The autopsy Flashcards
Who is the Coroner?
An independent judicial officer of the crown who has statutory duty to investigate the circustance of certain categories of death for the protection of the public
What are the cases that must be reported to the Coroner?
- The cause of death is unknown
- The deceased have not been seen by the certifying doctor either after death or within the 14 days before death
- The death was violent, unnatural or suspicious
- The death may be due to an accident (whenever it occurred)
- The death may be due to neglect by self or others
- The death may be due to an industrial disease or due to the deceased person’s employment
- The death may be due to an abortion
- The death occurred during an operation or before recovery from the effects of an anaesthetic
- The death may be a suicide
- The death occurred during or shortly after detention in police or prison custody
- The death may be related to poisoning
What is the Coroner’s autopsy?
Conducted to establish the cause of death
Once Coroner has the cause of death his remit is over
What are the reasons for hospital autopsy?
- 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
- Monitoring effectiveness of new treatments and teaching
- Research
Why is finding the cause of death important?
Death certificate data used for epidemiology
Accurate morbidity and mortality data is needed to:
- Monitor the nation’s health
- Direct the allocation of resources
- Detect environmental risks
What are the differences between hospital and Coroner’s autopsy?
HOSPITAL:
- Consent must be obtained from next of kin
- With consent any material can be taken
CORONER’S:
- No consent from next of kin needed (but their wishes should be considered)
- Material can only be taken if it bears upon the cause of death (with Coroner’s permission)
What information does a death certificate contain?
- 1a - immediate cause of death
- 1b - predisposing factor
- 1c - predisposing factor
- 2 - other factors contributing to but not directly leading to death
Name some natural causes of sudden unexpected death (in the community)
- Cardiovascular disease
- Coronary artery disease
- Hypertensive heart disease
- Cardiomyopathy
- Myocarditis
- Vascular system
- Ruptured aortic aneurism
- Central nervous system
- Non traumatic subarachnoid haemorrhage
- Intracerebral haemorrhage (strokes)
- Epilepsy (usually known - poorly controlled)
- Respiratory system
- Pulmonary embolus
- Asthma (usually known - poorly controlled))
- Gastro intestinal tract (usually known)
- Bleeding oesophageal varcies
- Bleeding ulcers
- Pancreatitis
Name some unnatural causes of sudden unexpected death
- Drugs
- Alcohol (not usually unexpected, often associated with GI problems or trauma)
- Trauma (self-induced or caused by others)
What is a bruise (contusion)?
An extraversated collection of blood which has leaked from damaged small arteries, venules and veins (but NOT capillaries)
A blunt trauma injury that occurs alone (skin intact) or is associated with other injuries
TRUE OR FALSE:
Bruises may form after death
TRUE
But this is usually small and lie on dependant parts
What is an abrasion?
A graze or scratch that is superficial of blunt trauma injuries
Confined to the epidermis
Can occur before and after death
Give two examples of abrasion
- Friction burn
- Car radiator
- Flooring
- Whip
- Stamp
What is a laceration?
A split to the skin resulting from blunt force overstretching the skin
They are deep and will bleed
Common where skin can be compressed between the force and underlying bone (e.g. scalp, elbow, shin)
What is the difference between a cut and a stab?
CUT = length of the injury is longer than its depth
STAB = depth of the wound is greater than the width
