Post mortem examination(autopsy)


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Post Mortem explained for Lawyers, Lay people,Medical Students

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Post mortem examination(autopsy)

  1. 1. Dr. Avinash Bhondwe<br />M.B.B.S.<br /> President I.M.A. Pune (2008-09)<br />Post-Mortem Examination(Autopsy) <br />
  2. 2. POST-MORTEM: DEFINITON<br />Post-mortem (meaning after death) may refer to:<br />In science:<br />an examination and dissection of a dead body to determine cause of death or the changes produced by disease.<br />Post-mortem examination, or autopsy, an examination of a corpse in order to determine cause of death <br />Postmortem studies, a neurobiological research method <br />
  3. 3. Objectives of Autopsy : <br />To find out the Cause of Death <br />To ascertain whether death is Natural or Unnatural <br />Whether death is Homicidal, Suicidal or Accidental <br />To ascertain Time passed since death <br />To establish the Identity of the body<br />Whether still-birth or live-birth of newly born infant <br />
  4. 4. Burns PM<br />PM In Action<br />Infant PM<br />
  5. 5. Modes of Death<br />Asphyxia(Respiratory Failure) <br />Syncope(Circulatory Failure) <br />Coma(Brain Death) <br />Mortuary Post-Mortem <br />
  6. 6. COMATOSE PATIENT<br />HOSPTAL MORTURY<br />Bodies outside an Autopsy Room<br />
  7. 7. Rules of Post-Mortem<br />Written order from the Police Officer<br />Day time <br />Place: In the Hospital <br />Where the dead body lies <br />Identity of the deceased to be established <br />Three great cavities opened (Cranial, Thoracic and Abdominal)<br />Writing post-mortem report on the spot <br />
  8. 8. Contents of Post-Mortem Report<br />Name of the deceased,<br />Identification <br />Place, date and time of post-mortem <br />External Examination <br />Internal Examination <br />Viscera and Samples collected for analysis <br />Opinion as to cause and manner of death <br />
  9. 9. Instruments & Accessories for Autopsy<br />
  10. 10. Instruments & Accessories for Autopsy<br />Scalpels, knives, scissors, bone-cutters,<br />Chisels, hammer, <br />Measuring tape, <br />Balance, <br />Glass bottles, vials <br />Facility for X-Ray, Photographs & Video-graphy<br />Chemicals as preservatives, like Formalin 40%,Rectified spirit, <br />Saturated solution of common salt <br />
  11. 11. External Examination of Unknown Body for Identification <br />Race, Sex, Age <br />Tattoo marks <br />Teeth <br />Distribution of Hair <br />Occupational Characteristics <br />Body should be photographed <br />Finger prints taken<br />
  12. 12. External Examination to ascertain time passed since death<br />Rectal Temperature <br />Hypostasis <br />Rigor Mortis <br />Stage of Putrefaction<br />Ova of flies and maggots<br />
  13. 13. Approximate times <br />for algor and rigor mortis in temperate regions <br />
  15. 15. External Examination of Clothes<br /><ul><li>Stains of : </li></ul>Blood <br />Mud<br />Saliva <br />Semen <br />Vomit <br />Pieces of glass, <br />Fibres, <br />hair (Preserve for chemical analysis) <br /><ul><li>Whether cuts, burns and holes correspond to injuries on the body</li></li></ul><li>External Examination of Eyes<br />Softening of eye ball <br />Opacity of cornea <br />Opacity of lens<br />
  16. 16. External Examination of Natural Orifices<br />For foreign bodies, injuries, discharges (blood/pus, froth) <br />Take swabs for examination<br />Nose <br />Mouth <br />Ears <br />Anus <br />Urethra <br />Vagina <br />
  17. 17. External Examination<br />Presence of Teeth/Dentures<br />
  18. 18. Childhood<br />Adulthood<br />Teeth through the years<br />External Examination to ascertain the age<br />Primary teeth sprout from milk buds and are temporary. Once they fall out, permanent teeth as seen on the other side appear. <br /><ul><li>Permanent adult teeth come in when primary teeth fall out; they are permanent because they establish roots inside the gums. Third molar come in around the mid teenage years.</li></li></ul><li>Standard Teeth Development for Age Determination<br />
  19. 19. Individual Characteristics<br /><ul><li>Size of tooth
  20. 20. Shape of tooth
  21. 21. Shape of root
  22. 22. Placement of tooth
  23. 23. Quantity of teeth
  24. 24. Combinations of dental work done:
  25. 25. Crowns
  26. 26. Extractions
  27. 27. Bridge
  28. 28. Fillings
  29. 29. Root canals </li></ul>Various dental work<br />
  30. 30. External Examinationof Marks<br />Cord, <br />ligature mark <br />Finger marks round the neck<br />Its exact position,<br />Manner <br />Application of the knot <br />
