An autopsy—also known as a post-mortem examination, necropsy (particularly as to non-human animals), autopsia cadaverum, or obduction—is a medical procedure A medical procedure with the intention of determining, measuring or diagnosing a patient condition or parameter is also called a medical test. Other common kinds of procedures are therapeutic , including the large group of surgical procedures. Rehabilitation procedures are included in this group that consists of a thorough examination A comprehensive examination is a specific type of exam taken by graduate students, which may determine their eligibility to continue their studies of a corpse A cadaver, corpse or lich is a dead human body. The Latin term cadaver is normally used for a body being used in medical training or research to determine the cause and manner of death Death is the termination of the biological functions that define a living organism. The word refers both to a particular process and to the condition that results thereby. The nature of the latter has been for millennia a central concern of the world's religious traditions and of philosophical enquiry. Belief in some kind of afterlife or rebirth and to evaluate any disease A disease is an abnormal condition affecting the body of an organism. It is often construed to be a medical condition associated with specific symptoms and signs. It may be caused by external factors, such as infectious disease, or it may be caused by internal disfunctions, such as autoimmune diseases or injury Injury is damage or harm caused to the structure or function of the body caused by an outside agent or force, which may be physical or chemical, and either by accident or intentional. Personal Injury also refers to damage caused to the reputation of another rather than physical harm to the body. A severe and life-threatening injury is referred to that may be present. It is usually performed by a specialized medical doctor called a pathologist In medicine, pathology is the study and diagnosis of disease. The related scientific study of disease processes is called "general pathology". Medical pathology is divided into two main branches, anatomical pathology and clinical pathology. Medical pathologists work through examination of organs, tissues, bodily fluids, and whole bodies.

Autopsies are either performed for legal or medical purposes. For example, a forensic autopsy is carried out when the cause of death may be a criminal matter, while a clinical or academic autopsy is performed to find the medical cause of death and is used in cases of unknown or uncertain death, or for research purposes. Autopsies can be further classified into cases where external examination suffices, and those where the body is dissected and internal examination is conducted. Permission from next of kin In many legal systems, rights regarding inheritance serve a decision making capacity where no clear will or instructions have been given, and the person has no spouse, flow to their closest relative (regardless of the age with a representative appointed if a minor), usually a child, a parent or a sibling. However, there are people without any may be required for internal autopsy in some cases. Once an internal autopsy is complete the body is reconstituted by sewing it back together.

History

The term "autopsy" derives from the Ancient Greek Ancient Greek is the historical stage in the development of the Greek language spanning the Archaic , Classical (c. 5th–4th centuries BC), and Hellenistic (c. 3rd century BC – 6th century AD) periods of ancient Greece and the ancient world. It is predated in the 2nd millennium BC by Mycenaean Greek. Its Hellenistic phase is known as Koine (& autopsia, "to see for oneself", derived from αυτος (autos, "oneself") and όψις (opsis, "eye").^[1] Around 3,000 BC, the ancient Egyptians Ancient Egypt was an ancient civilization of eastern North Africa, concentrated along the lower reaches of the Nile River in what is now the modern country of Egypt. The civilization coalesced around 3150 BC with the political unification of Upper and Lower Egypt under the first pharaoh, and it developed over the next three millennia. Its history were one of the first civilizations to practice the removal and examination of the internal organs of humans in the religious practice of mummification A mummy is a corpse whose skin and organs have been preserved by either intentional or incidental exposure to chemicals, extreme coldness, very low humidity, or lack of air when bodies are submerged in bogs. Presently, the oldest discovered mummified human corpse was a decapitated head dated as 6,000 years old and was found in 1936. The most.^[1][2]

