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human body autopsy

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Name of the Student
Professor’s Name
Biology
6th December 2015
Procedure of Autopsy
An autopsy is the mechanism of study of tissues from a dead organism. This method is employed during post-mortem studies to evaluate the cause of death of a human being. The procedure of autopsy includes a careful examination of the external morphology of the body and then the removal of all internal organs like the thoracic, abdominal and pelvic organs from the body. The procedure of unrestricted autopsy is done by the following steps.
Before dissection of the body parts thorough examination should be carried out on the external features of the dead body. Photographs and sketches must be used and the investigation should aim to find out the scars, open wounds, placement of intravenous catheters and insertion of endo-tracheal tubes must be noted (Roulson, Benbow, & Hasleton 551-9)
The personal belongings that are found in the anatomical location of the deceased person should be noted and entered in a case book. Before the cultures are done, the body should be checked for pneumothorax, air or fat emboli. Before opening the chest cavity, the examination of pneumothorax should be ensured. To test for the presence of pneumothorax, a perforation must be made in the chest cavity or the thorax. The effusions may be detected by the presence and escape of air bubbles after such perforations are done. The detection of fat emboli is done by isolating a fresh sample of blood clot. This section is frozen and an oil red 0 stain is added to detect the neutral fat (Turnbull, Osborn & Nicholas 601-4).

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This red oil test may also be performed on formalin fixed tissues that have not been processed by alcohol (The Autopsy Manual).
Dissection is carried out by making a Y shaped incision in the abdomen. After incision the abdominal panicles are measured. The chest plate should be removed and a sample of blood must be collected through needle insertion in the inferior vena cava. If clot in vena cava compromises with blood collection, the incision may be carried out in the ventricles and the pericardial sac should be used to collect blood. If there is not adequate blood in the heart the pulmonary arteries should be invaded to collect blood. The cultures of lung tissue effusions and abscess cavities and other areas of suspected infection must be carried out at this time. The pulmonary arteries should be palpated to search for the presence of pulmonary emboli. The retro peritoneum must be then investigated in-situ. The bowel should next be tied off at the Treitz ligament and retro sigmoidal junctures to remove the intestinal segments. However, in routine cases the intestines may be removed through the mesenteric surface (The Autopsy Manual).
When there is a suspected bowel infarction the intestines must be removed with the vascular connections. The arteries present on the neck and the upper extremities should be isolated along with the iliac arteries. Iliac veins must be examined and the deep venous system should be inspected for any patency. Separation of individual blocks is then carried out. The thoracic aorta should be transected at the level of diaphragm and freed up the esophagus and must be reflected inferiorly. After dissecting through inferior vena cava and its entrance into right atrium, the thoracic –abdominal block is divided into two blocks. The first block is the cardiopulmonary system and the second block is the peritoneal and retroperitoneal systems (The Autopsy Manual).
The adrenal glands are then removed and weighed and kept in formalin. Then the next block is dissected through the opening of larynx and the thyroid glands and parathyroid glands are removed and treated. For dissecting the second block the descending aorta should be opened till its bifurcation. The iliac arteries are then opened in a similar way. The renal arteries are identified and cross-sectioned for the analysis of luminal narrowing. The celiac arteries are then identified and the vessels are examined for the presence of atherosclerosis. The aorta and its bifurcation are then dissected along with kidneys and ureters. Kidney capsules should then be removed and the probes must be placed in the renal pelvis. The weight of kidneys and the cortical thickness must be assessed. The major and minor calyx is then opened. In males the prostate must be sectioned serially in 5 mm sections. Attention must be given to finding out the pelvic venous structures (for example prostatic plexus) for evaluating prostatic emboli. The remaining block of esophagus stomach and duodenum would then be evaluated. The esophagus, stomach and duodenum must be opened longitudinally and the mucosa to be examined (The Autopsy Manual).
The ampulla of Vater must be identified and common bile duct to be held open. It should be noted that the cystic ducts must be opened before the opening up of the hepatic ducts. Any gall stones must be retained at 4-degree centigrade for future chemical analysis. The liver is then weighed and dissected in 1.5 cm sections. The pancreas and the spleen are weighed and serially sectioned (The Autopsy Manual).
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References
 Roulson J, Benbow EW, & Hasleton PS. “Discrepancies between clinical and autopsy
diagnosis and the value of post mortem histology; a meta-analysis and review”.
Histopathology 47.6 (2005): pp. 551–9
The Autopsy Manual: The Beth Israel Deaconess Medical Center- Department of Pathology
Turnbull A.J., Osborn M., & Nicholas N.. “Hospital Autopsy: endangered or
extinct?”. ClinPath. 68 (2008), pp. 601–4

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