Autopsy Techniques

AUTOPSY

DEFINITION

CLASSIFICATION

PURPOSE

Examination for whole body of corpse, including external examination and internal examination and additional examinations

clinical autopsy autopsy anatomy and forensic autopsy / medicolegal autopsy

PURPOSE OF AUTOPSY
The purpose of autopsy is based on classification.
clinical autopsy
Determine the exact cause of death Customizing clinical diagnoses made during treatment with postmortem diagnosis

forensic autopsy
Determine the identity of the body Definitely determine cause and manner of death as well as the estimated time of death

Determine the effectiveness of treatment

Knowing the relationship with the clinical diagnosis of the disease process and clinical symptoms Education (anatomical autopsy)

Collect medical evidence

Make a written report objective and based on facts in the form of visum et repertum

Forensic Autopsy
There are a few things to note : The place is a morgue to doing autopsies An autopsy was performed only when there is demand from the authorities autopsy An autopsy should be done when there is a request autopsy Matters relating to the cause of death should be collected before starting the autopsy When the autopsy is done, should not be watched by families or layperson

Preparation before autopsy

Documents Equipment should be prepared :

Standard Precautions
In Indonesia a person to perform forensic autopsies are doctors or physicians, physician assistants, and timers. Immunization Staff should not suffer immunocompromise, open wounds, and acute dermatitis

Examination of corpse
external examination
inspection label that is usually attached to the body of the thumbs right foot Label the hospital to identify the body should remain on the bodies Cover of corpse, Clothes and jewelry of corpse livor mortis, post mortum rigidity, body temperature, decaying corpse inspection from head to toe

internal examination
incision cavity of the head, neck, chest cavity, abdominal cavity, pelvic cavity take out internal organs

support examination
histopathological examination

toxicology examination

microscopic DNA examination

serology examination

Autopsy Procedure
Autopsy procedure

External post mortem examination

Internal examination:

Inspection of internal organs appearance and position

Anatomical dissection

Sampling

Autopsy Techniques
R. Virchow One by one

A. Ghon Autopsy Techniques M. Letulle

removed as separate blocks

Removed as one single block then dissected into organ blocks

C. Rokitansky

All are dissected in situ

Examination of Organs
Examination of the structure of the tongue and neck Examination of the heart Examination of the lungs Intestinal examination Examination of the liver and gall bladder Examination of the spleen and pancreas Examination of the stomach Examination of the kidney, adrenal gland, ureter and bladder

Examination of Genitalia Interna

Depending on sex

Infanticide

Neck Injury

Autopsy Technique on Specific Case

Air Embolism

Pneumoth orax

Air Embolism
The initial superior portion of the body incision should be limited to just below the sternal notch Filled the pericardial cavity with water, submerging the heart entirely One incises in turn the right atrium, right ventricle, pilmonary artery

One should reflect the skin and muscles but cut only the rib cartilages from the second rib inferiorly

The cut edges of the pericardium are grasped with clamps and inspected the pericardial content

Look carefully for air bubbles

The sternum and anterior ribs are removed, exposing the pericardium

One then ligates the aorta securely and makes a small incision in the anterior pericardial sac

Pneumothorax

Holding the dissected skin and subcutaneous tissues of the chest to form a pocket adjacent to the ribcage

Filled the Pocket with water

Used a scapel to incise the thoracic cavity

The presence of air bubbles indicates a pneumothorax

Neck Injury
Make an I incision from incisura jugularis downward up to sompisis pubis Blood will flow and the neck area will be clean

Wedge the neck so the neck in the higher position

Open the skull cavity and remove the brain

Open the neck layer, find the blood infiltration

Open the chest cavity by cutting the chest cavity and ribs

Remove the heart

Infanticide
Autopsy on the body of the baby is more difficult than in adult bodies The important things that should be examinated on Infanticide are : Viability Still birth Cause of death Long live outside the womb

After Examination

Rekonstructi on of the Body

Sending Sample

Determinatio n the cause of death

Examination result repotr

Simple Forensic Laboratory Examination

Blood Examination

Presumptive test/ Screening

Confirmation test

Variety of Simple Blood Screening

1. Microscopic Examination. - Examination of the blood filter. - Determination of blood examination. 1. Chemical Examination. 2. Spectroscopic Examination. 3. Serology.

Examination of Seminal Fluid

Seminal fluid (semen) is one of the body fluids most often found in criminal investigations, especially in cases involving sexual offenses. Examination of Seminal Fluid
Presumptive test
Confirmation test

Hair Examination
Hair is the most stable tissue, because hair can ressist from decayed. Kind of examination: macroscopic and microscopic

Result
From hair examination we can determine

Cause of death

Victims identity

Weapon which is used

Kind of crime

Doers identity

Saliva Examination
Saliva examination is useful when there is a bitten wound on the victim. The method which is always used is:
Absorbtion - Inhibition

Urine Examination
This examination usually use for identification of drug abuse. Golden standard of the examination is:
Gas Chromatography/Mass Spectrometry