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Autopsy.pptx
- 1. A u t o p s y D r . G u r j e e t s i n g h P G T A M C H
- 3. Introduction Necropsy’ is semantically the most accurate description of the investigative dissection of a dead body, the word ‘autopsy’ is used so extensively that there is now no ambiguity about its meaning. Auto – Self Opsis – view / Examination. Necro – Dead Opsy – Examination / to see 3
- 4. First ML autopsy was done in bologna(italy) in 1302 by BARTOLAMEO DE VARIGNANA First ML autopsy was performed in india by DR.EDWARD BUCKLEY in august 1693 at CHENNAI. In 1374 right of autopsy was given by pope Antistius, the physician opined by external examination of the body of JULIUS CAESAR(100-44 BC) that out of 23 injuries on the body, the one that entered the chest between 1st and 2nd rib was the most fatal. History of Autopsy Scientific findings 4
- 5. The clinical or academic autopsy Anatomical Autopsy Psychological Autopsy Medicolegal Autopsy Virtual Autopsy TYPES 5
- 6. The clinical or academic autopsy Scientific findings 6
- 7. It is performed to study the normal structure of the human body ( anatomy). It is mostly done on unclaimed or donated bodies. Anatomist and medical students done for their studies. Anatomical Autopsy 7
- 8. Sources of the history are family members , friends, professional colleagues, teacher and physicians but not the police It is done to know about:- background of a person, His mental status, habits, personality, character It is undertaken on alleged cases of sucide to know about the mental status of the deceased at the time of death. Psychological Autopsy Scientific findings 8
- 9. Medico legal autopsy is a special type of examination of a dead body to find out the cause & nature of death, examining all the body cavities to help administration of justice & prosecution of guilty. Medicolegal Autopsy 9
- 10. • 1) To find out the cause of death. • 2) To find out the manner of death, whether accidental, suicidal or homicidal. • 3) To find out the time since death. • 4) To establish the identity of the deceased. • 5) To collect physical evidence in order to identify the object causing death. • 6) In new born infants to determine the question of live birth and viability. Aims and Objectives 10
- 11. The body should be labelled as soon as it arrives. The autopsy should be conducted in a recognized govt. mortuary. It should be conducted only when there is an official order authorizing the autopsy, from police or magistrate. Undue delay should not be done. The medical officer first read the inquest report carefully and find out the apparent cause of death. Body must be identified by the police constable. RULESOF MEDICO LEGAL AUTOPSY 11
- 12. Continued 12
- 14. Physical facilities Well autopsy room Cold storage facilities Good lighting Exhaust ventilation Running water. Good drainage with central drainage PRE- REQUISITES FOR MORTUARY 14
- 16. INTERNAL EXAMINATION Thorax and abdomen opened first but- Asphyxial deaths the neck should be examined after removal of the brain & viscera from the chest &abdominal cavities. Head injury the scalp & skull are opened first then the thorax & abdomen. strangulation layer wise examination of the anterior neck structures and insitu photography. 16
- 19. 19
- 21. Advantages of 4th Incision 21
- 23. 1) Technique of R.Virchow. Organs are removed one by one. This method has been used widely . 2) Technique of C.Rokitansky’s: This technique is characterized by in situ dissection, in part combined with the removal of organ blocks. 3)Technique of A. Ghon’s :Thoracic & cervical organs, abdominal organs & the urogenital system are removed as organ blocks.(enbloc removal). 4) Technique of M.Letulle: Thoracic,cervical,abdominal& pelvic organs are removed as one organ block (en masse removal)& subsequently dissected into organ blocks. 23
- 25. Endoscopic autopsy: Requires the use of rigid HOPKINS endoscope of 4mm and 8mm diameters with 0, 90, 130 degree view angles having a light source from fibreglass cable. The endoscope is fitted with zoom lens camera for photographic documentation. Uses: a. sinuses, fundus, external auditory meatus, larynx etc can be visualised directly. b. bullet tracts can be traced. c. hepatic, splenic, diaphragmatic injuries can be determined. d) intraperitoneal and thoracic haemorrhage can be visualized. e) neoplasm can be identified. 25
- 26. Adult method-scalp incision: The head is elevated slightly with a wooden block. A sharp scalpel blade can be used to cut through the whole thickness of the scalp from outside. It starts on right side over the mastoid and passes over palpable posterio- lateral ridges of parietal bones to reach opposite mastoid. The anterior and posterior halves of scalp are then reflected upto the superciliary ridges and the occipital protuberance respectively Dissection of organs (Dissection of scalp,skull,brainans): 26
- 27. Temporal and masseter muscles are cut on either sides. The saw-line is made in V shaped direction. Saw line starts from centre of forehead to the base of mastoid on both sides, and from these latter points backwards and upwards to a point a little above the external occipital protuberance Avoid sawing through the meninges and brain. Skull cap is removed by gently inserting and twisting the chisel at various places. SAWINGTHESKULL: 27
- 29. Removal of brain in fetus and infants Scientific findings 29
- 31. Points to be noted in brain examination: 31
- 32. Posterior approach:- This is most commonly used. A mid line incision is placed over the spinous processes, muscles are resected and bilateral laminectomy done. Anterior approach:- The vertebral bodies are removed after complete evisceration of the body by sawing through pedicles by lateral cut down each side SPINALCORDANDSPINE: Scientific findings 32
- 33. Easy to see upper part of cervical vertebrae. Spinal canal can be readily examined. Fracture of posterior part of vertebrae can be demonstrated . Continuity between lower brain stem and upper cervical cord can be maintained. Merits 33 Not much useful for pursuing the courses of peripheral nerves. Embalming fluid may leak from the incision and the back. Demerits POSTERIOR ASPECT:
- 36. Multi-slice Computed Tomography (MSCT) Magnetic Resonance Imaging (MRI) Magnetic Resonance Spectroscopy 3-D/ CAD Photogrammetry Essentials of virtopsy Scientific findings 36
- 37. Varying density values in a 3D MSCT reconstruction in a case of blunt trauma to the head. 37
- 38. 3D reconstruction of a skull fracture system from the MSCT data in a case of a motor vehicle accident with the victim having been run over by a car Scientific findings 38
- 39. CoronalT2 weighted MR image showing wound track (arrows) through the brain in a suicidal gunshot case Scientific findings 39
- 40. Merits and Demerits Scientific findings 40
- 47. STEP 2 Internal examination To expose the internal organs the pathologist must open the body. Select which shape the first cut is made in: Scientific findings 47
- 48. Scientific findings 48 STEP 1 External examination Select the hotspots to discover what forensic pathologists look for in particular parts of the body and the equipment they use.
- 50. To identify unknown person To find out cause of death To find out mode of death To find out nature of death To find out time since death CONCLUSION Scientific findings 50