Autopsies that opened the body to determine the cause of death are attested at least in the early third millennium BC, although they were opposed in many ancient societies where it was believed that the outward disfigurement of dead persons prevented them from entering the afterlife The afterlife is the idea that consciousness or the mind continues after the death of the body occurs, by natural or supernatural means. In many popular views, this continued existence often takes place in an immaterial or spiritual realm. Major views on the afterlife derive from religion, esotericism and metaphysics^[3] (as with the Egyptians, who removed the organs through tiny slits in the body).^[1] Notable Greek autopsists were Erasistratus Erasistratus was a Greek anatomist and royal physician under Seleucus I Nicator of Syria. Along with fellow physician Herophilus, he founded a school of anatomy in Alexandria, where they carried out anatomical research. He is credited for his description of the valves of the heart, and he also concluded that the heart was not the center of and Herophilus of Chalcedon, who lived in 3rd century BC Alexandria Alexandria , with a population of 4.1 million, is the second-largest city in Egypt, and is the country's largest seaport, serving approximately 80% of Egypt's imports and exports. Alexandria is also an important tourist resort. Alexandria extends about 32 km (20 mi) along the coast of the Mediterranean Sea in north-central Egypt. It is home to the, but in general, autopsies were rare in ancient Greece.^[3] In 44 BC, Julius Caesar Gaius Julius Cæsar/Caesar was a Roman military and political leader. He played a critical role in the transformation of the Roman Republic into the Roman Empire was the subject of an official autopsy after his murder The assassination of Julius Caesar was the result of a conspiracy of a group of senators, led by Gaius Cassius Longinus and Marcus Junius Brutus, who wanted to overthrow Julius Caesar, who in a civil war had risen from military general to political master of the Roman Republic. The conspirators killed Caesar on the Ides of March in 44 BC, which by rival senators, and the physician's report noted that the second stab wound Caesar received was the fatal one.^[3] By around 150 BC, ancient Roman Ancient Rome was a civilization that grew out of a small agricultural community founded on the Italian Peninsula as early as the 10th century BC. Located along the Mediterranean Sea, it became one of the largest empires in the ancient world legal practice had established clear parameters for autopsies.^[1]

The dissection of human remains for medical reasons continued to be practiced irregularly after the Romans, for instance by the Arab physicians Avenzoar Abū Merwān ’Abdal-Malik ibn Zuhr (also known as Ibn Zuhr, Avenzoar, Abumeron or Ibn-Zohr) (1091–1161) was an Arab Muslim physician, pharmacist, surgeon, parasitologist, Islamic scholar and teacher in Al-Andalus and Ibn al-Nafis Ala al-Din Abu al-Hassan Ali ibn Abi-Hazm al-Qurashi al-Dimashqi (born 1213), commonly known as Ibn al-Nafis (Arabic: ابن النفيس‎), was an Arab Muslim polymath—a physician, anatomist, physiologist, surgeon, ophthalmologist, Hafiz, Hadith scholar, Shafi`i jurist and lawyer, Sunni theologian, Islamic philosopher, logician, Arabic, but the modern autopsy process derives from the anatomists Anatomy is a branch of biology and medicine that is the consideration of the structure of living things. It is a general term that includes human anatomy, animal anatomy (zootomy) and plant anatomy (phytotomy). In some of its facets anatomy is closely related to embryology, comparative anatomy and comparative embryology, through common roots in of the Renaissance The Renaissance was a cultural movement that spanned roughly the 14th to the 17th century, beginning in Florence in the Late Middle Ages and later spreading to the rest of Europe. The term is also used more loosely to refer to the historic era, but since the changes of the Renaissance were not uniform across Europe, this is a general use of the. Giovanni Morgagni (1682–1771), celebrated as the father of anatomical pathology Anatomical pathology or Anatomic pathology (U.S.) is a medical specialty that is concerned with the diagnosis of disease based on the gross, microscopic, chemical, immunologic and molecular examination of organs, tissues, and whole bodies (autopsy),^[4] wrote the first exhaustive work on pathology, De Sedibus et Causis Morborum per Anatomen Indagatis (The Seats and Causes of Diseases Investigated by Anatomy, 1769).^[1]

