Posted: February 26th, 2023

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Week Seven: Discussion Forum

Discussion Topic

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Earlier in this course we talked about chemistry in funeral service and touched the surface on embalming chemistry. In this forum we will look at a specific topic in embalming chemistry a bit more in-depth. 

We learned this week about several compounds responsible for the odors associated with decomposition. Neutralizing and/or covering these odors is important to both client satisfaction and funeral home bottom lines. 

For this week, investigate ways that we in the funeral industry try to mask or neutralize these odors. You may use real world methods used by professional embalmers where you work or research from outside sources. 

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Week 7- Diseases of the Urinary System/Reproductive System/ Bones & Joints

Discussion Topic

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Choose a topic from the chapters on diseases of the urinary system, reproductive system, or bones and joints and present it to the class, covering the basics of pathogenesis and prognosis, as well as how it affects you as an embalmer. When posting, approach as if you are discussing the topic with someone with little or no knowledge about the topic. This means you need to provide details to help the person understand. That is what I expect when reading and grading your post. You must include diagrams and graphics to support your post, and make sure you include in your post the significance of why the diagram/graphic is important. Simply including the diagram/graphic will not be enough. 

TWO PEER RESPONSES:

TRENT’S POST:

Hematuria

Hematuria is a medical term that describes the presence of blood in the urine. It can be caused by a wide range of factors, including urinary tract infections, kidney stones, prostate problems, certain medications, and in some cases, it may be a sign of a more serious underlying medical condition, such as bladder or kidney cancer.

The pathogenesis of hematuria varies depending on the underlying cause. In some cases, the blood may come from the kidneys, while in other cases it may come from the bladder or urethra. A healthcare professional will typically perform tests to determine the underlying cause of the hematuria, such as urine tests, blood tests, and imaging tests.

Again, the prognosis for hematuria depends on the underlying cause. In some cases, hematuria may resolve on its own without any specific treatment, while in other cases, it may require treatment for the underlying condition. 

When it comes to embalming a person who died with hematuria, it can present some challenges. Hematuria can cause the body to appear discolored, which can make it more difficult to achieve a natural-looking appearance. Additionally, the presence of blood in the body can affect the effectiveness of embalming fluids, which can result in a less-than-ideal outcome. If the hematuria is caused by a kidney or bladder condition, it is important to understand the extent of the blood in the body and the effects it may have on the embalming fluids. In such cases, it may be necessary to use specialized embalming fluids that are formulated to work effectively in the presence of blood. You may also need to use additional techniques, such as pre-injection or localized injection, to ensure that the embalming fluid reaches all areas of the body.

Below I have included a figure to show how hematuria caused by a kidney condition can result in blood ending up in bladder. As you can see, the blood travels down from the kidneys through ureters before dumping into the bladder.

CHRISTINA’ S POST:

Pre-Eclampsia is a condition that occurs during pregnancy. This condition is serious and can lead to Eclampsia. Pre-Eclampsia and Eclampsia causes are unknown. The symptoms and characteristics of Pre-Eclampsia can be identified though. Pre-Eclampsia characteristics include swelling of the hand and face, sudden weight gain, headache, upper abdominal pain. Pre-Eclampsia can be identified by high blood pressure and protein in the urine. There is no treatment for this condition. Eclampsia is when the mother has seizures after the 20th week of gestation. It is suggested to carry the fetus until it can survive outside the mother’s womb safely because Pre-Eclampsia can lead to fetal death.

As an embalmer, I would worry about the hypertension and fluid retention. When we embalm someone who has edema, they can easily swell. The embalmer needs to take extra precautions with the rate of flow and pressure during injection. Unionalls will also be needed more than likely when the embalming process is complete.

I have included the symptoms and characteristics of Pre-Eclampsia and a chart with some facts about Pre-Eclampsia. The symptoms are common symptoms, so it is important to know what to look for.

characteristics of pre-eclampsia.webp

Week 7 Homework Assignment

Week 7 Homework Assignment

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Assignment Content

1.

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Choose two specific specific diseases, one of the Urinary System and one of the Bones and Joints. Write a 175 word abstract on each disease covering the basics of pathogenesis and prognosis, as well as how it affects you as an embalmer. This must be done in APA format. Make sure to include a bibliography and cite all of your sources. Wikipedia and WebMD are not an acceptable sources.  

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Disease

s of the Female Reproductive System

Area Affected

Disease

Definition

Notes

Degeneration

Tissue deteriation and function impairment due to disease

Endometritis

Inflammation of the inner lining of the uterus (endometrium)

Endocervicitis

Inflammation of the mucous membrane of the cervix

Endometriosis

Ectopic endometrium located in various sites throughout the pelvis or in the abdominal wall

Problems will arise at the time of menstruation. Swelling, bleeding, and intense pain occur due to the tissue attempting to slough off as in the uterus at menstruation.

