Autopsy 101: Post-Mortem Examination Information

What is an autopsy?

An autopsy is a medical term that refers to the examination of an already deceased body. The word itself is derived from the word autopsia, which is a Greek word that means “to see with one’s own eyes.” The procedure can also be referred to as an obduction or post-mortem examination.

There are several reasons for an autopsy to be performed, some of which include the following:

• When an unexpected, or perhaps even suspicious, death occurs.
• When the cause of death needs to be determined.
• To confirm a clinical diagnosis.
• For academic purposes, such as research or teaching at a medical school.
• To gain insight into possible genetic traits or diseases in a family.
• To provide evidence in a crime investigation.
• To provide closure for family members of the deceased. 
• On request by a family member or medical doctor.
• In case of a public medical health concern, such as an outbreak of sorts.

Autopsies are performed by medical doctors who have undergone specialized training in the examination of tissues and fluids in a body to determine a diagnosis. These skilled doctors are called pathologists. While this is the case for all clinical autopsies that are performed, a county coroner can do an autopsy in the event of the procedure being ordered by the state.

An autopsy will generally take two to three hours to complete, except if there are excessive complications. It is best to perform the procedure within 24 hours of death.

How is an autopsy performed?

1. External examination

A pathologist starts an autopsy from the outside of the body and works inwards. Therefore, the first step in the procedure is an external examination. The pathologist will first look at the outer appearance, including clothes and accessories. They note characteristics such as weight, height, eye color, hair color, texture and length, ethnicity, sex, and approximate age. This information can help provide evidence, as well as give clues to an identity if the body has not been positively identified.

The next step is still a part of the external examination, but it consists of having a closer look at the body itself. All of the clothes are taken off of the body until it is fully exposed, then the skin is carefully examined. Some of the things a pathologist will look for are gunpowder residue, flakes of skin or paint, injuries, or any evidence that can be used to determine what caused the death. They will also look at scars, tattoos, or any identifying marks.

2. X-rays

Finally, X-rays can be used to assess whether there are any bone abnormalities or foreign objects in the body, and ultraviolet light can be used to detect specific residues. This is the part of the procedure where hair or nail samples may be taken for further examination. This marks the end of the external examination. Note that all of the observations are written down, as well as recorded verbally.

3. Internal examination

The internal examination includes the examining of the chest and abdominal cavities, as well as the brain. This is done by making careful incisions. The chest and abdomen are accessed through Y- or U-incisions, which start at the shoulder, then meets at the sternum, and finally reach the pubic bone. The brain is reached by making an incision from ear to ear in the back of the skull, or by a triangular incision across the top part of the skull. These incisions bleed minimally, as the heart is no longer pumping blood. Before making the incisions, the torso is placed on a rubber block in a way that stretches out the body for maximum exposure and optimal examinations.

After performing the Y- or U-incision, the pathologist first examines all of the organs in place (by removing the frontal part of the rib cage), then they can remove all of the major organs (including the heart, lungs, liver, stomach, and spleen). The removal can be done using one of two techniques; the Virchow technique, which consists of removing each organ individually, or the Rokitansky technique, during which all of the organs are removed at once. The organs are then weighed to detect the presence of certain illnesses. Blood samples are also taken for further investigation. Small pieces of tissue from each organ is examined under a microscope.

The contents of the stomach are then examined. This is a good indicator of time of death, as the last meal, as well as its level of digestion, can be seen and used to determine a timeframe.

4. Testing of body fluids

Body fluids are tested for anything from drugs, to chemical and genetic composition, to infection, depending on the type of autopsy. Some of these fluids include blood, urine, bile, eye fluid. Note that some poisons will only be observable in some parts of the body, but not in others.

The organs are then either placed back in the body or preserved for teaching or research purposes.

5. Brain examination 

A pathologist will then typically move on to the head area. Another more concentrated external examination will take place to determine whether there are any signs of a head injury. Then an incision is made, and just like with the other organs, the brain is first examined inside the body, then removed to be examined further. Tissue samples are also taken.

Some of the other organs, but especially the brain, are often placed in formalin for a number of days before a dissection takes place. This is done to allow the organs to become more firm, which increases the ease and precision of the dissections.

If the pathologist finds anything unusual in any of the acquired tissue, the tissue will be preserved.

