FEDERAL UNIVERSITY NDUFU-ALIKE IKWO,

EBONYI STATE.

STUDENT INDUSTRIAL WORK EXPERIENCE SCHEME

(SIWES).

A REPORT OF SIX MONTHS STUDENT INDUSTRIAL

WORK EXPERIENCE SCHEME

AT

FEDERAL TEACHING HOSPITAL, ABAKALIKI.

BY

NAME: OTU, GLADYS FELIX

REG NO: FUNAI/B.SC/13/0326

DEPARTMENT: ANATOMY

COURSE TITLE: SIWES AND SEMINARS

COURSE CODE: ANA372

DATE: OCTOBER, 2017

Topic

A report of six (6) months student industrial work experience scheme

-------------------------- -------------------------

MISS ITORO GEORGE DATE

Departmental SIWES Coordinator

---------------------------- ---------------------

MR GABRIEL GODSON AKUNNA DATE

Departmental SIWES coordinator

DEDICATION

This work is dedicated to God Almighty, my loving mother,

siblings and course mates for their immense support throughout

the course of my SIWES program.

ACKNOWLEDGEMENT

My sincere gratitude goes to God Almighty for giving me the grace to make it

through the period of my SIWES program.

Also, I am grateful to my beloved mother for her kind words of encouragement and

support. My siblings are also not left out as they assisted me a great deal during

this period.

In the same vein, I want to thank my friends and course mates for their patience

and support throughout this period.

I am also very thankful to my departmental SIWES coordinators, Miss Itoro

George for her kindness during this period, and Mr Gabriel Godson Akunna for

encouraging me to be zealous.

Finally, I am most grateful to all my lecturers for their support and training me in

the field of anatomy.

TABLE OF CONTENTS

TITLE PAGE

DEDICATION

ACKNOWLEDGEMENT

CHAPTER 1
MEANING OF SIWES
OBJECTIVE OF SIWES
HISTORY OF FETHA
ORGANOGRAM

CHAPTER 2
DIFFERENT UNITS IN THE ORGANISATION
INSTRUMENTATION
OTHER RELEVANT EXPERIENCES

CHAPTER 3
WORK CARRIED OUT
MORTUARY UNIT
HISTOPATHOLOGY/TISSUE PROCESSING UNIT
MUSEUM UNIT
RADIOLOGY UNIT

CHAPTER 4
CONCLUSION
RECOMMENDATION
CHAPTER ONE

1.0 INTRODUCTION

1.1 HISTORY AND MEANING OF SIWES

The Student industrial work experience scheme (SIWES) was established as a result of the

realization by the Federal government of Nigeria in 1973 of the need to introduce a new

dimension to the quality and standard of education obtained in the country in order to achieve the

much needed technological advancement. It has been shown that a correlation exists between a

country’s level of economical and technological development and its level of investment in

manpower development (Oniyide, 2000).

The ITF solely funded the scheme during its formative years. But due to the elevated rate of

financial involvement, it was withdrawn from the scheme in 1978. In 1979, the Federal

Government of Nigeria handed the scheme to both the National University Commission (NUC)

changed the management and implementation of SIWES fund to ITF. It was effectively taken

over by ITF in July 1985 with the funding being solely borne by the Federal Government.

The Federal Government, ITF, the supervising agencies – NUC, NBTE, NCE (National

Commission for Colleges of Education), Employers of Labour, and the Institutions contribute it

one quarter in the management of SIWES. The various responsibilities are as follows:
FEDERAL GOVERNMENT

 To provide adequate funds to the ITF through the Federal Ministry of Industries.

 To make it mandatory for all ministries, companies and parastatals to offer places

of attachment for students in accordance with the provision of Decree No. 47 of 1971 as

amended in 1990.

INDUSTRIAL TRAINING FUND

Formulation of policies and guidelines on SIWES for distributions to all the SIWES Participating

bodies, institutions and companies involved in the scheme on a regular basis organizing

programs for the students prior to their attachment, receive and process master and placement list

from the institution and supervising agencies i.e. NUC, NBTE, NCE.

Supervise industrial attachment.

Disburse supervisory and student students allowance at the shortest possible time.

Provide insurance during student attachment/Training.

THE SUPERVISING AGENCIES

 Ensure the establishment and accreditation of SIWES units in institution under their

jurisdiction.

 Co-ordinate the appointment of full-time SIWES unit in all the institution.

 Ensure adequate funding of a SIWES unit in all the institutions of the Federation.

 Vet and approve master and placement list of students from participating

 Institutions and is been forwarded to ITF

 Monitor and review jobs-specification in collaboration with the Institutions towards

national minimum academic standard for all the programs approved for SIWES.
The Students Industrial Work Experience (SIWES) is a skill training program, designed to

expose and prepare students of different tertiary institution to real life work/situation after

graduation.

The scheme exposes students to industrial based skills necessary for smooth transition from the

classroom to the world of work. It affords students of tertiary institution the opportunity of being

exposed to the needed experience in handling machinery and equipment which are not available

in the education institute.

1.1.1. AIMS AND OBJECTIVES OF SIWES

 To provide an avenue for students in tertiary institutions to acquire industrial

skills and experience in their course of study.

 To expose students to work methods and technique in handling equipment and

machineries that may not be available in the institution.

 To prepare students for the work situation that they are likely to meet after

graduation

 To provide students with the opportunity to apply their theoretical knowledge in

real work situation, thereby bridging the gap between the university work and the actual

work practices.

 To expose students to the latest developments and technological innovations their

chosen professions.
 1.2. HISTORY OF FEDERAL TEACHING HOSPITAL, ABAKALIKI, EBONYI

STATE

The Federal Teaching Hospital, Abakaliki is a tertiary health institution in Abakaliki, Ebonyi

State, Nigeria dedicated to the provision of quality, accessible and affordable healthcare services;

and effective training and research.

The former Federal Medical Centre Abakaliki now Federal Teaching Hospital, Abakaliki was

established in the 1930s by the then colonial administration to serve as a casualty control post for

soldiers wounded in the Cameroon theatre of the 2nd world war. It subsequently became the

Abakaliki General Hospital, administered successively by the then Eastern Regional

Government, the then East Central, Anambra, Enugu and finally Ebonyi States Governments.

By 1973, the Hospital had a full complement of Consultant Staff and was approved for training

of House Officers. Subsequently, the facilities deteriorated and the progressive loss of Consultant

Staff as the East Central State was split into many States impacted adversely on the hospital

services. Thus, accreditation for training of House Officers lapsed and services deteriorated to

such an extent that the Hospital almost became moribund.

Following the agreement between the Federal government of Nigeria and the Enugu State

Government, the General Hospital, Abakaliki was taken over by the Federal Ministry of Health

as a Federal Medical Centre on March 1, 1990 with Dr. Ekuma Orji Uzor as the pioneer Medical

Director.

With the takeover, the Hospital made tremendous progress, and assumed all the responsibilities

of being a Federal Health Institution. Dilapidated facilities were rehabilitated in 1999, broken

down equipments were repaired and modern equipments acquired. Two additional modern

theatres were constructed and a modern neo-natal Unit commissioned. An ultramodern Casualty
and Children’s Emergency Unit and a Resident’s Hall Complex were put in place as well as an

Intensive Therapy Unit.

In 2007 Dr. Paul Olisaemeka Ezeonu, the erstwhile Head of Clinical services in the Medical

Centre took up the mantle of leadership as the Chief Medical Director. Following this,

developments in every department of the Hospital went upscale and have remained so.

The Hospital now has Consultants in most Clinical Department and has been able to reactivate

wards that were dormant because of death of Staff. Attendance has crept up steadily with

outpatient load of about eight thousand monthly. Accreditations for the training of House officers

have been granted.

On its part, the Ebonyi State University Teaching Hospital was earlier established as a Specialist

Hospital, Abakaliki, in the early 1980s. in 1996, following the creation of Ebonyi State and the

take-off of the State University, the Specialist Hospital was converted to a Teaching Hospital to

serve Ebonyi State University.

On 7th December, 2011, President Goodluck Jonathan in fulfillment of his election promise to

Ebonyi people upgraded the Federal Medical Centre to a Federal Teaching Hospital and directed

that Ebonyi State University Teaching Hospital be absorbed into the new mega Teaching

Hospital. The handover process was completed on 23rd December 2011 including the absorption

of the staff of the defunct EBSUTH.

The new Federal Teaching Hospital is indeed mega with retinue of Consultants in various

specialties, 604 bed capacity distributed in various departments and a capacity for 250 House

Officers. This foremost Health Institution which is one of its kind east of the Niger is continually

improving in strength, structure and facility and has the establishment of a School of Nursing and
Midwifery on its radar. The hospital complex of the School of Nursing and Midwifery billed to

accommodate a total of 360. Student nurses are already completed.

The new hospital complex is designed as a one stop complex to accommodate various units and

departments such as children’s emergency units and wards, Obstetrics and Gynecology (O&G)

wards and units, administration department, consulting rooms and about sixty wards among

others.

New structures constructed include resident Doctors and House Officers’ quarters comprising

several units of self-contained accommodations, medical records blocks, laboratories, dental

clinics and several other facilities with modern ancillary amenities to complement the structures.

Other on-going infrastructural developments at the NEW FETHA arena included the ultra-

modern auditorium with five thousand sitting capacity, a lecture hall to accommodate two-

hundred comfortably seated persons, a library and E-library structure and an ultra-modern

theatre.

According to the Architect handling the project Mr. Eric Adama, part of the on-going

construction include reclamation of some parts of the area to control the ecological challenges

being experience at the site

 1.2. ORGANISATIONAL CHART OF FEDERAL TEACHING HOSPITAL

ABAKALIKI.

