An autopsy, formally known as a post-mortem examination, is a specialized procedure conducted by a pathologist following death. Its purpose is to determine the precise cause of death (such as disease or injury) and to establish the manner of death, classifying it as natural, accidental, suicidal, homicidal, or undetermined. This systematic investigation involves a thorough assessment of the body’s exterior and interior.
Documentation and External Examination
The first physical step, occurring after legal authorization and identification, is the comprehensive external examination. Before any alteration is made, the body is documented through photography, capturing its state, clothing, and any trace evidence present. Height and body weight are precisely measured and recorded.
The pathologist performs a detailed head-to-toe inspection, noting identifying marks like scars, tattoos, or previous surgical incisions. Preliminary evidence is collected at this stage, particularly in forensic cases. This includes taking swabs of the mouth or external genitalia and collecting fingernail clippings or scrapings. This pre-incision collection preserves transient evidence, such as foreign DNA or trace materials, which could be lost during the internal examination.
Opening the Body Cavity
The internal examination begins with a major incision to access the torso’s cavities. The most widely employed method is the Y-incision, where a scalpel cut extends from each shoulder, meeting at the lower breastbone, and then continues downward to the pubic bone, typically deviating around the navel. The skin and muscle flaps are then dissected and reflected away from the chest wall and abdomen.
Accessing the chest cavity requires removing the sternum and attached rib cage, known as the breastplate. This is accomplished using specialized cutting tools, such as bone shears or an oscillating saw, to cut through the costal cartilage and ribs. To examine the brain, a separate incision is made across the scalp, and the skin is pulled back to expose the skull. An oscillating saw is used to cut a circumferential line around the cranium, allowing the top portion of the skull, or calvarium, to be lifted off.
Organ Dissection and Analysis
With the internal cavities exposed, the pathologist proceeds to organ dissection and analysis. Organs are systematically removed using one of several standardized methods. These include the Ghon technique, which removes the thoracic, abdominal, and urogenital organs in separate blocks, or the Rokitansky method, which involves extensive in-situ dissection before removal.
Each major organ, including the heart, lungs, liver, and kidneys, is individually weighed and measured. This weight is compared against expected values based on the decedent’s height and weight. Following this, a detailed gross examination is performed by slicing the organs into sections to visually inspect the internal tissue for abnormalities. Tissue samples are taken from each organ for histology (microscopic examination), and fluid samples, such as femoral blood and urine, are collected for toxicology screens.