The autopsy Flashcards
(19 cards)
What is a coroner?
- independent of crown, investigates circumstances of death
What is a coroner autopsy
- establish cause of death
What is a hospital autopsy?
- Through examination of deceased
- Audit: discrepancy between stated and actual cause of death
- Allows monitor effect of new treatment
- Research
What is a function of a death certificate?
data for epidemiology
What is the difference in consent procedures for hospital and coroner autopsies?
Hospital: must consent
- With consent can take any material
Coroner: don’t have to consent
- Tissue only taken if related to cause of death
How is the death certification carried out?
- Taken to registrar by family
What are the parts of a death certificate?
1a. Immediate cause of death
1b. Predisposing factor
1c. Predisposing factor leading to 1b
2. Other factor contributing but no directly related to death
What cases must be reported to a coroner?
- Cause unknown
- Not seen by certifying doctor immediately after death or within 14 days before
- Violent, unnatural, suspicious
- May be due to accident (whatever age it occurred, may happened a long time ago)!!
- Maybe due to neglect by self/others
- Industrial disease or employment!!
- Abortion
- During operation or before recovery from anesthesia (anything that is a big procedure)
- Suicide!!
- Shortly after police/prison detention (mental incapacity is an exception)
- Related to poisoning
What are the main causes of community death
- Coronary artery disease
○ Usually cardiac arrhythmia
○ Atherosclerosis most common autopsy finding
○ Others include: myocardial scarring, coronary artery thrombosis, acute/subacute MI - If arrhythmia is mechanism, diagnosis is one of exclusion
- Hypertensive heart disease (usually with atherosclerosis)
- Cause of death will be ischaemic heat disease
What are some other sudden cardiac related death?
- Cardiomyopathy
- Myocarditis
- Structural anomaly
- Floppy mitral valve
- Aortic stenosis
- Conduction abnormalities
What are vascular system related deaths?
- Aneurysm
- Non traumatic subarachnoid haemorrhage
- Intracerebral haemorrhage
- Epilepsy (if poorly controlled)
What are respiratory related deaths?
- Pulmonary embolus
- Asthma (if poorly controlled)
What are GIT related deaths?
- (not usually expected)
- Bleeding oesophageal varices
- Bleeding ulcers
- Pancreatitis
What are other non natural deaths?
- Drugs
- Alcohol
○ Associated with GIT problems and drugs use - Trauma (self or caused by others)
What are the characteristics of a bruise/contusion?
- Blunt trauma injury
- Either alone or associated with other injuries
- Extravasated blood collection that leaked from damaged small arteries and venules and veins
- Affected by skin laxness, fragility of vessels, coagulation
What are the characteristics of an abrasion?
- Graze/scratch
- Most superficial blunt trauma injury
- Only epidermis
- May occur before/after death
- Tangential force
- Vertical force
How do abrasions occur?
- friction burn
- car radiator
- Flooring
- Whip
- stamp
What are the characteristics of a laceration?
- Split into skin
- Blunt force trauma
- Deep and bleed
- Margins ragged with crushing and bruising
- “bridging fibers” across them
- Common where skin can be compressed between force and bone e.g scalp, elbow, shin
- “flaying” tangentially applied force leading to horizontal laceration
What are the characteristics of stabs and cuts?
- Edges clean and well demarcated
- Minimal injury to surrounding tissue
