Transcript: Autopsy | Definition, Types & Procedure

Explore autopsy definition and meaning. Identify the two types of autopsy and understand the
differences in autopsy procedure and results documentation for each type.
Definition
An autopsy is a complete external and internal medical examination of the body that occurs
after death. An autopsy is completed in an attempt to determine the cause of death when it's
not readily known.

Types
There are two types of autopsies: The forensic autopsy, and the medical autopsy. A forensic
autopsy is usually ordered when a person dies under suspicious circumstances, the death is
trauma-related, or if the death is sudden and the person was healthy. A medical autopsy is
completed when family wants to know more about the health-related issue that caused the
death, and to see if there are any health conditions that could affect other living relatives.

Procedure
Whether you are doing a medical or forensic autopsy, the standard procedure remains the
same. The autopsy starts with the pathologist completing the external examination of the
body. This examination is completed in order to document all scars, marks, tattoos, medical
devices, and anything else the doctor feels is relevant.

The examiner will use a diagram that shows the decedent's name, age, race, sex, autopsy or
case number, and the date the procedure was conducted. The external exam starts by
documenting everything from head to toe. This includes hair color and length, eye color and
pupil size, condition of teeth, any defects, height, and weight. A full set of photographs are
also taken during each step of the autopsy in order to have visual documentation.

After completion of the external examination and an overall set of photographs have been
taken, the autopsy technician or the pathologist will begin to dissect the body using the Y
Incision technique. Using a scalpel, an incision is made at the shoulders and continues to the
sternum making the top part of the Y. Then one single incision is made from the sternum to
the top of the pubic area, making sure that the incision loops around the belly button.

The next step is to reflect the skin back from the chest plate in order to expose the chest plate
and ribs. Once the autopsy technician or pathologist checks the chest plate and rib cage for
any defects, a stryker saw is used to cut through the clavicle bone. The cut continues
downward through the ribs, and the chest plate is removed, exposing the internal organs.

The autopsy technician or pathologist must decide whether to remove the internal organs in
two individual blocks, known as the Rokitansky method, or to remove all of the organs
individually. Block 1 is from the trachea to just above the large intestine. The organs that are
included in block 1 are the trachea, heart, lungs, liver, spleen, and stomach. The organs that
are included in block 2 are the large intestine, small intestine, kidneys, appendix, and the
adrenaline glands. While removing the organs, specimens of blood and urine are taken for
submission to a toxicology lab in order to test for over 500 types of drugs and poisons, as
well as for alcohol.

After completing the dissection of the chest and abdomen, the head is next, where an incision
is made behind one ear and goes across the back of the head to the opposite ear. The skin is
reflected, and the skull is opened using a stryker saw. After removing the cut portion of the
skull, the brain is examined and then removed. Lastly, the eye fluid or vitreous is extracted in
order to send the specimen to the toxicology lab to test for glucose levels and for alcohol.

Results
The results of an autopsy are used to determine the cause of death of an individual. In
medical cases, the results can alert other family members to diseases or health conditions that
could be tested for and treated. In forensic cases, the results can help determine if the death
was a homicide, a suicide, an accident, or even natural.

Lesson Summary
Let's review what we learned…

An autopsy is a complete external and internal medical examination of the body that occurs
after death. There are two types of autopsies: a forensic autopsy is ordered when a person
dies suspiciously, the death is trauma-related, or if the death is sudden; a medical autopsy is
completed when the family wants to know more about the health-related issue that caused the
death.

The procedure for an autopsy includes an external examination of the body from head to toe
in order to document everything from scars and tattoos to marks and medical devices. The
procedure also includes the dissection of the body, where the Y-incision technique is used to
open the torso and remove the organs, often through the Rokitansky method where the
internal organs are removed in two individual blocks. The dissection also involves cutting
open the head with a stryker saw and examining and removing the brain. Blood, urine, and
other body fluids are also removed and tested. The results of the autopsy are then used to
determine the cause of death of the individual.

What Is an Autopsy?
An autopsy is an examination of the body of a deceased individual to determine the cause of
death or learn other information about the manner of death. This procedure is sometimes
referred to as a postmortem examination, which means "after death"
The cause of death is the medical explanation for why the person died. The manner of death
refers to the circumstances surrounding and leading to the death, which will be defined as one
of four types:

Natural deaths are those caused by a disease process, such as cancer or infection.
Accidents are those caused by unintentional trauma.
Homicides are those resulting from someone else killing the person.
Suicides are caused by unnatural, self-inflicted means.