FEDERAL TEACHING HOSPITAL ABAKALIKI (FETHA)

FETHA 1 FETHA 2

CHIEF MEDICAL DIRECTOR (CMD)

CHAIRMAN, MEDICAL ADVISORY COMMITTEE (CMAC)

DIRECTOR OF ADMINISTRATION

INFORMATION THERAPEUTIC DIAGNOSTIC SUPPORT

DEPARTMENT DEPARTMENT DEPARTMENT DEPARTMENT

PHYSICAL
THERAPY
ADMISSION EMERGENCY CENTRAL
NURSING
SUPPLY
BILLING AND DIETARY
MEDICAL
COLLECTION
PHARMACY LABORATOR BIOMEDICAL
TECHNOLOGY
MEDICAL MEDICAL SURGERY
RECORDS PSYCHOLOG
CARDIOLOGY HOUSE KEEPING
SPORTS
AND SECURITY
INFORMATION MEDICINE RADIOLOGY
SYSTEMS OCCUPATIONAL
MAINTENANCE
THERAPY NEUROLOGY
ACCOUNTS
SPEECH/LANGUAGE MORBID ANATOMY/
PATHOLOGY TRANSPORTATIO
HUMAN HISTOPATHOLOGY N AND WORKS
RESOURCES SOCIAL
SERVICES
RESPIRATORY
CHAPTE
THERAPY
 CHAPTER TWO

2.0. DIFFERENT SECTIONS/UNITS OF THE ORGANISATION AND

INSTRUMENTATION

2.1. DEPARTMENT OF MORBID ANATOMY AND HISTOPATHOLOGY.

Amongst other relevant sections, the department of morbid anatomy and histopathology is very

important to the Federal teaching Hospital, Abakaliki. This is because of its contribution towards

maintaining and examination of patients tissues and also, educational services for research

purposes and student training.

Tissue biopsy may be carried out on patients who have various pathological complications

ranging from tissue cancer, tumor in the breast, kidney, liver, prostate and other tissues or organs

in the body. Embalmment of bodies after death is also part of the services rendered by this

department. In cases where the actual cause of death is not known, autopsy on these bodies is

carried out to ascertain the cause of death. Pathological cases that are relevant for academic

purposes are preserved and displayed in the department.

In other to conveniently perform this huge but important task, the department is divided into

three (3) units. They are:-

i. Mortuary unit

ii. Histopathology unit

iii. Museum unit.

 2.1.1. MORTUARY UNIT

The mortuary unit deals with the embalming of bodies that have been confirmed dead by a

physician. Corpses of humans are also stored and await identification by the bereaved and

disposal by burial, cremation or other methods. This unit also handles autopsy to find out the

actual cause of death.

2.1.2. HISTOPATHOLOGY LABORATORY UNIT

Histopathology is the study of microscopic changes or abnormalities in tissues that are caused as

a result of diseases. Histopathology uses both histology and cytology samples for diagnosis. This

unit collects samples from patients by excision for histology samples and by aspiration for

cytology samples. These samples undergo various stages of processes and analysis in order to

determine the nature of the disorder. These samples are also preserved in the process so as to

retain their original shape and structure as closely as possible and also to protect tissues from

autolysis and putrefaction.

The main use of histopathology is in clinical medicine where it typically involves the

examination of surgically removed tissue or aspirate for the purpose of detailed study to further

help in diagnosing, treating, and preventing future occurrences of a particular pathological

complication.

Diseased cells and biological tissues are also studied in histopathology for reasons such as:-
  Investigate crimes: Example, look for causes of injury or death such as

evidence of tissue damage by poisons, drugs or possibly deliberately targeted

biological pathogens.

 Investigate historical artefacts containing biological tissue in sufficiently

good condition to learn about the health of long deceased individuals.

 Study of ancient diseases.

The different sections under the laboratory unit include;

1. CYTOLOGY BENCH: Cytological samples (which could be blood, serum,

cerebrospinal fluid, etc) are being received and fixed here, prior to processing.

Cytological samples received here are being fixed in papanicolaou fixative and allowed

for a period of 20-30 minutes before being processed. The process of collecting

cytological samples used in my place of industrial training is fine needle aspiration

(FNA) which involves using a unique needle to draw the sample.

2. SURGICAL CUT-UP BENCH: Fixed tissues gotten from the surgical theater

are been cut open and into smaller sizes at this bench and returned into fixative prior to

processing.

3. PROCESSING SECTION: Already fixed tissues (cytological and histological)

are being processed on this section. The processes which include dehydration, clearing,

hydration, impregnation and embedding, depending on whether it’s a cytological or

histological sample or tissue.

 4. MICROTOMY SECTION: Already embedded tissues are being sectioned here

into fine ribbons with the help of the microtome. Embedded tissues which usually have a

block shape are attached to tissue blocks. The wooden blocks are clamped to the

microtome as it sections the tissue blocks into fine ribbons. The sectioned tissues are

placed in a water bath of about forty degree Celsius, so as to straighten the ribbon-like

tissue, which are picked up by slides before staining takes place.

5. STAINING BENCH: tissues brought to this bench are stained using any suitable

and acceptable stain. But the most widely used stain is hematoxylin and eosin (H&E)

stain except when the fixative used is osium tetroxide. Hematoxylin which is basic in

nature, stains the tissue blue or black, while, eosin which is acidic stains the cytoplasm

pink or red.

2.1.3. MUSEUM UNIT

The museum unit collects relevant pathological samples. These samples are preserved and

prepared for display and other purposes such as research and reference purposes. The curators

does the tissue pot construction and preparation of chemical solutions used for preserving and

displaying.

2.2. RADIOLOGY DEPARTMENT

Clinical radiology is a specialised branch of medicine that uses state of the art equipment and a

range of techniques to capture images of the inside of the body.

Clinical radiology uses three main kinds of imaging modalities to create images of the inside of

the body. These are:

 Plain radiograph and computed tomography (CT) scan, which uses ionising

radiation in the form of x-rays to image the body.

 Magnetic resonance imaging (MRI) scan which measures the radio waves

emitted while in an external magnetic field.

 Ultrasound which uses high frequency sound waves and not radiations to

image structures in the body.

Other important imaging modalities include:

 Contrast study

 Doppler`s sonography

 Angiography and fluoroscopy

 Mammography

 Nuclear medical imaging

The rapid advances in clinical radiology technology and therapy have dramatically improved the

diagnosis and treatment of illness and injury.

Clinical radiology has a range of benefits for the patient. These include:

i. It can eliminate the need for exploratory surgery.

ii. It is used to determine when a patient needs surgery.

iii. It assists in making a diagnosis and further management of most body conditions.
 iv. Interventional radiology, which involves treatment as well as diagnosis, involves

less risk, a shorter recovery time and less time in hospital than open surgery or key-hole

surgery.

v. It is used to visually guide the treatment of conditions such as heart disease and

stroke.

vi. It is used in screening for disease such as breast cancer (mammography), with

early detection, hence, reducing mortality rate.

vii. It improves cancer diagnosis and is also an effective treatment for cancer and

other diseases.

2.3. INSTRUMENTATION

2.3.1. MATERIALS USED IN THE MORTUARY UNIT

 Scalpel and Blades- for making incisions

 Dissecting Forceps- for holding tissues

 Needle and Thread- for stitching tissues

 Surgical Gloves- for protecting the arm from biohazards

 Face mask and eyes goggle- for protecting the face and eyes

 Rubber Tubule and Cannula- for delivery or removal of fluids

 Boots- for protecting the leg and feet from biohazard

 Embalming Table or Trolley- where dead bodies are kept for embalmment
 Laboratory Coats\ Aprons- for protection

 Embalming Tanks- contains embalming fluid

 Dyes- for dressing

 Cosmetics- for dressing

 Reagents- mostly embalming fluids which includes :-

 Isopropyl alcohol

 Propylene glycol

 Buffer formalin

 Liquefied phenol

 Water

 Mentholated spirit etc.

 Reagent Bottles- contain embalming fluid

Picture of Equipment in Mortuary unit

Dissecting kit Embalming tank

2.3.2. MATERIAL USED IN HISTOPATHOLOGY UNIT

 Histology and cytology samples- for diagnosis and research

 Scalpel and blades- for anatomical dissections and surgery

 Surgical knives- for anatomical dissections and surgery

 Gloves- cover and protect hands from biohazards

 Cassettes-for storing samples after grossing and during processing

 Cotton wool- for cleansing and also serves as barrier during embedding

 Surgical Cut-up board- where samples are placed and cut-up or grossed
 Syringe and Aspiration needles- for injecting into or withdrawing fluid from the

body

 Reagents- mostly fixatives, used to preserve the samples

 Reagent bottles-for storing reagents

 Reagent containers- contains reagents ready for use

 Microtome- for tissue trimming

 Electric Water bath- for floating tissue sections

 Electric Hot plate- for heating scalpels, knives, and drying of slides

 Automatic Tissue Processor- for processing tissues

 Wax Jar- contains molten wax

 Electric Oven- for melting wax and drying slides

 Diamond Pencil and Papers- for marking or labelling

 Electric Embedding machine- for burying tissue inside a molten wax

 Embedding mould- for shaping and moulding wax block during embedding

 Embedding knives and bolts- for pressing the tissue to the surface during embedding

 Wooden Blocks- for mounting wax blocks for sectioning

 Bunsen Burner and Tripod Stand- source of heat

 Gas cylinder- supplies gas to the Bunsen burner

 Binocular Microscope- for viewing very small objects beyond human eyes, e.g.

microorganisms

 Staining racks- for holding slides during processing

 Slides and Cover slips- for sample smears

 Stop watch- for keeping time

 Coupling jar- for fixing slides

 Refrigerator- for preserving samples

 Spatula-for lifting, mixing and spreading materials especially cassettes

 Microtome knives and Sharpener- sections tissues and sharpens microtome knives

 Conical flask- for storing reagents ready for use

 Measuring cylinder- for measuring reagents.

Pictures of Equipment Used in Histopathology Unit
2.3.3. MATERIALS USED IN THE MUSEUM UNIT

 Specimens- for potting

 Water filter- contains mounting fluid

 Measuring cylinder- for measuring fluids ready for use

 Glass pipette- for measurement

 Stirring rods- for stirring reagents

 Artery forceps- for holding samples

 Brain knives- for anatomical dissection

 Perspex cutter- for cutting perspex sheet

 Stainless Trays- for placing specimens

 Beaker- for measurement

 Twine- for tying tissue to centre plate

 Stitching Needle- for stitching tissues to centre plate

 Perspex Sheet- for making pots, cabinets, stoppers, centre plate

 T-square - for measurement

 Painter's Brush- for applying reagents

 Weighing Balance- for checking weight of samples

 Scissors- for cutting

 Manual and Electric Saw- for cutting perspex

 Manual and Electric Drilling Machine with Drilling Bits- for drilling holes into a pot

 Files(Rough and Smooth)- for smoothening the pot

 Workmate- a table where pots are constructed

 Wooden Mould- for arranging the pots in position

 Screwdrivers- for tightening screws into the wooden mould

 Forceps- for holding samples

 Syringes- for injecting or withdrawing fluids

 Funnels- for pouring fluids

 Perspex Glue or Cement- for adhesion to surface

 Masking Tape- for labelling

 Metre Rule- for measurement

 Display Shelves- for displaying finished pot

 Reagent Bottles-contains reagent such as mounting fluids

 Stop Watch- for keeping time

 Museum Jars- contains reagent

 Pencil- for marking and labelling

Picture of some Materials in the Museum Unit
 Hand
saw

Masking Perspex sheet

tape covered with
brown paper

Metre rule
Rough
Twine File

Measuring cylinder
Perspex containing chloroform and
cutter painter’s brush

2.3.4. MATERIAL USED IN RADIOLOGY DEPARTMENT

 X-ray machine – used during plain radiography to produce images of

structures within the body.