The two great nineteenth-century medical researchers Rudolf Virchow Rudolf Ludwig Karl Virchow was a German doctor, anthropologist, pathologist, prehistorian, biologist and politician, known for his advancement of public health. Referred to as "the father of modern pathology," he is considered one of the founders of social medicine and Carl von Rokitansky built on the Renaissance legacy to derive the two distinct autopsy techniques that still bear their names. Their demonstration of correspondences between pathological In medicine, pathology is the study and diagnosis of disease. The related scientific study of disease processes is called "general pathology". Medical pathology is divided into two main branches, anatomical pathology and clinical pathology. Medical pathologists work through examination of organs, tissues, bodily fluids, and whole bodies conditions in dead bodies and symptoms A symptom is a departure from normal function or feeling which is noticed by a patient, indicating the presence of disease or abnormality. A symptom is subjective, observed by the patient, and not measured and illnesses in the living opened the way for a different way of thinking about disease A disease is an abnormal condition affecting the body of an organism. It is often construed to be a medical condition associated with specific symptoms and signs. It may be caused by external factors, such as infectious disease, or it may be caused by internal disfunctions, such as autoimmune diseases and its treatment.

Purpose

The principal aim of an autopsy is to determine the cause of death The following is a list of the causes of human deaths worldwide for the year 2002, arranged by their associated mortality rates. There were 57,029,000 deaths tabulated for that year. Some causes listed include deaths also included in more specific subordinate causes , and some causes are omitted, so the percentages do not sum to 100. According to, the state of health of the person before he or she died, and whether any medical diagnosis Medical diagnosis refers both to the process of attempting to determine the identity of a possible disease or disorder and to the opinion reached by this process and treatment before death was appropriate.

In most Western countries The Western world, also known as the West and the Occident , is a term that can have multiple meanings depending on its context (e.g., the time period, the region or social situation). Accordingly, the basic definition of what constitutes "the West" varies, expanding and contracting over time, in relation to various historical the number of autopsies performed in hospitals has been decreasing every year since 1955. Critics, including pathologist In medicine, pathology is the study and diagnosis of disease. The related scientific study of disease processes is called "general pathology." Medical pathology is divided into two main branches, anatomical pathology and clinical pathology. Medical pathologists work through examination of organs, tissues, bodily fluids, and whole bodies and former JAMA JAMA: The Journal of the American Medical Association is an international peer-reviewed general medical journal, published 48 times per year by the American Medical Association. JAMA is the most widely circulated medical journal in the world editor Editing is the process of selecting and preparing language, images, sound, video, or film through processes of correction, condensation, organization, and other modifications in various media. A person who edits is called an editor. In a sense, the editing process originates with the idea for the work itself and continues in the relationship George Lundberg George D. Lundberg is a physician, board-certified pathologist, and, since February 1999, editor of Medscape. For 17 years prior to joining Medscape Dr. Lundberg served as editor of the JAMA, have charged that the reduction in autopsies is negatively affecting the care delivered in hospitals, because when mistakes result in death, they are often not investigated and lessons therefore remain unlearned.

When a person has given permission in advance of their death, autopsies may also be carried out for the purposes of teaching or medical research.

