Autopsy | History, Procedure, Purposes, & Facts (2024)

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Also known as: necropsy, postmortem, postmortem examination

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autopsy

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Also called:
necropsy, postmortem, or postmortem examination
Key People:
Karl, baron von Rokitansky
Related Topics:
forensic science
forensic anthropology
pathology
forensic medicine
forensic pathology

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autopsy, dissection and examination of a dead body and its organs and structures. An autopsy may be performed to determine the cause of death, to observe the effects of disease, and to establish the evolution and mechanisms of disease processes. The word autopsy is derived from the Greek autopsia, meaning “the act of seeing for oneself.”

History of autopsy

The early Egyptians did not study the dead human body for an explanation of disease and death, though some organs were removed for preservation. The Greeks and the Indians cremated their dead without examination; the Romans, Chinese, and Muslims all had taboos about opening the body; and human dissections were not permitted during the Middle Ages.

The first real dissections for the study of disease were carried out about 300 bce by the Alexandrian physicians Herophilus and Erasistratus, but it was the Greek physician Galen of Pergamum in the late 2nd century ce who was the first to correlate the patient’s symptoms (complaints) and signs (what can be seen and felt) with what was found upon examining the “affected part of the deceased.” This was a significant advance that eventually led to the autopsy and broke an ancient barrier to progress in medicine.

It was the rebirth of anatomy during the Renaissance, as exemplified by the work of Andreas Vesalius (De humani corporis fabrica, 1543) that made it possible to distinguish the abnormal, as such (e.g., an aneurysm), from the normal anatomy. Leonardo da Vinci dissected 30 corpses and noted “abnormal anatomy”; Michelangelo, too, performed a number of dissections. Earlier, in the 13th century, Frederick II ordered that the bodies of two executed criminals be delivered every two years to the medical schools, one of which was at Salerno, for an “Anatomica Publica,” which every physician was obliged to attend. The first forensic or legal autopsy, wherein the death was investigated to determine presence of “fault,” is said to have been one requested by a magistrate in Bologna in 1302. Antonio Benivieni, a 15th-century Florentine physician, carried out 15 autopsies explicitly to determine the “cause of death” and significantly correlated some of his findings with prior symptoms in the deceased. Théophile Bonet of Geneva (1620–89) collated from the literature the observations made in 3,000 autopsies. Many specific clinical and pathologic entities were then defined by various observers, thus opening the door to modern practice.

The autopsy came of age with Giovanni Morgagni, the father of modern pathology, who in 1761 described what could be seen in the body with the naked eye. In his voluminous work On the Seats and Causes of Diseases as Investigated by Anatomy, he compared the symptoms and observations in some 700 patients with the anatomical findings upon examining their bodies. Thus, in Morgagni’s work the study of the patient replaced the study of books and comparison of commentaries.

With Karl von Rokitansky of Vienna (1804–78), the gross (naked eye) autopsy reached its apogee. Rokitansky utilized the microscope very little and was limited by his own humoral theory. The French anatomist and physiologist Marie F.X. Bichat (1771–1802) stressed the role of the different generalized systems and tissues in the study of disease. It was the German pathologist Rudolf Virchow (1821–1902), however, who introduced the cellular doctrine—that changes in the cells are the basis of the understanding of disease—in pathology and in autopsy. He warned against the dominance of pathologic anatomy—the study of the structure of diseased tissue—alone as such and stressed that the future of pathology would be physiologic pathology—study of the functioning of the organism in the investigation of disease.

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The modern autopsy has been expanded to include the application of all knowledge and all of the instruments of the specialized modern basic sciences. The examination has been extended to structures too small to be seen except with the electron microscope, and to molecular biology to include all that can be seen as well as what still remains unseen.

Procedure

The autopsy procedure itself has changed very little during the 20th century. The first step is a gross examination of the exterior for any abnormality or trauma and a careful description of the interior of the body and its organs. This is usually followed by further studies, including microscopic examination of cells and tissues.

The main incisions in the body remain the same. For the torso, a Y-shaped incision is made. Each upper limb of the “Y” extends from either the armpit or the outer shoulder and is carried beneath the breast to the bottom of the sternum, or breastbone, in the midline. From this point of juncture at the bottom of the sternum the incision is continued down to the lower abdomen where the groins meet in the genital area.

There are different schools as to procedure beyond this point. In one method, each organ is removed separately for incision and study. In the so-called en masse methods the chest organs are all removed in a single group and all of the abdominal organs in another for examination. The great vessels to the neck, head, and arms are ligated—tied off—and the organs removed as a unit for dissection. The neck organs are explored in situ only or removed from below. Dissection then proceeds usually from the back, except where findings dictate a variation in the procedure. Usually groups of organs are removed together so that disturbances in their functional relationships may be determined. After study of the brain in position, it is freed from its attachments and removed in toto. The spinal cord also can be removed.

The dissector proceeds to examine the external and cut surface of each organ, its vascular structures, including arteries, lymphatics, fascial or fibrous tissue, and nerves. Specimens are taken for culture, chemical analysis, and other studies. Immediately upon completion of the procedure, all of the organs are returned to the body and all incisions carefully sewn. After the body’s proper restoration, no unseemly evidence of the autopsy need remain.

