Part 2- Embalming Process

Question 1

• Open thoracic, abdominal, pubic and cranial cavities.
• Remove any gauze packings or any foreign material from the cavities (instruments)
• Remove viscera and put into viscera bucket
• Aspirate cavities and wash remains with warm, soapy water.
• Inject the lower extremeties first
• Inject the arms

Answer 1

Autopsies or Postmortem Examinations

Question 2

• Open viscera with long scissors or long blanded knife (bistoury knife).
• Pour carefully any liquid from viscera into aspiration sink.
• Pour 1-3 bottles of cavity fluid over viscera, be sure to mix fluid and viscera thoroughly, then cover bucket.
  
  • If brain is left in the body, then it should be included with the viscera for treatment.

Answer 2

Remove Viscera and put into viscera bucket

Question 3

Prepare solution in machine and connect “Y” connection with two cannula tubes.

Answer 3

Aspirate all three cavities and wash remains with warm, soapy water.

Question 4

• Locate the bifurcation of the common iliacs just to the left of the lower spine at the termination of the aorta.
• Put a cannula in each branch of the “Y” into the right and left external iliacs.
• Be sure the internal branch of the common iliacs is tied or clamped off. (if not, fluid will leak into the pubic cavity)
• Locate the bifurcation of the common iliac veins just to the right of the lower spine and at the termination of the inferior vena cava.
• After observing a substantial amount of fluid in the drainage, clamp or tie off the vein; this will allow the penetration of fluid into the surface tissue. Create back pressure.
• Aspirate cavity after you are sure the legs are throughly embalmed.

Answer 4

Inject the lower extremities first

Question 5

Pose the features at the same time you inject the lower extremeties.

Answer 5

If you have more than one person

Question 6

• If possible, inject the arms from inside the thoracic cavity either from the arch of the aorta if intact or the subclavian arteries.

Answer 6

Arteries used for injecting the upper extremties for autopsied bodies.

Question 7

• Be sure you extend the arms outward and open the hands and flex the fingers to stimulate circulation.
• Encourage drainage by massage (toward the heart).
• After observing a substantial amount of fluid in the drainage, clamp or tie off the axillary or subclavian vein. This will allow penetration of fluid into the surface tissue (mottling)

Answer 7

Injection of the arms

Question 8

Medical Examiner (Medico-legal) or hospital

Answer 8

Types of Autopsies

Question 9

Concerned with the cause of death.

Answer 9

Both hospital and medical examiner autopsies

Question 10

Concerned with the manner of death.

Answer 10

Medical Examiner Autopsies (Medico-legal)

Question 11

Does not need permission for an autopsy.

Answer 11

Medical Examiner

Question 12

• Natural
• Homicide
• Accident
• Suicide
• Other
• Undetermined

Answer 12

Manner of Death

Question 13

Forces arterial solution into the tissues and cells.

Answer 13

Back Pressure

Question 14

An embalming instrument which is a one piece scalpel used for making incisions and excisions.

Answer 14

Bistoury

Question 15

Inject the head from these arteries.

Answer 15

Left and Right Common Carotid Arteries

Question 16

Never inject the head ______.

Answer 16

Simultaneously

Question 17

Inject this side of the head first.

Answer 17

Left

Question 18

Never inject the head with more than the ______ amount of pressure or rate of flow.

Answer 18

Minimum

Question 19

Before this, throughly cream the forhead; open cranial incision; remove the calvarium; have two small hemostats ready to clamp off the severed ends of the internal carotid arteries.

Answer 19

Posing Features

Question 20

The dome-like superior portion of the cranium; that portion removed during cranial autopsy.

Answer 20

Calvarium

Question 21

Start injection of the head only after _______.

Answer 21

Features are posed

Question 22

After you see fluid and only fluid leaking from the severed ends of the internal carotid arteries, ___________.

• These severed ends are found in the area desginated as the sella turcica, in the center and at the base of the cranial cavity.

Answer 22

Clamp them off with small hemostats

Question 23

In the center and at the base of the cranial cavity.

Answer 23

Sella Turcica

Question 24

Have hemostats read to clamp off any leakage from the severed branches of the carotid arteries.

Answer 24

Remain aleart for leakage in the neck along the channel of the carotid arteries.

Question 25

Often because of the inexcusable carelessness of certain \_\_\_\_\_\_\_\_\_\_\_, these arteries are mutilated beyond use and it comes necessary to hypodermically inject the face with fluid.

Answer 25

Pathologists

Question 26

Because of this, it becomes necessary to hypodermically preserve the sidewalls and flaps of both the thoracic and abdominal cavities. * Mix 1-2 gallons of strong solution in embalming maching. * Proportionally keep your pressure higher than your rate of flow; make these adjustments before embalming.