An autopsy is frequently performed in cases of sudden death, where a doctor is not able to write a death certificate, or when death is believed to be due to an unnatural cause. These examinations are performed under a legal authority (Medical Examiner or Coroner A coroner or forensics examiner is an official chiefly responsible for investigating deaths, particularly some of those happening under unusual circumstances, and determining the cause of death. Depending on the jurisdiction, the coroner may adjudge the cause him/herself, or act as the presiding officer of a special court . The office originated or Procurator Fiscal) and do not require the consent of relatives of the deceased. The most extreme example is the examination of murder Murder, as defined in common law countries, is the unlawful killing of another human being with intent , and generally this state of mind distinguishes murder from other forms of unlawful homicide (such as manslaughter). As the loss of a human being inflicts enormous grief upon the individuals close to the victim, as well as the fact that the victims, especially when medical examiners are looking for signs of death or the murder method, such as bullet A bullet is a projectile propelled by a firearm, sling, or air gun. Bullets do not normally contain explosives, but damage the intended target by impact and penetration. The word "bullet" is sometimes used to refer to ammunition generally, or to a cartridge, which is a combination of the bullet, case/shell, powder, and primer. This use wounds and exit points, signs of strangulation Strangling is compression of the neck that may lead to unconsciousness or death by causing an increasingly hypoxic state in the brain. Fatal strangling typically occurs in cases of violence, accidents, and as the auxiliary lethal mechanism in hangings in the event the neck does not break. Strangling does not have to be fatal; limited or, or traces of poison In the context of biology, poisons are substances that can cause disturbances to organisms, usually by chemical reaction or other activity on the molecular scale, when a sufficient quantity is absorbed by an organism. Legally and in hazardous chemical labeling, poisons are especially toxic substances; less toxic substances are labeled ". Many religions such as Judaism Judaism is the "religion, philosophy, and way of life" of the Jewish people. Judaism, originating in the Hebrew Bible and explored in later texts such as the Talmud, is considered by Jews to be the expression of the covenantal relationship God developed with the Children of Israel. According to traditional Rabbinic Judaism, God revealed and Islam Islam (Arabic: الإسلام‎ al-’islām, pronounced [ʔislæːm] [note 1]) is the monotheistic religion articulated by the Qur’an, a text considered by its adherents to be the verbatim word of their one, incomparable God (Arabic: الله‎, Allāh), and by the Prophet of Islam Muhammad's teachings and normative example (in Arabic called usually discourage the performing of autopsies on their adherents. Organizations such as Zaka ZAKA , is a series of voluntary community emergency response teams in Israel, each operating in a police district (two in the Central District due to geographic considerations). These organizations are officially recognized by the government. The full name is "ZAKA - Identification, Extraction and Rescue - True Kindness" (Hebrew: זק& in Israel Israel , officially the State of Israel (Hebrew: מְדִינַת יִשְׂרָאֵל (help·info), Medīnat Yisrā'el; Arabic: دَوْلَةُ إِسْرَائِيلَ‎, Dawlat Isrā'īl), is a country in Western Asia located on the eastern shore of the Mediterranean Sea. It borders Lebanon in the north, Syria in the northeast, Jordan and the and Misaskim in the USA ^ b. English is the de facto language of American government and the sole language spoken at home by 80% of Americans age five and older. Spanish is the second most commonly spoken language generally guide families how to ensure that an unnecessary autopsy is not made.

In medicine

Autopsies are important in clinical medicine as they can identify medical error Medical error is an inaccurate or incomplete diagnosis and/or treatment of a disease; injury; syndrome; behavior; infection or other ailment and assist continuous improvement Continuous Improvement Process is an ongoing effort to improve products, services or processes. These efforts can seek "incremental" improvement over time or "breakthrough" improvement all at once. Delivery (customer valued) processes are constantly evaluated and improved in the light of their efficiency, effectiveness and.

A study that focused on myocardial infarction Myocardial infarction or acute myocardial infarction (AMI), commonly known as a heart attack, is the interruption of blood supply to part of the heart, causing heart cells to die. This is most commonly due to occlusion (blockage) of a coronary artery following the rupture of a vulnerable atherosclerotic plaque, which is an unstable collection of (heart attack) as a cause of death found significant errors of omission and commission,^[5] i.e. a sizable number cases ascribed to myocardial infarctions (MIs) were not MIs and a significant number of non-MIs were actually MIs.

