Autopsy

Question 1

What are 2 types of autopsies

Answer 1

Hospital Autopsy

Medico-Legal Autopsies (>90%)

Question 2

Give 2 examples of Medico-Legal autopsies

Answer 2

Coronial

Forensic

Question 3

What are purposes of hospital autopsies and what do they require

Answer 3

Audit, Teaching, Governance, Research

Requires MCCD

Question 4

What does MCCD stand for?

Answer 4

Medical Certification of Cause of Death

Question 5

What are 3 different presumption in referring a death to a coroner?

Answer 5

Presumed natural (cause of death not known, not seen by doctor in last illness (within 14 days))
Presumed iatrogenic
Presumed unnatural

Question 6

What are examples of where a death is presumed unnatural

Answer 6

accidents, suicide, industrial death, unlawful killing, custody deaths, war/industrial pensions, neglect

Question 7

Examples of where a death is presumed iatrogenic

Answer 7

Peri or Postoperative deaths
Anaesthetic deaths
Abortion
Complications of therapy

Question 8

Who makes referrals for autopsy?

Answer 8

Doctor (NON statutory duty to refer; common law duty)
Registrar (Statutory duty to refer)
Others:
Relatives, Police, Anatomical Pathology Technicians etc

Question 9

What doctors perform autopsies?

Answer 9

Histopathologists (Hospital and Coronial autopsies)
Forensic Pathologists (Coronial)

Question 10

In autopsy what 4 Qs need to be answered?

Answer 10

Who was the deceased?
When did they die?
Where did they die?
How did they come about their death?

Question 11

Give 4 examples of legislation for coronial practice

Answer 11

Coroners Act 1988
Coroners Rules 1984
Amendment Rules 2005
*Coroners and Justice Act 2009

Question 12

Which legislation states consent must be received from relatives for ANY use of tissue retained at autopsy (if not subject to coronial legislation or retained for criminal justice purposes)

Answer 12

Human Tissue Act 2004

Question 13

**What are 5 steps of autopsy

Answer 13

History/Scene
External examination
Evisceration
Internal examination
Reconstruction

Question 14

What are other steps of autopsy e.g. instead of evisceration and internal examination

Answer 14

Digital Autopsy (CT scan full body)
Also digital photography or conventional dissection

Question 15

What is involved/looked for in external examination

Answer 15

Identification (gender, age, formal identifiers, clothing, body modification etc)
Disease and Treatment (why have autopsy)
Injuries

Question 16

What are steps involved in evisceration?

Answer 16

Y-shaped incision
Open all body cavities
examine all organs in situ
remove thoracic and abdominal organs
Remove brain

Question 17

What is examined in internal examination

Answer 17

Heart and great vessels 
Lungs, trachea, bronchi
Liver, gallbladder, pancreas
Spleen, thymus, lymph nodes 
Genitourinary tract
Endocrine organs
Central Nervous System

Question 18

Describe Y-shaped incision

Answer 18

Incision from 1cm behind lobe of ear running obliquely downwards (onto anterior) to suprasternal notch (from both ears)
Vertical incision from where they meet to pubis from there

Useful for detailed study of neck structures required