Autopsy - Revision history

Michael: /* Sample clinical history */ make future

2019-02-25T21:28:25Z

Sample clinical history: make future

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	===Sample clinical history===		===Sample clinical history===
	<pre>		<pre>
	A 63 year old male with a history of alcohol abuse was admitted on December 13, ~~2018~~ for		A 63 year old male with a history of alcohol abuse was admitted on December 13, 2022 for
	recurrent alcohol related pancreatitis. On December 21, he was found unresponsive at 0:15.		recurrent alcohol related pancreatitis. On December 21, he was found unresponsive at 0:15.
	Approximately fifteen minutes earlier, he was on oxygen and in no apparent distress. A code		Approximately fifteen minutes earlier, he was on oxygen and in no apparent distress. A code
	blue was called; however, the attempted resuscitation was unsuccessful. Death was declared		blue was called; however, the attempted resuscitation was unsuccessful. Death was declared
	at 1:00 on December 21, ~~2018~~.		at 1:00 on December 21, 2022.
	</pre>		</pre>

Michael: /* Cardiovascular system */

2019-02-25T21:27:47Z

Cardiovascular system

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	====Cardiovascular system====		====Cardiovascular system====
	[[Coronary arteries]]:		[[Coronary arteries]]:
	*[[Atherosclerosis]] -		*[[Atherosclerosis]] in the:
	**Left main coronary artery ~~30%~~.		**Left main coronary artery.
	**Left anterior descending coronary artery ~~75%~~.		**Left anterior descending coronary artery.
	**Left circumflex coronary artery ~~30%~~.		**Left circumflex coronary artery.
	**Right coronary artery ~~85%~~.		**Right coronary artery.

	*No identified atherosclerotic plaque rupture.		*No identified atherosclerotic plaque rupture.

Michael at 04:01, 6 January 2017

2017-01-06T04:01:40Z

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	===Respiratory system===		===Respiratory system===
	#Open trachea + bronchus (see ''Note'').		#Open [[trachea]] + bronchus (see ''Note'').
	#Examine proximal airway.		#Examine proximal airway.
	#Examine proximal pulmonary arteries.		#Examine proximal pulmonary arteries.

Michael at 22:12, 24 October 2015

2015-10-24T22:12:17Z

← Older revision		Revision as of 22:12, 24 October 2015
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	===Before the first incision===		===Before the first incision===
	If there is suspicion of pneumothorax - one the the three following can be done:<ref name=Ref_HospAuto120-1>{{Ref HospAuto\|120-1}}</ref>		If there is suspicion of [[pneumothorax]] - one the the three following can be done:<ref name=Ref_HospAuto120-1>{{Ref HospAuto\|120-1}}</ref>
	#Create a "pleural window" (between ribs by removing soft tissue... without entering the pleural cavity).		#Create a "pleural window" (between ribs by removing soft tissue... without entering the pleural cavity).
	#Open chest underwater and watch for air bubbles.		#Open chest underwater and watch for air bubbles.

Michael: /* Common pathologic findings */

2014-12-25T17:15:39Z

Common pathologic findings

← Older revision		Revision as of 17:15, 25 December 2014
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	*[[Acute tubular necrosis]] (ATN).		*[[Acute tubular necrosis]] (ATN).
	**ATN is difficult to prove on autopsy material.		**ATN is difficult to prove on autopsy material.
	**~~Look~~ for:<ref name=pmid19207286>{{Cite journal \| last1 = Kocovski \| first1 = L. \| last2 = Duflou \| first2 = J. \| title = Can renal acute tubular necrosis be differentiated from autolysis at autopsy? \| journal = J Forensic Sci \| volume = 54 \| issue = 2 \| pages = 439-42 \| month = Mar \| year = 2009 \| doi = 10.1111/j.1556-4029.2008.00956.x \| PMID = 19207286 }}</ref>		**On microscopy, look for:<ref name=pmid19207286>{{Cite journal \| last1 = Kocovski \| first1 = L. \| last2 = Duflou \| first2 = J. \| title = Can renal acute tubular necrosis be differentiated from autolysis at autopsy? \| journal = J Forensic Sci \| volume = 54 \| issue = 2 \| pages = 439-42 \| month = Mar \| year = 2009 \| doi = 10.1111/j.1556-4029.2008.00956.x \| PMID = 19207286 }}</ref>
	***Tubular epithelial whorls.		***Tubular epithelial whorls.
	***Tubulorrhexis.		***Tubulorrhexis.

