Autopsy

autopsia to see for oneself medical examination of a dead body to determine the cause of death performed when someone dies suddenly and unexpectedly performed at the request of the family of the deceased

 Aids in the evaluation of new diagnostic tests The assessment of new therapeutic interventions (drugs, devices, surgical techniques) Investigation of environmental and occupational diseases.

 useful in establishing valid mortality statistics Data derived from death certificates in the absence of autopsy data have repeatedly been shown to be inaccurate

 A physician cannot order an autopsy on a patient without the consent of the next-of-kin. A medical examiner can order an autopsy without the consent of the next-of-kin. Deaths that are investigated by the medical examiner or coroner include all suspicious deaths, and, depending upon the jurisdiction, may include deaths of persons not being treated by a physician for a known medical condition, deaths of those who have been under medical care for less than 24 hours, or deaths that occurred during operations or other medical procedures.

 A detailed report is prepared that describes the autopsy procedure and microscopic findings Gives a list of medical diagnoses and a summary of the case The report emphasizes the relationship or correlation between clinical findings (the doctor's examination, laboratory tests, radiology findings, etc.) and pathologic findings (those made from the autopsy).

TYPES OF AUTOPSY

Types of Autopsy

1. FORENSIC AUTOPSY
called coroners autopsy = seek to find the cause and manner of death and to identify the decedent = kind of autopsy that most people see on the television and in movies
= also

Types of Autopsy

2. CLINICAL AUTOPSY
= performed for research purposes = aims to determine, clarify, or confirm medical diagnoses that remained unknown or unclear prior to the patients death

 2 PURPOSES OF CLINICAL AUTOPSY:

to

gain insight into the pathological processes and determine what factor contributed to a patients death to ensure the standard of care at hospitals

Autopsy Tools

External Examination

I n t e r n a l

E X A M I N A T I O N

If not already in place, a plastic or rubber brick called a "body block" is placed under the back of the body, causing the arms and neck to fall backward whilst stretching and pushing the chest upward to make it easier to cut open.

Consist of examining the internal organs of the body for evidence or other indications for the cause of death.

INTERNAL EXAMINATION

a large and deep Y-shaped incision can be made starting at the top of each shoulder and running down the front of the chest, meeting at the lower point of the sternum. Forensic autopsies Suspected of strangulation

 Produce a more aesthetic finish during reconstitution of the body that the Y-shaped incision

a T-shaped incision made from the tips of both shoulder, in a horizontal line across the region of the collar bones to meet at the sternum (breastbone) in the middle.

a single vertical cut is made from the middle of the neck (in the region of the 'adam's apple' on a male body)

ORGANS are REMOVED and WEIGHED..

ORGANS are CUT UP in sections by a SCALPEL

Right lung: 300-400 gm Left lung: 250-350 gm Heart: 250-300 gm Liver: 1100-1600 gm Adrenals: 4 gm or so each Thyroid: 10-50 gm (LOTS of variability) Spleen: 60-300 gm (ditto) Brain: 1150-1450 gm

Virchows method
each organ is removed separately
the heart separate and the lungs separate, requires a little bit more knowledge about the body, as well as more expertise.

Rokitanskys method
removing the body organs all at once
heart, liver, kidneys, urinary bladder, prostate gland, etc., were removed in one block and then dissected on the autopsy table, apart. . This may also be important in examining gunshot wounds, stab wounds - to determine the trajectories.

Letulles method
en masse technique all the organs are removed as one large mass.

Ghons method
en bloc method

RIBS are SAWN OFF to expose ORGANS

Organs are REMOVED

BRAIN is REMOVED!
The brain is then either cut fresh or is placed in a 20% solution of formalin to fix it for future analysis

Intestines are DRAINED in a sink

The stomach is CUT OPEN

Microscopic samples are taken for further analysis

all major blood vessels are cut open

reconstitution of the Body

internal cavity is lined with cotton wool

ORGANS are then placed into a plastic bag

chest flaps are then closed and sewn

SKULL is sewed back in place

SHROUD

bODY MAY bE wrapped in a