GREGORIOS histopathology Autopsy didactic Notes PDF

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AUTOPSY NOTES S.CWHAT IS AUTOPSY?A detailed dissection of a decease person, done to determine why they died."Auto" - self, one's own"Opsis" - a sight, view= to see for oneselfPATHOLOGYthe study of disease. Pathology is a medical specialty studying disease processes, how they develop and what they ar...

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AUTOPSY NOTES

S.C.U

WHAT IS AUTOPSY?

TYPES OF AUTOPSY

A detailed dissection of a decease person, done to determine why they died.

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"Auto" - self, one's own "Opsis" - a sight, view = to see for oneself PATHOLOGY the study of disease. Pathology is a medical specialty studying disease processes, how they develop and what they are caused by and the application of this knowledge to the diagnosis of disease. NECROPSY A postmortem examination of a body after death or autopsy OBDUCTION

Forensic (Medico-Legal or Coroner's Autopsy)- autopsies with legal implications and are performed to determine if death was an accident, homicide, suicide or of natural event • Clinical/Pathological - are executed to diagnose a particular disease or for research purposes. Clinical autopsies are sometimes performed to assess the standard of care of hospitals.  Anatomical/Academic - are performed by students of anatomy for study purpose; Possible only when a person has given permission in advance of their death.

SOMATIC DEATH • The death of the entire body - resulting from the lack of oxygen caused by discontinuance of cardiac activity and respiration

opening of the dead. It is mostly used for the FORENSIC pathology mostly used, a slice of tissue in anatomy.

PRIMARY CHANGES:

DISSECTION

Circulatory, respiratory and nervous failure

Dissection is the dismembering of the body of a deceased animal or plant to study its anatomical structure.

SECONDARY CHANGES:

Why is Autopsy being performed?

RIGOR MORTIS – rigidity of muscles

The primary purpose of a postmortem examination in a hospital is to confirm a known or suspected diagnosis of the disease which caused the death of the patient.

LIVOR MORTIS – purplish discoloration

Evaluates the accuracy of diagnosis and the outcome of therapy  Eliminate suspicion, establishes final diagnosis  Checks the structure and course (pathogenesis) of the disease • Aids in forensic investigations

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ALGOR MORTIS- cooling of the body

of skin due to hemostasis POSTMORTEM CLOTTING – separation of red cells form the fluid phase of blood forming thrombi DESSICATION - wrinkling of the cornea and the anterior chamber of the eye PUTREFACTION – production of foul

AUTOPSY NOTES smelling gas AUTOLYSIS - self digestion of cells GENERAL RULES 

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01 Practice standard infection control precautions. (PPE, cut-resistant gloves, Vaccinations) 02 Postmortem examinations are carried out by adequate, well-trained staff. 03 For routine decontamination, all instruments and autopsy devices should be immersed in an enzymatic cleaner or detergent solution for at least 10 minutes, then rinsed with water and decontaminated with disinfectant such as 5.25% sodium hypochlorite for an additional 10 minutes 04 If multiple autopsies are to be performed sequentially, those with the greatest infective risk should be done first, before the staff becomes fatigued. 05 Aerosols should be limited.

1: Gloves, right or left palms 2: FFP-Mask, outside, front in the middle part 3: Safety goggles, on the lenses 4: Side area of safety goggles 6: Plastic apron, at the level of the chest/cleavage 7: Protective clothing back 7: Shoe, right or left in the forefoot area, on top 8: Shoe sole, right or left before leaving the autopsy room 9: Shoe sole, right or left after disinfection

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Influenza Leprosy Meningococcal meningitis Multidrug-resistant bacteria (methicillin-resistant Staphylococcus, vancomycin-resistant Enterococcus) Plague Prion diseases Rabies Rickettsial diseases (Rocky Mountain spotted fever) Systemic infections of unknown etiology Tuberculosis Typhoid fever

Example of Order of Priority for Consenting for Autopsy 1. Consent from the deceased prior to death" 2. An "attorney-in-fact" appointed as a result of the decedent's execution of a durable power of attorney for health care and authorized to consent to an autopsy 3. Spouse (not legally separated or divorced unless he or she has custody of eldest child if all children are minors) 4. Adult child age 18 or older 5. Adult grandchild 6. Parent 7. Adult sibling 8. Grandparents 9. Adult uncles and aunts 10. Other adult relative 11. Friend accepting responsibility for disposition of the body 12. Public official acting within his or her legal authority EXTERNAL INSPECTION

Some Infections for Which Postmortem Examinations Should Be Performed in a Separate or "Isolation" Room  Anthrax  Hantavirus  Hepatitis  Human immunodeficiency virus/acquired immunodeficiency  syndrome

IDENTIFICATION  All members of the autopsy team focus on a team statement of the patient name, medical identifiers, and autopsy restrictions for the case they are about to begin  Check the toe tag and match it with a copy of the autopsy consent form

AUTOPSY NOTES INSPECTION AND PALPATION  Measure the body length, and weigh it  Examine every part of the body and document any abnormalities  Surgical and non-surgical scars should be documented  Keep a handheld camera ready during the remainder of the dissection for photographs of in situ findings. INITIAL DISSECTION AND INTERNAL EXAMINATION Y- Shaped Incision 

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It begins at the shoulders, anterior to the acromial processes and sparing the top of the shoulders. The upper limbs of the incision penetrate to the ribs and meet at the level of the xiphoid process.

Modern autopsy techniques: Virchow method  Methodic Autopsy - Advocated by Rudolf Virchow (Father of Pathology) - organs are removed one by one - Advantage: Quick and suitable for beginners - sacrifices interorgan relationships - Disadvantage: Causes loss of continuity difficult to evaluate inter-relationship within organs  Letulle method - removes organ together in groups - allows the most rapid preparation of the body for removal to the mortuary - less dissection within the confines of the body cavity - offers greater safety to the prosector and assistant - difficult for some to perform without an assistant

S.C.U  Ghon method - removes organs in regional and functional groups - relatively easier for one person to carry out  Rokitansky method - "Systemic autopsy method" - Advocated by Carl Rokitansky, German pathologist 1804 1878 - in situ dissection - allows one to examine organs without removing them from the body - Advantage: In infected bodies (HIV, Hepatitis) - Disadvantage: difficult to perform 2T ORGAN WEIGHTS Liver Brain Right lung Left lung Heart Spleen Thyroid Adrenal

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