Autopsy-autopsy also known as a postpartum examination,necropsy.

 

AUTOPSY

An autopsy also known as a postpartum examination ,necropsy ,or autopsy  cadaverum – is a highly specialized surgical procedure that consists of a thorough examination of a  corpse by dissection to determine the cause and manner of death.

·         To evaluate any disease or injury that may be present.

·         It is usually performed by a specialized medical doctor called a pathologist.

·         Autopsies are performed for either 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 &internal examination is conducted.

·         Permission from next of kin may be required for internal autopsy in some cases.

 

Once an internal autopsy is complete the body is reconstituted by sewing it back together.

 

Purpose

·         The principal aim of an autopsy is to determine the cause of death, the state of health of the person before he or she died.

·         And whether any medical   diagnosis and treatment before death was appropriate

·         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 rite a death certificate ,or when death is believed to result from an un natural cause.

·         These examination   are performed  under a legal authority (Medical examiner or corner or procurator Fiscal) and do not require the consent of relatives of the deceased.

·         The most extreme example is the examination   of murder victims, especially when medical examiners are looking for signs of death or the murder method.

·         Such as bullet wounds and exit points, signs of strangulation, or traces or poison.

·        

Some religions including Judaism and Islam usually discourage the performing of autopsies on their adherents.

                                                                                                               

         Types   :

                         There are four main types of autopsies  

a)      Medico –Legal Autopsy or forensic or coroner’s autopsies or Forensic or coroner’s autopsies:

·         To   find   the cause and manner of death &to identify the decedent.

·         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

b)       Clinical or pathological autopsies:

·         Are performed to diagnose a particular disease or for research purposes.

·         They aim to determine, clarify, or confirm medical diagnoses that remained unknown or unclear prior to the patient’s death.

 

c)       Anatomical or academic autopsies   :

·         Are performed by students of anatomy for study purpose only.

d)      Virtual or medical imaging autopsies    :

·         Are   performed utilizing imaging technology   only , primarily magnetic resonance imaging (MRI)

                              And computer tomography(CT)

 

 

Forensic autopsy

A forensic autopsy is used to determine the case and manner of determine the cause and manner of death. Forensic science   involves the application of the sciences to answer questions of interest to the legal system. For example, in the united states law, each death is classified into one of five headings:

·        

Fig no 2

Natural

·         Accident.

·         Homicide.

·         Suicide.

·         Undetermined.

 

·         A forensic autopsy may include obtaining biological specimens form 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 their quantity .

 

·         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.

 

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

 

Clinical Autopsy:

·         Clinical autopsies serve two major purposes.

·         They are performed   to gain more insight into pathological processes.

·         To 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.

 

 EMBALMING

Embalming is the art and science of preserving human remains by treating them (in its modern form with chemicals )  to forestall decomposition .

·         The intention is to keep them   suitable for public display at a funeral, for  religious reasons, or for medical and  scientific purposes.

·         Such as their use as anatomical specimen

 

Goals:

The three goals of embalming   are   :

                                              I.            Sanitization

                                           II.            Presentation and

                                        III.            Preservation (or restoration ).

Embalming has a very long and cross cultural history  , with many cultures giving the embalming processes a greater religious meaning

Embalming is distinct from taxidermy  . Embalming preserves the human body intact , whereas taxidermy is the recreation of an animal’s form often using only the creature’s skin mounted on an anatomical form.

 

 

Process of Embalming:

1.      Place body on table

·         Undress the patient.

·         Valuables should be inventoried and placed in a safe location

2.      Primary Disinfection

·         Removal of surgical bandages and equipment

·         Washing the body  and  hair, cleaning under the fingernails.

·         Spray the body orifices and areas such as genitalia and air pits with disinfectant.

 

3.      Positioning the body

·         Including the positioning of the head ,arms, and making deceased  look  comfortable

4.      Features of the  body.

·          Shave face

·         Close eyes

·         Close mouth

5.      Arterial injection

·         Raise vessels for embalming

·         Select embalming chemicals

·         Injection of chemical through vascular system

·         Secure vessels with ligature after removal of the instrument.

6.      Cavity Treatment

·         Aspiration of materials from the cavity

·         Injection of chemicals into the cavity

7.      Terminal Disinfection

·         Pack orifices

·         Re-washing the hair and body using  disinfectant soap.

·         Cleaning instruments and equipment in the preparation room.

8.      Comities

·         Dress and Casket the body .