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Autopsy
*** Shopping-Tip: Autopsy
{{dablink|'''''Post-mortem''''', '''''postmortem''''' and '''''post mortem''''' redirect here. For other uses of this word, see
post-mortem (disambiguation).}}
An '''autopsy''', also known as a ''post-mortem examination'' or an ''obduction'', is a
medical procedure that consists of a thorough
examination of a
corpse to determine the cause and manner of a person's
death and to evaluate any
disease or
injury that may be present. It is usually performed by a specialized medical doctor called a
pathology pathologist.
A '''necropsy''' is a post-mortem examination performed on an animal.
General information
The term "autopsy" derives from the
Greek language Greek for "to see for oneself". "Necropsy" is from the Greek for "seeing a dead body".
There are two types of autopsies:
*''Forensic'': This is done for medical-legal purposes and is the one that is normally seen on
television or in the
news.
*''Clinical'': This is usually performed in
hospitals to determine a cause of death for
research and study purposes.
While
dissection of human remains for medical reasons has been practised irregularly for millennia, the modern autopsy process derives from the
anatomists of the
Renaissance. The two great
19th century nineteenth-century medical researchers
Rudolf Virchow and
Carl von Rokitansky built on the Renaissance legacy to derive the two distinct autopsy techniques that still bear their names. Their demonstation of correspondences between
pathological conditions in dead bodies and
symptoms and illnesses in the living opened the way for a different way of thinking about
disease and its treatment.
Forensic autopsy
In
United States law, deaths are placed in one of five categories of causes:
*Natural
*
Accident
*
Homicide
*
Suicide
*Undetermined
Following an in-depth examination of all the
evidence, a medical examiner or
coroner will assign a
cause of death as one of the five listed above.
The process
The body is received at a medical examiner's office or hospital in a
body bag or evidence sheet. A brand new body bag is used for each body to ensure that only
evidence from that body is contained within the bag. Evidence sheets are an alternate way to transport the body. An evidence sheet is a
sterile sheet that the body is covered in when it is moved. If it is believed there may be any significant
residue on the hands, for instance
gunpowder, a separate paper sack is put around each hand and taped shut around the wrist.
There are two parts to the physical examination of the body: the external and internal examination.
Toxicology,
Medical test biochemical tests and/or
genetic testing often supplement these and frequently assist the
pathologist in assigning the causes or causes of death.
External examination
The person responsible for handling, cleaning and moving the body is often called a ''diener'', the
German language German word for ''servant''. After the body is received, it is first
Photography photographed. The examiner then notes the kind of clothes and their position on the body before they are removed. Next, any evidence such as residue, flakes of paint or other material is collected from the external surfaces of the body.
Ultraviolet light may also be used to search body surfaces for any evidence not easily visible to the naked eye. Samples of
hair,
Nail (anatomy) nails and the like are taken and the body may also be
X-ray X-rayed.
Once the external evidence is collected, the body is removed from the bag, undressed and any
wounds present are examined. The body is then cleaned, weighed and measured in preparation for the internal examination. The
Weighing scale scale used to weigh the body is often designed to accommodate the
cart that the body is transported on; its weight is then deducted from the total weight shown to give the weight of the body.
If not already within an autopsy room, the body is transported to one and placed on a table. A general description of the body as regards
race,
sex, age,
hair color and length,
eye color and other distinguishing features (
birthmarks, old
scar Biological tissue tissue,
Mole (skin marking) moles, etc) is then made. A handheld
voice recorder or a standard examination form is normally used to record this information.
Internal examination
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. This gives the
prosector, a pathologist or assistant, maximum exposure to the
Torso trunk. After this is done, the internal examination begins. The internal examination consists of inspecting the
internal organs of the body for evidence of
physical trauma trauma or other indications of the cause of death. For the internal examination, a large and deep Y-shaped
incision is made from shoulder to shoulder meeting at the
sternum breastbone extending all the way down to the
pubic bone and will make a slight deviation to the side to avoid the navel. If the body is that of a woman, the incisions are made to go around the breasts so that the arms of the "Y" have a slightly curved appearance.
