Autopsy: Virchow’s Technique

Prepared by Group III

WHAT IS AUTOPSY?An autopsy is performed to achieve one or more of the following objectives: To identify the body or record characteristics that may assist

in identifying the deceased. To determine the cause of death or, in the newborn, whether

live birth occurred. To determine the mode of dying and time of death, where

necessary and possible. To demonstrate all external and internal abnormalities,

malformations and diseases.

To detect, describe and record any external and internal injuries.

To obtain samples for any ancillary investigations.To obtain photographs or retain samples for evidential or teaching use.

To provide a full written report and expert interpretation of the findings.

To restore the body to the best possible cosmetic condition before the release

What is autopsy?

An examination of the organs of the dead body to determine the cause of death or to study the pathologic changes present.

There are four principal autopsy techniques namely:

Technique of R. Virchow Technique of C. Rokitansky Technique of A. Ghon Technique of M. Letulle

What is Virchow’s technique of autopsy?

Rudolf Ludwig Carl Virchow

Father of modern pathology

First to develop the systematic method of autopsy.

HISTORY

Virchow’s technique

A technique of removing organs one at a time. This technique is good for demonstrating pathological change in individual organs, especially in high- risk autopsies

ORDER OF EXAMINATION

VIRCHOW’S TECHNIQUE

HEAD

THORACIC (CERVICAL)

ABDOMINAL ORGANS

ATTENTION: Next slides are photographs of actual autopsy so be mentally,

emotionally and physically prepared.

It consist of:

1. Incising the body

2. Inspecting the various organs

3. Examining the cavities systematically

4. Weighing and Measuring the organs

5. Checking for any pathology

6. Putting all the organs back in and padding

7. Suturing the body

INTERNAL EXAMINATION

Incising the body

To expose the heart, lungs and abdominal organs the prosector(the person performing the autopsy) will use the MODIFIED “Y” SHAPED INCISION.

Incising the bodyOther ways of incision

1. ‘I’ shaped Incision: It is a straight line incision extending from the chin to the symphysis pubis.

2. ‘Y’ Shaped Incision: This type of incision starts near the acromian process and progresses downwards towards the xiphoid process. The incision is then extended till the symphysis pubis. Also, a similar incision is made on the opposite side of the body.

3. Intermastoid incision. this type of incision is made from behind each ear across the top of the head that allows examination of brain

Inspecting the various organs

HEAD • The neck is extended by placing a wooden block under the shoulders.

• Fix head using a head rest.

• Intermastoidal incision is made i.e. from the mastoid process behind one ear to the vertex and again to the mastoid process of the other ear.

• Scalp flap is reflected forward to the superciliary ridge and backwards to the occipital protuberance. nd back to the center of the forehead. the base of the other mastoid process occipital protuberance base of the mastoid process

With the help of a saw, ‘V’ shaped cut is made so that the skull fits back correctly after autopsy.

• This ‘V’ shaped cut passes through: the center of the forehead

THORAX Chest muscles are dissected away. Chest is opened by cutting the costal cartilages with the help of a cartilage knife.

In case of elderly subjects, the costal cartilage may be calcified, hence, a bone saw or a rib shear is used to cut it out.

Thereafter, both the sternoclavicular joints are disarticulated and the chest is opened. 1.

ABDOMEN • 5 cm above the symphysis pubis the rectus muscles are

divided and a small cut is made. • Middle and the index fingers are then inserted and spread

in a ‘V’ shape. • Sharp braded knife is inserted between them and the

peritoneum is cut up to the xiphoid process. • Firstly, inspection is done and if any damage, free fluid,

perforations etc. are seen then these are noted. • Also, note should be made about the abnormalities,

positions, abdominal organs, adhesions, pathology (if any), injuries etc.

Examining the cavities systematically

Brain

Brain will deteriorate easily when there is no supply of blood in order to prevent we must do fixation:

1. The freezing

2. The prefusion Spinal cord Thorax Heart Lungs Neck Abdomen Stomach Intestine Liver Spleen pancreas Kidney bladder Prostate and testes

Weighing and Measuring the organs

Checking for any pathology

Example: Acute mycordial infarction, old myocardial infarction, brain stroke, renal cell carcinoma.

Acute Myocardial Infarction

Heart Cross Section

Light-colored tissue

indicates a

myocardial

infarction

Normal fatty tissue

Dark area shows

beginning of healing

– increased

blood supply

Old Myocardial Infarctions

Scar tissue

from an infarct at least two

weeks old.

Brain Stroke

Hemorrhage

Brain Cross Section (Vertical)

Renal Cell Carcinoma

Kidney Tumor

Putting all the organs back in and padding

Body cavities should be cleaned and made free from blood, fluids etc.

Organs are placed back in and excess space is packed with cotton/cloth etc. (esp. in the pelvis and the neck regions.)

Suturing the body

Dissection flaps are closed and sutured with thin twine. Skull is filled with cotton and absorbent material and the

skull cap is placed back in and the scalp is stitched.

“What a magnificent body, how I should like to see it on the dissecting table.” ― Ivan Turgenev, Father and Sons 

Thank you