forensic medicine autopsy ppt by Dr vimal prakash

2. AUTOPSY
THE
COLOR ATLAS OF

4. CRC PR ESS
Boca Raton London New York Washington, D.C.
AUTOPSYScott A. Wagner
THE
COLOR ATLAS OF

5. This edition published in the Taylor & Francis e-Library, 2005.
“To purchase your own copy of this or any of Taylor & Francis or Routledge’s
collection of thousands of eBooks please go to www.eBookstore.tandf.co.uk.”
ISBN 0-203-49438-5 Master e-book ISBN
ISBN 0-203-58667-0 (Adobe eReader Format)

6. Preface

8. Acknowledgments

10. About the Author

12. Introduction

14. Contents

18. 1
1 Approach to the Autopsy:
Purpose and Philosophy
WHAT IS AN AUTOPSY?
TYPES OF AUTOPSIES: HOSPITAL
AND MEDICAL–LEGAL

19. 2 Color Atlas of the Autopsy
WHAT IS THE PURPOSE OF THE AUTOPSY?
CASES THAT USUALLY REQUIRE
AN AUTOPSY

20. Approach to the Autopsy: Purpose and Philosophy 3
NATURAL DEATHS
UNNATURAL DEATHS
Homicides

21. 4 Color Atlas of the Autopsy
Suicides
Accidents
THE AUTOPSY: ASSEMBLING A PUZZLE

22. Approach to the Autopsy: Purpose and Philosophy 5
WHAT IS A FORENSIC PATHOLOGIST?

24. 7
2 Circumstantial and Medical History
IDENTIFY THE PROBLEM
AND “CHIEF COMPLAINT”
IDENTIFICATION OF THE BODY
DIRECT IDENTIFICATION BY FAMILY MEMBERS
PERSONAL FEATURES

25. 8 Color Atlas of the Autopsy
OBJECTS IN THE BODY
HIGHER-ORDER IDENTIFICATION
Fingerprints
Dental Identification
Deoxyribonucleic Acid
INVESTIGATIVE QUESTIONS
BASIC DEMOGRAPHIC QUESTIONS
QUESTION OF OCCUPATION
QUESTION OF MEDICAL HISTORY

26. Circumstantial and Medical History 9
QUESTION OF MEDICATIONS
QUESTION OF MENTAL HEALTH HISTORY
QUESTION OF ILLICIT DRUG USE
QUESTION OF ETHANOL USE
QUESTION OF HISTORY WITH LAW ENFORCEMENT
OR INCARCERATION
OTHER INVESTIGATIVE QUESTIONS

27. 10 Color Atlas of the Autopsy
FIGURE 2.1
FIGURE 2.2
FIGURE 2.3
FIGURE 2.4

28. Circumstantial and Medical History 11
FIGURE 2.5
FIGURE 2.6
FIGURE 2.7

29. 12 Color Atlas of the Autopsy
FIGURE 2.8
FIGURE 2.9
FIGURE 2.10

30. Circumstantial and Medical History 13
FIGURE 2.11
FIGURE 2.12
FIGURE 2.13

32. 15
3 External Examination:
The Preliminary Examination
SUITING UP: UNIVERSAL PRECAUTIONS
OPENING THE BODY BAG
CLOTHING AND VALUABLES

33. 16 Color Atlas of the Autopsy
BODY STORAGE
TRACE EVIDENCE
FOUR SIGNS OF DEATH
RIGOR MORTIS
ALGOR MORTIS
LIVOR MORTIS

34. External Examination: The Preliminary Examination 17
DECOMPOSITION
FOCUS ON WHAT IS NOT OBVIOUS
DOCUMENTING TRAUMATIC INJURIES:
DIAGRAMS AND DESCRIPTIONS

35. 18 Color Atlas of the Autopsy
RADIOLOGY AND IMAGING
PHOTOGRAPHY AND VIDEO
AS DOCUMENTATION TOOLS
SCARS, TATTOOS, AND OTHER
UNIQUE MARKS