Preeclampsia

Occurs in pregnant women usually during the third trimester

Characterized by edema of the extremities and face, high blood pressure and high albuminuria.

Could be caused by toxemia of pregnancy (there are not really any toxins in the body)

Can lead to convulsions, coma, and death (Eclampsia) NOTE: Preeclampsia is caused by this, it is not the same thing.

Fallopian (Uterine) Tubes

Salpingitis

Inflammation of the fallopian tubes

If this occurs bilaterally and is not treated properly, scar tissue may form and close off the tube causing sterility.

Tubal, Ectopic or Extrauterine Pregnancy

When a fertilized ovum attaches to the wall of the fallopian tube or abdominal surface

Embryo will die from lack of blood supply.

It may then calcify forming a lithopedion (stone child)

For an abdominal pregnancy to occur, the egg must have been fertilized before it reaches the fallopian tube and then not enter the tube.

Diseases of the Female Reproductive System

Area Affected

Disease

Definition

Notes

Ovaries

Oophoritis

Inflammation of the ovaries

Polycystic Ovaries

Numerous cysts on or in the ovaries

Dermoid Cysts

A cysts containing elements of hair, teeth or skin. Commonly seen in the ovaries and testes.

Vagina

Vaginitis

Inflammation of the Vagina

Can be caused by

· A gonococcal infection

· Mechanical irritations such as tight panty hose

· Chemical irritations and highly irritating uterine discharges.

· Yeast infections – Caused by the fungus
Candida albicans. Commonly seen as a complication of antibiotic therapy. The normal flora bacteria of the vagina are destroyed, allowing the fungus to grow.

Puerperal Sepsis

A condition of septicemia following childbirth

Caused by hemolytic streptococcus

Infection is usually spread by contaminated obstetrical instruments. More common in the past.

Breast

Mastitis

Inflammation of the mammary glands

Neoplasms

Cystadenoma or cystadenocarcinoma

A common tumor of the ovaries

Uterine Cancer

Most commonly affect the cervix

Cervical cancers are one of the most common malignancies of women worldwide. Usually squamous cell carcinomas

Leiomyoma of the uterus (Benign)

Very common tumor

Sometimes called a fibroid tumor

Carcinoma of the breast

Another of the most common malignancies of women

Spreads rapidly through the surrounding tissues. Including the blood and lymph vessels in the area.

Often requires surgical removal of the breast and surrounding tissues. (Mastectomy)

Diseases of the Male Reproductive System

Area Affected

Disease

Definition

Notes

Neoplasms

Testes and Epididymis

Orchitis

Inflammation of the testes.

May be caused by trauma, or as a complication of the mumps or other infectious diseases.

If this infection is serious enough, it may cause scarring, atrophy of the testes and sterility.

Cryptorchism or cryptorchidism

Failure of the testes or a testis to descend into the scrotum.

Sperm cannot develop properly because of the higher temperature in the pelvic cavity

Sterility is often a consequence.

Epididymitis

Inflammation of the epididymis

Usually the result of a gonococcal infection. Severe cases could cause scarring and stop the passage of sperm.

Varicocele

Varicose veins of the spermatic cord

Fairly common.

Prostate Gland

Prostatitis

Inflammation of the prostate gland

Usually secondary to urethritis. Often caused by
Neisseria gonorrheae and
Escherichia coli.

Benign Prostatic Hyperplasia

An enlargement of the prostate gland in men 50 and over.

NOT an inflammatory condition. Associated with a hormone imbalance. The consequence of this is interference with the passage of urine.

Scrotum

Hydrocele

The collection of serous fluid in the scrotum.

May be a complication of orchitis, epididymitis, or improper closure of the opening between the peritoneal cavity and the scrotum.

The term can actually be used to mean the collection of serous fluid in any sacculated cavity of the body.

Carcinoma of the prostate

Common in older men – Metastasizes rapidly to bone and lymph nodes

Carcinoma of the testes

Tumors of the testes are usually malignant. Most commonly affects men in their 20’s, 30’s and 40’s

Diseases of the Reproductive System

STD’s

Area Affected

Disease

Definition

Notes

STD’s

Refers to Both Male and Female

Non-Specific Urethritis (NSU)

One of the most common and widespread of the STD’s.

Most often caused by a chlamydial organism.

Genital Herpes

Characterized by painful, itchy ulcerations or blisters on the genitals and surrounding area.

