The body is then cleaned, weighed, and measured in preparation for the internal examination. A general description of the body as regards ethnic group , sex , age, hair colour and length, eye colour and other distinguishing features birthmarks , old scar tissue , moles , tattoos , etc. A voice recorder or a standard examination form is normally used to record this information. In some countries [ citation needed ] , e. This concept is sometimes termed a "view and grant".
The principle behind this is that the medical records, history of the deceased and circumstances of death have all indicated as to the cause and manner of death without the need for an internal examination.
If not already in place, a plastic or rubber brick called a "head block" is placed under the shoulders of the deceased, hyperflexing the neck making the spine arch backward while stretching and pushing the chest upward to make it easier to incise. This gives the APT, or pathologist, maximum exposure to the trunk. After this is done, the internal examination begins. The internal examination consists of inspecting the internal organs of the body by dissection for evidence of trauma or other indications of the cause of death.
For the internal examination there are a number of different approaches available:. There is no need for any incision to be made, which will be visible after completion of the examination when the deceased is dressed in a shroud. In all of the above cases the incision then extends all the way down to the pubic bone making a deviation to either side of the navel and avoiding, where possible; transsecting any scars which may be present.
Bleeding from the cuts is minimal, or non-existent, because the pull of gravity is producing the only blood pressure at this point, related directly to the complete lack of cardiac functionality. However, in certain cases there is anecdotal evidence that bleeding can be quite profuse, especially in cases of drowning.
At this point, shears are used to open the chest cavity. The prosector uses the tool to cut through the ribs on the costal cartilage, to allow the sternum to be removed; this is done so that the heart and lungs can be seen in situ and that the heart, in particular the pericardial sac is not damaged or disturbed from opening.
A PM 40 knife is used to remove the sternum from the soft tissue which attaches it to the mediastinum. Now the lungs and the heart are exposed.
The sternum is set aside and will be eventually replaced at the end of the autopsy. At this stage the organs are exposed. Usually, the organs are removed in a systematic fashion. Making a decision as to what order the organs are to be removed will depend highly on the case in question. Organs can be removed in several ways: The first is the en masse technique of Letulle whereby all the organs are removed as one large mass. The second is the en bloc method of Ghon.
The most popular in the UK is a modified version of this method, which is divided into four groups of organs.
Although these are the two predominant evisceration techniques, in the UK variations on these are widespread. One method is described here: The pericardial sac is opened to view the heart. Blood for chemical analysis may be removed from the inferior vena cava or the pulmonary veins. Before removing the heart, the pulmonary artery is opened in order to search for a blood clot. The heart can then be removed by cutting the inferior vena cava, the pulmonary veins, the aorta and pulmonary artery, and the superior vena cava. This method leaves the aortic arch intact, which will make things easier for the embalmer.
The left lung is then easily accessible and can be removed by cutting the bronchus , artery, and vein at the hilum. The right lung can then be similarly removed. The abdominal organs can be removed one by one after first examining their relationships and vessels. Most pathologists, however, prefer the organs to be removed all in one "block".
Using dissection of the fascia, blunt dissection; using the fingers or hands and traction; the organs are dissected out in one piece for further inspection and sampling. During autopsies of infants, this method is used almost all of the time. The various organs are examined, weighed and tissue samples in the form of slices are taken.
Even major blood vessels are cut open and inspected at this stage. Next the stomach and intestinal contents are examined and weighed. This could be useful to find the cause and time of death, due to the natural passage of food through the bowel during digestion. The more area empty, the longer the deceased had gone without a meal before death. The body block that was used earlier to elevate the chest cavity is now used to elevate the head.
To examine the brain , an incision is made from behind one ear, over the crown of the head, to a point behind the other ear. When the autopsy is completed, the incision can be neatly sewn up and is not noticed when the head is resting on a pillow in an open casket funeral. The scalp is pulled away from the skull in two flaps with the front flap going over the face and the rear flap over the back of the neck. The skull is then cut with a circular or semicircular bladed reciprocating saw to create a "cap" that can be pulled off, exposing the brain.
The brain is then observed in situ. Then the brain's connection to the cranial nerves and spinal cord are severed, and the brain is lifted out of the skull for further examination. If the brain needs to be preserved before being inspected, it is contained in a large container of formalin 15 percent solution of formaldehyde gas in buffered water for at least two, but preferably four weeks.
This not only preserves the brain, but also makes it firmer, allowing easier handling without corrupting the tissue. An important component of the autopsy is the reconstitution of the body such that it can be viewed, if desired, by relatives of the deceased following the procedure. After the examination, the body has an open and empty thoracic cavity with chest flaps open on both sides, the top of the skull is missing, and the skull flaps are pulled over the face and neck.
It is unusual to examine the face, arms, hands or legs internally. In the UK, following the Human Tissue Act all organs and tissue must be returned to the body unless permission is given by the family to retain any tissue for further investigation. Normally the internal body cavity is lined with cotton, wool, or a similar material, and the organs are then placed into a plastic bag to prevent leakage and are returned to the body cavity. The chest flaps are then closed and sewn back together and the skull cap is sewed back in place.
Then the body may be wrapped in a shroud , and it is common for relatives to not be able to tell the procedure has been done when the body is viewed in a funeral parlor after embalming. Around BCE, ancient Egyptians were one of the first civilizations to practice the removal and examination of the internal organs of humans in the religious practice of mummification. Autopsies that opened the body to determine the cause of death were attested at least in the early third millennium BC, although they were opposed in many ancient societies where it was believed that the outward disfigurement of dead persons prevented them from entering the afterlife  as with the Egyptians, who removed the organs through tiny slits in the body.
The dissection of human remains for medical or scientific reasons continued to be practiced irregularly after the Romans, for instance by the Arab physicians Avenzoar and Ibn al-Nafis.
In Europe they were done with enough regularity to become skilled, as early as , and successful efforts to preserve the body, by filling the veins with wax and metals. Giovanni Battista Morgagni — , celebrated as the father of anatomical pathology ,  wrote the first exhaustive work on pathology, De Sedibus et Causis Morborum per Anatomen Indagatis The Seats and Causes of Diseases Investigated by Anatomy, In , Andreas Vesalius conducted a public dissection of the body of a former criminal. He asserted and articulated the bones, this became the world's oldest surviving anatomical preparation.
It is still displayed at the Anatomical museum at the University of Basel. In the mids, Carl von Rokitansky and colleagues at the Second Vienna Medical School began to undertake dissections as a means to improve diagnostic medicine. The 18th-century medical researcher Rudolf Virchow , in response to a lack of standardization of autopsy procedures, established and published specific autopsy protocols one such protocol still bears his name.
He also developed the concept of pathological processes. During the turn of the 20th century, the Scotland Yard created the Office of the Forensic Pathologist, a medical examiner trained in medicine, charged with investigating the cause of all unnatural deaths, including accidents, homicides, suicides, etc. Post-mortem examination, or necropsy , is far more common in veterinary medicine than in human medicine.
For many species that exhibit few external symptoms sheep , or that are not suited to detailed clinical examination poultry, cage birds, zoo animals , it is a common method used by veterinary physicians to come to a diagnosis. A necropsy is mostly used like an autopsy to determine cause of death. The entire body is examined at the gross visual level, and samples are collected for additional analyses. From Wikipedia, the free encyclopedia.
For other uses, see Post-mortem disambiguation. This article is about the medical procedure. For other uses, see Autopsy disambiguation. The Anatomy Lesson of Dr. The lawsuit alleged that Murray repeatedly lied to cover up his use of propofol, did not keep sufficient medical records and was negligent in his use of medications on Jackson.
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