 Computed tomography machine - used during CT scan to visualise the interior

of the body and produces axial images. It is also used for PET-CT scan.

 Ultrasound machine – used during ultrasonography and doppler`s sonography.

 Magnetic resonance imaging machine – used during magnetic resonance

imaging.
  Mammography machine – used during mammography to image the soft

tissues of the breast.

 Contrast dye – introduced into the body during contrast study.

 Radionuclide – introduced into the body when nuclear medical imaging

modality is employed.

 Ultrasound gel – used during ultrasonography to displace air and enhance the

image gotten from the ultrasound transducer.

Pictures of Equipment used in Radiology

2.4. OTHER RELIEVANT EXPIRENCES

Apart from the wealth of knowledge I was able to tap into during the course of my industrial

training, I learnt other relevant things which I believe would help me in my career as an

anatomist and in my day to day living. They include but not limited to the following:-

i. I have been enlightened and I have seen ways in which medical equipment

and reagent should be handled to attain effective result.

ii. Though I have been taught the theoretical aspect of embalming, I got to

appreciate the knowledge more when I started embalming bodies myself.

iii. I have learnt patient-doctor relationship which should be patient-centred,

mutual-participation characteristics rather than active-passive cooperation in

terms of medical decision making.

 CHAPTER THREE

3.0. WORK CARRIED OUT DURING THE SIWES PROGRAM

3.1. THE DEPARTMENT OF MORBID ANATOMY/HISTOPATHOLOGY

As mentioned earlier, the department of morbid anatomy/histopathology has three (3) basic units.

These units are:

 Mortuary unit

 Histopathology unit

 Museum unit

I was exposed to the different ways works are carried out in these units. I would be outlining

them below.

3.1.1. MORTUARY UNIT

Morgue is a place for the storage of human corpses awaiting identification or removal for

autopsy or disposal by burial, cremation or other methods. In this section, I learnt embalming

techniques which is a method of preserving bodies that have been confirmed dead by a

physician. In modern times corpses have customarily been refrigerated to delay decomposition.

A mortuary generally performs five functions which ought to be kept physically separate as

sections namely;

i. the receipt and temporary storage of bodies;

ii. performing post-mortem;

iii. demonstration of post-mortem findings in cases of clinical interest or teaching

purposes;
 iv. a section for viewing and/or identification of a body and

v. accommodating visiting relatives/next of kin

3.1.1.1. EMBALMMENT is the process of disinfecting, preserving and restoring a diseased

human body to a more life-like appearance as possible.

AIMS OF EMBALMMENT:

 To prevent decomposition (in form of putrefaction and autolysis)

 To give the dead body a life-like appearance

 To make the deceased appear more presentable.

 To preserve the dead body

 To disinfect the dead body

METHODS OF EMBALMMENT:

 INFUSION: Is the gravity-flow method used for arterial embalming or by

pressure using embalming machines.

 INJECTION: Injection through the skin, muscles, tissues, orifices. This

method does not reach the organs; it only reaches tissues close to the skin.

 IMMERSION: To submerge the bodies in a pool of embalming fluid.

 REFRIGERATION: To put the bodies in a cold room (not really an

embalming technique because embalming fluids are not used).

EMBALMING FLUIDS:
Embalming is not done with a single fluid. Rather various mixture of formaldehyde,

glutaraldehyde or in some cases phenol which are then diluted to gain the final index of the

arterial solution. The three essential components of embalming fluids should focus on

disinfection, preservation, and restoration. The embalmer has a variety of embalming fluids

available to him or her. Pre-injection chemicals break up clots and condition vessels. Co-

injection chemicals restore dehydrated tissues, fight edema, and correct hard water. Cauterants

dry, seal and preserve open wounds. The most important chemical, the arterial fluid is made up

of preservatives, germicides, anticoagulants, dyes and perfume. The embalming fluids are

prepared from propylene glycol which keeps the muscle moist; 10% buffered formalin used as

fixative; isopropyl alcohol used as a preservative; and liquefied phenol, which is used as a mold

preventive. Colouring of the blood vessels is useful in their identification with a small amount of

amphyl, which is also used as a disinfectant.

FACTORS AFFECTING THE STABILITY OF EMBALMING FLUIDS

 TEMPERATURE: Extremes in temperature have a detrimental effect on the

shelf life of embalming fluids. Elevated temperatures accelerate polymerization of

formaldehyde and cause decomposition of its disinfectant and preservative

components. Depressed temperatures cause precipitation of the endothermic

solutes.

 TIME: All organic compounds exhibit a tendency to form polymers.

Methanol is incorporated into embalming fluids as an antipolymerization agent

for formaldehyde. The average shelf life of fluids is between two and five years.
  PH: One of the purposes of adding buffers to embalming fluids is to prolong

their shelf life. Strongly alkaline solutions cause decomposition of formaldehyde.

Highly acid solutions promote polymerization.

 LIGHT: Light has been cited as a factor influencing the speed of chemical

reactions. Light has two effects on embalming fluids:

a) It causes colour change, thus interfering with the eventual reaction of

the cosmetic dyes and

b) It increases polymerization of the formaldehyde; as a result, some

manufacturers have adopted tinted containers to prolong the shelf life of

their products.

ARTERIES USED FOR EMBALMMENT

a) Common carotid artery

b) Femoral artery

c) Brachial artery

3.1.1.2. EMBALMING TECHNIQUES:

MATERIALS NEEDED: Embalming fluids, Scalpel and blade, Forceps, Needle, Thread,

Gauze, Rubber Tubule or Cannula, Hand gloves, Face masks, Cotton wool, Light, Embalming

tanks and reagent bottles.

PROCEDURE FOR EMBALMMENT:

 A woman was received in the mortuary alongside her death notice brought to the

morticians by a ward attendant. This death notice was to show that both clinical and

anatomy signs of death has been confirmed by a physician. An authorization from the

family, as they filled the contract form was given to the mortician to embalm the body.

 Am embalming report was filled containing the body's personal items, details any

discolorations, cuts, bruises, etc on the body; and documents the procedures and

chemicals used during embalming. This report can become very valuable if a deceased's

family bring a lawsuit against the embalmer.

 A strong disinfectant was used to clean the skin, eyes, mouth and other orifices. Rigor

mortis was relieved by moving the limbs and head about and massaging the muscles (If

the deceased is a man, shaving is done at this point).

 The body was set in anatomical position with hand turned downwards. The external

genitalia area was covered with a piece of cloth or towel. The breast was arranged and

clamped to enable easy dressing for burial or cremation.

 The nasal and buccal cavities were filled with cotton to prevent any leakage during or

after embalming. This was done to retain all chemicals and fluid for better fixation.

 Arterial embalming begins by selecting an artery to inject the fluid into and a vein to

drain away blood but they do not drain blood in FETHA. The most commonly used artery

is the femoral artery because it is easily located unlike other arteries and situated

superficially in front of the thigh in the femoral triangle. The disadvantage of the femoral

artery is that the vessel is deep in obese cases, making it difficult to locate and difficult to

raise.
 A small oblique incision was made on the region of femoral triangle. The femoral

artery was exposed by cleaning the fascia of the artery to allow movement and space for

the cannula which was inserted into it.

 The embalmer raised the artery above the skin surface with aneurism hooks and

passed two suture strings beneath it to create a ligature to tie off the vessel once the

arterial tube was inserted to keep the cannula in place while embalming. This was done to

help avoid leakage or release of the tube due to pressure exerted by the embalming

apparatus.

 The artery was incised (very carefully as to not cut it in half) and an L-shaped arterial

Cannula (catheter) was inserted into the artery towards the heart. The ligature was now

tightened so that a seal was made between the tube and the artery.

 The cannula is connected to a polyethylene tubing which is connected to the gravity

embalming tank (improvised bucket) located above the body on a wooden pavement

attached to the wall.

 Before the embalming fluid was infused, air was removed from the connecting tube to

avoid any possible airlocks produced by the vessels of the woman's body during the

infusion of the fluid.

 Injection periods vary in each case taking 8-24 hours. This variability is due to the

ability of the body to accept the fluid at its own rate.

 When all the preparatory procedures have been completed, the pepcock was turned on

to allow the embalming fluids to flow through the tube, cannula and into the femoral

artery, thus dispersing the fluid into the vascular system.

  During embalming, mixture of blood and formalin was seen gushing out from the

eyes, nose and ears. A number of small whitish splotches appeared on the skin in the

region most effectively embalmed and then they spread peripherally. These splotches

were said by the embalmer to disappear within several hours without leaving any trace.

 A number of blisters also appeared over certain areas of the body surface, this

indicated that the pressure of the embalming fluid was too high; the embalmer later

injected it with a fluid filled hypodermic needle to ensure preservation of the area.

 Any area not receiving enough embalming fluid was injected by hand with a 10CC

syringe and a 14 gauge needle. These areas were lumbar region, gluteal region, feet, legs,

thigh, hand, forearm, abdomen, thorax, and face. When injecting these areas, the needle

was best inserted at a higher point than the injecting area to keep the fluid from leaking

out.

 While this was done, protective glasses, a mask, and impervious gloves were worn.

The exposure of harmful chemicals to the embalmer is greater at this time due to direct

injection and leakage that may occur.

 The body was kept till the relatives were ready for burial or cremation.

3.1.1.3. AUTOPSY: An autopsy is a detailed examination and dissection of the human body

after death. It is used to determine the likely cause of death as well as to evaluate the presence of

disease and/or injuries.

AIM: The major aim of autopsy is to specify:

 The time of death

  The cause of death

 Damage to the body (including damage from disease)

 The type of death (suicide, murder, or natural causes)

MATERIAL USED: enterotome, skull chisel, hagedorn needle, rib cutters, scalpel,

Toothed forceps, scissors, bone saw, breadknife, breadknife, saw blade, autopsy table, Arterial

tube, head rest, surgical gloves, goggle, jacket and apron, sternal saw, mallet, skull key, brain

knife, rib shears, speculum, post-mortem needle, medical syringes, Foley catheter, water bath,

tongue tie, formaldehyde.

