introduction to clinical sciences Flashcards
what are the two types of autopsies
hospital
medico-legal (cornial and forensic)
around how many autopsies performed are hospital ones
less than 10%
what is needed for a hospital autopsy
a medical certificate of cause of death
what is the purpose of a hospital autopsy
to be used for teaching, research and governance
when would a coronial autopsy be used
where death is not due to unlawful action
when would a fornesic autopsy be used
where death is thought unlawful (murder)
what is the role of the coronial autopsy
to answer the 4 Qs who was deceased when did they die where did they die how did their death come about
who can refer deaths to coroners
doctors (not statutory duty, common law duty, GMC gives guidance)
registrar of births, deaths and marriages (statutory)
relatives
police
why are deaths referred to coroner
presumed natural
presumed iatrogenic
presumed unnatural
what is a presumed natural death
cause of death not known
patient hasn’t seen doctor 14 days prior to death
most common
what is a presumed iatrogenic death
peri/postperative deaths
anaesthetic deaths
illegal abortions
complications of therapy
what is a presumed unnatural death
accidents industrial death suicide unlawful killing neglect custody death
what autoposies does a histopathologist perform
hospital and coronial
(natural deaths, drowning, suicide, accidents, road traffic deaths, fire deaths, industrial deaths and peri/postoperative deaths)
what autopsies does a forensic pathologist perform
coronial autopsies (homicide, death in custodty, neglect and any of other that may be due to an action of a thrid party)
during an external examination what factors are looked for during identification
formal identifiers gender, age body habitus jewellery body modification clothing
what are the 4 steps of external examination
identification, diesease and treatment, injuries and evisceration
what are the steps of evisceration
Y-shaped incision, from behind ears to clavicles and then down midline open all body cavities examine all organs in situ remove thoracic and abdo organs remove brain
what is checked during the internal examination of an autopsy
heart & greater vessels lungs, trachea and bronchi liver, gallbladder, pancreas avoid lower GI if possible (infection risk) spleen, thymus and lymph nodes genitourinary tract (common for cancer) endocrine organs CNS
what is acute inflammation
Acute inflammation is the initial and often transient series of tissue reactions to injury-may last from a few hours to a few days. e.g. appendicitis
what is inflammation
the local and physiological response to tissue injury
not a disease but a manifestation of one
what are the benefits of inflammation
involves the destruction of invading microorganisms and the walling off of an abscess cavity thereby preventing the spreas of infection
what are the limitations of inflammation
disease. e.g. an abscess in the brain will act as a space-occupying lesson compressing vital surrounding structures
fibrosis resulting from chronic inflammation may distort tissues and permanently alther their function
what are the acute inflammation steps
initial reaction of tissue to injury
vascular component: dilation of vessels
exudative component: vascular leakage of protein rich fluid
neutrophil polymorph (WBC) is the cell recruited to the tissue
what are the outcomes of acute inflammation
resolution - goes away
suppuration - pus formation (abscess)
organisation - healing by fibrosis
or progression to chronic inflammation`