After the gross examination of the body the findings are balanced one against another and a list of pathological findings is compiled; this list comprises the tentative or “provisional anatomical diagnoses.” Such diagnoses are grouped and arranged in the order of importance and of sequence. On occasion a quick microscopic study is done to confirm a diagnosis so as to assure its proper listing.

Autopsies document the disease processes that were in place at the time of the patient’s death, and most autopsies do not list an immediate or proximate cause of death. These factors are important in forensic cases, and they are often required in autopsy analysis even in situations when an autopsy itself is not required by law. After all studies—histological, chemical, toxicological, bacteriological, and viral—are completed, any errors of the provisional anatomical diagnoses are corrected and the final anatomical diagnoses and the final cause of death are listed. A statement of analysis of the autopsy that correlates the findings with the clinical picture, the “clinical pathological correlation,” concludes the record of the autopsy.

Autopsy | History, Procedure, Purposes, & Facts (2024)

FAQs

What are the purposes of an autopsy and what questions may the autopsy also answer? ›

The main reason for doing an autopsy is to answer any questions the doctor or family may have about the illness, cause of death, or any other medical conditions the deceased person may have had. Frequently, autopsy will identify the precise cause(s) of death, providing valuable information to both doctors and family.

What are the procedures for an autopsy? ›

How is an autopsy done? Autopsy procedure begins with the general and ends with the specific: First, a visual exam of the entire body is done, including the organs and internal structures. Then, microscopic, chemical, and microbiological exams may be made of the organs, fluids, and tissues.

What is the purpose of an autopsy quizlet? ›

An autopsy is a post mortem examination preformed on a corpse to determine the cause and manner of death. The prefix 'auto-' means 'self', and so autopsy means 'to see for oneself'.

What are the 4 things that autopsies can determine? ›

Issues of Concern
  • To establish the identity of the dead.
  • To determine the cause of death.
  • To assist in confirming or refuting the alleged manner of death, wherever possible.
  • To estimate the time since death (postmortem interval)

Can you refuse an autopsy? ›

Survivors may object, but at a price: California law, for example, lets decedents or their survivors block some autopsies but at the risk of forfeiting claims for benefits. (Cal. Ins. Code § 10111.5 (2022).)

What are two reasons an autopsy would be legally required? ›

States in the U.S. and countries across the world each have specific legal criteria for when a death requires a forensic autopsy. But in general, this type of autopsy is typically necessary when a death is: Unnatural (homicide, suicide or accident). Sudden or unexpected (especially in an infant or child).

Which two organs are not weighed during an autopsy? ›

All organs, except for the intestines and stomach are weighed.

How long after death should an autopsy be done? ›

Forensic pathologist Dr. Stephen J. Cina says that autopsies are best if performed within 24 hours of death, before organs deteriorate, and ideally before embalming, which can interfere with toxicology and blood cultures.

What body part is always removed during autopsy? ›

It's nothing to do with the piercing itself, however, as turns out tongues are always removed during autopsies. “I remove your tongue during an autopsy – we need to make sure you didn't bite down on it, make sure you don't have drugs in the back of your throat,” he explained.

What are 4 reasons that autopsies are performed? ›

The body is unidentified and the autopsy may aid in identification. The body is skeletonized. The body is charred. The forensic pathologist deems a forensic autopsy is necessary to determine cause and/or manner of death, or document injuries/disease, or collect evidence.

What is one of the greatest challenges of an autopsy? ›

One of the greatest challenges of an autopsy is examining the wounds. The essence of the medical examiner's job is to use his or her skill and experience to determine the true nature and cause of a particular wound. Depending on the type of wound or weapon used, this can get difficult.

What is the main purpose of postmortem? ›

A post-mortem examination, also known as an autopsy, is the examination of a body after death. The aim of a post-mortem is to determine the cause of death. Post-mortems are carried out by pathologists (doctors who specialise in understanding the nature and causes of disease).

What does not show up in autopsy? ›

What an autopsy report can't show. In general, an autopsy report cannot detail in what order a person's wounds were inflicted. The report will detail the number and location of wounds. Detectives can then use this information, along with other evidence that has been gathered, to infer how an incident unfolded.

Why is the tongue removed during autopsy? ›

Both terms essentially mean "examination after death." Why is the tongue removed during autopsy? The tongue is removed during autopsy to thoroughly examine the oral cavity, access other throat structures, document any abnormalities, take tissue samples for further examination, and eliminate obstruction.

What is the purpose of an autopsy report? ›

The goal of the autopsy report is to help the treating physicians and family of the deceased understand how and why the person died. In some cases, the autopsy report may give the medical team information that helps them to improve the care of future patients.

What is the purpose of an autopsy is to determine the _____ of death? ›

An autopsy may be performed to determine the cause of death, to observe the effects of disease, and to establish the evolution and mechanisms of disease processes. The word autopsy is derived from the Greek autopsia, meaning “the act of seeing for oneself.”

What is autopsy and its importance? ›

An autopsy (also referred to as post-mortem examination, obduction, necropsy, or autopsia cadaverum) is a surgical procedure that consists of a thorough examination of a corpse by dissection to determine the cause, mode, and manner of death; or the exam may be performed to evaluate any disease or injury that may be ...

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