Method and Procedures of Autopsy (Protocol)

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Method and Procedures of Autopsy(Protocol)
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Autopsy

• Definition and purpose
• Autopsy or post mortem examination
• A thorough examination of a body after death to
  help determine
• Why (cause of death)
• How (manner of death)

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REVIEW Cause of Death v. Manner of Death

• The cause of death is the medical findings or
  findings responsible for the death.
• What ultimately caused the person to die
• The manner of death is the legal classification
  of death, whether it be
• Natural - Accidental
• Suicide - Undeterminable
• Homicide
• Manner of death also refers to the events leading
  up to cause of death
• Ex. A suicidal gunshot wound was the manner of
  death, bleeding out was the cause of death

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Levels of Autopsy

• Complete - all body cavities are examined
• Limited - may include the head
• Selective - specific organs ONLY are examined

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Tests

• Infections
• Changes in body tissues and organs
• Chemicals
• Medications
• Drugs
• Poisons

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Process

• From Crime scene to funeral home

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At Crime Scene

• Photographs taken or body in original, found
  state
• Hands wrapped in plastic bags for later evidence
  collection
• Body temperature, lividity, and decomposition
  level measured
• Body placed in bag or wrapped in sheet for
  transport.

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Arrival of Body

• Body is received at medical examiners office or
  hospital in a body bag or with evidence sheet
  over top

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External Inspection (order dependant on person
performing autopsy)

• Weight of body
• Height of body
• Identifying marks
• Scars, tattoos
• Wounds
• Liver mortis
• Algor mortis
• Rigor mortis

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Internal inspection

• Y incision is made from left shoulder, down under
  the nipples and over to the right shoulder
• Then the scalpel is placed in the pit of the
  abdomen, below the sternum, and cut straight down
  and left of the belly button
• A second incision of the body circumnavigates the
  skull from ear to ear behind the head

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Internal Inspection (contd)

• The skin underlying tissues (muscle, fat, etc.)
  are then separated to expose the rib cage and
  abdominal cavity
• The front of the rib cage is removed to expose
  the neck chest organs

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Internal Inspection (contd)

• This opening allows the trachea (windpipe),
  thyroid gland, parathyroid glands, esophagus,
  heart, thoracic aorta, and lungs to be removed
• After removal of these, the abdominal organs are
  dissected free of clutter
• -liver, intestines, gallbladder and bile duct
  system, pancreas, spleen, adrenal gland, kidneys,
  ureters, urinary bladder, abdominal aorta, and
  reproductive organs

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Internal Inspection (contd)

• Two Methods for organ removal
• Rokitansky procedure all organs removed at once
• Virchow procedure each organ removed separately
  and immediately examined

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Internal Inspection (contd)

• To remove the brain, an incision is made in the
  back of the skull from one ear to the other
• The scalp is cut and separated form the
  underlying skull pulled forward
• The top of the skull is removed using a vibrating
  saw
• The entire brain is then gently lifted out of the
  cranial vault
• The spinal cord may also be taken by removing the
  anterior or posterior portion of the spinal column

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Internal Inspection (contd)

• The organs are separated and further dissected to
  reveal any abnormalities such as tumors, on the
  inside
• Samples are taken to be examined under a
  microscope

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Internal Inspection (contd)

• The organs are first examined by the pathologist
  to note any changes visible with the naked eye
• Examples of disease that may produce changes
  readily recognizable in the organs include
  atherosclerosis, cirrhosis of the liver, and
  coronary artery disease in the heart

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Closure

• The organs may be returned to the body after
  examination
• OR they may be retained for teaching, research,
  and diagnostic purposes
• The incisions in the body are sewn closed
• Depending on family wishes, body may be cremated
  or sent to funeral home for burial preparation.

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Autopsy

• Performance of an autopsy does not interfere with
  an open casket funeral service, as none of the
  incisions made in order to accomplish the autopsy
  are apparent after embalming and dressing of the
  body by the mortician