A systematic review A systematic review is a literature review focused on a single question that tries to identify, appraise, select and synthesize all high quality research evidence relevant to that question. Systematic reviews of high-quality randomized controlled trials are crucial to evidence-based medicine. An understanding of systematic reviews and how to of studies of the autopsy calculated that in about 25% of autopsies a major diagnostic error will be revealed.^[6] However, this rate has decreased over time and the study projects that in a contemporary US institution, 8.4% to 24.4% of autopsies will detect major diagnostic errors.

A large meta-analysis In statistics, a meta-analysis combines the results of several studies that address a set of related research hypotheses. In its simplest form, this is normally by identification of a common measure of "effect size", for which a weighted average might be the output of a meta-analyses. Here the weighting might be related to sample sizes suggested that approximately one third of death certificates are incorrect and that half of the autopsies performed produced findings that were not suspected before the person died.^[7] Also, it is thought that over one fifth of unexpected findings can only be diagnosed histologically Histology is the study of the microscopic anatomy of cells and tissues of plants and animals. It is performed by examining a thin slice (section) of tissue under a light microscope or electron microscope. The ability to visualize or differentially identify microscopic structures is frequently enhanced through the use of histological stains, i.e. by biopsy or autopsy, and that approximately one quarter of unexpected findings, or 5% of all findings, are major and can similarly only be diagnosed from tissue.

One study found that "Autopsies revealed 171 missed diagnoses, including 21 cancers, 12 strokes, 11 myocardial infarctions, 10 pulmonary emboli, and 9 endocarditis, among others".^[8]

Focusing intubated patients, one study found "abdominal pathologic conditions--abscesses, bowel perforations, or infarction--were as frequent as pulmonary emboli as a cause of class I errors. While patients with abdominal pathologic conditions generally complained of abdominal pain, results of examination of the abdomen were considered unremarkable in most patients, and the symptom was not pursued".^[9]

In veterinary medicine

Post-mortem examination is far more common in veterinary medicine than in human medicine. For many species that exhibit few external symptoms (sheep), or that are not suited to detailed clinical examination (poultry, cage birds, zoo animals), it is a common method used by veterinarians to come to a diagnosis.

Types

There are two main types of autopsies:^[10]

• Medico-Legal Autopsy or Forensic or coroner's autopsies seek to find the cause and manner of death and to identify the decedent.^[10] They are generally performed, as prescribed by applicable law, in cases of violent, suspicious or sudden deaths, deaths without medical assistance or during surgical procedures.^[10]

• Clinical or Pathological autopsies are performed for to diagnose a perticular disease or research purposes. They aim to determine, clarify, or confirm medical diagnoses that remained unknown or unclear prior to the patient's death.^[10]

• Anatomical or academic autopsies are performed by students of anatomy for study purpose only.

Forensic autopsy

A forensic autopsy is used to determine the cause of death. Forensic science involves the application of the sciences to answer questions of interest to the legal system. In United States law, deaths are placed in one of five manners:

• Natural
• Accident
• Homicide
• Suicide
• Undetermined

In some jurisdictions, the Undetermined category may include deaths in absentia, such as deaths at sea and missing persons declared dead in a court of law; in others, such deaths are classified under "Other". But, medical examiners also attempt to determine the time of death, the exact cause of death, and what, if anything, preceded the death, such as a struggle. A forensic autopsy may include obtaining biological specimens from the deceased for toxicological testing, including stomach contents. Toxicology tests may reveal the presence of one or more chemical "poisons" (all chemicals, in sufficient quantities, can be classified as a poison) and, the quantity of those chemicals. Because post-mortem deterioration of the body, together with the gravitational pooling of bodily fluids, will necessarily alter the bodily environment, toxicology tests may overestimate, rather than underestimate, the quantity of the suspected chemical. http://www.relentlessdefense.com/autopsy.html

Most states require the State medical examiner to complete an autopsy report and many mandate that the autopsy be videotaped.

Following an in-depth examination of all the evidence, a medical examiner or coroner will assign a manner of death as one of the five listed above, and detail the evidence on the mechanism of the death.