  31. 31. External Examination of Hands & other parts<br />Hands: For hair, cloth, mud, blood or weapon grasped<br />Scraping from under the nails taken<br />Genitalia, breasts <br />Condition of the body: <br />Stout or Emaciated? <br />
  32. 32. External Examination of Injuries<br />From head to foot& from front to back <br />Injury: Situation (Position) <br />Extent <br />Nature (Contusion, Abrasion, <br /> Lacerated, Incised, Stabbed or Punctured) <br />Dimension <br />Condition of Edges <br />Course and direction of bullet <br />Direction of blood smear <br />
  33. 33. External ExaminationTypes of Injuries<br />Contusion <br />Abrasion <br />Laceration <br />Incised Wound <br />Punctured/Stabbed wound <br />
  34. 34. Contusion<br />Abrasion<br />Laceration<br />Incised wound<br />Incised wound<br />Punctured Wound<br />
  35. 35.
  36. 36. Type of the Weapons<br />Hard & Blunt Objects<br />Sharp Objects<br />
  37. 37.
  38. 38. External Examinationof Burns<br />First Degree <br />Second Degree <br />Third Degree <br />Cause of burns: Fire, Fluid, Corrosive, Explosive <br />Percentage of Burns<br />
  39. 39. First Degree<br />Second Degree<br />Charred Body<br />Third Degree<br />
  40. 40.
  41. 41.
  42. 42.
  43. 43. Internal Examinationof Head<br />Order of Exam: <br /> Head-Thorax Abdomen <br />Head: Transverse section<br />Skull bones for fracture <br />Brain :<br />for injury, effusion of blood,<br />tumour<br />
  44. 44.
  45. 45.
  46. 46.
  47. 47.
  48. 48.
  49. 49. Internal Examination of Thorax<br /><ul><li>Ribs Fracture
  50. 50. Sternum fracture </li></li></ul><li>Internal Examination of Thorax<br />Pleural Cavities- for blood, fluid<br />Lungs- Collapsed, Full, Water<br />
  51. 51. Internal Examinationof Thorax<br />Pericardium <br />Heart <br />Chambers of Heart<br />Coronary Arteries<br /> Aorta, <br />
  52. 52. Internal Examinationof Thorax<br />Larynx, <br />Trachea, <br />Oesophagus<br />
  53. 53. Internal Examination of Abdomen<br />Peritoneum <br />Abdominal Cavity <br />Abdominal Organs <br />Pelvic Cavity <br />
  54. 54. Internal Examinationof Abdomen<br />Stomach <br />Small and Large Intestine <br />Liver, <br />Gall bladder <br />
  55. 55. Stomach <br /><ul><li>(Contents, Smell, Degree of digestibility)
  56. 56. (Surface, Size, Weight)
  57. 57. (Examine Inner Surface) </li></li></ul><li>Internal Examination of Abdomen<br />Pancreas <br />Spleen <br />Kidneys <br /><ul><li>For Necrosis
  58. 58. Size, Colour Weight,
  59. 59. Rupture, Calculi</li></li></ul><li>Internal Examinationof Male Pelvis <br />Bladder<br />Prostate<br />Testes, <br />
  60. 60. Internal Examination<br />Spinal <br /> Cord<br />
  61. 61. Internal Examination of Female Pelvis<br />
  62. 62. Internal Examination of Female Pelvis<br />
  63. 63. Internal Examination General<br />General Missing Organs: To be noted <br />Videography: When custodial death Suspected <br />Poisoning: Tissues/Samples of:- Stomach, Small & Large Intestine, Liver, Spleen, Kidney, Nail scraping, Skin (Inj.), <br />Uterus, Vagina, Spinal Cord, Heart, Lung, Brain, CSF, Long Bone, Blood, Vomit, Urine, Faeces, <br />
  64. 64. Postmortem Forensic Toxicology<br />Suspected drug intoxication cases<br />Homicides<br />Arson fire deaths<br />Motor vehicle fatalities<br />Deaths due to natural causes <br />
  65. 65. Internal Examination General<br />Samples/Organs kept in Preservative, <br />Closed in a Container, <br />Sealed and Labeled and Locked and <br />To be sent to Chemical Analyser<br />
  66. 66. Examination of Mutilated Bodiesor Fragments<br />Identification:<br />Dentures, <br />Fingerprints, <br />DNA Sampling, <br />Tattoo marks, <br />Condition of Teeth, <br />Deformities,<br />
  67. 67. Examination of Mutilated Bodiesor Fragments<br />Circumscribed Penis <br />Probable Age: From Skull, Teeth, Dentures, Gums in jaws<br />Colour of Hair, <br />Ossification of bones <br />Sex: From Head & Trunk (Hair, pelvis, femur, prostate, ovary, uterus etc.) <br />
  68. 68. Examination of Fragments Bones<br />Whether Bones are Human or not <br />Whether Female or Male (From Pelvis, Femur)<br />
  69. 69. Examination of Fragments Bones<br />The Age of the individual (From the centres of Ossification, Osteoporosis,Osteoarthritic changes) <br />Metallic poisoning (Like Arsenic, Antimony) <br />
  70. 70. Post-Mortem ReportIts Value<br />Not substantive piece of Evidence<br />Statement of the Medical Officer made in Court is substantive evidence <br />Medical Officer can use it for refreshing his memory while giving evidence <br />For Corroboration & Contradiction of Medical Officer <br />Reserving Opinion as to the cause of death <br />pending result of chemical analysis. <br />Negative Autopsy <br />