36. External Examination: The Preliminary Examination 19
ARTIFACTS OF MEDICAL INTERVENTION

37. 20 Color Atlas of the Autopsy
FIGURE 3.1
FIGURE 3.2
FIGURE 3.3

38. External Examination: The Preliminary Examination 21
FIGURE 3.4
FIGURE 3.5
FIGURE 3.6

39. 22 Color Atlas of the Autopsy
FIGURE 3.7
FIGURE 3.8
FIGURE 3.9

40. External Examination: The Preliminary Examination 23
FIGURE 3.10
FIGURE 3.11
FIGURE 3.12

41. 24 Color Atlas of the Autopsy
FIGURE 3.13

42. External Examination: The Preliminary Examination 25
FIGURE 3.14
A
FIGURE 3.15
BB

43. 26 Color Atlas of the Autopsy
FIGURE 3.16
FIGURE 3.17
FIGURE 3.18
FIGURE 3.19

44. External Examination: The Preliminary Examination 27
FIGURE 3.20
FIGURE 3.21
FIGURE 3.22
FIGURE 3.23

45. 28 Color Atlas of the Autopsy
FIGURE 3.26
FIGURE 3.25
FIGURE 3.24
FIGURE 3.27

46. External Examination: The Preliminary Examination 29
FIGURE 3.28
FIGURE 3.29
FIGURE 3.30
FIGURE 3.31

47. 30 Color Atlas of the Autopsy
FIGURE 3.32 FIGURE 3.33
FIGURE 3.34
FIGURE 3.35

48. External Examination: The Preliminary Examination 31
FIGURE 3.36
FIGURE 3.37

49. 32 Color Atlas of the Autopsy
FIGURE 3.38
FIGURE 3.39
FIGURE 3.40

50. External Examination: The Preliminary Examination 33
FIGURE 3.41
FIGURE 3.42
FIGURE 3.43

51. 34 Color Atlas of the Autopsy
FIGURE 3.44
FIGURE 3.45
FIGURE 3.46

52. External Examination: The Preliminary Examination 35
FIGURE 3.47
A
FIGURE 3.48
B

54. 37
4 External Examination:
Specific Injuries
FORENSIC INJURIES AND DEFINITIONS
BLUNT FORCE INJURIES
Laceration
Abrasion
Contusion
Avulsion

55. 38 Color Atlas of the Autopsy
SHARP FORCE INJURIES
Stab Wounds
Incised Wounds
Defense Wounds
Puncture Wounds
Chopping Wounds
Gunshot Wounds

56. External Examination: Specific Injuries 39

57. 40 Color Atlas of the Autopsy
A
FIGURE 4.1
B
FIGURE 4.2

58. External Examination: Specific Injuries 41
FIGURE 4.3
FIGURE 4.4

59. 42 Color Atlas of the Autopsy
FIGURE 4.5
FIGURE 4.6

60. External Examination: Specific Injuries 43
FIGURE 4.7
FIGURE 4.8

61. 44 Color Atlas of the Autopsy
FIGURE 4.9
FIGURE 4.10 FIGURE 4.11

62. External Examination: Specific Injuries 45
FIGURE 4.12
FIGURE 4.13
FIGURE 4.14

63. 46 Color Atlas of the Autopsy
FIGURE 4.15

64. External Examination: Specific Injuries 47
FIGURE 4.17
FIGURE 4.16

65. 48 Color Atlas of the Autopsy
FIGURE 4.19
FIGURE 4.18

66. External Examination: Specific Injuries 49
FIGURE 4.21
FIGURE 4.20

68. 51
5 External Examination:
Specific Body Areas
OVERALL “GESTALT”
SKIN
HAIR
SCALP
FACE
EYES

69. 52 Color Atlas of the Autopsy
NOSE
MOUTH
NECK
CHEST
BREASTS
ABDOMEN
EXTREMITIES, HANDS, FINGERS, NAILS
BACK