Answer 26

The descending aorta is often removed

Question 27

Connect this or a small trocar to pliable rubber embalming machine hose; be sure your instrument is sharp.

Answer 27

Hypo-valve Trocar (parietal needle)

Question 28

The person who invented the trocar.

Answer 28

Rogers

Question 29

The hypo valve trocar has a button and is smaller in size.

Answer 29

Difference between a trocar and a parietal needle

Question 30

Embalming instrument used to hypodermically inject areas of the body with embalming chemicals.

Answer 30

Parietal Needle (Hypo-valve Trocar)

Question 31

Inject all areas that \_\_\_\_\_\_\_\_\_\_\_. Do not forget to inject shoulder area, back side walls, front flaps, and reproductive organs.

Answer 31

Did not recieve fluid from arterial injection

Question 32

At this time, clean maching by running 6 gallons of water through it; clean all instruments and put them away. Leave water in machine.

Answer 32

After Injection

Question 33

Aspirate or _____ out all cavities.

Answer 33

Sponge

Question 34

Use this kind of needle with double strand suture cord to suture abdominal, pubic and thoracic cavity.

Answer 34

"S" Shaped Needle

Question 35

Liberally sprinkle _________ throughout the thoracic, abdominal and pelvic cavity.

Answer 35

Hardening Compound

Question 36

Fill cavities with ______ cotton or saw dust or return preserved viscera to cavity.

Answer 36

Batting

Question 37

Suture the sternum back onto the rib cage, and again sprinkle this over the entire area.

Answer 37

Hardening Compound

Question 38

Suture the three flaps together and then suture the abdomen down using a _____ stitch.

Answer 38

Baseball

Question 39

After the abdomen has been sutured downward with a baseball stitch, suture this from shoulder to shoulder with the baseball stitch.

Answer 39

The Throax

Question 40

If this is not done if the trachea has been removed, the result will be a flat neck.

Answer 40

Cotton and hardening compound is put in place

Question 41

This kind of needle is used to suture the cranial cavity.

Answer 41

Half Moon Needle (J-Shaped)

Question 42

* Dry out interior of cranium, cover base of skull with quick drying incision sealer. * Put hardening compound and cotton in cranial cavity, then replace calvarium after it has been saturated with hardening compound. * After the calvarium is firmly secured, place incision putty over the line of bone separation. * Return skin flaps to normal position * Suture the flaps together (with thin double strand suture).

Answer 42

Replacing the Calvarium

Question 43

Be sure the foramen magnum is tightly packed.

Answer 43

This prevents leaks

Question 44

* Wire it on after drilling a series of holes or use metal calvarium clamps (more secure). * Anchor the ligature cord at 3 points.

Answer 44

Methods of attaching calvarium

Question 45

1. Behind the right ear 2. Behind the left ear 3. At the center of posterior flap

Answer 45

3 points of anchoring the ligature to attach calvarium

Question 46

* Plaster of paris * Needle Injector * Cotton and sealer

Answer 46

Less successful methods of attaching the calvarium

Question 47

When suturing the flaps of a cranial autopsy, always do this.

Answer 47

Start from the right ear and suture toward the left ear.

Question 48

* Make a collection of small, curved hair combs often used by elderly women. These combs can be placed along the line of the incision to keep the average length of hair out of the way. * Superior method is to use spring loaded hair clips along incision line to keep hair out of the way.

Answer 48

In cases of long hair, tie the hair above and below the incision in a pony tail.

Question 49

* Always suture this incision before you injet any part of the body. * Suture with either a baseball stitch or a continuous glover stitch (roll stitch). * Be careful not to distort facial features * If you are alone, roll body over, put chin on head rest to keep face from hitting the table, then suture the incision. (in the prone position)

Answer 49

Spinal Autopsy

Question 50

* Wash all remains and shampoo the hair. * Dry the remains, especially the hair. * Put on the necessary plastic goods * Reposition the remains with special attention to the head and hands.

Answer 50

Completion of the embalming

Question 51

Positioned straight or slightly to the right, hair is combed.

Answer 51

Position of the head

Question 52

Packed with cotton to even them out.

Answer 52

Anterior Nares

Question 53

Should be closed.

Answer 53

Inner Canthus

Question 54

Should be combed and neatly organized.

Answer 54

Eyebrows

Question 55

Cotton behind these so they are straight and so that jewelry can be visible when placed on them.

Answer 55

Ear Lobes

Question 56

Left over right or at the sides of the body. Figers are together, not spread apart.

Answer 56

Hands

Question 57

Positioned straight (even the parts that you cannot see).

Answer 57

The body

Question 58

The first African American Embalmer

Answer 58

Prince Gyere