The title of the person who conducts the autopsy varies depending on the type of autopsy, the
county it is being performed in, and who requests the autopsy. Typically, they are done by a
pathologist, also called a medical examiner, who is a licensed doctor trained in forensic
pathology and appointed to their position. In some state-mandated cases, they may be
conducted by a coroner instead. Coroners are elected to their positions, and while most have
medical training, some counties do not require it. In those cases, the coroner can send the
body to a licensed medical examiner, or have one come in to perform the autopsy. Then the
coroner is only responsible for identifying the body, notifying next of kin, signing the death
certificate, and getting the personal belongings to the family. Part of an autopsy is identifying
the remains so that the families can be notified

Toe tags illustration

Autopsies can be requested for multiple reasons. Any time the cause of death is unknown or
is potentially related to a crime, an autopsy is standard procedure. The family of the deceased
can also request an autopsy if they have questions or concerns related to the death of their
loved one. If the death is not connected to a crime, then the family can place limitations on
the extent of the autopsy.

Types of Autopsy
There are two types of autopsies depending upon the manner of death. The first is a
forensic autopsy, which is done to find the cause of death and to collect any evidence from
the body that might help in a police investigation. The other kind is a medical autopsy,
which is done in a hospital for research or informational purposes.

The Forensic Autopsy

This type of autopsy is also called a "medico-legal" autopsy. This type of autopsy is
performed at the request of law enforcement by the coroner or medical examiner who has
medico-legal authority where the death occurred. A forensic autopsy is needed when a
person's death is suspicious, unexpected, or unnatural. It may also be conducted if the person
was involved in a crime to collect evidence for the case.

➔ Examples:

If a healthy person dies with no clear cause, there will likely be an investigation, even if there
are no obvious signs of trauma or a crime.
If someone is killed by the police, the cause of death is known, but an autopsy will help
clarify the manner of death and provide evidence for the person's guilt or innocence.
A forensic autopsy focuses on why and how the person died. Initially, the person performing
the autopsy tries to find evidence to determine whether or not the death was an accident.
Then, they collect as much data as possible to help aid in the investigation. Forensic autopsy
goals are:

Identify the remains.

Determine the cause and manner of death.
Collect any evidence found on the body that may aid in the criminal investigation.
Document all findings rigorously.

Medical Autopsy
A medical autopsy is sometimes called a "clinical" autopsy. It is used in situations where a
person dies a natural death and is usually conducted by the attending physician or medical
examiner at the hospital where the person passed. It can also be requested by families from
hospitals or from private medical examiners.

This type of autopsy is used to evaluate the accuracy of the individual's diagnosis and
treatment, or to learn more about the disease or health problem that caused the death. The
family may also be interested in the presence of other unknown health concerns which may
affect living family members. The typical goals of a clinical autopsy are:

Identify correlations between the deceased's reported symptoms and physical manifestations.
Evaluate the accuracy of the diagnosis and effectiveness of the treatment given.
Answer any questions the medical team was unable to determine during the patient's life.
Uncover any unknown illnesses, conditions, or complications that may have impacted
treatment and recovery.
Provide documentation on all findings, especially genetic conditions that may affect family
members and any observations that may affect insurance claims.
Autopsy Procedure
Whether the autopsy is forensic or medical, there is a procedure that the pathologist must
follow. There are two parts, the external examination, where information is collected from the
outside of the body, and the internal examination, where incisions are made, and the internal
organs are examined. The exception to this procedure would be if the family requests a
limited medical autopsy, in which case only certain organs would be examined.

The pathologist receives the body in a body bag or wrapped in a clean evidence sheet for
transport. The pathologist documents the procedure with the decedent's name, age, race, sex,
autopsy or case number, the date the procedure is conducted, and any findings during the
autopsy. This information is supplemented with extensive photography, especially in forensic
cases, to document all discoveries.

External Examination
Forensic and medical autopsies begin with an external examination of the body. This involves
a thorough inspection of the external parts of the body from head to toe. This part of the
process is more extensive and important in forensic autopsies. The specific steps will vary
slightly depending upon the case and pathologist, but the general steps can be found below:

When the body bag is opened or the sheet is removed, the body is photographed and any
evidence related to clothing is recorded before the body is touched.
Postmortem changes are recorded to help in determination/confirmation of time of death:
degree of rigor mortis, distribution of liver mortis, and decompositional changes, etc.
Evidence is collected from the surfaces of the body, hair, fingernails, clothing, etc. Special
lighting may be used to identify the presence of invisible secretions on the body.
Any bruises or other types of external wounds are examined, recorded, and tested for trace
evidence.
The body is X-rayed to identify abnormalities of foreign objects in the body. Dental X-rays
can also be used for identification.
Blood and other toxicology samples are taken for testing.
The person's height, weight, and other features that may help in identification are recorded
(facial description, eye and hair color, scars, shoe size, etc.)
After the external examination is completed, the body is cleaned and positioned face-up on
the autopsy table with a body block under the patient's back. This helps with the internal
examination by raising the chest, allowing the arms and neck to fall backward.

