Autopsy Flashcards
What are 2 types of autopsies
Hospital Autopsy
Medico-Legal Autopsies (>90%)
Give 2 examples of Medico-Legal autopsies
Coronial
Forensic
What are purposes of hospital autopsies and what do they require
Audit, Teaching, Governance, Research
Requires MCCD
What does MCCD stand for?
Medical Certification of Cause of Death
What are 3 different presumption in referring a death to a coroner?
Presumed natural (cause of death not known, not seen by doctor in last illness (within 14 days))
Presumed iatrogenic
Presumed unnatural
What are examples of where a death is presumed unnatural
accidents, suicide, industrial death, unlawful killing, custody deaths, war/industrial pensions, neglect
Examples of where a death is presumed iatrogenic
Peri or Postoperative deaths
Anaesthetic deaths
Abortion
Complications of therapy
Who makes referrals for autopsy?
Doctor (NON statutory duty to refer; common law duty)
Registrar (Statutory duty to refer)
Others:
Relatives, Police, Anatomical Pathology Technicians etc
What doctors perform autopsies?
Histopathologists (Hospital and Coronial autopsies) Forensic Pathologists (Coronial)
In autopsy what 4 Qs need to be answered?
Who was the deceased?
When did they die?
Where did they die?
How did they come about their death?
Give 4 examples of legislation for coronial practice
Coroners Act 1988
Coroners Rules 1984
Amendment Rules 2005
*Coroners and Justice Act 2009
Which legislation states consent must be received from relatives for ANY use of tissue retained at autopsy (if not subject to coronial legislation or retained for criminal justice purposes)
Human Tissue Act 2004
**What are 5 steps of autopsy
History/Scene External examination Evisceration Internal examination Reconstruction
What are other steps of autopsy e.g. instead of evisceration and internal examination
Digital Autopsy (CT scan full body) Also digital photography or conventional dissection
What is involved/looked for in external examination
Identification (gender, age, formal identifiers, clothing, body modification etc)
Disease and Treatment (why have autopsy)
Injuries
What are steps involved in evisceration?
Y-shaped incision Open all body cavities examine all organs in situ remove thoracic and abdominal organs Remove brain
What is examined in internal examination
Heart and great vessels Lungs, trachea, bronchi Liver, gallbladder, pancreas Spleen, thymus, lymph nodes Genitourinary tract Endocrine organs Central Nervous System
Describe Y-shaped incision
Incision from 1cm behind lobe of ear running obliquely downwards (onto anterior) to suprasternal notch (from both ears)
Vertical incision from where they meet to pubis from there
Useful for detailed study of neck structures required
