1. Autopsies

2. Autopsies A.Definition and purpose: an examination of a body after death to determine the cause of death or the character and extent of changes produced by disease/to see with one’s own eyes. A.Definition and purpose: an examination of a body after death to determine the cause of death or the character and extent of changes produced by disease/to see with one’s own eyes. B.Legal requirements to perform an autopsy: B.Legal requirements to perform an autopsy: 1. Must be a Coroner 2. Medical examiner or Pathologist

3. Reasons for autopsy 1. Determine which disease or injury caused death 2. Diagnosis - confirmation and understanding 3. Evaluate possible public health issue- for instance, if someone died and they think it could be from an illness that could potentially be spread to others, they would do an autopsy (i.e. West Nile Virus).***

4. Preparation 1. If not required by law, permission needed from next of kin *** 2. Legal consent form must be signed prior to performing the autopsy

5. Procedure 1. Complete medical history and review of records prior to performing the actual exam 2.External physical exam a.Body tag (shows who the person is) a.Body tag (shows who the person is) b.Weight and height/gender/fingerprints b.Weight and height/gender/fingerprints c.Clothing and valuables identified c.Clothing and valuables identified d.Scars, tattoos, injuries, wounds, bruises recorded (scars and tattoos are identifying marks, wounds and bruises could indicate foul play) d.Scars, tattoos, injuries, wounds, bruises recorded (scars and tattoos are identifying marks, wounds and bruises could indicate foul play) e.Foreign objects noted e.Foreign objects noted

6. Procedure continued f. Examine the body very closely, under magnification. Check clothing and skin for any marks that look out of the ordinary. Fibers that don’t seem to belong, droplets of blood, organic materials. If foul play suspected, check under fingernails, oftentimes you will find blood or skin from the attacker here. f. Examine the body very closely, under magnification. Check clothing and skin for any marks that look out of the ordinary. Fibers that don’t seem to belong, droplets of blood, organic materials. If foul play suspected, check under fingernails, oftentimes you will find blood or skin from the attacker here. g. Check for any dental work g. Check for any dental work

7. Procedure (cont.) 3.Photos and x-rays taken, if needed 4.Complete internal exam a. Dissection of head and abdomen b. Organs removed, weighed, measured, and examined c. Tissue samples examined under microscope d. Fluid samples tested for drugs, infection 5.After autopsy complete, legal death certificate will be signed***

8. Results 1. Natural death – disease or old age 2. Unnatural death – unnatural, unexpected, or unusual cases Question: Would an accidental drowning be considered a natural death?

9. Methods to determine time of death 1. Traditional indicators a. Rigor mortis Begins three hours after death in face and eyelid muscles Begins three hours after death in face and eyelid muscles Takes twelve hours to affect entire body Takes twelve hours to affect entire body Process reverses after 36 hours Process reverses after 36 hours

10. Lividity (hypostasis) Visible 30-60 minutes after death Visible 30-60 minutes after death Red cells settle and skin below turns red Red cells settle and skin below turns red In 6-10 hours, color becomes permanent In 6-10 hours, color becomes permanent

11. Lividity….continued

12. Body temperature a. Falls at rate of one degree per hour *** b. Obesity and warm environment slows cooling 4. None of the above are totally reliable and can be manipulated