Caused by Herpes simplex II virus. There is no cure. A recurrent disease. (The ulcers will heal but the virus remains dormant in the body and is reactivated often as a result of stress or in periods of low resistance)

Gonorrhea

Caused by the bacterium
Neisseria gonorrheae.

Characterized by suppuration.

Will lead to sterility if not properly treated.

Syphilis

Caused by the spirochete
Treponema pallidum.

Characterized by a three stage development.

Primary Stage

Characterized by a genital ulceration called a chancre – heals after about 4-6 weeks

Secondary Stage

Characterized by a generalized red skin rash and mucous patches. Small ulcerations on the mucous membranes.

These symptoms indicate the organism has spread throughout the body. Will last for 2 to 6 weeks.

Tertiary Syphilis

Characterized by areas of necrotic tissue called gumma.

Most commonly affected by this are the nervous and cardiovascular systems.

Neurosyphilis — Can cause several conditions

Damage to the brain causing mental deterioration and paralysis called general paresis.

Degeneration of the posterior part of the spinal cord called tabes dorsalis.

Cardiovascular syphilis — Tends to affect the arteries

Causes inflammation, aneurysms and aortic insufficiency.

Postmortem Conditions for both male and female reproductive system conditions

1. Rapid blood coagulation

2. Ascites

3. Edema

4. Infection

Diseases of the Urinary System

Area Affected

Disease

Definition

Notes

General Terms

Oliguria

A decrease in the amount of urine excreted.

May include kidney failure

Anuria

Complete suppression of urine excretion

Indicates total kidney failure

Polyuria

An increase in the amount of urine excreted

Usually an indication of problems somewhere in the body other than the kidneys. Such as diabetes insipidus

Albuminuria

The presence of albumin or protein in urine

Often associated with glomerulonephritis.

Hemoglobinuria

Hemoglobin in the urine

Associated with hemolytic anemias. Occurs due to certain poisons, snake bites, and malaria.

Hematuria

Blood in the urine

An important sign in tumors of the urinary system.
Also associated with glomerulonephritis.

Pyuria

Pus in the urine

Indicates a urinary tract infection

Glycosuria

Sugar in the urine

Associated with diabetes mellitus (sugar diabetes)

Uremia

The toxic condition of excess urea and other nitrogenous waste in the blood

Associated with renal insufficiency or failure. NOTE: Urine or urea in the blood will increase formaldehyde demand.

Diseases of the Kidneys

Nephritis

A general term for inflammation of the kidney

Glomerulonephritis

A form of nephritis in which the lesions affect primarily the glomeruli.

The glomeruli are the filtering capillaries of the kidney. Often follows a previous streptococcal infection. Especially those of the upper respiratory tract

Pyelitis

Inflammation of the renal pelvis.

The expanded upper part of the ureter.

Pyelonephritis

Inflammation of the kidney substance and pelvis. Most common kidney disease.

(Pyelitis and Pyelonephritis are caused by pyogenic bacteria that enter the kidney by way of the bloodstream or due to bacteria that have ascended from the bladder after entering through the urethra)

Hydronephrosis

A collection of urine in the renal pelvis due to an obstructed outflow. .

Hydroureters – The ureters above an obstruction dilated with urine

Nephrolithiasis

a formation of renal calculi – stones are also called kidney stones or nephroliths.

Stones are formed from mineral salts that precipitate out of the urine solution. Formed due to kidney inflammation, dietary problems, or hyperparathyoidism.

Diseases of the Urinary System

Area Affected

Disease

Definition

Notes

Ureter

Ureteritis

Inflammation of the ureters. Tube that carry urine from the kidneys to the urinary bladder.

Causes constriction and narrowing

Urinary Bladder

Cystitis

Inflammation of the urinary bladder

Usually occurs secondary to ascending urinary tract infections.

Urethra

Urethritis

Inflammation of the urethra Tube that carries urine from the urinary bladder to the outside of the body.

Ureteritis, Cystitis, and Urethritis are all generally caused by infections with pyogenic bacteria that work their way up the urinary tract.
SUCH AS: Neisseria gonorrheae, Chlamydia trachomatis, Escherichia coli, Treponema pallidum, Proteus species, and Pseudomonas species

Polycystic Kidneys

A condition in which there is the formation of many cysts in or on the kidney

Can lead to a variety of renal problems.
1. Enlargement of the cysts compressed the surrounding renal tissue
Cysts are prone to infection

Other Classes of Organic Compounds

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Carboxylic Acids
The carboxylic acids are also known as organic acids.
They are characterized by the presence of the carboxyl group (-COOH).
The carboxyl group is an end carbon to which a double bonded oxygen and a hydroxide group are attached.

