Topic 1 - The Autopsy

Question 1

What are the two types of autopsy and which is more common?

Answer 1

Hospital autopsies which account for less than 10% of uk autopsies and medico-legal autopsies which account for more than 90% of uk autopsies - includes coronial autopsies.

Question 2

What are the four questions a coronial autopsy aims to answer?

Answer 2

To find out:

• Who died
• When they died
• Where they died
• How they died

Question 3

What are the three main categories of death referred to the coroner and what are examples of each?

Answer 3

• Presumed natural: cause of death not known, most common referral (eg meningitis or a heart attack)
• Presumed Iatrogenic: Caused by a medical professional (peri/postoperative deaths, deaths from anaesthetic, complications of therapy; ie ADR and illegal abortions).
• Presumed unnatural: Accidents, Suicide, murder, neglect, death in custody and industrial death; working with asbestos.

Question 4

Who performs which autopsies?

Answer 4

Histopathologist: Performs most autopsies (without crime - Natural deaths eg drowning, accidents, road traffic deaths, suicide, deaths due to fire etc)

Forensic pathologist: (crime - Homicide, death in custody, neglect or any that would be performed by a histopathologist if third party involvement is suspected).

Question 5

What does evisceration involve?

Answer 5

• Y-shaped incision from behind the ears down to the clavicles then down to the mid line
• Open all body cavities And examine all organs in situ
• Remove thoracic and abdominal organs
• Remove the brain

Question 6

Which organ/ organs are avoided if possible in an internal examination and why?

Answer 6

The lower GI tract is avoided if possible as it presents an infection risk.