the autopsy

Question 1

What are the 2 types of autopsy

Answer 1

1. Hospital

Consent must be obtained from the relatives. With the relevant consent, any material can be taken.

2. Coroners

No consent of family needed (but their wishes should be considered)

Material can only be taken if it bears upon the cause of death (with Coroner’s permission)

Question 2

Types of trauma

Answer 2

Bruise 
Cut 
Stab 
Laceration 
Abrasion

Question 3

Bruise

Answer 3

1-an extraversated collection of blood which has leaked from damaged small arteries, venules and veins but NOT capillaries
2-Blunt trauma injury, occurs alone (skin intact)
-you can bruise after death

Question 4

Abrasion

Answer 4

Graze or scratch due to tangential force (The most superficial of blunt trauma injuries.)
Confined to the epidermis
-can occur before and after death

Abrasion examples – Friction burn, Car radiator, Flooring, Whip, Stamp.

Question 5

Laceration and where does it mainly occur

Answer 5

Split to skin due to blunt force trauma.
They are deep and will bleed

Common where skin can be compressed between the force and underlying bone e.g. Scalp, elbow, shin.

examples – Fall, Punch, Stick, Hammer, Bomb, Wheel of car (flaying).

Question 6

Cut

Answer 6

Split in skin = longer than it is deep

Question 7

Stab

Answer 7

Split in skin that is deeper than long

Question 8

What are some Unnatural causes of unexpected sudden death?

Answer 8

Drugs
alcohol: GI problems and use drugs with it
Trauma: self induced

Caused by an object with a sharp or cutting edge

Question 9

What are some natural causes of sudden unexpected death in cardiovascular disease

Answer 9

Coronary artery disease:
Cardiac arrhythmia is usual mode of death
Anatomical finding: coronary artery atherosclerosis

Other finding:

• myocardial scarring
• coronary artery thrombosis
• acute or subacute MI

Ischaemic heart disease
Hypertensive heart disease:
-accompanied by coronary artery atherosclerosis, usual death caused by acute cardiac arrhythmia

Other causes:
cardiomyopathy
myocardium

Question 10

Natural cause of sudden unepxcted death in vascular system

Answer 10

Rupture aortic aneurism

associated with atheroscelorosis and hypertension

Question 11

Natural cause of sudden unexpected death in CNS

Answer 11

Non traumatic subarachnoid heamorrhage:
berry aneurism: most common type of brain aneurysm
Intracerebral heamorrhage: caused by bleeding within the brain tissue itself

cause: hypertensions

Question 12

Natural cause of sudden unexpected death in Respiratory system

Answer 12

• Pulmonary embolus

- asthma

Question 13

Natural cause of sudden unexpected death in Gastro intestinal tract

Answer 13

Bleeding ulcers
pancreatitis
bleeding oesophageal varices

Question 14

List 4 causes of cases that the coroner must check?

Answer 14

• The cause of death is unknown.
• The death was violent, unnatural or suspicious
• The death may be due to an accident
• The deceased has not been seen by the certifying doctor either after death or within the 14 days before death

Conducted to establish the cause of death

Question 15

what are the reasons for hospital autopsies

Answer 15

Allows a very thorough examination of the deceased, the extent of their disease, their treatment and its effects

Audit – Major discrepancies between stated cause of death and actual cause of death (main diagnosis missed in 15% of cases subsequently autopsied Cameron et al 1980. )
Monitoring effectiveness of new treatments e.g. complex congenital heart disease.
Teaching e.g. unrivalled clinic pathological correlation.
Research e.g. knowledge of variant CJD relies heavily on study of post mortem brain tissue.