largest vein in the body; located to the right of the aorta at the posterior abdominal wall; primarily used for blood drainage in cases of partial autopsy or organ donation

right atrium of the heart

the center for venous drainage in the dead human body; routinely (during embalming of a nonautopsied body) a drainage device is inserted into the right jugular vein and guided into this

direct heart drainage

historic method first practiced when embalming was done at the residence of the deceased; today it is recommended for infectious cases to eliminate contact with blood and bodily fluids

- ascending aorta

- arch of the aorta

- descending aorta

- accompanying veins

the parts of the aorta:

brachiocephalic artery

the first branch off of the arch of the aorta; only exists on the right side of the body

right subclavian artery and the right common carotid artery

the brachiocephalic artery bifurcates (splits) into:

- common carotid

- facial

arteries used for injection of the head and neck:

- subclavian

- external iliac

arteries used for injection of the trunk:

- axial

- brachial

- radial

- ulnar

arteries used for the injection of the upper extremities:

- femoral

- popliteal

- anterior tibial

- dorsalis pedis

arteries used for the injection of the lower extremities:

aorta and brachiocephalic

almost all of the arteries we discussed are paired, with the exception of the:

common carotid artery

most common artery used for injection (right); provides direct distribution to the face and is close to the center of circulation (heart); incisions may be visible after dressing; facial swelling may occur (over-injected)

anatomical guide of the common carotid artery

along the medial border of the sternocleidomastoid (SCM) muscle

linear guide of the common carotid artery

from the sternoclavicular articulation to the anterior surface of the lobe of the ear

anatomical limit (right) for the common carotid artery

begins at the level of the sternoclavicular articulation and terminates at the level of the superior border of the thyroid cartilage

anatomical limit (left) for the common carotid artery

begins at the level of the second costal cartilage and terminates at the superior border of the thyroid cartilage

accompanying vein for the common carotid artery

located lateral and superficial in relation to the common carotid artery

• Supraclavicular - along the superior border of the clavicle

• Parallel - along the posterior border of the inferior 1/3 of the sternocleidomastoid muscle

place(s) of incision for the common carotid artery:

internal jugular vein

what is the accompanying vein for the common carotid artery?

anatomical guide for the facial artery

along the inferior border of the mandible, just anterior to the angle of the mandible

anatomical guide for the subclavian artery

the clavicle bone

place of incision for the subclavian artery

along the upper margin of the clavicle, about 1/3 the distance from the shoulder and the root of the neck

anatomical limit (right) for the subclavian artery

begins at the sternoclavicular articulation and terminates at the lateral border of the first rib

anatomical limit (left) for the subclavian artery

begins at the level of the second costal cartilage and terminates at the lateral border of the first rib

linear guide of the axillary artery

through the center of the base of the axillary space and parallel to the long axis of the upper extremity when abducted

anatomical guide of the axillary artery

posterior to the medial border of the coracobrachialis muscle

anatomical limit of the axial artery

begins at the lateral border of the first rib and terminates at the inferior border of the tendon of the teres major muscle

place of incision for the axillary artery

along the anterior margin of the hairline of the axilla

accompanying vein for the axillar artery

located medial and superficial in relation to the axillary artery

axillary artery

artery that is close to the face, center of circulation (heart), and center of venous drainage; vessels are relatively superficial; care must be taken when positioning the arms during injection

linear guide of the brachial artery

from the center of the base of the axillary space to the center of the forearm just below the bend of the elbow

anatomical guide of the brachial artery

artery lies posterior to the medial border of the belly of the biceps brachii muscle