Autopsy

Autopsy
 An autopsy is also known as a post-
mortem investigation.
 The word "autopsy" comes from the Greek
words "auto" and "opsis", and it literally
means "to see for oneself".
 An autopsy is performed to determine the
cause, manner and mechanism of death.
 Autopsy
 The first known legal autopsy was ordered by a
magistrate in Bologna in 1302.

 To understand the human anatomy better, and to

improve their skills, the artists Leonardo da Vinci and
Michelangelo each performed autopsies.

 The autopsy really became significant in 1761, when

Giovanni Morganni published his great work On the
Seats and Causes of Diseases as Investigated by
Anatomy. This work contained descriptions of 700
autopsies.
 Autopsy
 Today there are two types of autopsies:
medical and legal.
 A medical or clinical autopsy is performed
to determine the medical cause of death
or for research purposes.
 A legal or forensic autopsy is performed
when the cause of death is a possible
criminal manner.
Who Performs An Autopsy
 A medical autopsy will be
performed by a
pathologist at the
hospital.
 A forensic autopsy will be
performed by a Medical
Examiner (M.E.) at the
Morgue.
 A funeral director or
mortician does not
perform an autopsy.
 What is the Purpose of
An Autopsy?
 The M.E. will perform an autopsy to:
 Identify the deceased
 Establish approximate time and date of death
 Determine the manner, cause and mechanism of death

 Other duties of the M. E. include:

 Collecting Evidence from the clothing and body of the
deceased
 Protecting the personal belongings of the deceased
 At the Morgue

 1. The body bag is unsealed and opened.

 2. The body is photographed in the body
bag.
 3. Description of the clothing is recorded.
 4. Evidence is collected from the clothing
and the body.
 At the Morgue

 5. If it is a homicide investigation, the hands will

have been bagged at the scene. The M.E. will
remove the bags and collect fingernail scrapings.
 6. UV radiation is used to enhance any
secretions that should be collected.
 7. X-rays are taken as needed.
 8. The body is removed from the bag and
undressed in preparation for the external
examination.
 The External Examination
 During the external
examination, any
wounds, bruises, scars,
etc. will be examined,
measured and recorded.

 The body is also weighed

and fingerprinted during
this stage of the autopsy.
 The External
Examination (cont)
 During the external examination, the M.E.
will also observe and record all of the
information related to decomposition.
 This information is very important for the
determination of time of death, body
position at the time of death and location
of the body at the time of death.
9 Ways of Estimating Actual
Time of Death
 Rigor mortis
 Algor mortis: Body Core Temperature
 Livor mortis: (Lividity)
 Potassium levels in vitreous humor and the
clouding of the cornea
 Stomach Contents
 Evidence of Decomposition
 Presence/absence of purge fluids
 Drying of the tissue
 Insect Larval Instars
 Rigor Mortis
 Rigor Mortis- is the state of rigidity that results
from release of lactic acid after death; the
body’s pH changes from alkaline to acid.
 Rigidity begins with shorter muscles of the face
and extremities, the fingers and toes; then the
neck; moves down and out the long muscles of
the extremities and the forearms with the legs
stiffening last. The process is reversed in the
same order until the body is no longer stiff.
 Approximate Time Frame of Rigor
Mortis
 Time After Stage of Rigidity
Death

 1-4 hours jaws & neck rigid; rest of body limp

 Up to 8 hrs everything down to the legs is rigid
 For 12 hrs everything remains rigid
 24 hrs jaw is limp but everything else is rigid
 30-32 hrs everything but the legs are limp
 36 hrs no rigidity
 Circumstances that effect rigor
mortis
 Starvation – thinner bodies
stiffen faster
 Extreme temperatures –
cooler temperatures slow
onset of rigor
 Physical exertion right before
death speeds the onset of
rigor
 Victims of drowning will not
show signs of rigor until
removed from the water
Algor Mortis
 Algor Mortis- process in which the
body temperature continually
cools after death until it reaches
room temperature. It is also called
the death chill.

 The body temperature will be

taken at the crime scene. The
temperature may be a rectal or
liver reading.

 The body generally loses 2

degrees in the first hour and then
at a rate of 1 to 11/2 degrees per
hour.

 Once a body has reached ambient

temperature, temperature will no
longer aid in time of death.
 Circumstances that effect
Algor Mortis
 Body Size – a larger body cools much slower.
 Clothing- the more clothing on the body the
slower it cools.
 Body temperature at time of death – if someone
has a fever when they die that must be
considered when calculating rate of cooling.
 Ambient Temperature – if someone dies in a
cold location then the body will cool off sooner.
 Rigor mortis And Algor mortis
used together
Temperature of Stiffness of Time since
Body to the Majority of the Death
touch Body
Warm Not Stiff Dead for less
than 3 hours
Warm Stiff Dead between
3 and 8 hours
Cold Stiff Dead between
8 and 36 hours
Cold Not Stiff Dead longer
than 36 hours
 Livor Mortis
Livor mortis is the settling of the blood, causing the skin to
change colors. Due to gravity, blood settles in the lowest
parts of the body. However, body parts that are in
contact with the floor or other objects will not develop
lividity patterns.

Lividity indicates the position of the body after death.

When lividity becomes fixed, then the distribution of the
lividity pattern will not change even if the body’s position
is altered.

