Hello, curious minds and seekers of knowledge! Have you ever found yourself intrigued by the mysteries of the human body and the scientific processes used to understand it, even after life has ended? An autopsy, a procedure steeped in both medical precision and detective work, offers a window into the causes of death and the secrets held within our biology.
The autopsy is a medical version performed to determine the cause of death and the scientific reason someone died to figure it out. A medical examiner or pathologist will work for it. Sometimes the autopsy is inconclusive. It often takes a toxicology report to determine if someone had drugs, alcohol, or another substance in their system and whether death is a homicide, natural accident, or suicide. That’s the manner of death, and that’s a legal distinction.
What happens during an autopsy procedure? If you’ve been following the news surrounding the Michael Brown killing, then you’ve probably heard about the multiple autopsies that have been requested. The county medical examiner’s office did the first. The family requested the second, and the US Department of Justice conducted the third.
Three autopsies are a lot to perform on a single body, so why are they doing this? What’s the point? Can additional autopsies provide new information? Sometimes, yes. This is a high-profile case, so, understandably, multiple autopsies might be warranted. For the most part, as long as the first autopsy was performed correctly, there’s no need for a second or third.
We’re going on a respectful and informative journey to explore what happens during an autopsy. From the initial incisions to the detailed examination of organs, we’ll uncover the steps and significance of this vital medical procedure. Whether you’re a budding pathologist, a true crime enthusiast, or simply someone with a thirst for understanding the intricacies of the human body, this exploration promises to enlighten and educate. So, let’s approach this topic with an open mind and a keen sense of curiosity as we delve into the fascinating world of autopsies.
What is an autopsy?
Anatomical pathology technologists are trained to open the dead body, and they’re the people who work in the mortuary. They are known as forensic pathologists. The words autopsy and post-mortem are interchangeable. That’s because they mean the same thing.
Autopsy comes from the Greek meaning “to see for oneself.” It means opening up the body, looking inside, and seeing the cause of death. Post-mortem is from the Latin word “after death.” So it’s an examination after death to find out why somebody died.
The coroner does the vast majority of post-mortems in the UK. The coroner is somebody with a legal qualification. They are responsible for determining who died, how they died, when, and where. Around 500,000 deaths every year in England and Wales. About 45% of those are referred to the coroner.
What happens during the autopsy?
During an autopsy/post-mortem examination, a medical professional, typically a forensic pathologist, systematically examines a deceased person’s body to determine the cause and manner of death. Here is a general overview of what happens during an autopsy:
External Examination: The body is first visually inspected externally. The pathologist examines the body for any injuries, signs of trauma, or external abnormalities. They may measure and document these findings, take photographs, and note any identifying marks or scars.
Internal Examination: The pathologist then proceeds to perform an internal examination. An incision is made along the body’s midline, from the top of the chest to the pubic bone. The pathologist carefully dissects and examines the body cavity’s organs, tissues, and structures.
Organ Examination: Each major organ is examined individually, including the heart, lungs, liver, kidneys, brain, and others. The pathologist assesses their size, appearance, and internal structures for abnormalities, such as tumors, infections, or signs of disease.
Sample Collection: During the autopsy, various samples may be collected for further analysis. This can include blood, urine, tissue samples, and other bodily fluids sent to a laboratory for toxicology, microbiology, or histopathology tests.
Documentation and Analysis: Detailed notes and observations are recorded throughout the autopsy process. The pathologist documents their findings, measurements, descriptions of each organ, and relevant findings related to the cause of death.
Closure: Once the examination is complete, the body is reconstructed, and the incision is closed using sutures or staples. The body is then released to the appropriate authorities or funeral home for further processing.
First, the examiner looks at the body’s clothes for any evidence of trauma, blood, or any signs of injury. Next, they remove the clothes to inspect the skin further and perform a physical exam. X-rays may be taken to reveal what may potentially be inside broken bones and bullet locations. Examiners will take a further look at examining the organs in place before removing them and weighing them. It often includes the brain.