Internal Examination
The internal examination looks at the organs and any internal damage to the body. There are
multiple techniques for the order and technique of organ removal, the most common methods
are explained below. The internal examination begins with a large, deep incision to open the
chest and abdominal cavities. There is some variation in this form, as seen in the image
below.
These are the three common types of incisions that are used during autopsies

Autopsy incisions illustration

The internal examination process is similar for medical and forensic autopsies, with some
exceptions for individual diseases/injuries. The general steps are listed here:

The most common type of incision used to open the internal cavity of the body is done with a
scalpel and is called a Y-incision. In some cases, the pathologist will use a different shape to
compensate for different body types, wounds, etc.
The skin, muscle, and soft tissues are pulled back to expose the rib cage, then the rib cage
itself is cut with a stryker saw on each side and the front chest plate is removed.
The organs are removed for examination.
En Masse Technique: A series of cuts are made to detach the larynx, esophagus, bladder,
and rectum from the body, then the organs are detached from the spinal cord. Some ligaments
and arteries are cut to free them completely, then the entire organ set can be removed at once
for further examination.
Rokitansky Technique: The organs are removed in two blocs. The first bloc is the trachea,
heart, lungs, liver, spleen, and stomach. The second bloc is the large intestine, small intestine,
kidneys, appendix, and adrenaline glands. Blood and urine specimens are collected and lab-
tested for over 500 types of drugs, poisons, and alcohol
En Bloc Technique: The organs are removed in three blocs. The cervical and thoracic organs
are in the first bloc, the abdominal organs are the second, and the urogenital organs are the
third.
Virchow Technique: Each organ is individually removed and examined. This is especially
used in limited autopsies.
The organs undergo various levels of scrutiny, depending on the circumstances surrounding
the death. They are weighed, and samples are taken and tested. Stomach contents may be
examined, and some blood vessels may be bisected and studied.
The body block is positioned behind the neck to raise the head. Then, a scalpel is used to cut
the scalp and pull it away from the skull in two flaps.
The skull is opened with a stryker saw. The skull cap can then be removed, exposing the
brain for inspection and removal.
Vitreous fluid is drained from the eyes for glucose and alcohol testing once the brain is
removed.
Autopsy Results
After the autopsy, the medical examiner or coroner will produce a report outlining the
information they collected. Their report will have their detailed findings along with
photographs, scans, and test results.

This will look different for forensic and medical autopsies, but will generally contain
information like: identification and description of the remains, cause of death, manner of
death (accident, suicide, homicide, or natural), any other injuries/health conditions, and any
other evidence or requested information.

Lesson Summary
An autopsy is a postmortem examination of a body done by a pathologist or coroner to
determine the cause and manner of death. The cause of death is the medical explanation for
the death, and the manner of death refers to whether the person dies of natural causes or as a
result of an accident, homicide, or suicide. There are two types of autopsies: forensic
autopsies, which are used in criminal investigations to determine the cause and circumstances
surrounding an unusual or suspicious death, and medical autopsies, which are used by doctors
and families to learn more about the health and reasons for a death due to natural causes.

The autopsy procedure begins with an external examination, where information and evidence
are collected from the outside of the body, followed by an internal examination, which
involves cutting the body open with a Y-incision (usually) and examining the organs and
internal cavities. The organs may be removed using several different techniques, including:
the En masse technique (removing all of the organs at once), Rokitansky technique (removing
the organs in two blocs: first from the chest, second from the lower abdomen), En bloc
technique (removing the organs in three blocs: first cervical and thoracic, then abdominal,
and third urogential), or the Virchow technique (removing each organ individually). Finally,
the brain is removed and examined and vitreous fluid is removed from the eyes. When
finished, the pathologist writes an autopsy report that includes detailed descriptions of
findings along with pictures and test results.

Frequently Asked Questions

Who does the autopsy?
Autopsies are most often conducted by pathologists, or medical examiners, who are
physicians with a medical degree. In certain counties, they are sometimes conducted by
coroners who may have varying levels of medical training.

What is the purpose of autopsy?

An autopsy is an examination of a deceased body. It is a process used to determine the cause
and manner of death.
How many types of autopsy are there?
There are two types of autopsy. The first is a forensic autopsy, which is done in cases of
suspicious deaths along with a criminal investigation. The second is a medical autopsy, which
is requested by doctors or the family to learn more information about the health and death of
those who died by natural causes.