Clinical autopsy

Clinical autopsies serve two major purposes. They are performed to gain more insight into pathological processes and determine what factors contributed to a patient's death. Autopsies are also performed to ensure the standard of care at hospitals. Autopsies can yield insight into how patient deaths can be prevented in the future.

Within the United Kingdom, clinical autopsies can only be carried out with the consent of the family of the deceased person as opposed to a medico-legal autopsy instructed by a Coroner (England & Wales) or Procurator Fiscal (Scotland) to which the family cannot object.

Prevalence

In 2004 in England and Wales, there were 514,000 deaths of which 225,500 were referred to the coroner. Of those, 115,800 (22.5%) resulted in post-mortem examinations and there were 28,300 inquests, 570 with a jury.^[11]

In the United States, autopsy rates fell from 17% in 1980^[12] to 14% in 1985^[12] and 11.5% in 1989,^[13] although the figures vary notably from county to county.

Process

The body is received at a medical examiner's office or hospital in a body bag or evidence sheet. A brand new body bag is used for each body to ensure that only evidence from that body is contained within the bag. Evidence sheets are an alternate way to transport the body. An evidence sheet is a sterile sheet that the body is covered in when it is moved. If it is believed there may be any significant residue on the hands, for instance gunpowder, a separate paper sack is put around each hand and taped shut around the wrist.

There are two parts to the physical examination of the body: the external and internal examination. Toxicology, biochemical tests and/or genetic testing often supplement these and frequently assist the pathologist in assigning the cause or causes of death.

External examination

At many institutions the person responsible for handling, cleaning, and moving the body is often called a diener, the German word for servant. In the UK this role is performed by an Anatomical Pathology Technologist who will also assist the pathologist in eviscerating the deceased and reconstruction after the autopsy. After the body is received, it is first photographed. The examiner then notes the kind of clothes and their position on the body before they are removed. Next, any evidence such as residue, flakes of paint or other material is collected from the external surfaces of the body. Ultraviolet light may also be used to search body surfaces for any evidence not easily visible to the naked eye. Samples of hair, nails and the like are taken, and the body may also be radiographically imaged.

Once the external evidence is collected, the body is removed from the bag, undressed, and any wounds present are examined. The body is then cleaned, weighed, and measured in preparation for the internal examination. The scale used to weigh the body is often designed to accommodate the cart that the body is transported on; its weight is then deducted from the total weight shown to give the weight of the body.

If not already within an autopsy room, the body is transported to one and placed on a table. A general description of the body as regards ethnicity, sex, age, hair color and length, eye color and other distinguishing features (birthmarks, old scar tissue, moles, etc.) is then made. A handheld voice recorder or a standard examination form is normally used to record this information. In some countries e.g. France, Germany, and Canada, an autopsy may comprise an external examination only. This concept is sometimes termed a "view and grant". The principles behind this being that the medical records, history of the deceased and circumstances of death have all indicated as to the cause and manner of death without the need for an internal examination.^{[citation needed]}

Internal examination

If not already in place, a plastic or rubber brick called a "body block" is placed under the back of the body, causing the arms and neck to fall backward whilst stretching and pushing the chest upward to make it easier to cut open. This gives the prosector, a pathologist or assistant, maximum exposure to the trunk. After this is done, the internal examination begins. The internal examination consists of inspecting the internal organs of the body for evidence of trauma or other indications of the cause of death. For the internal examination there are a number of different approaches available:

• a large and deep Y-shaped incision can be made starting at the top of each shoulder and running down the front of the chest, meeting at the lower point of the sternum. This is the approach most often used in forensic autopsies so as to allow maximum exposure of the neck structures for later detailed examination. This could prove essential in cases of suspected strangulation.
• a T-shaped incision made from the tips of both shoulder, in a horizontal line across the region of the collar bones to meet at the sternum (breastbone) in the middle. This initial cut is used more often to produce a more aesthetic finish to the body when it is re-constituted as stitching marks will not be as apparent as with a Y-shaped incision
• a single vertical cut is made from the middle of the neck (in the region of the 'adam's apple' on a male body)

In all of the above cases the cut then extends all the way down to the pubic bone (making a deviation to the left side of the navel).