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Carboxylic Acids
Organic acids have the general formula of R-COOH.
The “R” may be either a hydrogen in the simplest case or an alkyl group.
The carboxylic acids have the suffix “-OIC” with most common names ending in –“IC”.

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Carboxylic Acids
The rule for naming acids:
take the name of the corresponding alkane.
Drop the “-e” and add the ending “-oic” and add the word acid.

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Carboxylic Acids
The smallest of the organic acids is formic acid (methanoic acid).
Formic acid is the result of the oxidation of formaldehyde(methanal).

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Carboxylic Acids
The 2nd of the organic acids is acetic acid (ethanoic acid).
Ethanoic acid is produced from the oxidation of acetaldehyde (ethanal).
This is the type of acid found in vinegar.

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Ketones
The ketones are characterized by the presence of the carbonyl functional group located on an inside carbon of the chain.
The double bonded oxygen must be attached to an inside carbon of a chain of carbons.
There must be at least 3 carbons in the chain before you can have a ketone.

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Ketones
The ketones as a class have the general formula R-CO-R.
The “R”s must be alkyl groups.
They do not need to be the same alkyl group.
Ketones have the suffix of “-ONE”

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Ketones
The rule for naming ketones:
Take the name of the corresponding alkane.
Drop the “-e” and add “-one”.
The name for those with more than 4 carbons should be preceded by the address of the carbon with the double bonded oxygen using smallest numbers.

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Ketones
Ketones may also be named by the alkyl method:
First name the two alkyl groups on either side of the carbonyl group.
Do not count the carbon with the double bonded oxygen)
Add the word “ketone”.

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Ketones
The smallest of the ketones is propanone.

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Ketones
Propanone is also known as:
Acetone.
Dimethyl ketone.

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Esters
Esters are formed from the removal of water that occurs between an organic acid (carboxylic acid) and an alcohol.

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Esters

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Esters
They are characterized by the presence of a –COOC – functional group.
This is a double bonded oxygen attached to a carbon that is then attached to an oxygen which is then attached to another carbon.
I know it sounds confusing, but look at the picture.

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Esters
There are minimum of 2 carbons separated by an oxygen before you can have an ester.
Esters have the general formula R-COO-R.
The “R”s do not need to be the same. The first “R” may even be a hydrogen.

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Esters
Esters are named according to the parent compounds from which they are derived. The rules for naming an ester:
Take the name of the parent alcohol followed by a parent acid.
Drop the ending “-ic” from the acid name and add “-ate”.
The common names for these compounds are derived similarly but using the common name of the parent acid.

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Esters
The esters as a class of compounds all tend to have very pleasing odors.
Esters are found in some cavity fluids, sanitizing sprays, and sealing lacquers.

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Esters
Esters can cause eye irritation and also irritate mucous membranes.

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Esters
A common ester is methyl salicylate, known as oil of Wintergreen which is a common perfuming agent. Methyl salicylate is an aromatic ester.

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Ethers
Ethers are formed from the dehydration that occurs between two alcohols. The alcohols do not need to be the same.
There are characterized by the presence of oxygen in the carbon chain. The functional group looks like this: -C-O-C-.

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Ethers
There are minimum of 2 carbons separated by an oxygen before you can have an ether.
Ethers have the general formula R-O-R.
The “R”s do not have to be the same, they may be of different numbers of carbons.
Neither “R” may be only a hydrogen.

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Ethers
Ethers derived from the same parent alcohol are called simple ethers while those derived from 2 different alcohols are called mixed ethers.

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Ethers
The rule for naming ethers:
Name the two carbon chains (alkyl groups).
Add the word ‘ether’.
Some ethers are simply identified by the name of the parent alcohol. Instead of saying “diethyl ether” it is called “ethyl ether”.

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Ethers
Another way to name the ethers is to use the “aloxy method”.
Name the smallest alkyl group by its “aloxy” name such as “methoxy” or “ethoxy”.
Follow with the alkane name of the longest alkyl group.

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Ethers
One of the most common ethers is ethyl ether. Ethyl ether is used as an anesthetic and is a general purpose solvent.

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Ethers
Ethers are usually extremely flammable and can form explosive mixtures with air. One should never use an ether near a flame or spark which is why surgeons wear nonconductive shoes when in the operating room.

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Amines
The amines are derived from ammonia where a hydrogen has been replaced by an alkyl group.
Amines resemble an alkane that is had one of its hydrogens replaced by an amino group (-NH2).