6. Final procedures

Once all of the organs have been thoroughly examined and either been put back or been preserved, the body is stitched back up. The breastbone and ribs are also returned to their original positions. Before the organs are returned, they are placed in bags to prevent leakage, and the inside of the body is lined with a wool-like substance. This procedure does not disturb an open casket funeral, as none of the incisions will be visible after the burial preparations have been made.

7. Autopsy report and medical diagnosis

Furthermore, it is important to note that each autopsy will be unique, depending on the purpose of the procedure. At the end of the procedure, an in-depth report is written. This report contains all of the observations made during the procedure, as well as explanations of any of the findings and the results. It also gives a medical diagnosis and a detailed summary of the case, explaining how conclusions were drawn.

After the autopsy

During the autopsy, photographs may be taken. This can be done for a number of reasons:

• Photographs of the findings can be taken to use as evidence in a court case.
• Photographs of the organs or tissues can be taken for teaching and research purposes.

Furthermore, some of the organs may be preserved in formalin to allow for:

• More examinations.
• Sampling to use in microscopy.
• Presentation at conferences or lectures.
• Use during medical training.

Note that the pathologist needs to be granted permission by the family to preserve any organs. Tissue may also be frozen and stored for future use (diagnostic or research purposes).

There are also certain laboratory studies that can be requested to be done, including:

• Cultures to identify certain infectious agents like bacteria, viruses, or even fungi.
• Chemical analysis to identify metabolic abnormalities.
• Genetic studies to identify any harmful mutations.
• Toxicology studies to identify any exposure to drugs or poisons.

When can an autopsy be requested?

In the US, the procedure can be ordered if the death took place surrounded by suspicious circumstances, or in special circumstances like a death that takes place during a surgical procedure.

If an autopsy is not ordered, it can be requested by a relative who gives permission for it to be performed. This relative also has the right to determine the nature and scope of the procedure (determining which organs may be examined or used for other purposes after the procedure).

Mortuary equipment used by professional morticians

There are many tools necessary during an autopsy, some of which include:

• Post mortem saws
• Rib shears
• Bone cutting forceps
• Post mortem needles
• Head blocks

However, the things that can determine the success or failure of the procedure are the larger equipment.

Body coolers

Body coolers are essential for the preservation of bodies and the delay of the decomposition of the body. Having a dead body that smells bad and looks like it is decaying before your eyes is not ideal at a funeral. Body coolers avoid this situation. Having good quality body coolers is, therefore, a necessary part of an autopsy and everything that comes before and after the procedure.

Autopsy tables

Autopsy tables are used to support the body during the procedure and are designed to allow the body to be positioned in a way that allows for the most efficient examination. They also provide a clean and smooth surface on which to work. These tables need to be sturdy, stable and made of good quality, strong material to ensure longevity and optimal use.

An autopsy table with a sink is a piece of equipment that allows the practitioners to wash the body and keep everything clean and hygienic. This is important because of the sterile nature of the procedure and the environment in which it takes place.

Embalming sink stations

Embalming refers to the preservation of the body. As previously mentioned, this is not only essential for the funeral, but also for the autopsy procedure. An embalming sink station is an effective way to keep your facility clean and safe to use.

Furthermore, when dealing with things like human flesh and organs, things tend to get messy. It is necessary to have an area where you can clean up so hygiene can be maintained.

Body concealment table (cadaver cart)

Protecting the body from stares is a good way of showing respect to the person that once occupied that body. It is inevitable that the body would need to be transported, and having a body concealment trolley is the perfect way to respect the body and give it the privacy it deserves. While this device is not strictly necessary in a medical sense, it is best to have one ready.

Body weighing scale

Bodyweight can tell a pathologist a lot of different things, and help them draw various conclusions. It is often challenging to maneuver a dead body in order to weigh it, and a body weighing scale is the perfect instrument to simplify the process. A good quality scale is, therefore, significant to ensure an accurate reading.

Accuracy and quality are crucial 

There are a lot of different tools and instruments that are necessary to carry out a successful autopsy. If these tools are not of the highest quality, various complications can arise. During an autopsy, accuracy is crucial, and an inaccurate reading (caused by cheap instruments) can create a significant change in the conclusion drawn.

An autopsy is a complicated procedure that requires a lot of different instruments, as well as different perspectives and approaches. It can be used for a variety of various reasons, but it ultimately allows a pathologist to draw an accurate conclusion.

Do you have questions about the equipment used by professional morticians? Ask our team about the tools needed to be efficient with your next autopsy.