PROCEDURE

1. Before performing an Autopsy: Normally permission for an autopsy is given by the

deceased person`s family. However, if there are legal or forensic concerns surrounding the cause

of death, an autopsy may be mandated by the courts or by a coroner.

Appropriate data of the person are also gathered before commencing the autopsy. This is because

there are many factors that can come into play leading to a person`s death. so it’s important to

have the person`s full medical history, as well as a full history surrounding the events preceding

his/her death in order to make the investigation and the dissection of the body as helpful as

possible. The police may play a role in investigating the crime scene, if there is one, and further

look into evidence that could support a potential cause of death.

NOTE: Depending on the suspected cause of death, an autopsy may only need to be done on

certain body parts, and not necessarily on the whole body. It varies depending upon the case. For

instance, in someone who died in a fatal road traffic accident, the exterior of the body is usually

examined to identify wounds and haemorrhage on the body. And the interior is not dissected.
2. During an Autopsy: when carrying out autopsy, the following steps are taken:

i. Examination of the bodies exterior: first the height of the person is noted,

then the weight, age, and sex of the body. Any distinguishing characteristics like

birthmarks, scars, or tattoos are also noted. The clothing and skin is also checked

for marks that look out of the ordinary. Droplets of blood, organic materials, and

any residues found on clothing are also noted. Also any bruises, wounds or marks

on skin are noted. Photograph may be helpful as well, to document the

appearance of the body and any significant findings or unusual things noticed

amidst the investigation. Therefore photograph is taken with clothes on, as well

as nude.

ii. Check the genital area for any signs of rape. Bruising and tearing are

common in such cases

iii. Take blood sample. It can be used for DNA purposes, or it can help t

determine if the victim was on drugs, had been using alcohol, or whether there

was poisoning involved. A urine sample is also taken from the bladder using a

syringe because just like the blood, the urine can be used in tests to detect drugs

or poisons.

iv. Open the body cavity once the initial examinations are completed. Using a

scalpel, make one large “Y” or “I” shaped incision from the neck across the

thorax, then down to that pubic bone. Spread open the skin and check to see if

any rib are broken. Split the rib cage using the rib shears, open it up, and examine

the lungs and heart. Note any abnormalities. Then take a second blood sample

directly from the heart.

 v. Examine each organ in the thorax individually. Weigh each organ, record

anything notable, and take a tissue sample in case further examination is needed.

Many of the organs in the thorax is also sub-dissected by opening them up and

examine them to look for disease. Next take out the organs in the abdomen,

observe anything notable in the. Weight each one of them before taking samples

from them. Sub-dissect the organs to examine them.

vi. Observe the eyes carefully. The presence of tiny, broken blood vessel

(petechial rash) can show sign of choking or strangulation.

vii. Look at the head. Check for any trauma to the skull, including fractures or

bruises. Then remove the top of the skull, and remove the brain. Follow the same

procedures as with all other organs, weight the brain and take a sample

3. After the Autopsy examination: after the interior and exterior post-mortem examination has

been completed, the record made is checked for any error. Then all organs are returned to their

position in the body. The reflexed skin is brought back and the incision is sutured.

SIGNIFICANCE

The cause of death is stated from the record gotten during examination. Many clues are gotten

that could help relevant authorities to stop a murderer. Death certificate is issued to the family of

the victim by the chief medical examiner. This enables the family to be able to be able to bury or

cremate the victim.

3.1.2. HISTOPATHOLOGY UNIT

Histopathology is the branch of science that deals with the gross and microscopic study of tissue

affected by disease. In this unit, I learnt it provides diagnostic service for evaluation of biopsy

specimens from human as well as live animals. These laboratory processes samples for diagnosis

and also for research needs. The samples received require tissue preparation and are then treated

and analysed using techniques appropriate to the type of tissue and the investigation required.

This led to the division of the unit into six (6) subsections or benches. They are;

1. Cytology Bench

2. Surgical Cut-up Bench

3. Tissue Processing Bench

4. Embedding Bench

5. Microtome Bench

6. Staining Bench

3.1.2.1. CYTOLOGY BENCH

Cytology is the study of the structure and function of cells. The examination of cells under a

microscope is used in the diagnosis of various diseases. In this subsection, cytology samples such
as Fine Needle Aspiration (FNA) are collected. The samples received should have a request form

that enlists the patient's information and history alongside the description of site of origin. The

samples are given numbers (accession numbers) that will help to identify each sample for each

patient.

COLLECTION OF A BREAST SPECIMEN

PRINCIPLE: To collect a breast specimen which will allow for cytological preparation and

evaluation in the laboratory.

METHOD OF CYTOLOGY COLLECTION

 ASPIRATION CYTOLOGY: It is the aspiration of specimens of cells through a hollow

needle, using a syringe by a means of suction and their subsequent examination under the

microscope after suitable preparation. It is valuable in diagnosis of lesions of the breast,

thyroid, lymph nodes, liver, lungs, skin, soft tissues and bones. The technique is now widely

used, especially for superficial cysts or tumours, and has become a specialised branch of

diagnostic pathology. Example is Fine Needle Aspiration Cytology.

 Fine Needle Aspiration Cytology (FNAC): is a technique that uses samples

obtained from fine-needle aspiration to provide information on the cells of tumours or

cysts. It is useful for detecting the presence of malignant cells, particularly in lumps of

the breast and thyroid gland.

STEPS TO BE FOLLOWED BEFORE PERFORMING THE ASPIRATION

a. Relevant history and clinical details, radiological findings, provisional diagnosis

etc. must be entered in the requisition form. Site of FNA must be clearly stated.

b. Lesion to be aspirated is palpated and its suitability for aspiration assessed. The

appropriate needle is selected accordingly.

c. The procedure must be clearly explained to the patient and consent and co-

operation ensured. Patient may be anxious which needs to be allayed. Ignoring this

simple but crucial step can result in failure.

d. Before starting the procedure, ensure that all the required equipment, instruments

and supplies are available.

e. All universal precautions should be followed during the procedure.

MATERIALS NEEDED:

Glass microscope slides (Frosted-end slides),Coupling jar containing 95% alcohol, Syringes,

Needles, Pencil for marking, Gloves, Cotton wool, Alcohol or Methylated spirit

PROCEDURE FOR FINE NEEDLE ASPIRATION CYTOLOGY:

a. FNA is usually carried out with the patient lying supine on an examination couch or

in a sitting position.

b. Localise the mass cleanse firmly with an alcohol swab (as used for routine injection).

c. Local anaesthetic may not be necessary.

 d. Apprehensive patients must be reassured about the procedure.

e. Label two slides for each sample with the patient's name.

f. Introduce the needle into the mass. Create negative pressure and maintain.

g. Sample area vigorously on several planes, maintaining the negative pressure.

h. Release the plunger on syringe to equalize pressure and withdraw the needle from

the mass.

i. Place a small drop of the aspirated sample onto a glass slide.

j. Place a second glass slide on the top of the drop of aspirated material and smear the

slides against each other. Avoid excessive pressure when preparing the smears to prevent

cell distortion and crush artefact.

k. Fix the slides with a 95% alcohol in a Coupling jar immediately. If both breasts are

being aspirated, indicate from which breast the sample was obtained on the glass slides.

l. A minimum of two samples per site is recommended.

m. The sample is sent to the Laboratory immediately for processing.

PROCEDURE FOR PROCESSING CYTOLOGY SAMPLE

a. The sample is left in a Coupling jar containing 90% alcohol for thirty (30) minutes to

one (1) hour after collection.

b. Remove slides from Coupling jar and place in a staining rack.

c. Hydrate the samples in descending concentrations of alcohol at one (1) minute to

two (2) minutes interval.

(Absolute I% alcohol 2mins 90% alcohol 2mins 70% alcohol)

d. Rinse in scot tap water

e. Dip in haematoxylin stain for three (3) to five (5) minutes.

f. Rinse in scot tap water to wash off the excess stain from the cytoplasm.

Note: Haematoxylin (basic stain) stains nucleus blue.

Eosin (acidic stain) stains cytoplasm red

g. Dip in Acid alcohol (1% HCl) three times to wash off the stain entirely from the

cytoplasm. It should not stay long in the acid alcohol because it can denature the whole

cell.

h. Dip in Eosin stain for thirty minutes to stain the cytoplasm

i. Rinse in scot tap water

j. Dehydrate the sample in ascending concentrations of alcohol at one(1) minute to two

minutes interval.

(70% alcohol 2mins 90% alcohol 2mins 100% alcohol)

k. Dry in air or oven (at room temperature).

l. Rinse in a clearing solution (Xylene) which helps for a better optical differentiation.

The clearing solution should be colourless and its refractive index should be close to that

of the cover slip, slides and mounting medium. Slides should remain in the clearing

agent until cover slipping is performed.

m. Pick a slide and clean the back with gauze and not with cotton wool because it can

leave some particles on the slide.

 n. Mounting medium (Distrene Plasticiser Xylene-DPX mountant) used to bond the

slide and the cover slip should be compatible with the clearing agent, transparent, and

has a refractive index similar to the glass slide and the stained specimen. Adequate

mounting should be applied to protect the cellular material from air-drying and

shrinkage, and to prevent fading of the cell sample.

o. The cellular material should be covered by a suitably sized cover slip or covering

material of appropriate quality. Different methods used to cover slip include placing the

mounting medium on the cover slip, then inverting the cover slip onto the slide surface,

or lowering the slide onto a cover slip containing adequate mounting medium.

p. Press the cover slip to remove air-bubbles trapped inside to prevent misinterpretation

of result while viewing with the aid of a microscope

q. Ideally, the mounting medium should be allowed to dry before the slides are

reviewed to reduce movement of cellular material during the slide examination.

SIGNIFICANCE: It provides accurate result and information for diagnosis and research if

processed well.
PICTURES OF THE STEPS IN PROCESSING CYTOLOGY SAMPLE

Coplinjar Staining rack 90% Alcohol

70% Alcohol Scot tap water

Hematoxylin

3.1.2.2. SURGICAL CUT-UP (GROSSING) BENCH

In this subsection, pathology specimens (histological) are inspected with bare eye to
Obtain diagnostic information. Grossing refers to the examination and dissection of surgical

specimens. An accurate diagnosis from this tissue is dependent on correct identification,

handling and processing. The grossing of a specimen can be done either before or after fixation

or following it. It is ideal to gross larger specimen in a fresh state and smaller following fixation.

Grossing is usually done by a pathologist.