Lividity usually becomes fixed between 10 and 15 hours

after death.
 Livor Mortis
 Time after death when
lividity patterns are visible:

 ½ hour - 1st seen on a

fair-skinned individual
 8 hrs- lividity is fixed

The lividity patterns

indicate that this person
died while lying on their
back.
 Importance of Livor Mortis:

1. Patterns can help to establish

time of death.
2. Patterns can indicate if the
body has been moved.
Clues from the eyeball
 Stomach contents
 The stomach empties 4-6 hours after a meal.
Therefore, if the stomach is empty, death likely
occurred several hours after eating.
 If the small intestine is empty, death probably
occurred 24 hours after the victim’s last meal.
 If the colon is empty, death likely occurred 48-
72 hours after last meal.
 The type of food eaten and the amount will
affect this timeline.
 Decomposition, Purge Fluids and
dry decay
 Decomposition begins immediately after death.
 The bacteria in the intestinal tract is released
into the rest of the body where it begins to
breakdown tissues. This process is known as
putrefaction.
 Enzymes in the cells break down the cells and
begin self-digestion throughout the body. This
process is known as autolysis.
 Both of these processes release gas which is
responsible for the smell associated with
dead/decaying organisms.
 Decomposition, Purge Fluids
and dry decay
 The breakdown of the tissues may take
several days up to several years.
 This occurs in four stages:
 1. Fresh or Initial
 2. Putrefaction
 3. Black Putrefaction
 4. Dry Decay
 Decomposition, Purge Fluids and
dry decay
 Fresh/Initial decay (first 24 hours)
 Corpse appears normal, but internal bacterial decay
and autolysis has begun.
 Putrefaction (2-5 days)
 Corpse is swollen due to build up of gases and an
odor is obvious. The corpse has a greenish color. Skin
blisters form, eyeballs collapse, hair begins to fall out
and the skin recedes from nails.
 The skin begins to look marbled due to blood vessels
forming a web-like pattern.
 Decomposition, Purge Fluids and
dry decay
 Black Putrefaction (5-10 days)
 There is a very strong odor. The flesh appears black,
gases continue to escape and the corpse collapses.
 Purge fluids leak from the mouth and nose.
 Skin slippage occurs and eyeballs liquify.
 Dry Decay (10 days until complete)
 Corpse is almost dry so further decay slows from lack
of moisture. Approximately one year must pass
before all smell is gone from the bones.
 Insect larval Instars

 This will be a factor if the body was located so

that insects had access to the body.
 Flies will lay eggs on the body. Maggots hatch
from the eggs within 24 hours. The maggots
mature through three different instar stages.
The length of the maggot will indicate which
instar stage and aid the M.E. to estimate time of
death.
 Internal Examination

 After the external examination and

decomposition analysis is complete and all
information is recorded, the M.E. will prepare
the body for the internal examination.
 A body block will be placed under the back of
the body to cause the arms and neck to fall
backwards and the chest to protrude forward.
The makes it easier to make the Y-incision on
the torso.
 Internal Examination
The V-part of the Y incision is cut from the left
shoulder, down under the nipples and over to
the right shoulder. Then the scalpel is placed in
the pit of the abdomen, below the sternum and
cut straight down and left of the belly button to
form the rest of the Y incision.
Shears are used to open the chest cavity.
A saw is used to cut through the ribs and sternum.
The entire chest plate is removed.
 Internal Examination
Next, the organs will be removed from the body.
There are two Methods for Organ Removal. Each
method was designed by and named for German
pathologists.
The Rokitansky procedure: organs are removed
all at once and then examined.
The Virchow procedure: each organ is removed
separately and immediately examined.
 Internal Examination
 No matter how they
are removed from the
body, each organ is
weighed and
examined.
 Small slivers may be
cut from an organ for
microscopic
examination.

 Internal Examination
 The organs will be inspected for the
following:
 Heart- trauma damage; stenosis;
ventricular fibrillation
 Lungs- trauma; toxic gases, vapors and
dusts; fire; CO, heroin overdose; lung
disease
 Liver; cirrhosis; trauma damage
 Internal Examination
 Next, the brain is examined.
 The M.E. makes a cut from ear to ear on
the back of the head.
 The scalp is peeled forward to expose the
skull. The skull is examined for any
contusions.
 A skull saw is used to cut off the top halve
of the skull and expose the brain.
 Internal Examination
 The brain is observed
while in the skull and
then removed.
 If the brain needs to
be preserved for later
inspection it is placed
in formalin.
 The Final steps
 All of the organs are placed in a plastic
bag to prevent leakage. The bag is placed
inside the body cavity.
 The chest plate and skull cap are replaced.
 The chest flaps and scalp are sewn back
together.
 The body is then returned to the family
and disposed.
 Autopsy report

 The M.E. uses all of the information from

the autopsy to determine the cause,
manner and mechanism of death.
 These will be listed on the Death
Certificate.
 These findings also determine if the death
was due to a crime.
 The Cause of death
 The cause of death is the illness or injury
that actually begins the dying process.
Examples include:
1. Gunshot wound
2. Drowning
3. Blunt Force Trauma
4. Strangulation
5. Stab Wound
 The Mechanism of Death

 The mechanism of death is the

physiological reason that a person dies.
 Examples include:
 Lack of oxygen
 Loss of Blood
 Shock
 Sepsis
 The Manner of death
 There are five manners of death:
 Accident

 Homicide

 Natural Causes

 Suicide

 Undetermined

The manner of death may be changed once on a

death certificate. An undetermined manner is
only used until a final decision is made.
Cause, manner and mechanism of
death
One can die of a massive hemorrhage (the
mechanism of death) due to a gun shot
wound through the head (cause of death)
as a result of being shot (homicide),
shooting yourself (suicide), dropping a
gun and it discharging (accident), or not
being able to tell which (undetermined).
All of which are manners of death.
 Medical Examiner

A medical examiner is a medical doctor, usually a

pathologist and is appointed by the governing
body of the area. There are only 2 certified
forensic pathologists in the Ph.
.