Prosection Specifics and Examination of Blocks

Question 1

How should you separate the heart from the lungs in the cardiothoracic block?

Answer 1

By transecting the pulmonary arteries and veins near the hilum of the lungs

Question 2

When should you NOT separate the heart from the lungs?

Answer 2

In cases of congenital heart malformations

Question 3

During your dissection of the cardiothoracic block, you find 10mL of fluid in the pericardium - is this normal?

Answer 3

Yes - up to 20mL of fluid in the pericardium in normal

Question 4

What is one major pathological finding you should look for when examining the heart and lungs?

Answer 4

Pulmonary emboli

Question 5

What should you check the lungs for before inflating them?

Answer 5

Lobar architecture

Pleural surface abnormalities

Question 6

What feature can you use to orient the trachea?

Answer 6

Posterior trachea is membranous

Question 7

What diseases and conditions are associated with inhalation of asbestos?

Answer 7

Asbestos pleural effusion
Pleural plaques
Pleural fibrosis
Pulmonary diffuse interstitial fibrosis
Bronchogenic carcinoma
Diffuse malignant mesthelioma
Other neoplasms

Question 8

What do asbestos bodies look like?

Answer 8

Clear colorless central fiber of uniform thicknes, sheathed with a golden-brown iron-protein complex that is iron-positive

Question 9

When during the prosection should you section the adrenals, and why?

Answer 9

The adrenals should be removed and sections as quickly as possible, due to their rapid rate of autolysis

Question 10

How do you separate the GU and GI blocks?

Answer 10

By transecting the celiac trunk, the superior and inferior mesenteric arteries, and the gonadal arteries

Question 11

How should you dissect and examine the kidneys?

Answer 11

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

Question 12

How should you dissect and examine the uterus?

Answer 12

Put scissors through external os and open uterus along the right and left lateral surfaces

Question 13

How should you dissect and examine the bladder?

Answer 13

Open along the anterior surface with a Y incision

Males only - do not open the prostatic urethra

Question 14

How can you find the ampulla of Vater?

Answer 14

By gently squeezing the gallbladder and looking for the flow of bile

Question 15

What should you take note of when sectioning the pancreas?

Answer 15

Splenic artery (can be calcified)
Pancreatic duct
Peripancreatic lymph nodes

Question 16

Where should you open up the stomach?

Answer 16

Along the greater curvature

Question 17

At what point should you transect the duodenum?

Answer 17

Distal to the pylorus

Question 18

How should you section the heart?

Answer 18

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

Question 19

What happens during gross sign-out with the attending pathologist?

Answer 19

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

Question 20

What are Provisional Anatomic Diagnoses?

Answer 20

A list of diagnoses based on the gross findings at autopsy

Question 21

What are Final Anatomic Diagnoses?

Answer 21

Finalized provisional anatomic diagnoses, further developed using the information obtained from microscopic sign-out
These are relayed to the clinicians and family