HOW TO COLLECT HISTOLOGY SAMPLE

 Larger specimens including whole organs or parts were removed during

surgical operations. (E.g. a uterus after a hysterectomy).

 Pieces of tissue rather than whole organs are removed as biopsies, which often

require smaller surgical procedures that can be performed whilst the patient is still

awake but sedated. Biopsies include excision biopsies, in which tissue is removed

with a scalpel (e.g. a skin incision for a mole) a core biopsy, in which a needle is

inserted into a suspicious mass to remove a slither or core of tissue that can be

examined under the microscope (e.g. to investigate a breast lump).

Surgical cut-up bench

MATERIALS NEEDED: A cutting board, specimen containers, 10% formal saline, forceps of

various sizes, scissors of various types and size, probe, bone cutting saw or electric bone cutter,

scalpel handle, disposable blades, long knife and ruler to measure the size of lesion and

specimens, Box with cassettes and labels, reagent container, disposable gloves.

PROCEDURE FOR GROSSING:

 Identification of the specimen-confirmation of patient and anatomical site from which

the specimen has been obtained.

 Clinical details

 Gross description – written record of physical appearance of the specimen

 Shape or configuration: round, spherical, ovoid, elliptical, cylindrical,

rectangular, irregular, polypoid, exophytic, endophytic, gyriform, ulcerated,

heaped up, raised, linear, whorled, bulging, multiloculated, cystic, vesicular,

globular, etc.

 Colour: red, tan brown, red-purple to brown black, transparent, haemorrhagic,

etc.

 Odour: only if obvious, rancid, burnt, etc.

 Take the measurements and weights

 Only a small portion from the large specimen is put in cassettes which are fixed in a

suitable fixative.

 Label each cassette with a number or letter, or combination of both using led-pencil

 Indicate the content of each cassette and summarise the total number of cassettes.

 Gross examination should be done by a skilled person so as to collect important part

of the sample for accurate diagnosis and because the success of tissue sectioning depends

majorly on grossing.

 Only soft tissue can be cut into small blocks and processed directly.

 Bony specimens need to be decalcified before processing.

 SIGNIFICANCE: Helps to examine pathology specimens with bare eye to obtain diagnostic

information prior to fixation.

3.1.2.3. FIXATION

It is the process of using chemicals to prevent deterioration of tissues thereby maintaining the

tissue chemistry and architecture as life-like as possible after death. Tissue chemistry can be

altered by the action of certain fixative. The architecture allows the determination of its

microanatomy while chemistry allows localization of various clinical constituents.

PRINCIPLES OF FIXATION

a. By action of some fixatives on the side group of

b. By denaturation of protein (splitting protein molecules to expose inner bonds on which some

other fixative chemicals act).

CLASSIFICATION OF FIXATIVES

Various criteria of classifying fixative;

i. Number of chemicals that constitutes the fixative:

They are two ways;

a. PRIMARY FIXATIVE: It has only one fixative e.g. formalin, ethanol, methanol, 10%

formal saline, 10% normal saline.

 b. SECONDARY OR COMPOUND FIXATIVE: It has two or more fixative fixatives and

combined in a solution e.g. Zenker's formal (contains mercuric chloride, potassium dichromate

and formalin), Acetic acid and Picric acid, Formal alcohol, Carnoys fluid.

ii. Specific application of the fixative:

They are two ways;

a. MICROANATOMICALFIXATIVES: These are used to preserve the anatomy of the tissue

e.g. 10% formal saline, buffered formalin

b. CYTOLOGICAL FIXATIVES: These are used to fix intracellular structures.

They are;

 NUCLEIFIXATIVES: These fixatives fix nucleus sometimes at the detriment of the

cytoplasm e.g. Carnoy's fluid, Fleming's with acetic acid, Clarke's fluid, Newcomer's fluid. The

pH of the fluid must be 4.4 or less.

 CYTOPLASMIC FIXATIVES: These fixatives fix the cytoplasm sometimes at the

detriment of the nucleus e.g. Fleming's fluid without acetic acid, Helly's fluid, Scardin's fluid,

Regaud's fluid, Formalin with post-chroming.

PROCESSES TISSUE UNDERGO BEFORE FIXATION (SEVERAL CHANGES TISSUE

UNDERGO WHEN CUT-OFF FROM THE BODY)

 SHRINKAGE: The cells will show abnormal sizes and shapes. Shrinkage occurs due

to loss of water.

 OSMOTIC CHANGES: If the tissue is left in a fluid, the osmotic change could

either cause a swelling change depending on the osmotic pressure of the fluid.

 PUTREFACTION/ POST-MORTEM DEFECT: Putrefaction is the degradation of

tissue by microorganisms that integrate it.

 AUTOLYSIS/ PERMEABILITY CHANGES: Permeability changes occur due to

lack of oxygen, lysosomes diffuse and cut through their membranes and digests the cells.

Therefore, autolysis can be defined as cell death as a result of enzymes contained in the

cell. These lysosomes contain enzymes like sulphatases, proteinases, carboxypeptidases,

aminopeptidases. They degrade cells by hydraulic actions.

QUALITIES OF A GOOD FIXATIVE

a. It should kill rapidly without distortion.

b. It should penetrate the tissue rapidly and evenly.

c. It should prevent osmosis and leaking of the cell and tissue constituents

i.e. it should render substances of the cell insoluble.

d. It should allow accurate histochemistry of the tissue constituents.

e. It should be able to permit the use of dyes and other reagent.

 f. It should prevent autolysis and putrefaction.

g. It should permit long storage of tissue.

h. It should give good optical differentiation to unstained tissue constituent

for easy microscopy.

i. It should harden the tissue for easy handling and renders it insensitive to

subsequent treatment.

j. It should permit restoration of natural colour of photomicrograph.

k. It should be simple to prepare and economical to use.

COMMONLY USED FIXATIVE: For Most tissues use 10% formalin except in brain tissue

which uses 20% formalin

3.1.2.4. TISSUE PROCESSING BENCH

Tissue processing is a procedure that takes place between tissue fixation and the

embedding/sectioning of paraffin blocks. It is the process of passing tissue gradually through a

series of reagents which end in the solid medium. This process is aimed at providing a solid

support medium to the tissues to enable section cutting. This can be done by an automatic tissue

processor, a machine which happened to be faulty throughout my period of attachment.

There are three (3) main steps in Tissue Processing;

 Dehydration
  Dealcoholisation(Clearing)

 Impregnation(Infiltration)

a. DEHYDRATION

It is the process in which the water content in the tissue to be processed is completely reduced by

passing the tissue through increasing concentrations of dehydrating agents. Paraffin wax is

hydrophobic; therefore most of the water in the tissue must be removed before it can be

infiltrated with wax. A series of increasing concentrations until absolute alcohol is used to ensure

that the water in tissue is gradually replaced by the alcohol and to avoid excessive distortion of

the tissue. Various components of the cells are also removed by this process such as water

soluble proteins and lipids

PRINCIPLE: To remove water from tissue which is present either bound to the tissue or free in

the tissue.

Various dehydrating agents used are;

 Ethyl alcohol

 Acetone

 Isopropyl alcohol

 Dioxane
METHODS OF DEHYDRATION

 RAPID METHOD:

70%Alcohol 90% Alcohol Absolute Alcohol I Absolute Alcohol II

30minutes 1hour 30minutes 1hour

 ROUTINE METHOD:

70%Alcohol 90% Alcohol Absolute Alcohol I Absolute AlcoholII

3 hours 3 hours 3 hours 3 hours

NOTE: The time in each step is dependent on the type and size of the sample but as a general

rule the intervals given above is used.

SIGNIFICANCE: Dehydration is done so that paraffin wax which is used for impregnation can

be easily miscible as it is immiscible with water.

b. DEALCOHOLISATION(CLEARING)

It is the process of removing absolute alcohol from tissue and replacing it with a solvent which is

miscible with absolute alcohol and paraffin wax. The aim is to increase the refractive index of

the tissue making the tissue transparent or clear. Clearing agents can also be called antimedia

because they can also remove alcohol from tissue. Examples of antimedia are benzene, touluene,
xylene, petroleum ether, chloroform, cedar wood oil, carbon disulphate, tetrahydrofural and

carbon tetrachloride.

PRINCIPLE: To remove alcohol in the tissue and replaced by a fluid which will dissolve the

wax used for impregnating tissue.

QUALITIES OF A GOOD ANTIMEDIA

 Removes alcohol quickly.

 Clears the tissue without causing much hardening.

 Do not dissolve dyes used in staining.

 It is not highly volatile.

 It is able to mix with dehydrating and impregnating medium

METHODS OF CLEARING

 RAPID METHOD:

Xylene I Xylene II

30minutes 30minutes

 ROUTINE METHOD:

Xylene I Xylene II

3 hours 3 hours

SIGNIFICANCE OF DEALCOHOLISATION: It removes alcohol and also increases the

refractive index of the tissue, making the tissue transparent or clear.

c. IMPREGNATION(INFILTRATION)

Infiltration is when the final xylene is replaced with molten paraffin wax which infiltrates the

tissue. Molten paraffin completely displaces clearing agents from the tissue and goes to fill the

intra and inter cellular spaces and cavities within the cell, thereby making the tissue solid enough

for easy microtomy.

PRINCIPLE: To keep tissue in a molten wax which infiltrates the interstices of the tissue and

replace the clearing agent.

Infiltration of molten paraffin wax into tissue can be carried out in two ways;

a. Impregnation at normal pressure (Manual/Automatic impregnation): This is

carried out by the manual and automatic machine. In manual impregnation, hot air oven is

used, maintained at a temperature of 50C to 100C above the melting point of wax (52

degrees to 58 degrees) to keep the wax in molten state.

b. Impregnation at reduced pressure (Vacuum impregnation): Infiltration is faster

when done at a reduced pressure in a vacuum oven. It involves rapid replacement of clearing

agent with paraffin wax at a reduced pressure using vacuum oven.

Materials used: Reagent container, molten wax, Vacuum oven, spatula, forceps, samples in

cassettes

Methods of impregnation

 Rapid method:

Paraffin wax I Paraffin wax II Paraffin wax III

30minutes 30minutes 30minutes

 Routine method:

Paraffin wax I Paraffin wax II Paraffin wax III

2hours 2hours 2hours

The jar containing paraffin wax I, II and III should be put in oven at a temperature of 50C to

100C above the melting point of wax to keep the wax in molten condition. After the final

infiltration, the tissue cassettes are transferred to embedding bench.