Autopsy procedure step-by-step
Two processes follow during an autopsy.
- Internal examination.
- External examination (Skull, Thorax, Abdomen).
There’s the external examination, where they look at the outside of the body. Also, they try to find evidence of injury, disease, or anything that appears out of the ordinary. Anything on the body relevant to the case, like clothing, gunpowder residue, or DNA from another person, gets sent to a different lab for analysis. Everything is documented with photographs.
Then, there’s the internal examination, where they cut the body open, starting at the shoulders and going down to the groin. A standard autopsy looks at the chest, abdomen, and pelvis organs. If other body parts, like the legs, arms, or brain, are suspected of being involved in the person’s death, those also get inspected. The purpose of this is to examine the patient’s organs.
Many of the instruments used for the postmortem, like rib shears, scissors, knives, rib cages, rib fields, etc., are not particularly specialized. There are a lot of steps involved, and forensic pathologists perform autopsies. They’re generally split into two separate procedures.
Step 1, Personal identity of corps
Pathologists will first check the label to see who it is, its weight, height, name, date of birth, and so on. After that, if there is any clothing on the body, they take that off. They also cover the private parts. The dead body will lie on the table with the head slightly elevated. It’s time to clean the body. Then, they inspect the body to see where all the blood has settled. It is called lividity, and if you’ve watched TV crime shows, you’ll know that dead bodies will have purple parts where that blood has settled.
Step 2, Determination of cause and manner of death
The pathologist will collect the sample and preserve it safely. They check all vital signs because no one wants to bury a living person. The dead bodies can groan and move, but that’s because gases are in the body, and muscles harden during that period. It is called rigor mortis when the body goes stiff. Pathologists use a trocar, which looks like a funnel, to release gases. In mediacal term it is known as “cadaveric spasm”.
Step 3, Physical examination
In the next step, Pathologists use skin-colored glue or eye caps to ensure the eyes are closed. No one wants to turn up to a casket and see a gaping mouth and wide-open eyes staring at them. Then, they find the common carotid artery and drain the blood vessels. At the same time, they inject embalming chemicals into the arteries. They use an electric pump for this, which works like the heart.
The blood comes out, and the fluid goes in. This process is all about preserving the body. There’s also cavity embalming, which first involves putting one of those trocars into the chest cavity and removing all the fluids and gases.
After that, a formaldehyde-based chemical embalming mixture will be put in those cavities. If there are some places where the chemicals haven’t been reached, they can do something called hypodermic embalming. It is finding the right spot to inject the chemicals. In that case, cauterizing chemicals will dry the wounds and bleach them.
If there are big holes, pathologists use fillers such as plaster of Paris and then color the filler with a spray tan. Dead bodies aren’t always the sweetest smelling globally, so they use powders to make them more pleasing to the olfactory sense.
Step 4: Opening of body cavities
Now, it’s time to open the body to examine the internal body parts. Pathologists make what’s called a “Y-Incision.” It is a Y shape starting from the shoulders that meet at the chest and goes down to the pubic area. Now, the organs are exposed.
The next step is to make a series of cuts to sever certain body parts connected under the hood. It means disconnecting organs attached to the spinal cord, and it’s a lot of snipping around. Once the snipping is done, the pathologist will then remove the organs. He’s going to scalp, cutting from one ear, across the forehead, to the other, and around. That cut is divided into two parts, and those parts of the scalp will be pulled from the skull. When that cap comes off, it makes a popping sound.
The brain is connected to the spinal cord, so that connection has to be severed. Once that’s done, the body can take it out. What’s taken out will now be analyzed. The body’s stomach contents will be examined, as eye fluid, bile, urine, liver tissue, and blood tests will be done. The following important task is to reconstruct the body and sew it up. Every stage pathologist considers that this is somebody’s loved one, and they may want to see them again afterward.