Bleeding from the cuts (if there even is any) is minimal, because
gravity is producing the only
blood pressure.
An electric
saw dubbed a "Stryker saw" is most often used to open the chest cavity. The prosector uses the
tool to saw through the ribs on the lateral sides of the chest cavity to allow the
sternum and attached ribs to be lifted as one chest plate; 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
scalpel is utilized to remove any soft tissue that is still attached to the posterior side of the chest plate. Now the
lungs and the heart are exposed. The chest plate is set aside and will be eventually replaced at the end of the autopsy.
At this stage all the
organ (anatomy) organs are exposed. Then a series of cuts, along the vertebral column, are made so that the organs can be detached and pulled out in one piece for further inspection and sampling. 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 its contents are examined and weighed. This could be useful to find the cause and time of death.
The body block that was utilized earlier to elevate the chest
cavity is now used to elevate the head. To examine the
brain, a cut is made from behind one ear, across the forehead, to the other ear and around. These incisions are made on the back of the
head so that 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
funeral where it is open casket. 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 an
electric saw to create a "cap" that can be pulled off, exposing the brain. The
dura - the soft tissue
membrane that covers the brain remains attached to the "cap". The brain's connection to the
spinal cord is severed, and the brain can then be easily lifted out of the skull for examination. If the brain needs to be preserved before being inspected, it is contained in a jar of
formalin (Ten percent solution of
formaldehyde gas in buffered
water) for at least two weeks. This not only preserves the brain, but also makes it firmer allowing easier handling without corrupting the tissue.
Reconstitution of the body
An important aim of the autopsy is to reconstitute 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
chest 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. The organs are replaced or
incinerated, the chest flaps are 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 of the deceased to not be able to tell the procedure has been done when the deceased is viewed in a
funeral home funeral parlor after
embalming.
Other information
The principal aim of an autopsy is to discover the cause of
death, to determine the state of health of the person before he or she died, and whether any medical
diagnosis and treatment before death was appropriate. Studies have shown that even in the modern era of use of high technology scanning and medical tests, the medical cause of death is wrong in about one third of instances unless an autopsy is performed. In about one in ten cases the cause of death is so wrong that had it been known in life the medical management of the patient would have been significantly different.
In most
Western countries the number of autopsies performed in hospitals has been decreasing every year since 1955. Critics, including
pathologist and former
JAMA editor George Lundberg, have charged that the reduction in autopsies is negatively affecting the care delivered in hospitals, because when mistakes result in death, they are often not investigated and lessons learned.
When a person has given permission in advance of their death, autopsies may also be carried out for the purposes of teaching or medical research.
An autopsy is frequently performed in cases of sudden death, where a doctor is not able to write a death certificate, or when death is believed to be due to an unnatural cause. These examinations are performed under a legal authority (Medical Examiner or
Coroner) and do not require the consent of relatives of the deceased. The most extreme example is the examination of
murder victims, especially when medical examiners are looking for signs of death or the murder method, such as
bullet wounds and exit points, signs of
strangulation, or traces of
poison.
See also
*
forensic science
*
human body disposal
*
pathology
*
John Tonge Centre
*
Gunther von Hagens
External links
-
Autopsy - a detailed description by a
pathologist complete with cartoon figures.
-
The Virtual Autopsy - a site from the
University of Leicester were one examines the patient, looks at the (medical) history and gets a try at the diagnosis.
-
''HBO's Autopsy'' - a series on
HBO about forensics and autopsies.
-
''BBC News - Controversial Autopsy goes ahead'' - news story about Prof.
Gunther von Hagens performing the first public autopsy in the UK in 170 years.
-
Video clip of a public autopsy performed by
Gunther von Hagens
-
www.autopsyvideo.com- This site offers autopsy documentaries, one produced with the aid of The LA County Coroner's Office.
Category:Death
Category:Pathology
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fr:Autopsie
gl:Autopsia
it:Autopsia
id:Otopsi
ja:検死
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pt:Autópsia
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