* MOR 225 Chapter 17 (Homework)

Discuss the two methods for embalming a thoracic only autopsy.

1. Locate the terminal portion of the thoracic aorta on the vertebral column in the diaphragm. Insert an arterial tube into the aorta. Clamp the tube in place with a hemostat or tie the tube in place. Inject downward. This will embalm the abdominal walls, abdominal contents and lower extremities. Keep in mind that leakage may occur. 2. raise the right femoral artery, insert a tube direct upward toward the abdomen. Also insert a tube downward to inject the right leg. Inject the right leg first then upward. The upward facing tube will embalm the left leg, abdominal contents and the trunk. Tie it closed by clamping the thoracic aorta when you see the fluid flowing from this artery and back into the thoracic cavity.

Describe the general order for embalming the autopsied body

1. Unwrap the body and wash and disinfect the body. Relieve rigor mortis 2. Set the features and shave 3. Open the autopsy sutures and remove the viscera. Treat the viscera and set it aside 4. Locate and tie ligature on all 6 vessels 5. Prepare the arterial solution 6. Inject arterial fluid the the legs, R arm, L arm, L carotid and R caroitd 7. Apply an supplemental treatments 8. Hydroaspirate the cavities 9. Prepare the abdominal/thoracic cavities for reentry of viscera. Fill the neck. 10. Suture the abdominal autopsy 11. Prepare the calvarium 12. Suture scalp 13. Rewash and dry the body 14. Apply any additional treatments and surface pacs 15. If necessary apply plastics and re set features 16. Apply massage cream and store. Finish embalming report.

Discuss several treatments for embalming the trunk walls in the autopsied body.

The tissues in the trunk walls can be injected hypodermically with a trocar. All of the tissues need to be channeled, with special emphasis on the buttocks, breast, neck and shoulder areas. In addition to hypodermically treating the trunk walls, you can also perform surface embalming. Various tissues can be cut back and painted with autopsy gel which is made to cling to the lateral walls and penetrate the tissues. You can also use cotton, sheeting and paper towels saturated with cavity fluid, and place them in areas such as the area between the trunk wall and rib cage, or within the cavities.

Reasons for a hospital autopsy

When the doctors haven't made a firm diagnosis When the death follows unexpected complications When the death follows the use of an experimental drug or procedure When the death follows a surgical procedure done for diagnostic purposes and the case doesn't fall into the jurisdiction of the medical examiner or coroner When the death occurs suddenly or unexpectedly, and the case doesn't fall into the jurisdiction of the medical examiner or coroner When environmental or workplace hazards are suspected When death occurs during or after childbirth When there are concerns about a hereditary disease and how it may affect other family members When the cause of death could affect insurance settlements When death occurs in a hospital and the patient comes from a nursing home and quality of care is questioned

partial autopsy

cranial, thoracic, or abdominal cavity.

In all autopsies:

ensure the disinfectant and preservation of the decedent. Many of the vessels will already be available and can be used for injection. The viscera will need to be treated with cavity fluid and placed back into the body. All incisions must be tightly sutured and sealed

complete autopsy

includes the cranial, thoracic, abdominal, and pelvic cavities.

thoracic autopsy

one or more organs are removed from the thoracic cavity

cranial autopsy

only the brain is removed

abdominal autopsy

organs are removed from the abdominal cavity

Describe several methods for securing the calvarium.

1.Suture through the temporalis muscles and up across the calvarium. Suture through the cut portion of the temporalis muscle still attached to the temporal bone and through that portion of the muscle still attached to the calvarium. 2.Separately suture that cut temporalis muscles on either side of the head. 3.Use calvarium clamps. Several varieties are available. 4.Drill opposing holes in the calvarium and the temporal bone and wire the calvarium into position. 5.Use superglue to help hold the calvarium in position. 6.Use plaster of Paris. This older method of attachment may have advantages if the skull was fractured. The base of the skull would be aligned and plastered into position. (Prior to arterial injection). Later, the cranial cavity can be filled with cotton and this can be covered with plaster, and the calvarium (or its pieces) can be placed into position. 7.Use needle injector wires. Use four wires on each side: two attached to the temporal bone. Then crisscross the wires. Use mortuary putty along the cut line, which can also be used to fill missing muscle area of the temporal.

Describe several methods to preserving autopsy viscera.

1: If the viscera is returned to the body you should snip the organs inside the bag and pour two bottles of cavity fluid. Return the bag to the cavity and set into place. 2: If the viscera is returned to the body you should snip the organs inside the bag and pour two bottles of cavity fluid. Let the viscera sit in the cavity fluid for several hours. Return the viscera sans bag and cover with absorbent autopsy hardening compound.

Describe the embalming methods for an abdominal only autopsy.

1: To inject the thorax, upper extremities, and head use the abdominal aorta. Use an arterial tube to inject upwards and clamp it. 2: Raise the right common carotid artery; insert the tube upward for the right side of the head, and downward for the trunk, arms, and thorax. Check for leakage in the abdominal cavity, clamp off as needed. Hypodermic needles will be used to preserve the abdominal walls and if needed the buttocks. With both methods you need to check distribution and raise/inject the femoral arteries if needed. Use autopsy gel, or absorbent sheeting covered in cavity fluid, or perhaps viscerock on the abdominal cavity. Aspiration and cavity fluid injection can be done either through the diaphragm or by inserting the trocar through the rib cage. This can be done before or after the abdominal cavity has been sutured. Suture the abdominal incisions using a baseball stitch.

Reasons for a coroner autopsy

All sudden deaths not easily recognizable All deaths occurring in suspicious circumstances All deaths resulting from violence or trauma Any fetal death where the mother hasn't been un the care of a physician All criminal abortions regardless of length of pregnancy and spontaneous abortions beyond 16 weeks gestation All deaths where the death is not readily explainable on the basis of disease Any death where the body is unidentified or unclaimed Any death where there is uncertainty as to whether or not it should be reported to the coroner's office

Discuss the three methods for embalming a cranial only autopsy:

Method 1: Raise the right and left common carotid arteries. Insert tubes in both, directed upward toward the head. Then insert one tube directed downward toward the trunk in the right common carotid artery. Tie off the lower portion of the left common carotid. Use the right internal jugular vein for drainage. Inject downward first to embalm extremities and the trunk. Clamp off leakage in the cranium from the right and left vertebral arteries. Inject the left and right sides of the head, clamping off the left and right internal carotid arteries. Method 2: Raise the right common carotid artery and the right internal jugular vein. Insert two tubes, one directed upward toward the head and one directed downward toward the trunk. Inject downward, clamping off the right and left vertebral arteries and the left internal carotid artery. Inject up the right side of the head. Clamp off the right internal carotid artery in the base of the skull. Method 3: Raise the right femoral artery and vein. Insert into the artery one tube directed upward and one tube directed to the foot. Inject the right leg. Then inject upward toward the trunk and the head. Clamp of the right and left internal carotid arteries and the right and left vertebral arteries. After arterial injection, dry the cranial cavity, paint it with autopsy gel, and fill it with cotton. Attach the calvarium and suture the scalp back into position using the inversion or baseball stitch.Spread plenty of incision seal powder or mortuary putty within the incision as the suturing progresses. Begin suturing on the right side of the head and end on the left.