Autopsy Flashcards
What are the 3 main types of an autopsy
- Coronal
- Hospital
- Forensic
What is a hospital biopsy
A biopsy requested to learn the nature/process of a disease
When can a hospital autopsy be carried out
When there is a death certificate
There is a known cause of death
Who can consent be obtained by
Partner Parent Child Sibling Grandparent o Grandchild
What is a coronal post mortem autopsy
When a coroner request for an autopsy in order to identify the nature and cause of the death
Who is a coroner
Independent judicial officer appointed and part of the local authority i,e they are not NHS empolyed. (Qualified lawyer with at least 5 years of experience)
What is the aim of the coronal post mortem
Detect the cause of the any death where there is a reasonable cause to detect that is of unnatural or unkown nature
What can be a unnatural or unkown nature of death
- sudden or unexpected death
- unnatural i.e drug related
- patient that died less than 24 hours post admission from hospital and not seen by a clinic within the last 2 weeks
As a junior doctor if there is a death of unkown or unnatural nature what do you do
- Call the coroner office/ medical examiner
2. Discuss the case and give a basic rundown of the history
What is the difference between coronal and hospital autopsy
Coronal autopsy: coroner wants to determine if the death was unatural
Hospital autopsy: death must be a natural cause and must have a death certificate, we are answering the fine detail for interest.
What is a forensic autopsy
Forensic autopsy investigates cases of a suspicious death
How do we start an autopsy, what are the 2 things we need to consider
- Is it a natural or unnatural cause of death
2. Special circumstances: safety precautions, histology, toxicology, microbiology
What is the first step to an autopsy
External examination
What does an external examination involve
Looking at: Height Weight Identification of patient Document patient of disease process, identify marks, evidence of surgery
What is the next step to an autopsy
Evisceration
What is evisceration
Exposing internal organs ready for removal and disection
How do we carry out evisceration
- Incision in the neck to the suprapubic region and retract the skin and muscles from the anterior chest wall to expose the rib cage
- Remove the rib shield to see the lungs and heart
- Remove the bowel from the jejenum to the rectum for evidence of perforation, dilation or ischaemia
What is the next step after evisceratons
Dissection of organs
What is the most common technique in disecction to examine the organs
En bloc/ en masse technique
What is the en bloc/ en masse technique
Removal of the organs within their systems such as thoracic , cervical, abdominal and pelvic organs
After an autopsy what are the further investigations that you can do
- histology
- immunochemistry
- blood
- urine
- hair
- skeletal muscle
- csf
- spleen for genetic testing
- toxicology: drugs, metabolities
What is a ct/digital autopsy
When the body is scanned by a ct scan and a report is formualted