3. Post mortem examinations

Question 1

2 types of autopsies/post mortems

Answer 1

1. hospital (consent) post mortems: require consent of relatives, to confirm clinical diagnosis, nowadays not very common
2. medico-legal post mortems: because death is unknown or of certain category, on the instruction of police for ex., relative consent is not needed

Question 2

Types of death when autopsies are done (8)

Answer 2

1. uncertified death (doctor does not know the cause)
2. trauma
3. suicide
4. alcohol/drug abuse
5. medical care
6. death in custody
7. death at work
8. other (other violent, suspicious or unexplained causes)

Question 3

In some countries, particularly Middle East and Muslim, post mortem examination can be (4)

Answer 3

1. External only
2. External + blood sampling
3. External + partial internal
4. External + CT

Ideal is still external+internal (full)

Question 4

Standard procedure (3)

Answer 4

1. available background information (prior to death, medical history)
2. external examination (clothing, personal items, general appearance, PM changes, external injuries)
3. internal examination
   (trauma, natural disease, samples for further examination)

Question 5

General appearance characteristics

Answer 5

• height, weight, build
• hair, beard, eyes, teeth
• tattoo, piercing, jewellery
• old scars, fractures, injuries

Question 6

Post mortem changes observation 2 reasons

Answer 6

1. to recognise what is normal and not confuse it as injury
2. to determine how long the person has been dead

Question 7

Questions regarding external injuries (3)

Answer 7

1. what kind of injury and thus what is the cause?
2. is it fresh or old?
3. is there an overall pattern or recognisable feature?

Question 8

Other external signs might include (2)

Answer 8

1. asphyxial signs
2. natural disease signs

Question 9

Standard post mortem dissection procedure (5)

Answer 9

1. midline incision from neck to pubis
2. skin is reflected back
3. front of ribcage is removed
4. organs are removed and dissected
5. for head incision is made across the top part of the scalp from ear to ear, skull is then opened horizontally with a saw and the brain exposed

Question 10

Further investigations (4)

Answer 10

1. tissues for microscopic examination - histology
2. blood, urine and other samples for alcohol and drugs - toxicology
3. swabs or tissues for detecting infections - bacteriology
4. tissue samples and blood to detect genetic abnormalities - genetics

Question 11

Main samples used for toxicology are (5)

Answer 11

• blood
• urine
• bile
• vitreous
• stomach

Question 12

Post mortem imaging (3)

Answer 12

1. identification (X-ray and CT)
2. trauma (X-ray and CT)
3. natural disease (CT only)

Question 13

Legal aspects of death (3)

Answer 13

1. confirming
2. certifying
3. reporting

post mortem examination
1. external
2. internal
3. investigations