Embalming 2- Autopsy

autopsy defined

• Postmortem examination of the dead

human body

• Autopsies are defined by the extent of

the postmortem examination.

• Partial autopsy is limited to a specific

cavity or region of the body and the

incision is made in accordance with that

• Complete autopsy examines the entire

body and a standard Y incision is used

autopsy types

Family must give permission

and may limit the extent of the

autopsy

Medical (Hospital)

• Ordered by the medical

examiner or coroner

Medicolegal (Forensic)

Medical Autopsy

Confirm a diagnosis

Unexpected medical complications

Experimental drug, device, procedure, or unusual

therapy

Sudden, unexpected, or mysterious circumstances

Environmental or workplace hazards

During or after childbirth

Hereditary disease

Contagious diseases

When COD can affect insurance settlements

When patient care is questioned

Will go to the ME when:

• When a Dr can't give a COD

• Suspicious circumstances

• Violence or trauma Fetal or stillborn

• Any unidentifiable or unclaimed

Common Forensic Autopsies

Homicide

Death in the workplace

Car accidents

SIDS

Overdoses Poisonings

Epileptics

Anorexia Nervosa

Inmates

ME determine

Cause of death

Manner of death

Time of death

Recovering, identifying, and/or preserving

evidence

Provide factual information

Separate internal from external causes

Complete autopsy takes

1. Cranial cavity and its contents (Brain, Pituitary

gland, inner ear)

2. Vitreous of Eye

3. Organs of the Neck (including the tongue)

4. Thoracic cavity and its contents

5. Abdominal cavity and its contents

6. Pelvic cavity and its contents

7. Testes of the Scrotum

8. Spine cord section (dorsal approach, ventral

approach, cranial approach)

Outline of Treatment

Disinfect, bathe

Proper positioning

of the head and

shoulders

Shave and set

features before or

after cranial

injection

Remove temporary sutures holding the cavities together

Remove the bagged viscera from cavity

Locate and place ligature around the arteries

Prepare the embalming fluid (STRONG)

Inject using an appropriate Rate of Flow

Hypodermic treatment

Disinfection

Apply topical droplet spray on

body and orifices

• Bathe with germicidal soap

• Wash /Soak Hair

• Relieve rigor mortis

Positioning

Properly position the decedent on the head blocks, shoulder blocks

Ensure they are in the center of the table

Slightly elevate the head end and lower the foot end of the table

setting features

Shave if needed – Always ask for permission and

document who and when!

• Make sure the eyes are at the proper projection

• If the eyeball has lost its structural integrity build

the shape back up with cotton and an eye cap.

• Needle injector or mouth suture

Viscera Treatment

Remove viscera from the cavity

Place in a bucket

Add two bottles of cavity fluid into the viscera

Place bucket in a safe place where you won't knock it over

Place sternum in bucket or out of the way during the embalming process

Aspirate out all left-over fluids from the cavity

Locate Arteries

Locate L and R Carotid

• Locate L and R Axillary

• Locate L and R Iliac / Femoral

• Place ligature around all arteries

• Sometimes the ME will leave the arch of the aorta

and arteries can be easily accessed from this

point

injection

he legs first, followed by arms,

then head (Lower Pressure)

• Clamp off the internal carotids with

hemostats in the head before

injection

• Closely watch the face for swelling

when doing the head

• left side of the head first,

followed by the right side.

• Keep hemostats readily available to

clamp off any leaking vessels

Let drainage enter cavity, aspirate as needed

Drainage can be continuous or intermitted

Problems?

o Clamp off veins to add pressure for

diffusion

o Massage

o Increase pressure

o Increase rate of flow

Hypodermic Treatment

• Hypodermically treat the

glutes, back of neck, chest,

abdomen region (especially if

the person is corpulent)

• Hypodermically treat any other

region that did not get proper

fluid distribution

Create channels with the hypodermic

trocar

Inject embalming chemical

Be careful of you own hands

Be careful not to disrupt the integrity of

the body. (poking holes through the skin)

Treat Internal Surface and prepare cavities

Aspirate out all fluid from cavity

Thoroughly dry

Use autopsy gel to coat the insides of the cavity,

including sternum

Place autopsy powder in cavity to coat all walls

PACK THE NECK WITH COTTON

all throat organs have been removed. We must

pack this area to restore its natural shape

Place viscera in its bag back into the cavity, if the

viscera is not returned fill the cavity with absorbent

material

Place sternum back before suturing

Preparation of the Cranial Cavity

Remove absorbent material

• Dry any remaining liquids

• Brush walls of the cranium vault with autopsy gel

• Place incision seal powder followed by cotton into the foramen magnum

• Plack vault tightly with cotton

• Brush glue on the margins of the calvarium and the margins of the skull

• Replace and align the calvarium

• Suture through the temporalis muscles

• Apply mortuary putty along the seem where the bone of the skull meets the

calvarium. Continue with a coating of putty over the entire calvarium

• Reflect the scalp to its original position, fully covering the calvarium

Suture Cranial Cavity

Start behind the right ear and suture to the left ear.

Single or double Ligature. White or Black. Use Baseball or Worm

(inversion)

Be careful not to get hair in the suture to avoid wicking

Try to make this suture small and tight to prevent leakage

Exploratory Autopsy

Battered child

• Multiple incisions to check for contusions under the skin

• Suture or glue

Embolism

• Long incisions, usually on the legs

• Pack with cotton and/or drying powder

• Suture as usual

Drug overdose

• Excising of tissue, usually on arms by elbows

• Cannot suture

• Treat and pack and wrap in plastic