Bleeding from the cuts is minimal, or non-existent, because the pull of gravity is producing the only blood pressure at this point, related directly to the complete lack of cardiac functionality. However, in certain cases there is anecdotal evidence to prove that bleeding can be quite profuse, especially in cases of drowning.

At this point shears are used to open the chest cavity. It is also possible to utilise a simple scalpel blade. The prosector uses the tool to saw through the ribs on the lateral sides of the chest cavity to allow the sternum and attached ribs to be lifted as one chest plate; this is done so that the heart and lungs can be seen in situ and that the heart, in particular the pericardial sac is not damaged or disturbed from opening. A scalpel is used to remove any soft tissue that is still attached to the posterior side of the chest plate. Now the lungs and the heart are exposed. The chest plate is set aside and will be eventually replaced at the end of the autopsy.

At this stage the organs are exposed. Usually, the organs are removed in a systematic fashion. Making a decision as to what order the organs are to be removed will depend highly on the case in question. Organs can be removed in several ways: The first is the en masse technique of letulle whereby all the organs are removed as one large mass. The second is the en bloc method of Ghon. The most popular in the UK is a modified version of this method which is divided into four groups of organs. Although these are the two predominant evisceration techniques in the UK variations on these are widespread.

One method is described here: The pericardial sac is opened to view the heart. Blood for chemical analysis may be removed from the inferior vena cava or the pulmonary veins. Before removing the heart, the pulmonary artery is opened in order to search for a blood clot. The heart can then be removed by cutting the inferior vena cava, the pulmonary veins, the aorta and pulmonary artery, and the superior vena cava. This method leaves the aortic arch intact, which will make things easier for the embalmer. The left lung is then easily accessible and can be removed by cutting the bronchus, artery, and vein at the hilum. The right lung can then be similarly removed. The abdominal organs can be removed one by one after first examining their relationships and vessels.

Some pathologists, however, prefer to remove the organs all in one "block". Then a series of cuts, along the vertebral column, are made so that the organs can be detached and pulled out in one piece for further inspection and sampling. During autopsies of infants, this method is used almost all of the time. The various organs are examined, weighed and tissue samples in the form of slices are taken. Even major blood vessels are cut open and inspected at this stage. Next the stomach and intestinal contents are examined and weighed. This could be useful to find the cause and time of death, due to the natural passage of food through the bowel during digestion. The more area empty, the longer the deceased had gone without a meal before death.

The body block that was used earlier to elevate the chest cavity is now used to elevate the head. To examine the brain, an incision is made from behind one ear, over the crown of the head, to a point behind the other ear. When the autopsy is completed, the incision can be neatly sewn up and is not noticed when the head is resting on a pillow in an open casket funeral. The scalp is pulled away from the skull in two flaps with the front flap going over the face and the rear flap over the back of the neck. The skull is then cut with what is called a Stryker saw, name for its manufacture, to create a "cap" that can be pulled off, exposing the brain. The brain is then observed in situ. Then the brain's connection to the cranial nerves and spinal cord are severed, and the brain is then lifted out of the skull for further examination. If the brain needs to be preserved before being inspected, it is contained in a large container of formalin (15 percent solution of formaldehyde gas in buffered water) for at least two but preferably four weeks. This not only preserves the brain, but also makes it firmer allowing easier handling without corrupting the tissue.