Significance of infiltration: It increases the optical differentiation and hardens the tissue which

helps in easy sectioning of the tissue.

3.1.2.5. EMBEDDING BENCH

Embedding is the process of burying tissue in an embedding medium such as molten paraffin

wax, thus, supporting the processed tissue bit when solidified. This medium not only makes it

possible for easy microtomy but also for easy preservation of tissue for future use. Tissue should

be well oriented in the mould during embedding so that a complete representation of all parts of

the tissue is presented in cut sections.

Principle: To bury tissue in mould containing molten paraffin wax.

Embedding is performed in special containers called moulds. These containers help to give shape

to the wax containing the tissue when it set. There are many types of embedding moulds but we

used two types;

 Pairs of L-shaped mould: Pieces of rust-proof metals held together by a

hinge, they are called L-shaped embedding mould.

  Metal containers: A rectangular or square shaped metallic container.

Materials used: Bunsen burner, forceps, tripod stand, Vacuum oven, moulds, molten wax, wax

jar, hot plate, cassettes, gauze, groundnut oil or engine oil, knives, bolts, processed samples.

PROCEDURE FOR EMBEDDING TISSUE:

a. Using forceps pick out the paraffin infiltrated tissue cassettes from the stainless jar

containing liquid wax.

b. Remove the paraffin infiltrated tissue from the tissue cassettes

c. Arrange the L-shaped moulds or the metal container on the table, depending on the one

you want to use and grease with engine or groundnut oil for easy separation of the wax

from the mould. Use a gauze to block any possible leakage from the L-shaped mould to

avoid wastage.

d. Pour a little hot paraffin wax from the wax jar directly from the oven into the mould to

fill the base area of the mould.

e. Bury the tissue samples inside the molten paraffin wax quickly before the wax starts to

solidify. Try and arrange your samples so that they lie horizontally within the mould, this

will make the orientation and trimming of the block easier.

f. Use a warm forceps or head of a bolt to slightly press the tissue down to the surface of

the mould.

g. Ensure that the tissue touches the surface of the mould and not left hanging by using a

warm forceps or knife to melt any solidifying wax.

h. Place the label close to the tissue for easy identification.

 i. Fill the empty portion of the mould to the brim in order to get a perfect square shape.

j. Once the top of the wax has solidified, leave to solidify on its own or lift the mould

carefully, and place it in cold water to speed up the solidification process. Leave in water

for about 10minutes.

k. Remove the mould from the sample and cut the wax into blocks. Cut it when it is soft

(i.e. when it is not too solid) to avoid breaking or for easy cutting.

l. Trim the wax blocks to a suitable size and shape.

m. Mount the wax block on a wooden block by placing a hot knife between the wax block

and the wooden block. Label the blocks and proceed to microtome bench for microtomy.

Significance: It helps in the proper alignment and orientation of tissues in wax blocks for easy

sectioning.

3.1.2.6. MICROTOME (SECTIONING) BENCH

In this subsection, tissues are been sectioned into thin slices. Microtomy is the process of making

thin slices of tissues for anatomical observation with a microscope. Sections can range from

hundreds of microns to tens of nanometres in thickness depending on the target of observations.

PRINCIPLE: To use a rotary microtome or any other type of microtome to make thin sections

for microscopy.

MATERIALS USED: Water bath, wax blocks embedded with tissues, rotatory microtome,

microtome blade, distilled water, frosted slide, glycerol and egg albumen, 20% alcohol.
PROCEDURE FOR SECTIONING:

I. Set the water bath to reach 48 േ 4 ̊C above the temperature of paraffin wax before

sectioning to hot water. This is used to float the tissue section prior to picking with a

slide.

II. Place the wax blocks faced down on ice cubes for 10minutes to chill the block to

facilitate fast sectioning. This renders the block sufficiently hard for thin sectioning.

III. Put the wax block in the block holder of the microtome.

IV. Place a very sharp fresh blade on a microtome and lock it in place and make sure blade

guards are closed. Lock microtome handle when not in use.

V. Adjust the block holder screws to place the block parallel to the blade.

VI. Unlock handle and turn handle until samples starts cutting a little. The block is repeatedly

sectioned at 20microns thickness per slice to remove excess wax till the entire surface of

the tissue is exposed, discard the paraffin ribbon.

VII. Secure and readjust the wax block and section the block at 3-5microns, this gives you a

nice ribbon for easy microscopy. Some tissue biopsies are sectioned at different thickness

but anything above 5microns is a thick section.

VIII. Gradually pick the sections with a forceps and lower onto a water bath.

IX. If difficulty is encountered in spreading of the tissue, float the section on a zinc surface

containing 20% alcohol to increase the surface tension before transferring to the water

bath.

X. Allow the section to remain on a water bath until it has spread sufficiently.
 XI. Pick the section with the plain side of a frosted slide, a mixture of glycerol and albumen

at ratio of 50:50 is applied on the slide before picking the section from the water bath to

enable the section stick to the slide.

XII. Place the slides with paraffin sections on a hot plate or oven for 20 minutes (so the wax

just starts to melt) to bond the tissue to the glass and also to dry some of the moisture.

XIII. Label the biopsy number on the frosted end of the slide with a pencil.

XIV. Arrange the slide on a staining rack for staining.

Significance: It enables making thin slices of tissues for anatomical observation with a

microscope.

3.1.2.7. STAINING BENCH

Most cells are colourless and transparent, and therefore histological sections are stained in some

way to make the cells visible. The techniques used can either be specific, selectively staining

particular chemical groupings or molecules within cells or tissues, or non-specific, staining most

of the cells in much the same way.

PRINCIPLE: To stain histological sections in order to make the cell structures visible when

viewed with a microscope.

HAEMATOXYLIN AND EOSIN STAIN (H&E)

This is a good general stain and widely used. Most of the slides, when it is not otherwise stated

are stained with H&E. Hematoxylin acts as a basic stain via a substance called Hematien which

is formed in solutions of hematoxylin. It stains nucleic acids in the nucleus (chromatin and
nucleolus) and cytoplasm (ribosomes) blue. Eosin is an acid aniline dye which stains the more

basic proteins and other materials pink or red. It is thus mainly a cytoplasmic stain.

HAEMATOXYLIN STAIN CONSTITUENTS:

 Hematoxylin - 2.5g

 Absolute alcohol - 250ml

 Potassium alum - 50g

 Mercuric chloride - 1.25g

 Distilled water - 500ml

 Glacial acetic alcohol - 20ml

EOSIN STAIN CONSTITUENTS:

 Eosin - 10g

 Distilled water - 1000ml

PROCEDURE FOR STAINING:

 Arrange the slides in staining rack

 Dewax in xylene for 15minutes, a procedure also known as rehydration.

 Rinse in absolute alcohol

 Rinse in 90% alcohol

 Rinse in 70% alcohol

 Rinse in 50% alcohol

  Rinse in water

 Dip in hematoxylin stain for 6 minutes depending on the strength of the hematoxylin.

o Note: The hematoxylin should be prepared and left for 2 months before use. The stain

matures with use, also the strength of the stain increases with use, till 6months when the

strength starts to fall.

 Rinse in scot tap water to wash off excess stain

 Rinse in acid alcohol

 Dip in eosin and leave for 6 minutes

 Rinse in water by dipping twice

 Mount it using DPX mountant, leave in xylene while mounting.

 Dry the slides in air, making it ready for viewing with a microscope.

SIGNIFICANCE: Helps to make most colourless and transparent cells visible when viewed

with a microscope.

3.1.3. MUSEUM UNIT

Subsections in museum unit:

 Workshop (production section): where pots are constructed.

 Storage subsection: where equipment and materials for pot-making are stored.

 Display subsection: where potted specimens and artworks are kept and displayed

on shelves.
  Office: where seats, tables and all needed in the curator's office are kept.

BASIC MUSEUM TECHNIQUES:

1. Collection

2. Preparation

3. Fixation

4. Restoration

5. Preservation/Mounting

6. Presentation

3.1.3.1. COLLECTION OF MUSEUM SAMPLES:

Any specimen received in the museum should be recorded in a reception book and given a

number followed by year. This number will stay with specimen even after it is catalogued in its

respective place. This number is written on tie-on type label in indelible ink and is firmly

attached or stitched to the specimen. The reception book should contain all necessary

information about the specimen (clinical, gross and microscopic findings). Two major sources of

specimen maybe post-mortem/autopsy specimen or biopsy specimen.

3.1.3.2. PREPARATION OF SPECIMEN:

An ideal specimen is received fresh in unfixed state. However, it is mostly obtained from

histopathology laboratory after being examined, thus will already be formalin fixed.
3.1.3.3. FIXATION OF THE SPECIMEN:

Tissues should be suspended in the fixative to prevent its deformation thereby maintaining the

normal shape of the tissue. Fixation enables the preservation of tissue in a life-like state as

possible. Most of the fixatives used in preserving tissues in the pathology museum are formalin

based. The fixatives we used were mostly Kaiserling based. Specimen is stored in the Kaiserling

I Solution for 1 month depending on the size of the specimen. The specimen should not rest on

bottom or an artificial flat surface will be produced on hardening due to fixation. The volume of

the fixative used should be 10times the size of the tissue to be prepared. Larger specimen should

be injected for uniform penetration.

KAISERLING SOLUTION I CONSTITUENTS:

 40% Formalin - 400ml

 Potassium nitrate - 30g

 Potassium acetate - 60g

 Distilled water(tap water) - Making the solution up to 2000ml (2litres)

3.1.3.4. RESTORATION OF COLOUR:

It is required to restore colour of the specimens, as they lose their natural colour on fixation. The

recommended method is the Kaiserling II method. It involves removing the specimen, washing it

in running water and transferring to 80% ethyl alcohol for 10 minutes to 1hour depending on the

size of specimen. Ethyl alcohol is a reducing agent. The specimen is then kept and observed for

colour change. After this step, specimen is ready for preservation. The period of immersion in
this solution is to be controlled to prevent permanent bleaching as nothing can be done to restore

the colour.

3.1.3.5. PRESERVATION OF SPECIMEN:

The recommended solution for this step is Kaiserling III solution. This is the final solution in

which the specimen will remain for display. This solution is the current mounting fluid. It is

based on glycerine solution to make the formalin hardened tissue soft. Glycerine is a

preservative. Specimen is washed again in tap water. Do not mix sodium acetate and glycerine as

it does not dissolve faster but dissolve sodium acetate in formalin first before adding glycerine.

