Please be patient with me and my horrible illustrations😝I promise I have a point!!! PA’s that perform autopsies do not have a ton of interaction with funeral homes aside from arranging transportation and assisting them with removal of the bodies out of the fridge. There are some things a PA will do to RESPECT the funeral director, knowing they will be going into the body after us.
One of those is paying attention to the carotid arteries. The carotid arteries are used to push embalming fluid up into the head and neck so it is not decomposing during a viewing. In a normal embalming, when a body is not autopsied, this is a non issue because the circulatory system should be intact. The funeral director can make an incision in the neck to access the carotid artery. No big deal. Unfortunately when we do an autopsy, we are cutting things out all over the place and disrupting the circulatory system. We have to be careful not to disrupt the carotids.
Let’s try to figure out my drawings🤣
Photo 1. This is the skin reflected over the head to fully expose the ribs and neck. “Chin” is to orient you. The larynx is outlined as a yellow rectangle. I carefully dissect around the larynx, lift it up, and dissect it off of the backbone. Carefully doing this will leave the carotids long and they can be cut around the clavicle. Some PA’s, like myself, prefer this method. They are very long and the funeral director can easily find them. Some PA’s cut them at any length and tie them with a string so the funeral director can find them. Why do they need them to be sticking out and identified? Funeral directors are very educated in anatomy and would have no issue finding them, however it’s respectful on our part because the arteries can get lost. If they are cut too short they retract up into the head making embalming a bit more difficult.
Photo 2. I make my incision just above the Adam’s apple (thyroid cartilage)
Photo 3. I would cut off the larynx, closely on each side, leaving the carotids intact. The red incision is👎🏻too short. These carotids would be likely to get sucked up into the head. The green incision is 👍🏻better. Funeral directors like it long!😜