Reconstitution of the body

An important component of the autopsy is the reconstitution of the body such that it can be viewed, if desired, by relatives of the deceased following the procedure. After the examination, the body has an open and empty chest cavity with chest flaps open on both sides, the top of the skull is missing, and the skull flaps are pulled over the face and neck. It is unusual to examine the face, arms, hands or legs internally. In the UK, following the Human Tissue Act 2004 all organs and tissue must be returned to the body unless permission is given by the family to retain any tissue for further investigation. Normally the internal body cavity is lined with cotton wool or an appropriate material, the organs are then placed into a plastic bag to prevent leakage and returned to the body cavity. The chest flaps are then closed and sewn back together and the skull cap is sewed back in place. Then the body may be wrapped in a shroud and it is common for relatives of the deceased to not be able to tell the procedure has been done when the deceased is viewed in a funeral parlor after embalming.

See also

• Virtopsy

References

1. ^ ^{a b c d e} Rothenberg, Kelly (2008). "The Autopsy Through History". in Ayn Embar-seddon, Allan D. Pass (eds.). Forensic Science. Salem Press. pp. 100. ISBN 978-1587654237.
2. ^ [1]
3. ^ ^{a b c} Schafer, Elizabeth D. (2008). "Ancient science and forensics". in Ayn Embar-seddon, Allan D. Pass (eds.). Forensic Science. Salem Press. pp. 43. ISBN 978-1587654237.
4. ^ Giovanni Battista Morgagni -- Britannica Online Encyclopedia
5. ^ Ravakhah K (2006). "Death certificates are not reliable: revivification of the autopsy". South. Med. J. 99 (7): 728–33. doi:10.1097/01.smj.0000224337.77074.57. PMID 16866055.
6. ^ Brian Gallagher, Burton EC, McDonald KM, Goldman L (2003). "Changes in rates of autopsy-detected diagnostic errors over time: a systematic review". JAMA 289 (21): 2849–56. doi:10.1001/jama.289.21.2849. PMID 12783916.
7. ^ Roulson J, Benbow EW, Hasleton PS (2005). "Discrepancies between clinical and autopsy diagnosis and the value of post mortem histology; a meta-analysis and review". Histopathology 47 (6): 551–9. doi:10.1111/j.1365-2559.2005.02243.x (inactive 2008-06-20). PMID 16324191.
8. ^ Combes A, Mokhtari M, Couvelard A, et al. (2004). "Clinical and autopsy diagnoses in the intensive care unit: a prospective study". Arch. Intern. Med. 164 (4): 389–92. doi:10.1001/archinte.164.4.389. PMID 14980989.
9. ^ Papadakis MA, Mangione CM, Lee KK, Kristof M (1991). "Treatable abdominal pathologic conditions and unsuspected malignant neoplasms at autopsy in veterans who received mechanical ventilation". JAMA 265 (7): 885–7. doi:10.1001/jama.265.7.885. PMID 1992186.
10. ^ ^{a b c d} Strasser, Russell S. (2008). "Autopsies". in Ayn Embar-seddon, Allan D. Pass (eds.). Forensic Science. Salem Press. pp. 95. ISBN 978-1587654237.
11. ^ UK Department for Constitutional Affairs (2006), Coroners Service Reform Briefing Note, p. 6
12. ^ ^{a b} Center for Disease Control (1988) , Current Trends Autopsy Frequency -- United States, 1980-1985, Morbidity and Mortality Weekly Report, 37(12);191-4
13. ^ DA Pollock et al (1993), Temporal and geographic trends in the autopsy frequency of blunt and penetrating trauma deaths in the United States, JAMA, 269(12):1525-31 PubMed

External links

• Autopsy - a detailed description by a pathologist complete with cartoon figures.
• The Virtual Autopsy - a site from the University of Leicester where one examines the patient, looks at the (medical) history and gets a try at the diagnosis.
• How Stuff Works - Autopsies
• Autopsy of a Murder - An interactive exploration of a murder scene and the science involved in a criminalistic investigation: autopsy and laboratory expertise. Produced by the Montreal Science Centre for its namesake exhibition.
• Prevention of Infection during autopsy It lists the risk factors and prevention strategies during post mortem examination.

Categories: Death | Pathology | Forensic techniques

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