Leave solution to stand for 2 – 3 days before using to ensure proper mixing of chemicals. Adjust

the pH to 8.0 with sodium hydroxide to preserve the colour because colour fades with pH

changes. Add 0.4% sodium hydrosulphite (NaHS) immediately before sealing the pot.

KAISERLING III SOLUTION CONSTITUENTS:

 Glycerine - 300ml

 Sodium acetate - 100g

 Formalin - 5ml

 Tap water - Making the solution up to 1000ml (1litre)

CONSTRUCTION OF POT (HOW TO POT A TISSUE):

 Measure the width, length, and the thickness of the tissue to be potted.

 Measure and mark on the Perspex, the tissue measurements and cut with perspex

cutter (leave an excess of 1cm on the perspex while measuring).

 Place the edge of the perspex that is longer on the workmate and align well. (Do not

place the shorter edges to prevent breakage when placed weight).

 Remove the protective paper around the edges.

 Clean the edge with chloroform.

 Apply the perspex cement and place the third surface on top of the two equal

opposite surfaces aligned on the wooden workmate.

 Place a weight on it and leave overnight.

 Clean the opposite side of the third surface with chloroform before applying

perspex cement. Place this fourth surface opposite to the third surface on the free

edges.

 Place a weight on it and leave overnight

 Clean the top of the pot with chloroform, apply perspex cement and attach to the

four edges of the pot. File off excesses to make it fit in.

 Place a weight on it and leave overnight

 Fix stoppers to prevent rocking or sliding of centre plate. The space between

stoppers should be the same with the thickness of the centre plate.

 Attach the tissue to a centre plate using nylon thread and needle to stitch it to the

centre plate through the holes drilled on the centre plate. Double knots should be

made by threads, on the specimen surface. The centre plate should be 1.0mm

smaller than the pot (i.e. 0.5mm on both sides).

 Mounting fluid is run into within 1cm of the top. Insert the centre plate with the

attached tissue into the pot along the stoppers.

 Air bubbles trapped between the specimen and the centre plate is released with a

broad-bladed spatula and then fill the pot with mounting fluid.
  Drill two holes on the base of the pot to allow escape of trapped air in the pot. This

is done to prevent the reaction of air with the chemicals to form carbonic acid which

corrodes and lead to autolysis.

 Clean the edges of the base with chloroform before applying perspex cement. Place

it lightly in position to cover the pot. Place a weight on it and leave overnight to

allow escape of air bubbles.

 Clean the holes with chloroform before closing with perspex rod dipped in perspex

cement. Leave it to set before cutting the rod, then, file to smoothen the base. (Use

syringe to fill the pot through the holes if the volume of the mounting fluid reduced

before closing with perspex rod).

 File and smoothen any rough edges.

 Turn the base so as to be in touch with the surface of the shelf to hide the rough

base.

3.1.3.6. PRESENTATION (DISPLAY) OF SPECIMEN:

 Colour coding of the specimen may be grouped into different categories and each

category, assign a specific colour according to our convenience.

 Labelling of the pot with the reference number, name of lesion and colour coding for

the category of the specimen are the most desired details on the label of museum pot.

 Equal significance should be given to the statistical significance of each disorder, and

the changes that are taking place in the incidence of each.

Potted tissues displayed on the display stand in the museum

3.2. TESTS CARRIED OUT IN THE DEPARTMENT OF RADIOLOGY

Radiology a discipline in medicine that uses electromagnetic radiation echoes from sound waves

and contrast dye for the diagnosis and treatment of injury and disease. Radiology as a discipline

has different imaging modalities employed when imaging several pathological conditions. Thus

modalities include but are not limited to the following:

 Plain radiograph

 Computed tomography

 Magnetic resonance imaging

 Ultrasound scan

 Doppler`s sonography
  Contrast study

 Angiography and fluoroscopy

 Mammography

 Nuclear medical imaging

3.2.1. PLAIN RADIOGRAPHY

This involves the imaging of the body using x-rays radiation. X-rays are a form of radiation

similar to visible light, radio waves and microwaves. X-radiation is special because it has a very

high energy level that allows the x-ray beam to penetrate through the body and create an image

or picture.

PRINCIPLE:

The image is created due to the x-ray beam being absorbed differently by different structures or

parts in the body. A dense structure like bone absorbs a high percentage of the x-ray beam

(which appears light grey on the image), whilst low density structures like soft tissues absorb a

small percentage (which appears dark grey on the image). The body has many different

structures of varying densities and this difference creates a picture or image.

METHOD:

I. Before a Plain Radiograph: Before any plain radiograph is taken, the

following are noted and performed:

  An x-ray request form or referral letter from a doctor. This is a legal

requirement and no x-ray examination can be performed without it.

 Patients are taken to a changing room to remove their clothes and wear a

hospital gown. This ensures the x-ray is of the highest quality as some

clothing can make it difficult to see the images clearly.

 Certain items like watches, necklaces and certain types of clothing that

contain metal objects such as zips are removed because these items may

interfere with the quality of the image.

II. During a plain radiograph:

 A radiographer (a trained x-ray technologist) escorts the patient through

to an x-ray examination room.

 The procedure is explained to the patient

 Depending on the part of the body that is to be imaged, the patient is

asked to remain in a standing, sitting or lying position. (most plain

radiographs are done with the patient lying down).

 Depending on the pathological organ that is to be imaged, the

radiographer determines whether an anterior-posterior (AP), posterior-

anterior (PA), lateral or oblique view should be used to image the organ.

NOTE: Most organs, particularly organs in the chest are well represented in

images gotten from posterior-anterior (PA).

 The radiographer instructs the patient to stay still few seconds before

shooting the x-radiation beam. Any movement might make the image

blur.
 III. After a plain radiography: A radiologist (specialist x-ray doctor) then carefully

assesses the images, makes a diagnosis and produces a written report n the findings.

The report is sent to the referring doctor, specialist or allied health professional that

referred the patient for the test.

NOTE: X-ray takes less than 15 minutes for the total procedure. X-rays are

invisible and the patient will not feel anything.

Image of a normal plain radiograph film

SIGNIFICANCE

Plain radiography is used to image most structures in the respiratory system, cardiovascular

system, musculoskeletal system and urinogenital system. X-ray images of the gastrointestinal

tract are appreciated only when contrasts are introduced.

X-ray imaging is useful to diagnose disease and injury such as pneumonia, heart failure,

fractures, bone infections, arthritis, cancer, blockage of the bowel, and collapsed lung, etc.
3.2.2. COMPUTED TOMOGRAPHY

Computed tomography is commonly called “CT”. Computed tomography is a way of using x-

rays to take pictures or images in very fine slices of the body that the doctor has asked to be

investigated.

PRINCIPLE

In computed tomography the x-ray tube continuously rotates around the cranio-caudal axis of the

patient. A beam of radiation passes through the body and hits a ring or a moving ring segment of

detectors. The incoming radiation is continuously registered; the signal is digitized and fed into a

data matrix taking into account the varying beam angulations. The data matrix can then be

transformed into an output image. The CT machine`s tube rotation continues as the patient is fed

through the ring-like CT gantry, thus generating not single slice scans but spiral volume scans of

larger body.

PROCEDURE

I. Before a CT scan: Before any CT scan, some CT scan tests require preparation

but others do not. Example of CT scan test that does not need preparation include:

brain, sinus or facial bones, temporal bones (inner ear spine, knee or wrist, and

CT scan of the bones.

 Many types of CT require an injection of iodinated contrast material to

show blood vessels and some organs. For these tests, the patient is told

to fast prior to his/her appointment. Fasting for 2-4 hours is common and

the patient is allowed to drink water over this time to avoid dehydration.

 When iodinated contrast injection is required, the radiographer uses a

needle to insert a cannula into the vein in the patient`s arm or back of
 his/her hand so that the iodine contrast can be inserted into the cannula

during the test.

 Test investigating the abdomen normally requires the patient to drink a

different kind of iodinated contrast solution to outline the intestine. This

would also require fasting. The patient is usually asked to drink part of

the whole dose an hour prior to the scanning time and the rest of it just

before entering the scanning room.

 Depending on the type of scan, the patient is usually asked to change

into a gown to avoid parts of his/her clothing affecting the scan.

II. During a CT Scan: the CT scan equipment is a large square machine with a

circular hole or gantry.

 The patient is told to lie on the bed attached to the scanner (this may

be feet first or head first depending on the part of the body being looked

at).

 The bed will then be raised to a high level with the circular hole in the

scanner and the bed slides in and out of the hole several times while

pictures are being taken.

NOTE: It is important for the patient not to try to move during the scan as

it will affect the quality of the pictures and make them harder for the

radiologist to interpret.

 The radiographer performing the scan may ask the patient to hold his

/her breath for some scans.

  If the test requires an iodinated contrast injection, the radiographer will

come into the room to administer it using either a hand held syringe or a

mechanical pump. The pump helps to put the iodinated contrast in at a set

rate and allows for the scanner to target specific areas of the body.

 Once the radiographer has reviewed the images briefly to check that

the appropriate areas have been shown, they will come into the room to

help the patient off the bed.

III. After the CT Scan: After the scan, the radiographer does not give the patient

any result. This is the responsibility of the doctor that referred the patient for the

scan. The radiologist interprets the image scan and provides the report to the

patient`s doctor.

Once the patient is out of the scan room, it is likely that he/her would be shown to

an area where someone will check to know if the patient is ok. Then the cannula

is removed from the patient. The patient can now go home and wait for the result

from his/her doctor.

Image of a CT scan slice of the abdomen

SIGNIFICANCE
 a. CT scan are a fast, effective and accurate way of assisting doctors to make a

diagnosis and treat disease conditions

b. Because of their high tech, CT scan images bones and bone marrows very

clearly. These can help to diagnose bone marrow tumour

c. CT scan imaging modality is usually employed when imaging the respiratory

system, cardiovascular system, gastrointestinal tract, musculoskeletal system

and the urinogenital system.

3.2.3. MAGNETIC RESONANCE IMAGING

Magnetic resonance imaging (MRI) is a scanning procedure that uses strong magnets and

radiofrequency pulses to generate signals from the body. These signals are detected by a radio

antenna and processed by a computer to create images of the inside of the body.

PRINCIPLE

The principle of MRI is the directional magnetic field associated with charged particles in

motion. Nuclei containing an odd number of protons and/or neutrons have a characteristic

motion. Because nuclei are charged particles, this motion produces a small magnetic moment.

When a human body is placed in a large magnetic field, many of the free hydrogen nuclei align

themselves with the direction of the magnetic field. The nuclei precess about the magnetic field

direction like gyroscopes.