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Amines
Amines are derivatives of ammonia and/or proteins in the body.
Amines are organic compounds characterized by the amino functional group. As a group this class of compounds are identified by the general formula R-NH2.
The “R” stands for the alkyl group.

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Amines
Amines have the suffix “-amine.”
The rules for naming this class of compounds are similar to naming alcohols in that the amino group is treated like a hydroxide and should be addressed if its position could be confused.

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Amines
Amines are important because they are associated with decomposition of proteins in the body. They are characterized by disagreeable odors and the fact that they form alkaline solutions because they are Lewis bases.
If you are really interested, you can look up Lewis compounds on your own.

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Amines
Some amines have 2 amino groups in their structure and are known as diamines.
The 2 most common diamines that are associated with decomposition of the human body are putrescine and cadaverine.
As you can imagine, these both quite literally stink. Bad.

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Amines
Amines are basic compounds and easily form salts.

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Quaternary Salts
Quaternary ammonium salts are formed from the action of tertiary amines with organic halides.
Some quarternary ammonium salts have both a detergent action and an antibacterial action.

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Quaternary Salts
They are used medicinally as antiseptics.
Benzalkonium Chloride (zephiran chloride) is used to store sterile instruments, as a wet dressing, or may be even used to irrigate the bladder and urethra.

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Amides
Amides may be derived from the dehydration of organic acids and ammonia (or an amine). Because this is a neutralization reaction, chemically they are ammonium salts.

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Amides
Amides are any group of compounds derived from ammonia by the substitution or replacement of a hydrogen by a carbonyl group (C=O).

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Amides
They may be derived from the acid by replacing the hydroxide (-OH) group with an amino group (-NH2).
The simplest of the amides as a class have the following general formula, R-CONH-R.
the 1st “R” stands for the alkyl group from the parent acid. The 2nd “R” is the alkyl group from the parent amine.
Amides have the suffix “-amide”.

R
R
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Amides
The rules for naming amides:
Name the alkyl group of the amine.
If the amide is derived from ammonia and not from an amine then omit this part of the name).
Take the name of the parent acid, drop the “-oic” and replace it with the amid suffix “-amide”.
Common names of the acid parent may be used as well; just drop the suffix “-ic” and add the “-amide”.

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Amides
Two of the more common amides found in the preparation room are dimethyl formamide and diethyl formamide and are solvents.

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Amides
Another amide of some significance to us as embalmers is urea.

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Amides
Urea is a diamide produced as a waste product from the metabolism of proteins in the body. Urea is the substance that must be removed by the kidneys to produce urine.

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Amides
If urea is not removed from the body a condition known as uremia occurs. This is problematic because urea will bond with formaldehyde and neutralize it.
We combat this generally by ensuring we use higher index fluids or higher concentration/volume to meet preservative demand.

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Mercaptans
Thioalcohols or mercaptans are very similar to the alcohols except that the oxygen in the hydroxyl group has been replaced by a sulfur.
They have the general molecular formula of R-SH.
Some of the common mercaptans are methyl mercaptan and ethyl mercaptan.

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Mercaptans
Methyl mercaptan is the odor of urine after the ingestion of asparagus.
This is probably why you can’t find a methyl mercaptan scented Yankee candle.
Ethel mercaptan is the substance that is added to natural gas to give it a detectable odor.
Another popular seller at Yankee candle, I’m sure.

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Closing Notes
In closing this chapter, I offer you the following advice:
Write and rewrite the charts in the summary at the conclusion of chapter 10.
Draw linear guides of the oxidation reactions until you can do it from memory.
The reductions are simply the exact opposite. If you can draw oxidations from memory you should be able to work your way back using reductions.
Utilize online study sites such as Quizlet and Study Stack to assist you in memorization.
Making your own note cards for the general molecular formulas and general formulas is an absolute must.
Prefixes and suffixes also need to be note carded and memorized.
There is no substitution for spending the time and doing the work if you want to retain this for the long term.
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References:
The following Textbook References were used to create this presentation:
Funeral Service Chemistry by Professional Trade Schools
Embalming: Theory, History, and Practice by Robert G. Mayer (5th Edition).
Charts were taken from the textbook unless otherwise indicated
 
Pictures and art used in this presentation have the reference and location stored in the graphic. Please hover the mouse over the image to find where it was obtained.
 