70. External Examination: Specific Body Areas 53
GENITALIA
RECTUM/ANUS

71. 54 Color Atlas of the Autopsy
FIGURE 5.1

72. External Examination: Specific Body Areas 55
FIGURE 5.2
FIGURE 5.3
FIGURE 5.4

73. 56 Color Atlas of the Autopsy
FIGURE 5.5
FIGURE 5.6

74. External Examination: Specific Body Areas 57
FIGURE 5.7
FIGURE 5.8
FIGURE 5.9

75. 58 Color Atlas of the Autopsy
FIGURE 5.10

76. External Examination: Specific Body Areas 59
FIGURE 5.11

77. 60 Color Atlas of the Autopsy
FIGURE 5.12

78. External Examination: Specific Body Areas 61
FIGURE 5.13

79. 62 Color Atlas of the Autopsy
FIGURE 5.14

80. External Examination: Specific Body Areas 63
A B
FIGURE 5.15

81. 64 Color Atlas of the Autopsy
A
B
FIGURE 5.16

82. External Examination: Specific Body Areas 65
A
FIGURE 5.17
FIGURE 5.18

84. 67
6 Internal Examination:
Opening of Body Cavities
and Initial Assessment

85. 68 Color Atlas of the Autopsy
DISSECTION OF THE SKIN AND OPENING OF THE CHEST AND ABDOMEN
FIGURE 6.1
FIGURE 6.2

86. Internal Examination: Opening of Body Cavities and Initial Assessment 69
B
C
FIGURE 6.2 (CONTINUED)

87. 70 Color Atlas of the Autopsy
A
FIGURE 6.4
FIGURE 6.3

88. Internal Examination: Opening of Body Cavities and Initial Assessment 71
B
C
FIGURE 6.4 (CONTINUED)

89. 72 Color Atlas of the Autopsy
FIGURE 6.5
A
FIGURE 6.6

90. Internal Examination: Opening of Body Cavities and Initial Assessment 73
C
B
FIGURE 6.6 (CONTINUED)

91. 74 Color Atlas of the Autopsy
FIGURE 6.7
FIGURE 6.8

92. Internal Examination: Opening of Body Cavities and Initial Assessment 75
FIGURE 6.9
FIGURE 6.10

93. 76 Color Atlas of the Autopsy
C
FIGURE 6.10 (CONTINUED)

94. Internal Examination: Opening of Body Cavities and Initial Assessment 77
FIGURE 6.11

95. 78 Color Atlas of the Autopsy
FIGURE 6.11 (CONTINUED)

96. Internal Examination: Opening of Body Cavities and Initial Assessment 79
SURVEY OF CHEST TISSUES AND ORGANS
FIGURE 6.12
FIGURE 6.13

97. 80 Color Atlas of the Autopsy
FIGURE 6.14
FIGURE 6.15

98. Internal Examination: Opening of Body Cavities and Initial Assessment 81
FIGURE 6.16

99. 82 Color Atlas of the Autopsy
FIGURE 6.17
FIGURE 6.18

100. Internal Examination: Opening of Body Cavities and Initial Assessment 83
FIGURE 6.19
FIGURE 6.20

101. 84 Color Atlas of the Autopsy
FIGURE 6.21

102. Internal Examination: Opening of Body Cavities and Initial Assessment 85
FIGURE 6.22 FIGURE 6.23
FIGURE 6.24

103. 86 Color Atlas of the Autopsy
FIGURE 6.25

104. Internal Examination: Opening of Body Cavities and Initial Assessment 87
SURVEY OF ABDOMINAL ORGANS
FIGURE 6.26

105. 88 Color Atlas of the Autopsy
FIGURE 6.27
FIGURE 6.28

106. Internal Examination: Opening of Body Cavities and Initial Assessment 89
FIGURE 6.29
FIGURE 6.30

107. 90 Color Atlas of the Autopsy
FIGURE 6.31

108. Internal Examination: Opening of Body Cavities and Initial Assessment 91
FIGURE 6.32
FIGURE 6.33

109. 92 Color Atlas of the Autopsy
FIGURE 6.34

110. Internal Examination: Opening of Body Cavities and Initial Assessment 93
FIGURE 6.35

111. 94 Color Atlas of the Autopsy
FIGURE 6.36

112. Internal Examination: Opening of Body Cavities and Initial Assessment 95
COLLECTING BLOOD, URINE, BILE, AND VITREOUS SPECIMENS FOR TOXICOLOGY
FIGURE 6.37