Michael: /* Extremities */ fix

2014-12-25T17:07:08Z

Extremities: fix

← Older revision		Revision as of 17:07, 25 December 2014
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	Body should be examined for ''defensive-type wounds'':		Body should be examined for ''defensive-type wounds'':
	*Between the ~~finger, esp.~~ thumb and pointing finger.		*Between the fingers - especially thumb and pointing finger.
	*Dorsal aspect of the hand.		*Dorsal aspect of the hand.
	*Forearm.		*Forearm.

Michael: fix sp

2014-12-11T08:27:34Z

fix sp

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	===Who has authority?===		===Who has authority?===
	*Consent should be given by the ''~~executer~~ of the estate''.<ref name=olduhnconsent>URL: [http://www.docstoc.com/docs/51609856/CONSENT-FOR-AUTOPSY http://www.docstoc.com/docs/51609856/CONSENT-FOR-AUTOPSY]. Accessed on: 27 September 2010.</ref>		*Consent should be given by the ''executor of the estate''.<ref name=olduhnconsent>URL: [http://www.docstoc.com/docs/51609856/CONSENT-FOR-AUTOPSY http://www.docstoc.com/docs/51609856/CONSENT-FOR-AUTOPSY]. Accessed on: 27 September 2010.</ref>

	====Hierarchy====		====Hierarchy====
	If the ''~~executer~~ of the estate'' is not specified the hierarchy is as follows:<ref name=olduhnconsent/>		If the ''executor of the estate'' is not specified the hierarchy is as follows:<ref name=olduhnconsent/>
	#Spouse - by marriage (same sex ''or'' opposite sex) ''or'' by common-law ''or'' by together the parents of a child ''or'' by cohabitation agreement (in law).		#Spouse - by marriage (same sex ''or'' opposite sex) ''or'' by common-law ''or'' by together the parents of a child ''or'' by cohabitation agreement (in law).
	#If no spouse, any children 16+ years old,		#If no spouse, any children 16+ years old,
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	Notes:		Notes:
	*Exact hierarchy may vary by jurisdiction.		*Exact hierarchy may vary by jurisdiction.
	*The power a person that is designated as ''power of attorney for health care decisions'' does not have the authority to consent for an autopsy; their power ends with death (unless they are also the ''~~executer~~ of the estate'').		*The power a person that is designated as ''power of attorney for health care decisions'' does not have the authority to consent for an autopsy; their power ends with death (unless they are also the ''executor of the estate'').
	*In clinical medicine, it is allowable to skip down the hierarchy if ''the'' "consent giver" is not reachable, e.g. if a child of the patient is present they can consent in emergency circumstances, if the spouse is ''not'' reachable. In the context of (non-corner's) autopsies, '''the hierarchy has to be followed strictly''', as there is no such thing as an "emergency autopsy"; it is ''not'' acceptable to ask the child of the decedent 'cause they aren't distraught like the spouse of the decedent.		*In clinical medicine, it is allowable to skip down the hierarchy if ''the'' "consent giver" is not reachable, e.g. if a child of the patient is present they can consent in emergency circumstances, if the spouse is ''not'' reachable. In the context of (non-corner's) autopsies, '''the hierarchy has to be followed strictly''', as there is no such thing as an "emergency autopsy"; it is ''not'' acceptable to ask the child of the decedent 'cause they aren't distraught like the spouse of the decedent.
	*In non-corner's cases/non-medical examiner's cases, a physician ''cannot'' give consent for an autopsy.		*In non-corner's cases/non-medical examiner's cases, a physician ''cannot'' give consent for an autopsy.
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	*Y-shaped incision (standard):		*Y-shaped incision (standard):
	**Superior "points" of the Y ~ at the deltoid muscle.		**Superior "points" of the Y ~ at the deltoid muscle.
	**"~~Confuence~~ of lines" in the Y ~ inferior to the suprasternal notch.		**"Confluence of lines" in the Y ~ inferior to the suprasternal notch.
	*Neck dissection incisions:		*Neck dissection incisions:
	**Deltoid to mastoid process.		**Deltoid to mastoid process.
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	Notes:		Notes:
	*The ~~sterum~~ may have cleft or foramen - as an anatomical variant.<ref name=pmid10803333>{{cite journal \|author=Fokin AA \|title=Cleft sternum and sternal foramen \|journal=Chest Surg. Clin. N. Am. \|volume=10 \|issue=2 \|pages=261–76 \|year=2000 \|month=May \|pmid=10803333 \|doi= \|url=}}</ref>		*The sternum may have cleft or foramen - as an anatomical variant.<ref name=pmid10803333>{{cite journal \|author=Fokin AA \|title=Cleft sternum and sternal foramen \|journal=Chest Surg. Clin. N. Am. \|volume=10 \|issue=2 \|pages=261–76 \|year=2000 \|month=May \|pmid=10803333 \|doi= \|url=}}</ref>
	*If the decedent has a history of a [[CABG]] removal of the chest plate should be done with care to preserve the grafts.		*If the decedent has a history of a [[CABG]] removal of the chest plate should be done with care to preserve the grafts.

