1. Autopsy
Forensic Pathology

2. What is an Autopsy?
Postmortem examination of the organs and tissues of a body to determine cause of death or pathological conditions.
Includes the dissection of a corpse.

3. Type of Autopsies
Medical
Forensic
Private

4. Why do an Autopsy?
Primary reason is to determine cause of death, there are other benefits to individual families, the practice of medicine, and the community at large.

5. Benefits of an Autopsy
Allaying a family’s fears about what they could have done to prevent the death.
Providing family members information about potential genetic diseases that may have implications for them.
Medical education, training and research leading to improved health care.
Providing information about preventable causes of disease and accident and other public health hazards.

6. Forensic Benefits of an Autopsy
Investigation of homicide, suspected homicide, other unexplained or suspicious deaths, and deaths apparently due to accident or injury.

7. Forensic Pathologist
Also called medical examiners or coroners.

8. Role of the Forensic Pathologist
4 broad determinations are to be made by the pathologist:
Cause of Death – medical diagnosis denoting disease or injury
Mechanism of Death – altered physiology by which disease/injury produces death (arrhythmia, exsanguination)
Manner of Death
1. Homicide 2. Suicide 3. Accidental 4. Natural Causes 5. Unknown
Time of Death

9. Cause & Mechanism of Death
Asphyxiation
Strangulation
Drowning
Fire victim
Exsanguination
Major blood loss
Blunt force trauma
Sharp force trauma
Chemical trauma

10. Manner of Death-Natural
Natural: 80 year old dies of congestive heart failure.
Natural deaths are the cause of the majority of deaths that occur.
The manners of death in this category include:
heart failure,
disease, and
death during sleep etc. The autopsy reveals certain aspects of the death, whether it occurred suddenly, unexpectedly or if the person was critically ill and hadn't seen a doctor in the last two weeks.

11. Manner of Death Homicide-death caused by another person
Suicide-death inflicted upon self
Accidental-unintentional and without malice, group swimming and one drowns
Unknown/Undetermined-absolute cause not able to be determined

12. Estimating the time of death
An accurate assessment is of great importance to police in narrowing down the list of suspects.
It can allow police to pinpoint the time during which they need to find out what the suspects were doing and allows them to eliminate people who have an alibi for that period from there enquiries.

13. Can estimate time of death from
body temperature (algor mortis)
insect action (forensic entomology)
stomach contents (stage of digestion)
last known activity (last sighting, newspaper/mail)
normal postmortem changes
rigor mortis (Hours)
livor mortis/lividity (Hours)
Desiccation
Putrefaction (days 4-10)
cell autolysis (also called butyric fermentation) (days 10-20)
dry decay (days 20-50)

14. Estimating Body Temperature
A healthy human body temperature is approximately 37°C (98.6°F) .
Upon death, the body temperature begins to fall at a constant rate about 1.5°F every hour until it reaches the ambient temperature,(temperature of the area surrounding the body).
This postmortem cooling of the body is called algor mortis.
The most accurate measurement of core body temperature is taken by inserting a thermometer into the liver.
At the death scene, death investigators sometimes measure body temperature rectally. (less reliable but significantly more convenient).

15. Estimating Body Temperature
Assuming that the body temperature was normal at the time of death, the following formulas can be used to estimate the time of death within the first 12 hours:
Time since death (in hours)= 37°C − Current body temperature OR
0.78
In the first 12 hours:
head, arms, and legs cool rapidly.
body temperature will drop 9.4°C

16. If the body temperature is below 27
If the body temperature is below 27.6°C, then the victim has been dead for more than 12 hours
The following formula would be used if the victim died more than 12 hours before the body was found:

17. Estimating Time of Death
Autopsy: medical dissection and examination of a body in order to determine the cause of death
Rigor Mortis: medical condition that occurs after death and results in the shortening of muscle tissue and the stiffening of body parts in the position they are in when death occurs. Occurs within 24 hours and gone within 36 hours

18. Estimating Time of Death
Livor Mortis or lividity: medical condition that occurs after death and results in the settling of blood in areas of the body closest to the ground. Begins immediately after death and lasts for 12 hours
Algor Mortis: postmortem changes that cause a body to lose heat. Process in which the body continues to cool to room temperature. 1 – 1.5 degree/hour

19. Body temperature
Following death, the body begins to cool at a rate which depends on a range of factors.
A naked body will cool faster than a clothed one;
A large adult will cool slower than that of an infant;
A body in a prone spread-eagled position will cool faster than a body slumped in the corner;
A body exposed to air currents will cool faster than one in a protected area.

20. Evidence to be Collected at Autopsy
Victim’s clothing
Fingernail scrapings
Head and pubic hairs
Blood (for DNA typing)
Vaginal, anal, and oral swaps (sex-crimes)
Recovered bullets/knives from body
Hand swabs from shooting victims (for GSR analysis)

21. Trauma to the Human Body Role of the Pathologist
Determine type of wound
Measure the dimensions (length, width, depth)
Position relative to anatomical landmarks
Determine initial location if wound involves cutting, slashing, etc.
Determine height from heel

22. Types of Wounds (Trauma)
Lacerations
Incised Wound
Puncture
Abrasion
Contusion
Gunshot

23. Abrasions

24. Contusions
Assuming the victim was healthy, color changes a contusion or a bruise goes through can give rough estimate of time of injury:
• Dark blue/purple (1-18 hours)
•Blue/brown (~1 to 2days)
•Green (~ 2 to 3 days)
•Yellow (~3 to 7 days)

25. Gunshot Wounds Things for pathologist to learn: • type of firearm
• distance of gun to victim
• entrance vs exit wounds
• track of projectile

26. Gunshot Wounds
Stippling – powder burns on the skin when the gun is inches to a few feet from the Victim
Starring of a contact wound – barrel touching the skin

27. Autopsy-Steps Involved:
External Examination
measurements - length, weight
inspection of external surface for injury, discoloration, “cause of death” signs

28. Autopsy-Steps Involved:
2. Opening of Trunk
a. ‘Y’ incision
b. Open rib cage
c. Condition of heart
d. Remove organs

29. Autopsy 2d. Remove Organs:
must cut ligaments holding organs in the body cavity and through the trachea and rectum
transfer organ block to a dissecting table
examine organs in proper order (weigh, physical exam in and out, take tissue samples, save other appropriate samples)
Heartliverspleenkidneyspancreasbladder genitalia complete G.I. tract
save postage stamp sized amount of tissue
examine tissue under a microscope for bacteria,disease

30. Autopsy-Steps Involved:
3. Remove brain cut around cranium using “Stryker saw” store for 2 weeks in 10% formaldehyde
4. Closing