AUTOPSY

Autopsy

 Systematic examination of a cadaver for study or for determining the cause of death
 Prosector: Pathologist;
 Diner: Assistant;

Purpose of Autopsy
 Determine the etiology or cause of death of a patient
 Determine the pathogenesis
 Preservation of tissues of the dead person for further research
 Improvement of safety standards of living

*AUTOPSY is done as soon as possible in order to prevent various post-mortem changes that can
occur in the dead body

Types of autopsy
 Complete autopsy
 Partial autopsy
 Selective autopsy

HOW IS AN AUTOPSY PERFORMED?

 PREPARATORY MEASURES
 EXTERNAL INSPECTION
 INTERNAL INSPECTION
 DISSECTION, EXAMINATION OF ORGANS
 ANALYSIS OF TISSUE, FLUIDS AND OTHER SPECIMENS

1. PREPARATORY MEASURES
Consent: given by the nearest kin
Documents: such as clinical abstract in coordination with the attending physician, Medical
records

2. EXTERNAL INSPECTION
Scrutinize both anterior and posterior surfaces
Observe for:
 Signs of violence
 Lacerations
 Identifying marks
 Edema
 Hemorrhages
 Jaundice
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3. INTERNAL INSPECTION
Primary incision of abdomen and thorax

4. DISSECTION, EXAMINATION OF ORGANS

HEART
Dissection: Open the heart by following the blood flow
 Blood flow method
 Transverse
 Start the incision by opening the inferior vena cava and cut thru the superior vena
cava
KIDNEY
Divide the kidney into anterior and posterior halves along the longitudinal axis of convexity

LUNGS
Sagittal section

5. ANALYSIS OF TISSUE, FLUIDS AND OTHER SPECIMENS

 What to culture?
 How to obtain culture?
 Peritoneal fluid
 Pleural fluid
 Lung tissue for culture
 Complete autopsy

Examination of the organs of the 3 major cavities of the body

Spinal cord is not removed and examined

Blood vessels of arms and legs are also not examined

Principle techniques of autopsy

Virchow’s Technique
Organs are removed one by one or individually
Widely used

Rokitansky’s Technique
In situ dissection, in part combined with “en bloc” removal
Ex. thoracic cavity (lungs, heart, diaphragm), respiratory system
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Principle techniques of autopsy

3. Ghon’s Technique
Removal of cervical, abdominal and urogenital system organs as organ blocks or
EN BLOC

4. Letulle’s Technique
Organs are removed EN MASSE and then followed by dissection into organ blocks
Best for routine inspection and preservation of connections between organs and
organ system

Postmortem changes

SOMATIC DEATH

Death of an organism as a WHOLE

 Primary changes:
 Circulatory failure
 Respiratory failure
 CNS failure
 Secondary changes:
 Algor mortis
 Rigor mortis
 Livor mortis
 Putrefaction
 Autolysis
 Postmortem clotting
 Dessication

1. Algor mortis
 1st demonstrable change after death is cooling of the body
 At room temp: 2’-2.5’F/hour (1st hour)
 1.5-2’F/hour (next 12 hours)
 1’F/hour (next 12-18 hours)
 As a rule, the body cools at 1.5’F/hour (50% of cases)
 Not a reliable indicator as to the time of death
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2. Rigor mortis
 Rigidity of the body or stiffening of the body
 This interlocking is fixed & produces rigor mortis w/o shortening of the muscles
 Sets w/in 2 hours after death (head & neck)
 Complete w/ 12 hours
 Persists about 3-4 days

3. Livor mortis
 Blood supply gravitates to the skin vessels w/c becomes toneless & dilate after circulation
ceases
 Becomes evident as early as 20 mins after death
 Fully evident w/in 4-8 hours
 Tardien spots: petechiae
 Cause: sinking of fluid blood into capillaries of dependent parts of the body
 Value: if body position has changed at scene of death

4. putrefaction
 Rotting or decomposition of body by bacterial action
 Changes seen:
 Greenish blue discoloration in the belly
 Muscle softening
 Corneal retraction
 Loss of rigor mortis
 Skin peeling, swelling of face
5. autolysis
 Liberation of hydrolytic enzymes
 Self-digestion of cells
 Putrefactive bacteria: enhances cellular destruction
 Postmortem autolysis: no inflammatory response

6. Postmortem clotting
 Occurs slowly or immediately after death
 Settling and separation of RBCs from the fluid phase
 Must be differentiated with ante-mortem clot

7. dessication
 mummification
 Drying and wrinkling of the cornea and anterior chamber of the eye due to the
absorption of the aqueous humor
 Estimation of time of death