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	**Capsule of the spleen is white - resembles sugar-coating.		**Capsule of the spleen is white - resembles sugar-coating.
	**Importance: ''none'' - benign.		**Importance: ''none'' - benign.
	*Splenomegaly secondary to [[portal hypertension]].		*[[Splenomegaly]] secondary to [[portal hypertension]].

	===Kidney===		===Kidney===

Michael: /* Hierarchy */

2014-12-11T08:24:38Z

Hierarchy

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	*The power a person that is designated as ''power of attorney for health care decisions'' does not have the authority to consent for an autopsy; their power ends with death (unless they are also the ''executer of the estate'').		*The power a person that is designated as ''power of attorney for health care decisions'' does not have the authority to consent for an autopsy; their power ends with death (unless they are also the ''executer of the estate'').
	*In clinical medicine, it is allowable to skip down the hierarchy if ''the'' "consent giver" is not reachable, e.g. if a child of the patient is present they can consent in emergency circumstances, if the spouse is ''not'' reachable. In the context of (non-corner's) autopsies, '''the hierarchy has to be followed strictly''', as there is no such thing as an "emergency autopsy"; it is ''not'' acceptable to ask the child of the decedent 'cause they aren't distraught like the spouse of the decedent.		*In clinical medicine, it is allowable to skip down the hierarchy if ''the'' "consent giver" is not reachable, e.g. if a child of the patient is present they can consent in emergency circumstances, if the spouse is ''not'' reachable. In the context of (non-corner's) autopsies, '''the hierarchy has to be followed strictly''', as there is no such thing as an "emergency autopsy"; it is ''not'' acceptable to ask the child of the decedent 'cause they aren't distraught like the spouse of the decedent.
	*In non-corner's cases, a physician ''cannot'' consent an autopsy.		*In non-corner's cases/non-medical examiner's cases, a physician ''cannot'' give consent for an autopsy.

	===Religious objections===		===Religious objections===

Michael: /* Hierarchy */

2014-12-11T08:23:24Z

Hierarchy

← Older revision		Revision as of 08:23, 11 December 2014
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	Notes:		Notes:
			*Exact hierarchy may vary by jurisdiction.
	*The power a person that is designated as ''power of attorney for health care decisions'' does not have the authority to consent for an autopsy; their power ends with death (unless they are also the ''executer of the estate'').		*The power a person that is designated as ''power of attorney for health care decisions'' does not have the authority to consent for an autopsy; their power ends with death (unless they are also the ''executer of the estate'').
	*In clinical medicine, it is allowable to skip down the hierarchy if ''the'' "consent giver" is not reachable, e.g. if a child of the patient is present they can consent in emergency circumstances, if the spouse is ''not'' reachable. In the context of (non-corner's) autopsies, '''the hierarchy has to be followed strictly''', as there is no such thing as an "emergency autopsy"; it is ''not'' acceptable to ask the child of the decedent 'cause they aren't distraught like the spouse of the decedent.		*In clinical medicine, it is allowable to skip down the hierarchy if ''the'' "consent giver" is not reachable, e.g. if a child of the patient is present they can consent in emergency circumstances, if the spouse is ''not'' reachable. In the context of (non-corner's) autopsies, '''the hierarchy has to be followed strictly''', as there is no such thing as an "emergency autopsy"; it is ''not'' acceptable to ask the child of the decedent 'cause they aren't distraught like the spouse of the decedent.

Michael: +image

2014-11-06T07:14:20Z

+image

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			[[Image:Rembrandt Harmensz. van Rijn 007.jpg\|thumb\|300px\|An autopsy.]]
	'''Autopsy''' was once a mainstay of [[pathology]]. It is now in decline and uncommonly done. Fetal autopsy is dealt with in a separate article called ''[[fetal autopsy]]''.		'''Autopsy''' was once a mainstay of [[pathology]]. It is now in decline and uncommonly done. Fetal autopsy is dealt with in a separate article called ''[[fetal autopsy]]''.