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THE AUTOPSYTHE AUTOPSY

FORENSIC PATHOLOGYFORENSIC PATHOLOGY

MEDICAL EXAMINER or MEDICAL EXAMINER or CORONERCORONER

Coroner- elected position, most not Coroner- elected position, most not medical professionals, undertakers, medical professionals, undertakers, politicians, required qualifications- politicians, required qualifications- US citizen, over 21 yo. US citizen, over 21 yo.

Medical examiner- physicians, most Medical examiner- physicians, most not trained in forensic pathologynot trained in forensic pathology

The AutopsyThe Autopsy

An autopsy is an examination of the An autopsy is an examination of the body after deathbody after death

Internal and external examsInternal and external exams Purpose is to document any disease Purpose is to document any disease

or injury that may have contributed or injury that may have contributed to the deathto the death

Overall purpose is to create an Overall purpose is to create an opinion regarding the cause and opinion regarding the cause and manner of death manner of death

When Forensic Pathology is When Forensic Pathology is AppliedApplied

violent deathsviolent deaths homicide homicide accidents accidents suicides suicides suspicious suspicious sudden and sudden and

unexpected unexpected child or infant child or infant

deathsdeaths

prisonersprisoners persons under persons under

institutional careinstitutional care drugs or alcohol drugs or alcohol deaths in close deaths in close

proximity to proximity to surgerysurgery

suspicion of public suspicion of public health threathealth threat

The AutopsyThe Autopsy USESUSES::

--establish COD, establish COD, MODMOD

TODTOD-weapon used-weapon used-find identity of -find identity of

deceaseddeceased-determining the -determining the

effect of trauma or effect of trauma or pre-existing pre-existing conditionsconditions

Manners of DeathManners of Death

Natural- dies of cancerNatural- dies of cancer Homicide- gunshot woundHomicide- gunshot wound Suicide- gunshot woundSuicide- gunshot wound Accident- fallen off an icy ladderAccident- fallen off an icy ladder UndeterminedUndetermined

Causes of Death/Causes of Death/Mechanism of DeathMechanism of Death

AsphyxiaAsphyxia– StrangulationStrangulation– DrowningDrowning– SmotheringSmothering

WoundsWounds– BulletBullet– StabStab– Blunt ForceBlunt Force– RapeRape– PoisoningPoisoning– BurnBurn– Traffic FatalitiesTraffic Fatalities

The AutopsyThe Autopsy Average a couple Average a couple

hourshours Performed in an M.E. Performed in an M.E.

or coroner’s officeor coroner’s office Performed normally Performed normally

8am-4pm, or 24hrs a 8am-4pm, or 24hrs a day, 7 days a week, day, 7 days a week, 365 days a year.365 days a year.

Autopsies may cost Autopsies may cost from several hundred from several hundred to several thousand to several thousand dollars depending on dollars depending on purpose and types of purpose and types of tests run.tests run.

External ExamExternal Exam

EvidenceEvidence MeasurementsMeasurements PhotographsPhotographs Odor- cyanide (almond), alcoholOdor- cyanide (almond), alcohol Wounds, bruises, needle marks, Wounds, bruises, needle marks,

petechia petechia TattoosTattoos Rigidity, LividityRigidity, Lividity

TOD- Stages of TOD- Stages of DecompositionDecomposition

Rigor Mortis-Rigor Mortis- stiffening of muscles and body stiffening of muscles and body parts in position at death parts in position at death

Due to loss of ATP in muscle cellsDue to loss of ATP in muscle cells Begins 1-2 hours after deathBegins 1-2 hours after death Starts at top of body and proceeds downwardStarts at top of body and proceeds downward Complete within 8-12 hrsComplete within 8-12 hrs Muscles will relax as break down occurs, 24-Muscles will relax as break down occurs, 24-

36hr36hr Environment affects rateEnvironment affects rate


Livor Mortis-Livor Mortis- blood settling down towards blood settling down towards areas closest to the groundareas closest to the ground

Determine position at death (death-12 Determine position at death (death-12 h)h)

Red Blood Cells settle and break down in Red Blood Cells settle and break down in tissues (bruising), (1-2 hrs)tissues (bruising), (1-2 hrs)