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XIII. DISEASE OF THE

URINARY SYSTEM

A. Terms dealing with urinary disturbances
1. Oliguria
– a decrease in the amount of urine excreted
– may indicate kidney failure
2. Anuria
– complete suppression of urine excretion
– indicates total kidney failure

3. Polyuria
– an increase in amount of urine excreted
– usually an indication of problems somewhere in the body other than the kidneys
– such as diabetes insipidus

4. Albuminuria
– the presence of albumin or protein in urine
– often associated with glomerulo-nephritis
– hemoglobin in the urine
– associated with hemolytic anemias
– that occur due to certain poisons, snake bites, and malaria
5. Hemoglobinuria

A. Terms dealing with urinary disturbances
6. Hematuria
– blood in the urine
– an important sign in tumors of the urinary system
– also associated with glomerulo-nephritis

– pus in the urine
– indicates a urinary tract infection
– sugar in the urine
– associated with diabetes mellitus (sugar diabetes)
7. Pyuria
8. Glycosuria

B. Uremia
– the toxic condition of excess urea and other nitrogenous wastes in the blood
– associated with renal insufficiency or failure

C. Disease of the kidney
1. Nephritis
– a general term for inflammation of the kidney

C. Disease of the kidney
2. Glomerulonephritis
– a form of nephritis in which the lesions affect primarily the glomeruli
– the glomeruli are the filtering capillaries of the kidney

C. Disease of the kidney
2. Glomerulonephritis
– a form of nephritis in which the lesions affect primarily the glomeruli
– the glomeruli are the filtering capillaries of the kidney
– often follows a previous streptococcal infection
– especially those of the upper respiratory tract

C. Disease of the kidney
3. Pyelitis
– inflammation of the renal pelvis
– the expanded upper part of the ureter

– inflammation of the kidney substance and pelvis
– most common kidney disease
4. Pyelonephritis

The two previous conditions are caused by pyogenic bacteria that enter the kidney by way of the bloodstream or due to bacteria that have ascended from the bladder after entering through the urethra.

C. Disease of the kidney
5. Hydronephrosis
– a collection of urine in the renal pelvis due to an obstructed outflow

C. Disease of the kidney
5. Hydronephrosis
– a collection of urine in the renal pelvis due to an obstructed outflow
– Hydroureters
– the ureters above an obstruction dilated with urine

C. Disease of the kidney
6. Nephrolithiasis
– the formation of renal calculi
– stones are also called kidney stones or nephroliths

D. Ureteritis
– inflammation of the ureters
– the tubes that carry urine from the kidneys to the urinary bladder
– causes constriction and narrowing
E. Cystitis
– inflammation of the urinary bladder
– usually occurs secondary to ascending urinary tract infections

This bladder at autopsy has been opened to reveal areas of hyperemia of the mucosa. This is acute cystitis.

F. Urethritis
– inflammation of the urethra
– the tube that carries urine from the urinary bladder to the outside of the body
— Ureteritis, Cystitis, and Urethritis are all generally caused by infections with pyogenic bacteria that work their way up the urinary tract

G. Polycystic Kidneys
– a condition in which there is the formation of many cysts in or on the kidney
– can lead to a variety of renal problems:
– enlargement of the cysts compresses the surrounding renal tissue
– cysts are prone to infection

XIV. DISEASE OF THE FEMALE
REPRODUCTIVE SYSTEM

Most of the inflammations of the parts of the female reproductive tract are due to numerous bacterial infections that often are associated with STD’s to be discussed later

A. Uterus
– inflammation of the uterus
– inflammation of the inner lining of the uterus(endometrium)
1. Metritis
2. Endometritis

– inflammation of the mucous membrane of the cervix
– ectopic endometrium located in various sites throughout the pelvis or in the abdominal wall
3. Endocervicitis
4. Endometriosis

5. Preeclampsia
– could be caused by a condition called toxemia of pregnancy
– occurs in pregnant women usually during the third trimester
– can lead to convulsions, coma, and death (Eclampsia)
– there are not really any toxins in the body
– characterized by edema of the extremities and face, high blood pressure and high albuminuria

B. Fallopian (Uterine) Tubes

– inflammation of the fallopian tubes
1. Salpingitis

B. Fallopian (Uterine) Tubes

– inflammation of the fallopian tubes
– when a fertilized ovum attaches to the wall of the fallopian tube or abdominal surface
1. Salpingitis
2. Tubal, Ectopic or Extrauterine Pregnancy

– it may then calcify forming a lithopedion
– embryo will die from lack of blood supply
– or stone child

C. Ovaries
– inflammation of the ovaries
– numerous cysts on or in the ovaries
1. Oophoritis
2. Polycystic Ovaries

– a cyst containing elements of hair, teeth or skin
– commonly seen in the ovaries and testes
3. Dermoid Cysts

D. Vagina
– inflammation of the vagina
1. Vaginitis

– a gonococcal infection
– mechanical irritations such as tight panty hose
– chemical irritations and highly irritating uterine discharges
– yeast infections
– can be caused by:

1. Vaginitis
– caused by the fungus Candida albicans
– commonly seen as a complication of antibiotic therapy
– the normal flora bacteria of the vagina are destroyed, allowing the fungus to grow
– yeast infections

2. Puerperal Sepsis
– a condition of septicemia following childbirth
E. Breasts
– inflammation of the mammary glands
– caused by a hemolytic streptococcus
– infection is usually spread by contaminated obstetrical instruments
– Mastitis

F. Neoplasms
– a common tumor of the ovaries

1. Cystadenoma or cystadenocarcinoma
In this TAH-BSO specimen, the right ovary (on the left of the image) has been replaced by a solid serous carcinoma. The contralateral ovarian tumor is grossly cystic and could be termed a “cystadenocarcinoma.“ This cancer, which was discovered at exploratory laparotomy, apparently developed very rapidly; the patient had a normal pelvic ultrasound exam only 2 months before.

2. Uterine cancer
– cervical cancers are one of the most common malignancies of women worldwide
– most commonly affects the cervix
– usually squamous cell carcinomas
3. Leiomyoma of the uterus
– sometimes called a fibroid tumor
– also a very common tumor

4. Carcinoma of the breast
– another of the most common malignancies of women
– spreads rapidly through the surrounding tissues
– including the blood and lymph vessels in the area

4. Carcinoma of the breast
– another of the most common malignancies of women
– called a mastectomy
– spreads rapidly through the surrounding tissues
– including the blood and lymph vessels in the area
– often requires surgical removal of the breast and surrounding tissues

XV. DISEASE OF THE MALE
REPRODUCTIVE SYSTEM

A. Testes and Epididymis
– inflammation of the testes
– trauma
– as a complication of the mumps or other infectious diseases
– if this infection is serious enough, it may cause scarring, atrophy of the testes and sterility
– may be caused by
1. Orchitis

2. Cryptorchism or cryptorchidism
– failure of the testes or a testis to descend into the scrotum

sterility is often a consequence
– sperm cannot develop properly because of the higher temperature in the pelvic cavity
– in other words…

3. Epididymitis
– inflammation of the epididymis
– usually the result of a gonococcal infection
– severe cases could cause scarring and stop the passage of sperm

4. Varicocele
– varicose veins of the spermatic cord
– a fairly common occurrence

B. Prostate Gland
– inflammation of the prostate gland
– usually secondary to urethritis
– Muscle organ which surrounds the first part of the urethra
– often caused by Neisseria gonorrheae and Escherichia coli
1. Prostatitis

2. Benign Prostatic Hyperplasia
– an enlargement of the prostate gland in men 50 and over

2. Benign Prostatic Hyperplasia
– NOT an inflammatory condition
– an enlargement of the prostate gland in men 50 and over
– associated with a hormone imbalance
– the consequence of this is interference with the passage of urine

C. Scrotum
– the collection of serous fluid in the scrotum
– may be a complication of orchitis, epididymitis, or improper closure of the opening between the peritoneal cavity and the scrotum
1. Hydrocele
– the term can actually be used to mean the collection of serous fluid in any sacculated cavity of the body

D. Neoplasms
1. Carcinoma of the prostate
– common in older men
– metastasizes rapidly to bone and lymph nodes

2. Carcinoma of the testes
– tumors of the testes are usually malignant
– this most commonly affects men in their 20’s, 30’s and 40’s
Normal
Malignant

E. STD’s

This section applies to both the male and female reproductive systems

1. Non-specific Urethritis (NSU)
– most often caused by a chlamydial organism
– one of the most common and widespread of the STD’s

2. Genital Herpes
– caused by the Herpes simplex II virus
– there is no cure
– a recurrent disease
– characterized by painful, itchy ulcerations or blisters on the genitals and surrounding areas

3. Gonorrhea
– characterized by suppuration
– caused by the bacterium Neisseria gonorrheae
– will lead to sterility if not properly treated

4. Syphilis
– caused by the spirochete Treponema pallidum
– characterized by three stages of development

– characterized by a genital ulceration called a chancre
– heals after about 4-6 weeks
a. Primary stage

b. Secondary stage
– characterized by a generalized red skin rash and mucous patches

– will last for 2 to 6 weeks
– small ulcerations on the mucous membranes
– these symptoms indicate the organism has spread throughout the body

c. Tertiary syphilis
– characterized by areas of necrotic tissue called gumma
– most commonly affected by this are the nervous and cardiovascular systems

Neurosyphilis
– can cause several conditions
a) damage to the brain causing mental deterioration and paralysis called
general paresis
b) degeneration of the posterior part of the spinal cord called
tabes dorsalis

2) Cardiovascular syphilis
– tends to affect the arteries
– especially the aorta
– causes inflammation, aneurysms and aortic insufficiency

Postmortem Conditions for both male and female reproductive system conditions

1.

