Prosection Specifics and Examination of Blocks Flashcards
How should you separate the heart from the lungs in the cardiothoracic block?
By transecting the pulmonary arteries and veins near the hilum of the lungs
When should you NOT separate the heart from the lungs?
In cases of congenital heart malformations
During your dissection of the cardiothoracic block, you find 10mL of fluid in the pericardium - is this normal?
Yes - up to 20mL of fluid in the pericardium in normal
What is one major pathological finding you should look for when examining the heart and lungs?
Pulmonary emboli
What should you check the lungs for before inflating them?
Lobar architecture
Pleural surface abnormalities
What feature can you use to orient the trachea?
Posterior trachea is membranous
What diseases and conditions are associated with inhalation of asbestos?
Asbestos pleural effusion Pleural plaques Pleural fibrosis Pulmonary diffuse interstitial fibrosis Bronchogenic carcinoma Diffuse malignant mesthelioma Other neoplasms
What do asbestos bodies look like?
Clear colorless central fiber of uniform thicknes, sheathed with a golden-brown iron-protein complex that is iron-positive
When during the prosection should you section the adrenals, and why?
The adrenals should be removed and sections as quickly as possible, due to their rapid rate of autolysis
How do you separate the GU and GI blocks?
By transecting the celiac trunk, the superior and inferior mesenteric arteries, and the gonadal arteries
How should you dissect and examine the kidneys?
Place kidney on the table with the hilum facing up and the anti-hilar surface facing down
Cut the kidney coronally like a bagel - one half will remain attached to the aorta and bladder
Measure thickness of cortex and medulla
Breadloaf each half at 1cm intervals
How should you dissect and examine the uterus?
Put scissors through external os and open uterus along the right and left lateral surfaces
How should you dissect and examine the bladder?
Open along the anterior surface with a Y incision
Males only - do not open the prostatic urethra
How can you find the ampulla of Vater?
By gently squeezing the gallbladder and looking for the flow of bile
What should you take note of when sectioning the pancreas?
Splenic artery (can be calcified)
Pancreatic duct
Peripancreatic lymph nodes
Where should you open up the stomach?
Along the greater curvature
At what point should you transect the duodenum?
Distal to the pylorus
How should you section the heart?
Serially cross-section the coronary arteries to look for atherosclerotic diseases
Serially cross-section the heart from the apex to the base to evaluate the ventricles
Open the heart according to blood flow to evaluate the atria and valves
What happens during gross sign-out with the attending pathologist?
You will present gross findings to the attending and give another brief clinical history
Attendings will usually find something else, since they know more and fixation can make some things more apparent
What are Provisional Anatomic Diagnoses?
A list of diagnoses based on the gross findings at autopsy
What are Final Anatomic Diagnoses?
Finalized provisional anatomic diagnoses, further developed using the information obtained from microscopic sign-out
These are relayed to the clinicians and family