Fixed then death > 10 hrsFixed then death > 10 hrs Not Fixed then death (skin turns white Not Fixed then death (skin turns white

when pressure applied) < 10 hrswhen pressure applied) < 10 hrs


Algor Mortis-Algor Mortis- body loses heat after body loses heat after death, ~ 1-1.5 F (.4 -.75 C)/hr until death, ~ 1-1.5 F (.4 -.75 C)/hr until environmental temp. reachedenvironmental temp. reached

Affected by environment, body fat, Affected by environment, body fat, clothingclothing

TODTOD Ocular Fluid (vitreous Ocular Fluid (vitreous

humor)-humor)- after death after death blood cells in eye blood cells in eye break open and break open and release potassium, release potassium, amt of K present can amt of K present can indicate TODindicate TOD

Open eyes- eyes dry, Open eyes- eyes dry, cloudy film, 2-3 hrs. cloudy film, 2-3 hrs. after deathafter death

Closed eyes- ~24 hrsClosed eyes- ~24 hrs

TODTOD

Stomach Contents-Stomach Contents- digestion of last digestion of last mealmeal

Full undigested Full undigested meal : 2-4 hrsmeal : 2-4 hrs

Stomach empty, SI Stomach empty, SI full: 4-6 hrsfull: 4-6 hrs

Small Intestine Small Intestine empty- > 12 hrs empty- > 12 hrs

TODTOD

Insect Infestation-Insect Infestation- stage of life cycle stage of life cycle of insects on DB is indicative of TODof insects on DB is indicative of TOD

““The blowfly is the first “witness” to The blowfly is the first “witness” to arrive at the crime scene”arrive at the crime scene”

The pathologist first examines the outside of the body. A great The pathologist first examines the outside of the body. A great deal can be learned in this way. Many pathologists use deal can be learned in this way. Many pathologists use

scalpels with rulers marked on their blades.scalpels with rulers marked on their blades.

The body is opened using a The body is opened using a Y-shaped incision from Y-shaped incision from shoulders to mid-chest and shoulders to mid-chest and down to the pubic region. If down to the pubic region. If the head is to be opened, the head is to be opened, the pathologist makes a the pathologist makes a second incision across the second incision across the head, joining the bony head, joining the bony prominences just below and prominences just below and behind the ears. When this behind the ears. When this is sewed back up, it will be is sewed back up, it will be concealed by the pillow on concealed by the pillow on which the dead person's which the dead person's head rests. head rests.

The pathologist uses a The pathologist uses a scalpel for these incisions. scalpel for these incisions. There is almost no bleeding, There is almost no bleeding, since a dead body has no since a dead body has no blood pressure except that blood pressure except that produced by gravity.produced by gravity.

The incisions are carried down toThe incisions are carried down to the skull, the rib cage and the skull, the rib cage and breastbone, and the cavity which contains the organs of the breastbone, and the cavity which contains the organs of the abdomen. The scalp and the soft tissues in front of the chest abdomen. The scalp and the soft tissues in front of the chest are then reflected back. Again, the pathologist looks around are then reflected back. Again, the pathologist looks around

for any abnormalities.for any abnormalities.

The pathologist weighs The pathologist weighs both lungs together, both lungs together, then each one then each one separately. Afterwards, separately. Afterwards, the lungs may get the lungs may get inflated with fixative inflated with fixative

The rest of the team is The rest of the team is continuing with the continuing with the removal of the other removal of the other organs. They have organs. They have decided to take the decided to take the urinary system as one urinary system as one piece, and the digestive piece, and the digestive system down to the system down to the small intestine as small intestine as another single piece. another single piece. This will require careful This will require careful dissection dissection

Autopsy VideosAutopsy Videos

http://news.nationalgeographic.com/news/http://news.nationalgeographic.com/news/2007/03/070313-autopsy-video.html2007/03/070313-autopsy-video.html

http://investigation.discovery.com/investigation/http://investigation.discovery.com/investigation/quiz-central/dna-forensics/autopsies.htmlquiz-central/dna-forensics/autopsies.html

http://www.ebaumsworld.com/video/watch/http://www.ebaumsworld.com/video/watch/972837/972837/

http://www.youtube.com/watch?v=1OErkBJ8Ha4http://www.youtube.com/watch?v=1OErkBJ8Ha4