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R. virchow's technique of autopsy
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Autopsy: Virchow’s Technique
Prepared by Group III
WHAT IS AUTOPSY?An autopsy is performed to achieve one or more of the following objectives: To identify the body or record characteristics that may assist
in identifying the deceased. To determine the cause of death or, in the newborn, whether
live birth occurred. To determine the mode of dying and time of death, where
necessary and possible. To demonstrate all external and internal abnormalities,
malformations and diseases.
To detect, describe and record any external and internal injuries.
To obtain samples for any ancillary investigations.To obtain photographs or retain samples for evidential or teaching use.
To provide a full written report and expert interpretation of the findings.
To restore the body to the best possible cosmetic condition before the release
What is autopsy?
An examination of the organs of the dead body to determine the cause of death or to study the pathologic changes present.
There are four principal autopsy techniques namely:
Technique of R. Virchow Technique of C. Rokitansky Technique of A. Ghon Technique of M. Letulle
What is Virchow’s technique of autopsy?
Rudolf Ludwig Carl Virchow
Father of modern pathology
First to develop the systematic method of autopsy.
HISTORY
Virchow’s technique
A technique of removing organs one at a time. This technique is good for demonstrating pathological change in individual organs, especially in high- risk autopsies
ORDER OF EXAMINATION
VIRCHOW’S TECHNIQUE
HEAD
THORACIC (CERVICAL)
ABDOMINAL ORGANS
ATTENTION: Next slides are photographs of actual autopsy so be mentally,
emotionally and physically prepared.
It consist of:
1. Incising the body
2. Inspecting the various organs
3. Examining the cavities systematically
4. Weighing and Measuring the organs
5. Checking for any pathology
6. Putting all the organs back in and padding
7. Suturing the body
INTERNAL EXAMINATION
Incising the body
To expose the heart, lungs and abdominal organs the prosector(the person performing the autopsy) will use the MODIFIED “Y” SHAPED INCISION.
Incising the bodyOther ways of incision
1. ‘I’ shaped Incision: It is a straight line incision extending from the chin to the symphysis pubis.
2. ‘Y’ Shaped Incision: This type of incision starts near the acromian process and progresses downwards towards the xiphoid process. The incision is then extended till the symphysis pubis. Also, a similar incision is made on the opposite side of the body.
3. Intermastoid incision. this type of incision is made from behind each ear across the top of the head that allows examination of brain
Inspecting the various organs
HEAD • The neck is extended by placing a wooden block under the shoulders.
• Fix head using a head rest.
• Intermastoidal incision is made i.e. from the mastoid process behind one ear to the vertex and again to the mastoid process of the other ear.
• Scalp flap is reflected forward to the superciliary ridge and backwards to the occipital protuberance. nd back to the center of the forehead. the base of the other mastoid process occipital protuberance base of the mastoid process
With the help of a saw, ‘V’ shaped cut is made so that the skull fits back correctly after autopsy.
• This ‘V’ shaped cut passes through: the center of the forehead
THORAX Chest muscles are dissected away. Chest is opened by cutting the costal cartilages with the help of a cartilage knife.
In case of elderly subjects, the costal cartilage may be calcified, hence, a bone saw or a rib shear is used to cut it out.
Thereafter, both the sternoclavicular joints are disarticulated and the chest is opened. 1.
ABDOMEN • 5 cm above the symphysis pubis the rectus muscles are
divided and a small cut is made. • Middle and the index fingers are then inserted and spread
in a ‘V’ shape. • Sharp braded knife is inserted between them and the
peritoneum is cut up to the xiphoid process. • Firstly, inspection is done and if any damage, free fluid,
perforations etc. are seen then these are noted. • Also, note should be made about the abnormalities,
positions, abdominal organs, adhesions, pathology (if any), injuries etc.
Examining the cavities systematically
Brain
Brain will deteriorate easily when there is no supply of blood in order to prevent we must do fixation:
1. The freezing
2. The prefusion Spinal cord Thorax Heart Lungs Neck Abdomen Stomach Intestine Liver Spleen pancreas Kidney bladder Prostate and testes
Weighing and Measuring the organs
Checking for any pathology
Example: Acute mycordial infarction, old myocardial infarction, brain stroke, renal cell carcinoma.
Acute Myocardial Infarction
Heart Cross Section
Light-colored tissue
indicates a
myocardial
infarction
Normal fatty tissue
Dark area shows
beginning of healing
– increased
blood supply
Old Myocardial Infarctions
Scar tissue
from an infarct at least two
weeks old.
Brain Stroke
Hemorrhage
Brain Cross Section (Vertical)
Renal Cell Carcinoma
Kidney Tumor
Putting all the organs back in and padding
Body cavities should be cleaned and made free from blood, fluids etc.
Organs are placed back in and excess space is packed with cotton/cloth etc. (esp. in the pelvis and the neck regions.)
Suturing the body
Dissection flaps are closed and sutured with thin twine. Skull is filled with cotton and absorbent material and the
skull cap is placed back in and the scalp is stitched.
“What a magnificent body, how I should like to see it on the dissecting table.” ― Ivan Turgenev, Father and Sons
Thank you