Legal Medicine - Autopsy Outline PDF

**OUTLINE** I. **Autopsy** II. **Kinds of Autopsy in Death Investigation** III. **Postmortem Examination** IV. **Stages of the Postmortem Examination** V. **Techniques of Autopsy** A. **View and Grant System** B. **In-Situ Examination** C. **En Bloc/ En Masse Removal of Organs** D. **...

**OUTLINE** I. **Autopsy** II. **Kinds of Autopsy in Death Investigation** III. **Postmortem Examination** IV. **Stages of the Postmortem Examination** V. **Techniques of Autopsy** A. **View and Grant System** B. **In-Situ Examination** C. **En Bloc/ En Masse Removal of Organs** D. **Systemized Removal of Organs** E. **Normal Weight of Human Organs in Grams** VI. **General Kinds of Autopsies** A. **Medico-legal Autopsy/ Forensic/ Coroner's Autopsies** B. **Clinical or Pathological Autopsies** C. **Anatomical or Academic Autopsies** D. **Virtual or Medical Imaging Autopsies** E. **Physiological Autopsies** VII. **Why Autopsies Should be Performed** VIII. **Mandatory Autopsy Should be Performed in the Following** IX. **Persons Authorized to Perform Autopsies** X. **When Shall Autopsy be Performed on a Dead Body** XI. **Mistakes in Autopsies** XII. **Negligent Autopsy** XIII. **Negative Autopsies** +-----------------------+-----------------------+-----------------------+ | **LEGEND** | | | +=======================+=======================+=======================+ | ⭐ | 🖊️ | 📖 | | | | | | Must | Lecture | Book | | | | | | Know | *\[lec\]* | *\[bk\]* | +-----------------------+-----------------------+-----------------------+ AUTOPSY {#autopsy.TransOutline} ======= - The term **'autopsy'** means **'to see for oneself'** - Synonymous with the terms: - post-mortem - post-mortem examination - necropsy - In modern practice, an **autopsy** is usually taken to indicate a detailed examination which includes the external examination of the corpse, and the evisceration and subsequent careful dissection of the contents of the cranial, thoracic, abdominal, and pelvic cavities. - According to Dr. Solis of Legal Medicine: A comprehensive study of a dead body performed by a trained physician employing recognized dissection procedures and techniques may include the removal of tissue sections and body fluids for further analysis. KINDS OF AUTOPSY IN DEATH INVESTIGATION {#kinds-of-autopsy-in-death-investigation.TransOutline} ======================================= 1. **Hospital Autopsy / Non-Official Autopsy** 2. **Medico-legal Autopsy / Official Autopsy** +-----------------------------------+-----------------------------------+ | **Table** **1.** Hospital vs. | | | Medico-legal Autopsy | | +===================================+===================================+ | **HOSPITAL AUTOPSY** | **MEDICO-LEGAL AUTOPSY** | +-----------------------------------+-----------------------------------+ | - Determining the cause of | - Determining the cause, | | death. | manner, & time of death. | | | | | - Providing correlation of | - Recovering, identifying, and | | clinical diagnosis and | preserving evidentiary | | clinical symptoms. | material. | | | | | - Determining the effectiveness | - Providing interpretation and | | of therapy | correlation of facts and | | | circumstances related to | | - Studying the natural course | death. | | of the disease process. | | | | - Providing factual, objective | | - Educating students and | medical report for LEA, | | physicians. | prosecution and defense | | | agencies. | | | | | | - Separating death due to | | - 🖊️Autopsy done in a hospital | disease from death due to | | morgue by a resident | external causes for | | pathologist. | protection of innocent. | +-----------------------------------+-----------------------------------+ POSTMORTEM EXAMINATION {#postmortem-examination.TransOutline} ====================== - Although postmortem examination can be used interchangeably with autopsy or necropsy, a clear definition of **post-mortem examination** states that it refers to the external examination of a dead body **without incision** being made. - 🖊️There is no dissection and during the process of post-mortem exam, it may **include the recovery of blood and other body fluids for further analysis**. - 🖊️ Usually, what health officers of the municipalities and provinces are doing is what we call post-mortem examination. **Figure** **2.