PROCEDURE
I. Before an MRI Scan: safety in the MRI scanner is vital. The strong magnetic

fields can attract and interfere with metal objects that the patient might have in or

on him/her (including electronic and magnetic devices). Some of this interaction

can cause harm or death.

 To ensure safety of patient during an MRI scan, the patient would be

required to complete a safety questionnaire. If a friend or relative will be

in the scanning room with you, they would also need to complete a safety

questionnaire.

 If the patient has a pacemaker or other implants, it is important to tell

the radiographer before the scan. An alternative test might be arranged.

NOTE: Objects in the patient`s body that can cause particular harm or be

damaged include: pacemakers, aneurysm clips, heart valve replacements,

neuro-stimulators, cochlear implants, metal fragments in the eyes, metal

foreign bodies, magnetic dental implants and drug infusion pumps.

 Patients are advised not to wear any makeup or hairspray, as many of

these products have tiny metal particles that could interfere with the scan

and reduce the quality of the images. They might cause the area to heat up

and, on rare occasions, burn the skin.

 Patients are advised to leave objects such as watches, jewellery,

mobile phones, belts, safety pins, hairpins and credit cards at home.

 Fasting for a MRI procedure might be required in some cases.

 Patients are told to bring any previous X-ray, computed tomography or

ultrasound films. This is important because the radiographer might like to

 review the older studies or see if the patient`s condition has changed since

his/her last scan.

 The patient is usually asked to change into a gown. This increases

safety.

II. During an MRI Scan: the questionnaire would be reviewed and discussed

with the patient before entering the scan room.

 The patient is asked to lie down on the scan table and given a buzzer to

hold. When the patient squeeze it, an alarm sounds in the control room and

the patient would be able to talk to the radiographer.

 During the scan, the MRI scanner is very noisy. It`s noisy level can

damage the hearing of the patient therefore, the patient is given an earplug

or headphone to reduce the noise to normal level.

 Depending on the type of MRI the patient is having and the particular

situation, the patient might have:

a. Leads placed on the chest to monitor his/her heartbeat if

having a heart scan.

b. A small plastic tube taped on the finger to check his/her

breathing and heart rate if having sedative medication.

c. A needle inserted into a vein in his/her arm if any

medication is required during the scan.

NOTE: The most common medication injected is a contrast agent

called gadolinium contrast medium. This highlights the part of the

 body being scanned, which can give more information to the

radiologist who is going to access the problem.

 The scan table will then move into the centre of the machine. The

patient`s head might be inside or outside the scanner, depending on the

part of the being scanned. The scan process is painless. The patient might

feel warm during the scanning.

 The patient needs to lay still and hold his/her position during the scan.

The patient can breathe normally but occasionally, during some types of

MRI, the patient is asked to hold his/her breathe.

NOTE: Breathing and movement can make the image blurry and

assessment of the problem might be difficult.

MRI image of the head

SIGNIFICANCE

a. MRI has no known long-term harmful effects, provided the safety precautions are

followed
 b. MRI scan doesn’t use radiation. It can be used safely during pregnancy and also on

younger people and children.

c. MRI scan can show certain conditions that test can’t show

d. MRI can be used to image most systems in the body in any direction to obtain

maximum information and provides the information in high-quality images.

e. MRI can also provide information as data or graphs.

3.2.4. ULTRASOUND

An ultrasound scan is a medical test that uses high frequency sound waves to capture lives

images from the inside of the a patient’s body. Unlike other imaging techniques, ultrasound uses

no radiation. For this reason, it`s the preferred method for viewing a developing foetus during

pregnancy.

PRINCIPLE

In ultrasonography, the sound waves are generated artificially by means of piezoelectric crystals.

When connected to an alternating current of certain frequency, these crystals vibrate and thus

emit a sound wave of the same frequency, but if they are exposed to sound waves of a certain

frequency, they will produce an alternating current of that frequency.

If, by way of ultrasound gel, the crystal is brought into direct contact with the body, the emitted

ultrasound waves spread through the tissue. The tissue absorbs, scatters, or reflects them. Only

the reflection of sound back to the piezoelectric crystal will result in a signal as the basis for an

image.
PROCEDURE

1. Before an ultrasound scan: This totally depends on the area or organ that

is being imaged.

 For abdominal examination, the sonographer may tell the patient to

fast for 8-12 hours before the ultrasound. This is because undigested

food can block the sound waves, making it difficult for the technician

to get a clear picture.

 For examination of the gallbladder, liver, pancreas, or spleen, the

patient may be told to eat a fat free food the evening before the scan

and then to fast until the procedure is carried out. However, the patient

can continue to drink water and take any medication as instructed

 For examination of the urinary system, the patient might to ask to

drink lots of water and to hold his/her urine so that the bladder is full

and better visualised.

2. During an ultrasound scan: The patient changes his/her clothing into a

hospital gown.

 The patient is told to lie down on a table with a section of his/her body

exposed (the exposed part depends on the location of the organ that is

to be imaged).

 The sonographer will apply the ultrasound jelly to the patient`s skin.

This prevents friction so that the ultrasound transducer can be rubbed

easily on the skin. The ultrasound jelly also helps to transmit the sound

waves.
  The transducer is placed on the skin of the patient and constantly

adjusted to produce images in different direction of the organ that is

been imaged.

 Depending on the area being examined, a patient might need to change

position so that the sonographer can have better access.

3. After an Ultrasound scan: after the procedure, the gel will be cleaned off

from the patient`s skin.

NOTE: In imaging the oesophagus and other related structures like the heart, the

sonographer performs a trans-oesophageal approach by passing the transducer

through the mouth into the oesophagus. The rectum and other related structures

can be imaged via a trans-rectal approach (inserting the transducer into the

rectum).

The brain of neonate can be imaged through a trans-frontanelle approach. In this

approach, the sonographer places the transducer on the anterior frontanelle

because that area lacks the presents of bone tissue.

Ultrasound imaging modality is not idle when imaging the respiratory system

because sound waves don’t transmit via air medium. But an ultrasound transducer

can be used to image the pharynx.

 Ultrasound image showing a foetus in the womb

SIGNIFICANCE

a. Ultrasound doesn’t use radiation therefore; it is the idle imaging modality for

pregnancy.

b. Ultrasound can provide a view of the bladder, brain (in infants), eyes, gallbladder,

kidneys, liver, ovaries, pancreas, spleen, thyroid, testicles, uterus, blood vessels etc.

c. An ultrasound is also a helpful way to guide surgeons` movements during certain

medical procedures, such as biopsies and fine needle aspiration.

3.2.5. CONTRAST STUDY

Contrast radiography is a method of studying the organs using x

  Intravenous pyelography allows the doctor to examine the kidneys, ureters,

and bladder.

PRINCIPLE

X-ray works by passing through the body. Because bones easily block the x-rays easily, they

show up clearly, but organs and other tissue, like blood vessels, stomach, and the colon do not

block x-ray so easily. The contrast medium would highlight these specific areas in the body and

help them to be seen in greater detail on x-ray images.

PROCEDURE

a. Before the scan: the patient might be asked to fast before the scan. But water

can be taken to prevent dehydration. Fluid can also be administered through the

vein. For barium enema, the patient is given a laxative or enema the day before

the test and asked to follow a liquid diet for 12-24 hours.

b. During the scan: The patient is asked to remove jewellery, watches, hearing

aids, or other metallic items that might interfere with the x-ray. The type of test

the patient is going to receive determines the method of introducing the contrast

medium.

 For upper gastrointestinal and small bowel series, barium contrast is

swallowed or injected into the small intestine (enteroclysis).

 For lower gastrointestinal series, a small tube will be inserted gently

into the patient`s rectum and the barium contrast would flow into the

bowel.
  For intravenous pyelography, the contrast is passed intravenously to the

structures of the urinary system.

The radiographer will take random images of the targeted organ using plain

radiography or computed tomography.

NOTE: Contrast is also used in magnetic resonance imaging. The contrast

used in MRI is gadolinium contrast medium.

X-ray Image of the abdomen showing the small intestine with the help of contrast medium

SIGNIFICANCE

a. Contrast medium helps to highlight a specific organ of interest in the body.

b. It helps to diagnoses tumours, cancer, inflammation, blood vessel rupture etc.

c. It increases the image quality of plain radiograph, CT scan and MRI.

bn

KEY WORDS USED TO DESCRIBE AREAS/SECTIONS IN SPECIFIC

IMAGING MODALITIES

CHAPTER FOUR

4.1. CONCLUSION

This SIWES attachment was a privilege and I had no regrets exploring because of the massive

practical knowledge I was able to gain. For me, it was not just another academic requirement, I

saw it as a job and I had to work hard to contribute to my organisation`s success and most

importantly, my success. I was able to acquire not just theoretical but practical knowledge in the

following fields:

i. Embalming and mummification

ii. Autopsy
 iii. Tissue processing techniques

iv. Tissue pot construction

v. Different radiological imaging techniques.

This period of my SIWES attachment bettered and improved my relationships with people to a

very great deal. I encountered a lot of people, doctors and patients alike, interacting with them on

day to day basis helped me keep a positive mind-set and talk to people in a heart-warming way.

4.2. PROBLEMS ENCOUNTERED

 In the organisation where I did my industrial training, most machines were not

available, some were too obsolete to carry out recent procedure, while some of the

available machines were faulty and had been abandoned. Therefore some

procedures were performed manually, skipped or manoeuvred. This required

much labour and was also time consuming plus sometimes the end results were

affected.

 In some units, I was restricted from very important knowledge by the industrial

based supervisor. The reason being that my course of study is not hundred

percentage related to some important tests carried out in the unit. Thus I wasn’t

able to acquire thorough knowledge of such test procedures.

 Financially, I was challenged. Unlike my school where I walk to lectures every

day, here I have to take public transportation to my place of work five times a

week for twenty-weeks. This was a very big challenge for me because no

financial assistance was rendered to me either by the ITF or the organisation

where I was attached.

4.3. RECOMMENDATION

1. The hospital management should ensure regular maintenance and provision of all

laboratory equipment and machinery to enable students on industrial training carry

out their practical effectively.

2. I also suggest ITF should liaise with some companies where they will take up

students for industrial training. This will help students who find it difficult to find

attachments or who end up in companies where they do nothing.

3. There should be regular disbursement or payment of the students’ allowances to

enable most students participates effectively in all the activities of SIWES.

4. The SIWES operators need to beef up their strategies to enable the program

function effectively so that the students being served can optimally gain experience of

work to enable them adjust properly to the work of paid employment.