Evisceration and General Prosection Flashcards
Describe the Y incision
Begins at the point near the acromial process of the clavicle on both sides and extends to the xiphoid process of the sternum
From the xiphoid process it extends mid-sagitally down the abdomen, around the umbilicus, to the pubic bone
Thoracic incisions should be made deep
Abdominal incisions should not penetrate the peritoneum
If a female is to be buried in a low-cut dress, how should you adjust the Y incision?
The initial incisions should go laterally to and underneath the breasts
What are some pros and cons of the en masse removal of organs performed during autopsy at Duke?
Pros - preserves vascular supply and organ relationships, and the body is available for funeral homes sooner
Cons - organ blocks can be difficult to handle
What things should you note during the evisceration?
Organ situs and anatomical relationships Absence of organs Pleural effusions or ascites Adhesions, including extend Surfaces of organs - adhesions, exudate, perforation, suture lines, tumors, etc. Pleural and peritoneal cavities
What is included in the cardiothoracic block?
Heart Great vessels Lungs Trachea and bronchi Thyroid Thymus (possibly)
What is included in the gastrointestinal block?
Esophagus Stomach Proximal duodenum Liver Gallbladder Extrahepatic biliary tree Pancreas
At what points is the bowel incised and removed?
At the ligament of Treitz (between duodenum and jejunum) and the rectum
What is included in the genito-urinary block?
Aorta Adrenals Kidneys Ureters Bladder Prostate/testes OR uterus/fallopian tubes/ovaries
What is included in the central nervous system block?
Brain (saved for cutting)
Spinal cord
Dura
Pituitary gland
What is included in the lymphoid/heme block?
Spleen
Bone marrow
Lymph nodes (thoracic, abdominal, and pelvic)
What tools will you mostly use during the prosection?
Forceps Scissors Scalpels Knives Probes Syringes Towels Fingers
How are the organ blocks usually oriented for separation and dissection?
With the posterior aspect facing up
How should you section a large organ?
Cut a center slice (about 2 cm thick) through the hilum and all lobes/areas to be saved
Thoroughly dissect and section the remainder by breadloafing
Should you saw back and forth to get through a large organ?
NO! Organs should be sections with single, clean cuts
How can you distinguish where a section was taken when taking multiple sections?
Use a “shape code”
For example, in the lungs: RUL = square, RML = triangle, RLL = circle