113. 96 Color Atlas of the Autopsy
FIGURE 6.38
FIGURE 6.39

114. Internal Examination: Opening of Body Cavities and Initial Assessment 97
FIGURE 6.40

116. 99
7 Organ and Tissue Removal

117. 100 Color Atlas of the Autopsy
HEART EXCISION
FIGURE 7.1

118. Organ and Tissue Removal 101
FIGURE 7.2
FIGURE 7.3

119. 102 Color Atlas of the Autopsy
FIGURE 7.4

120. Organ and Tissue Removal 103
LUNG EXCISION
FIGURE 7.5

121. 104 Color Atlas of the Autopsy
FIGURE 7.6

122. Organ and Tissue Removal 105
FIGURE 7.7
FIGURE 7.8

123. 106 Color Atlas of the Autopsy
LIVER EXCISION
FIGURE 7.9
FIGURE 7.10

124. Organ and Tissue Removal 107
FIGURE 7.11

125. 108 Color Atlas of the Autopsy
FIGURE 7.11 (CONTINUED)

126. Organ and Tissue Removal 109
FIGURE 7.12

127. 110 Color Atlas of the Autopsy
FIGURE 7.13

128. Organ and Tissue Removal 111
SPLEEN EXCISION
FIGURE 7.14

129. 112 Color Atlas of the Autopsy
FIGURE 7.15

130. Organ and Tissue Removal 113
SMALL AND LARGE BOWEL EXCISION
FIGURE 7.16

131. 114 Color Atlas of the Autopsy
FIGURE 7.17

132. Organ and Tissue Removal 115
FIGURE 7.18

133. 116 Color Atlas of the Autopsy
FIGURE 7.19

134. Organ and Tissue Removal 117
FIGURE 7.20

135. 118 Color Atlas of the Autopsy
FIGURE 7.21

136. Organ and Tissue Removal 119
FIGURE 7.22

137. 120 Color Atlas of the Autopsy
FIGURE 7.23

138. Organ and Tissue Removal 121
FIGURE 7.24

139. 122 Color Atlas of the Autopsy
FIGURE 7.25
FIGURE 7.26

140. Organ and Tissue Removal 123
ADRENAL GLAND AND KIDNEY REMOVAL
FIGURE 7.27

141. 124 Color Atlas of the Autopsy
FIGURE 7.28
FIGURE 7.30
FIGURE 7.29

142. Organ and Tissue Removal 125
FIGURE 7.31

143. 126 Color Atlas of the Autopsy
FIGURE 7.32
FIGURE 7.33

144. Organ and Tissue Removal 127
FIGURE 7.34

145. 128 Color Atlas of the Autopsy
FIGURE 7.35

146. Organ and Tissue Removal 129
FIGURE 7.36

147. 130 Color Atlas of the Autopsy
FIGURE 7.37
FIGURE 7.38

148. Organ and Tissue Removal 131
AORTA EXAMINATION
FIGURE 7.39

149. 132 Color Atlas of the Autopsy
FIGURE 7.39 (CONTINUED)

