Difference between revisions of "Autopsy"
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'''Autopsy''' is a part of pathology. | '''Autopsy''' is a part of pathology. | ||
In a hospital autopsy the most important thing is: ''proper consent''. | |||
==Consent== | |||
*Consent should be given by the ''executer of the estate''.<ref>URL: [http://www.docstoc.com/docs/51609856/CONSENT-FOR-AUTOPSY http://www.docstoc.com/docs/51609856/CONSENT-FOR-AUTOPSY]. Accessed on: 27 September 2010.</ref> | |||
#If the ''executer of the estate'' is not specified the hierarchy is as follows: | |||
#Spouse: married (same sex ''or'' opposite sex) ''or'' common-law ''or'' together the parents of a child ''or'' cohabitation agreement in law. | |||
#if no spouse, any children 16+ years old, | |||
#if no children, either parent, | |||
#if no parent, any brother or sister 16+ years old, | |||
#if no sibling, any next-of-kin 16+ years old, | |||
#if no next-of-kin, the person lawfully in possession of the body (not the hospital). | |||
Notes: | |||
*The power a person that is designated as ''power of attorney for health care decisions'' does not have authority to consent an autopsy; their power ends with death (unless they are also the ''executer of the estate''). | |||
==External exam== | ==External exam== | ||
Revision as of 02:43, 28 September 2010
Autopsy is a part of pathology.
In a hospital autopsy the most important thing is: proper consent.
Consent
- Consent should be given by the executer of the estate.[1]
- If the executer of the estate is not specified the hierarchy is as follows:
- Spouse: married (same sex or opposite sex) or common-law or together the parents of a child or cohabitation agreement in law.
- if no spouse, any children 16+ years old,
- if no children, either parent,
- if no parent, any brother or sister 16+ years old,
- if no sibling, any next-of-kin 16+ years old,
- if no next-of-kin, the person lawfully in possession of the body (not the hospital).
Notes:
- The power a person that is designated as power of attorney for health care decisions does not have authority to consent an autopsy; their power ends with death (unless they are also the executer of the estate).
External exam
Is very important in the forensic context.
External exam findings are found in the forensic pathology article.
Internal exam
Is usually where the money is in non-forensic autopsies, i.e. hospital autopsies.
Hyoid bone
- Important in forensic pathology.
- Fracture is seen in manual strangulation.
- May appear fractured if triticeous cartilage (or triticeal cartilage) is present;[2][3] triticeous cartilage may be confused with a fragment of hyoid bone.
- Triticeous is pronounced tri-tish´us.[4]
Spleen
Main article: Spleen
Sugar-coated spleen
- Properly referred to as hyaloserositis of the spleen.
- Capsule of the spleen is white - resembles sugar-coating.
- Importance: none - benign.
Liver
- Portal vein patency.
Kidney
Size of the kidney - small kidneys are seen in chronic renal failure.
Nephrosclerosis
- Flea-bitten appearance - seen in hypertension.[5]
ATN
- ATN is difficult to prove on autopsy material.
- Look for:
- Heme-granular casts in the lumen.
- Regenerative activity (mitoses).
Brain
- One should saw through the skull completely, i.e. one should not "crack" the skull open with a chisel.
- Cracking open the skull may result in artefactual fractures that are impossible to differentiate from antemortem fractures.
- Cuts into the brain (from opening the skull) are not difficult to distinguish from antemortem injuries.
Weird stuff
- Leukostasis in acute myelogenous leukemia can lead to congestion of organs and fatal haemorrhages.
- Hyperviscosity syndrome - in leukemia.[8]
Starvation
- Serous fat atrophy.
- Gross appearance: brown goo replaces fat.
- May be associated with blood vessel tortuosity.[9]
- Gross appearance: brown goo replaces fat.
Normal organ mass
Caucasoid population of 684 adults:[10]
| Men | Women | |
| Heart | 365 +/- 71 g | 312 +/- 78 g |
| Right lung | 663 +/- 239 g | 546 +/- 207 g |
| Left lung | 583 +/- 216 g | 467 +/- 174 g |
| Liver | 1677 +/- 396 g | 1475 +/- 362 g |
| Spleen | 156 +/- 87 g | 140 +/- 78 g |
| Right kidney | 162 +/- 39 g | 135 +/- 39 g |
| Left kidney | 160 +/- 41 g | 136 +/- 37 g |
See also
References
- ↑ URL: http://www.docstoc.com/docs/51609856/CONSENT-FOR-AUTOPSY. Accessed on: 27 September 2010.
- ↑ Di Nunno N, Lombardo S, Costantinides F, Di Nunno C (March 2004). "Anomalies and alterations of the hyoid-larynx complex in forensic radiographic studies". Am J Forensic Med Pathol 25 (1): 14–9. PMID 15075682.
- ↑ URL: http://faculty.ksu.edu.sa/Prof.Hamam/curses/Jurnals%20Club/225-Triticeous%20cartilage.pdf. Accessed on: 10 September 2010.
- ↑ URL: http://medical-dictionary.thefreedictionary.com/triticeous. Accessed on: 15 September 2010.
- ↑ Ono, H.; Ono, Y. (Nov 1997). "Nephrosclerosis and hypertension.". Med Clin North Am 81 (6): 1273-88. PMID 9356598.
- ↑ Heemskerk, S.; van Haren, FM.; Foudraine, NA.; Peters, WH.; van der Hoeven, JG.; Russel, FG.; Masereeuw, R.; Pickkers, P. (Feb 2008). "Short-term beneficial effects of methylene blue on kidney damage in septic shock patients.". Intensive Care Med 34 (2): 350-4. doi:10.1007/s00134-007-0867-9. PMID 17926021.
- ↑ Tan, CD.; Rodriguez, ER.. "Blue dye, green heart.". Cardiovasc Pathol 19 (2): 125-6. doi:10.1016/j.carpath.2008.06.012. PMID 18703358.
- ↑ http://cat.inist.fr/?aModele=afficheN&cpsidt=18942659
- ↑ KC. 14 September 2010.
- ↑ de la Grandmaison GL, Clairand I, Durigon M (June 2001). "Organ weight in 684 adult autopsies: new tables for a Caucasoid population". Forensic Sci. Int. 119 (2): 149–54. PMID 11376980.