Autopsy

It answers the vital question of why a physician lost their patient, confirming diagnoses or revealing unexpected conditions. This direct feedback is essential for continuous medical improvement

For Clinical Accuracy:

By accurately documenting causes of death on death certificates, autopsies provide reliable vital statistics. This data is crucial for tracking disease prevalence, identifying public health threats, and allocating resources effectively.

For Public Health:

It is a primary investigative method for understanding the nature of major diseases like cancer, heart disease, and stroke, paving the way for future treatments.

For Medical Research:

It is an indispensable tool for enforcing criminal law, providing objective evidence in cases of homicide, accident, or suspicious death.

For Legal and Criminal Justice:

 Ultimately, the knowledge gained from an autopsy contributes to the future care of living patients, improving diagnostics, treatments, and preventative medicine for all.

  For the Living:

Death of the whole organism

Somatic Death:

Cessation of circulation and respiration.

Historic Definition (pre-1960s):

Irreversible cessation of all vital functions, including those of the entire brain

Modern Definition:

Primary (1°) Changes –

"The Shutdown"

List the primary changes CRC

·        Circulatory Failure (heart stops)

·        Respiratory Failure (breathing stops)

·        CNS (Central Nervous System) Failure (brain function ceases)

Secondary (2°) Changes

– "Postmortem Phenomena"

LIST Secondary changes

·        Algor Mortis

·        Rigor Mortis

·        Livor Mortis

·        Postmortem Clotting

·        Dessication

·        Putrefaction

·        Autolysis

No responsiveness to stimuli

Coma:

Absence of spontaneous breathing.

Apnea:

Absent Brainstem Reflexes:

o   Fixed, dilated pupils unresponsive to light

o   No corneal (blinking) reflex

o   No gag or cough reflex

o   No sucking/rooting reflexes in infants

Electrocerebral Silence:

Flat EEG

Criteria for Brain Death (American Academy of Neurology):

Coma

apnea

Absent Brainstem reflexes

Electrocerebral silence

Organs are removed and dissected one by one, individually.

Virchow

Most widely used globally. Allows detailed study of each organ, but may disrupt inter-organ relationships.

Virchow

Combines in-situ dissection with en bloc removal.

Rokitansky

Maintains some organ context. Ideal for observing relationships within organ systems, especially in natural anatomical positions.

Rokitansky

Organs removed by functional system (e.g., thoracic block, abdominal block).

Ghon

Organs are removed by the system or cavity

Ghon

Preserves the relationship within a specific system

Ghon

En masse ( one mass ) removal

Letulle

All thoracic, abdominal, and pelvic organs are removed together in one large aggregate from the larynx down to the rectum.

Letulle

Very efficient and preserves all organ relationships

Letulle

Normal programmed cell death (e.g., skin shedding).

Necrobiosis:

Pathological cell death due to disease or trauma

Necrosis:

Small petechial hemorrhages that can appear in areas of lividity due to the rupture of capillaries

Tardieu Spots

Blood separates into a dark red cellular layer and a yellow, gelatinous “chicken fat” plasma layer. This is different from antemortem clots ( thrombi )

Postmortem clotting

The Abdomen often turns greenish due to the formation of hydrogen sulfide gas by bacteria reacting with hgb

Discoloration

This is the ultimate end-stage of decomposition

Putrefaction

The dehydration of tissues, which can occur in dry, arid conditions, leading to the preservation of the body

Dessication/Mummification

Type of necrosis, the most common

Coagulation

Architecture of the dead is preserved for a time ( tombstone formation )

Coagulation

Type of necrosis wherein the dead cells are completely digested, forming a viscous liquid mass

Liquefaction

Type of necrosis

A combination of coagulation and liquefaction. appears as a yellow, cheesy, crumbly material

Casous

Necrosis of a limb or digit, often with superimposed bacterial infection and sulfide gas production

Gangrenous

Arterial occlusion

Dry gangrene

Venous occlusion

Wet gangrene

Broken down into fatty acids, which combine with calcium to form chalky white precipitates ( saponification )

Fat

The accumulation of fat globules within the parenchymal cells of an organ

Fatty degeneration

Fatty degeneration is most commonly see in

liver due to alcoholism or metabolic syndrome

“Chicken fat” and “currant jelly” layers

Postmortem clot

Smooth and rubbery consistency

Postmortem clot

Not attached to the vessel wall

Postmortem clot

Assumes the shape of the vessel

Postmortem clot

No distinct layers, Granular and Friable

Antemortem Thrombus

Rough, granular, brittle consistency

Antemortem Thrombus

Firmly attached to the underlying vessel wall

Antemortem Thrombus

Seldom conforms to the shape of the vessel

Antemortem Thrombus