150. Organ and Tissue Removal 133
FIGURE 7.40

151. 134 Color Atlas of the Autopsy
FIGURE 7.41
FIGURE 7.42

152. Organ and Tissue Removal 135
FIGURE 7.43
FIGURE 7.44

153. 136 Color Atlas of the Autopsy
FIGURE 7.45

154. Organ and Tissue Removal 137
UTERUS REMOVAL
FIGURE 7.46

155. 138 Color Atlas of the Autopsy
BLADDER REMOVAL
FIGURE 7.47

156. Organ and Tissue Removal 139
FIGURE 7.47 (CONTINUED)

157. 140 Color Atlas of the Autopsy
NECK DISSECTION
FIGURE 7.48

158. Organ and Tissue Removal 141
FIGURE 7.49
FIGURE 7.50

159. 142 Color Atlas of the Autopsy
FIGURE 7.51

160. Organ and Tissue Removal 143
FIGURE 7.52
FIGURE 7.53

161. 144 Color Atlas of the Autopsy
FIGURE 7.54

162. Organ and Tissue Removal 145
FIGURE 7.55
FIGURE 7.56

164. 147
8 Individual Organ Examination

165. 148 Color Atlas of the Autopsy
HEART
FIGURE 8.1
FIGURE 8.2

166. Individual Organ Examination 149
FIGURE 8.3
FIGURE 8.4

167. 150 Color Atlas of the Autopsy
FIGURE 8.5

168. Individual Organ Examination 151
FIGURE 8.6
FIGURE 8.7

169. 152 Color Atlas of the Autopsy
FIGURE 8.8
FIGURE 8.10
FIGURE 8.9

170. Individual Organ Examination 153
FIGURE 8.11
FIGURE 8.12

171. 154 Color Atlas of the Autopsy
A
FIGURE 8.13

172. Individual Organ Examination 155
FIGURE 8.14
FIGURE 8.15

173. 156 Color Atlas of the Autopsy
FIGURE 8.16

174. Individual Organ Examination 157
FIGURE 8.17
FIGURE 8.18

175. 158 Color Atlas of the Autopsy
FIGURE 8.19
FIGURE 8.20

176. Individual Organ Examination 159
FIGURE 8.21

177. 160 Color Atlas of the Autopsy
FIGURE 8.22
FIGURE 8.23

178. Individual Organ Examination 161
FIGURE 8.24
FIGURE 8.25 FIGURE 8.26

179. 162 Color Atlas of the Autopsy
FIGURE 8.27

180. Individual Organ Examination 163
LUNG
FIGURE 8.28

181. 164 Color Atlas of the Autopsy
FIGURE 8.29

182. Individual Organ Examination 165
FIGURE 8.30

183. 166 Color Atlas of the Autopsy
FIGURE 8.31

184. Individual Organ Examination 167
FIGURE 8.33
FIGURE 8.32

185. 168 Color Atlas of the Autopsy
FIGURE 8.34
FIGURE 8.36
FIGURE 8.35

186. Individual Organ Examination 169
FIGURE 8.37
FIGURE 8.38

187. 170 Color Atlas of the Autopsy
FIGURE 8.39

188. Individual Organ Examination 171
FIGURE 8.40
FIGURE 8.41

189. 172 Color Atlas of the Autopsy
FIGURE 8.43
FIGURE 8.42

190. Individual Organ Examination 173
NECK ORGANS: EPIGLOTTIS, VOCAL CORDS, TRACHEA, THYROID, CARTILAGE, STRAP
MUSCLES, HYOID BONE
FIGURE 8.44

191. 174 Color Atlas of the Autopsy
FIGURE 8.45

192. Individual Organ Examination 175
FIGURE 8.46

193. 176 Color Atlas of the Autopsy
FIGURE 8.47
FIGURE 8.48

194. Individual Organ Examination 177
FIGURE 8.49
FIGURE 8.50

195. 178 Color Atlas of the Autopsy
FIGURE 8.51
FIGURE 8.52

196. Individual Organ Examination 179
FIGURE 8.53
FIGURE 8.54

197. 180 Color Atlas of the Autopsy
FIGURE 8.55

198. Individual Organ Examination 181
FIGURE 8.56

199. 182 Color Atlas of the Autopsy
FIGURE 8.57

200. Individual Organ Examination 183
LIVER
FIGURE 8.58
FIGURE 8.59
FIGURE 8.60

201. 184 Color Atlas of the Autopsy
FIGURE 8.61
FIGURE 8.62

202. Individual Organ Examination 185
FIGURE 8.63

203. 186 Color Atlas of the Autopsy
FIGURE 8.64

204. Individual Organ Examination 187
FIGURE 8.65

205. 188 Color Atlas of the Autopsy
SPLEEN
FIGURE 8.66
FIGURE 8.67

206. Individual Organ Examination 189
FIGURE 8.68

207. 190 Color Atlas of the Autopsy
URINARY TRACT: KIDNEYS, BLADDER, URETER, PROSTATE
FIGURE 8.69
FIGURE 8.70

208. Individual Organ Examination 191
FIGURE 8.71
FIGURE 8.72

209. 192 Color Atlas of the Autopsy
FIGURE 8.73
FIGURE 8.74

210. Individual Organ Examination 193
FIGURE 8.75

211. 194 Color Atlas of the Autopsy
FIGURE 8.77
FIGURE 8.76

212. Individual Organ Examination 195
FIGURE 8.78

213. 196 Color Atlas of the Autopsy
FIGURE 8.79
FIGURE 8.80

214. Individual Organ Examination 197
ESOPHAGUS AND STOMACH
FIGURE 8.81
FIGURE 8.82

215. 198 Color Atlas of the Autopsy
FIGURE 8.83

216. Individual Organ Examination 199
FIGURE 8.84
FIGURE 8.85

217. 200 Color Atlas of the Autopsy
UTERUS AND OVARIES
FIGURE 8.86
FIGURE 8.87
FIGURE 8.88