2.

3.

4.
Rapid blood coagulation
Ascites
Edema
Infection

XVI. DISEASES OF THE
BONES & JOINTS

A. Bones
– inflammation of bone tissue
– the formation of cysts and fibrous nodules within bones
a. osteitis fibrosa cystica
– due to a hormone imbalance
1. Osteitis

– a chronic inflammation resulting in thickening and deformation
b. Paget’s Disease
– also known as osteitis deformans
– looks like an over-production of bone
Paget’s disease of the humerus. Note how dense and wide the bone is. It is also patchy from areas of active bone turnover.

2. Osteomyelitis
– inflammation of bone marrow
– bacteria enter by way of broken bones or through the blood or lymph streams

Osteomylitis of the Forearm

Case History: This 13 y.o. healthy teenager sustained a both bones (radius and ulna) forearm fracture, grade I open, playing football at summer camp. It was washed out and plated 3 days later.
Clinical Course: He developed fever, chills, and drainage of the wound several weeks after treatment. He was referred shortly after given oral antibiotics, 6 weeks after injury, with the following presentation.

This was the wound at presentation. Sero-purulent drainage from the mid-aspect of the wound required frequent dressing changes

Surgical Exploration:
The hardware was removed. Surgical findings revealed extensive fibrinous debris, purulence, dead bone (the white sequestrum), and a shell of new bone

3. Osteoporosis
– an increase in porosity or loss of bone density
– most commonly seen in women after menopause
– bone becomes brittle and tends to break more easily

4. Rickets
– the softening of bone in children
– bones stay soft and deformed
– Vitamin D is essential for absorption of calcium from the digestive tract
– due to a deficiency of vitamin D
– long, weight-bearing bones of the leg tend to be bent or “bowed”

5. Osteomalacia
– softening of bones due to faulty calcification in adulthood
– may also be due to a lack of vitamin D

6. Periostitis
– inflammation of the outer covering of bone (the periosteum)
– tuberculosis of the vertebral column
– produces a
humpbacked malformation
– usually due to bacterial infection
– vertebrae are destroyed and collapse
7. “Pott’s Disease”

8. Achondroplasia
– causes a form of dwarfism
– a defect in the formation of cartilage in the growth centers of long bones

Twin brothers

9. Marfan’s Syndrome
– leads to a form of giantism
– a hereditary condition of connective tissue and skeletal structures

10. Abnormal curvatures of the spine
– an abnormal posterior curvature of the spine
– a humpback

a. Kyphosis

b. Lordosis
– an abnormal anterior curvature of the spine

c. Scoliosis
– a lateral curvature of the spine in opposite directions
– causes an S-shaped curvature

11. Fractures
– a break that does not pierce the skin

a. Simple or Closed fracture

b. Compound or Open fracture
– a break in which at least a piece of the bone pierces the skin resulting in an open wound
– could also be a wound that leads to a bone that is broken

c. Comminuted fracture
– a break in which the bone is splintered or crushed

– there must be at least three pieces of bone to constitute this

d. Greenstick fracture
– a break in which the bone is cracked or broken on one side and bent on the other

B. Joints
– inflammation of a bursa
– small, sac-like structures that contain synovial fluid
– help to reduce friction in areas where a lot of movement occurs

1. Bursitis

2. Arthritis
– inflammation of a joint
– trauma
– tumors
– degenerative conditions of old age
– allergic reactions
– infectious agents
– bacteria, fungi, and viruses
– could result from:
– may be either acute or chronic

– Most common forms of arthritis:
– affects mainly women age 20-40
– an inflammatory disease
a. Rheumatoid arthritis
– a form of chronic arthritis
– there is usually bilateral involvement of the hands and wrists

– inability of joint movement
– in the later stages the joint may be destroyed and the bones fused together causing a permanent crippling
– Ankylosis

b. Osteoarthritis
– affects both men and women later in life
– a degenerative disease rather than inflammatory
– affects the larger, weight-bearing joints
– another chronic arthritis

– not usually bi-lateral
– thought to be associated with “wear and tear” on the joints

c. Gout
– an hereditary form of arthritis
– deposits urates of sodium crystals around certain joints
– the result of a metabolic problem with uric acid in the body

– causes an intense and painful inflammation

! ! ! ! ! ! !
EXAM # 3

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