Step 5, Autopsy report
After all, organs have been analyzed, and the medical examiner has said the cause of death, those organs could take many journeys. Samples of the patient’s blood, urine, and other fluids are collected and sent to a toxicology lab to look for drugs, alcohol, or poisonous substances in a person’s system. Anything else that’s left gets put back inside the body. They send them back to the funeral home, where the family is issued an official autopsy report and a death certificate.
They might be disposed of, or they might be preserved in the body. Unfortunately, some bodies are pretty much beyond repair. They have decomposed so severely that there’s nothing to do to make them presentable. In these cases, the pathologist will seal and refrigerate the body or body parts in the morgue. That funeral has to be quick due to the stench of decomposition.
In most cases, though, they can embalm the body, even if it’s in a bad state. Forensic pathologists must be careful when performing autopsies as gruesome as the whole process. They must make all their incisions so that an open-casket funeral can still be conducted if the family wants it.
The most common cause of death is ischemic heart disease. A blockage in those vessels is one of the hardest things to see on imaging. It can be only a couple of millimeters long, and the FIR departure can be only one or two millimeters wide. So that’s quite hard to see. On average, a combination of imaging and perhaps some targeted biopsies may be the future post-mortem.
Complete autopsy process overview (During & After Autopsy)
First, pathologists remove the lungs and heart, then loosen the skin up to the chin to reach the tongue and throat without leaving visible marks. Next, they remove the liver, pancreas, stomach, and kidneys.
Finally, they remove the kidneys, bladder, bowels, and reproductive organs. Now that the body is an empty cavity, the doctor turns their attention to organs and examines each.
The doctor didn’t find any obvious damage to many organs, so they took samples to analyze, including a toxicology screening. After the samples are prepared, the doctor carefully returns organs to the body, roughly where they belong, then carefully sews up incisions.
The doctor completes their report and releases the body to the funeral home. Two attendants arrive to transport the body to the funeral home. They load their bodies onto a stretcher and gather clothes and personal belongings.
Then, the dead body can be registered. The embalmer unwraps the body and cleans it thoroughly with a disinfectant spray. Then, they make a small incision in the groin and fill the body with formaldehyde.
The embalmer makes another incision under the ribcage and inserts a metal suction tool called a trochar attached to a pump system into the chest cavity. Once the body is completely drained, the embalmer refills it with a liter of fluid, which saturates the organs and mitigates any nasty smells.
Now that the embalming is complete, it’s time to prepare the body for viewing. After a thorough cleaning, to their dismay, the first item they put on their body is an adult diaper! This is meant to protect the coffin and clothes. Finally, they carefully place the body into the coffin.
How long does it take for one single autopsy to be completed?
A post-mortem takes about an hour to do from start to finish. It takes longer to describe. A specialist can do some in 20 to 30 minutes if there’s a self-evident cause of death. It tends to be pretty quick post-mortems on thin people. They are faster than post-mortems on people who’ve got more fat.
It’s easier to get at the organs when they’re not covered in layers of fat, and it can be challenging to dissect them. For a fatty dead body, a tricky post-mortem helps to save time. They’ve had tubes, lines, and things that can take 3 or 4 hours.
This exploration has not only shed light on the technical aspects of autopsies but has also highlighted the importance of approaching such topics with respect and sensitivity. Thank you for joining me on this informative voyage into the heart of forensic pathology. Until our next adventure into the realms of medical science and beyond, keep nurturing your curiosity, respect the mysteries of life and death, and continue to seek knowledge in all its forms.
Read More:
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References:
Rothenberg, Kelly. “The Autopsy Through History.” Forensic Science.
Clark MJ (2005). “Historical Keyword “autopsy.”
Elizabeth C Burton, Kim A Collins. Religions and the Autopsy
Roulson J, Benbow EW, Hasleton PS. “Discrepancies between clinical and autopsy diagnosis and the value of post mortem histology; a meta-analysis and review.”
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