218. Individual Organ Examination 201
FIGURE 8.89

219. 202 Color Atlas of the Autopsy
FIGURE 8.90

220. 203
9 Examination of the Head, Skull,
Brain, and Spinal Cord

221. 204 Color Atlas of the Autopsy
SCALP EXAMINATION AND EXCISION OF THE BRAIN
FIGURE 9.1

222. Examination of the Head, Skull, Brain, and Spinal Cord 205
FIGURE 9.2

223. 206 Color Atlas of the Autopsy
FIGURE 9.3

224. Examination of the Head, Skull, Brain, and Spinal Cord 207
FIGURE 9.4
FIGURE 9.5

225. 208 Color Atlas of the Autopsy
FIGURE 9.6

226. Examination of the Head, Skull, Brain, and Spinal Cord 209
FIGURE 9.7

227. 210 Color Atlas of the Autopsy
FIGURE 9.8
FIGURE 9.9

228. Examination of the Head, Skull, Brain, and Spinal Cord 211
FIGURE 9.10
FIGURE 9.11

229. 212 Color Atlas of the Autopsy
FIGURE 9.12
FIGURE 9.13

230. Examination of the Head, Skull, Brain, and Spinal Cord 213
FIGURE 9.14
FIGURE 9.16
FIGURE 9.15

231. 214 Color Atlas of the Autopsy
FIGURE 9.17
FIGURE 9.18

232. Examination of the Head, Skull, Brain, and Spinal Cord 215
FIGURE 9.19
FIGURE 9.20

233. 216 Color Atlas of the Autopsy
FIGURE 9.21
FIGURE 9.22

234. Examination of the Head, Skull, Brain, and Spinal Cord 217
FIGURE 9.23

235. 218 Color Atlas of the Autopsy
FIGURE 9.24
FIGURE 9.25

236. Examination of the Head, Skull, Brain, and Spinal Cord 219
FIGURE 9.26

238. 221
10 Microscopic Examination

239. 222 Color Atlas of the Autopsy
FIGURE 10.1
FIGURE 10.2

240. Microscopic Examination 223
FIGURE 10.3
A
FIGURE 10.4
B
B

241. 224 Color Atlas of the Autopsy
FIGURE 10.5
FIGURE 10.7 FIGURE 10.8
FIGURE 10.6

242. Microscopic Examination 225
FIGURE 10.9
FIGURE 10.11
BB
FIGURE 10.10

243. 226 Color Atlas of the Autopsy
FIGURE 10.12
FIGURE 10.14 FIGURE 10.15
FIGURE 10.13

244. Microscopic Examination 227
FIGURE 10.16
FIGURE 10.18
FIGURE 10.19
FIGURE 10.17

245. 228 Color Atlas of the Autopsy
FIGURE 10.20
FIGURE 10.22 FIGURE 10.23
FIGURE 10.21

246. 229
11 Postmortem Laboratory Analysis
of Drugs, Chemicals,
and Microorganisms
THE SCENE AND THE BODY

247. 230 Color Atlas of the Autopsy
SPECIMENS TO OBTAIN AT AUTOPSY
BLOOD
URINE
VITREOUS HUMOR
GASTRIC CONTENTS
BILE
TISSUES AND OTHER SPECIMENS

248. Postmortem Laboratory Analysis of Drugs, Chemicals, and Microorganisms 231
FIGURE 11.1
FIGURE 11.3
FIGURE 11.2

249. 232 Color Atlas of the Autopsy
FIGURE 11.4
FIGURE 11.5

250. Postmortem Laboratory Analysis of Drugs, Chemicals, and Microorganisms 233
FIGURE 11.6

252. 235
12 Review Questions:
Putting It All Together
ANSWER THE FOLLOWING QUESTIONS.
CHOOSE:

253. 236 Color Atlas of the Autopsy
CHOOSE THE BEST ANSWER.

254. Review Questions: Putting It All Together 237
ANSWERS

256. 239
References and Suggested Reading

258. 241
Index
A
B
C

259. 242 Color Atlas of the Autopsy
D
E
F
G
H

260. Index 243
I
J
K
L
M
N

261. 244 Color Atlas of the Autopsy
O
P
R
S
T

262. Index 245
U
V
W
Y