** Post Mortem Examination - Autopsy is usually performed in Authorized Morgues - 🖊️ Although there are some autopsies done outside authorized morgues, autopsies should always be done or performed in authorized morgues.  **Figure 3.** Autopsy in morgues STAGES OF THE POST-MORTEM EXAMINATION OF THE DEAD BODY {#stages-of-the-post-mortem-examination-of-the-dead-body.TransOutline} ====================================================== - Identification of the Body - Photography - External examination - Clothing - Inspection of the body - Height - Rigor, algor, livor mortis - Physical injuries - Marks of therapy - \*Internal Examination - 🖊️ During autopsy, before dissection is done in the body, a medico-legal officer usually processes the body, try to identify the body, taking photographs of the entire body as well as the injuries sustained by that body, external examination of the clothing, looking for clues, blood stains, or any body fluids present in the clothing as well as holes that indicates injury inflicted on the body. - 🖊️ Inspection of the body will include the measurement of the height, determining the condition if it is already in rigor, algor, or livor mortis are already present. Usually a medio-legal officers conduct measurement of the injuries sustained by the victim. If the victim was brought to the hospital, evidence of a surgical procedures or marks of a therapeutic indication will be seen on the body e.g., needle puncture marks, suture marks and if the body was opened, you will see also repair done inside the body during the internal examination. - 🖊️ Initially we do measurement of the height. After which, we proceed with the dissection by opening up the chest, the abdomen, and the pelvic cavity. **Figure 2.** Measurement of the height  **Figure 3.** Dissection in Autopsy TECHNIQUES OF AUTOPSY {#techniques-of-autopsy.TransOutline} ===================== - View and Grant System - Rokitansky - Virchow - Le Tulle or Ghon A. VIEW AND GRANT SYSTEM {#a.-view-and-grant-system.TransSubtopic1} ------------------------ - A **non-invasive** procedure which involves an experienced pathologist externally examining the body of the deceased whilst considering the deceased's history and the events surrounding the death. - 🖊️ The pathologist will confirm to the **Procurator Fiscal** or prosecutor that a full postmortem examination is required if they are not in a position to certify the cause of death on the basis of a View and Grant examination. - To determine whether the cause of death could be accurately predicted without the need for a necropsy, and thus to consider whether a \"view and grant\" system of issuing a cause of death. - Applications: - Inhospitable environment - Cliffs, alps, middle of the ocean, desert - Speed is essential - 🖊️cause of death should be immediately established - Cultural and religious prohibitions with known death circumstances - 🖊️like our Muslim brothers wherein autopsy is not allowed by their religious beliefs B.IN-SITU EXAMINATION (ROKITANSKY) {#b.in-situ-examination-rokitansky.TransSubtopic1} ---------------------------------- - This procedure is characterized by **in situ dissection**, in part combined with en bloc removal. There is a removal of the notable organs. - Circumstances that histopathology examination is limited or meaningless - Applications: - Far advanced decomposition - Drowning - Burns - Cultural and religious prohibitions - In-Situ Examination - Retrieve fluids. Peripheral blood is preferred especially if for alcohol determination. - 🖊️In Rokitansky technique, you open up the body and then pay particular attention to the different organs inside the body and you only examine those bodies while they are **still connected with each other.** And you can remove one organ and examine it for histopathological purposes or for dissection purposes. **Figure 4.** In-Situ Examination (Rokitansky) C. EN BLOC/ EN MASSE REMOVAL OF ORGANS {#c.-en-bloc-en-masse-removal-of-organs.TransSubtopic1} -------------------------------------- +-----------------------------------+-----------------------------------+ | **Table 2. Ghon vs Le Tulle** | | +===================================+===================================+ | **GHON** | **LE TULLE** | +-----------------------------------+-----------------------------------+ | - One block | - En masse | | | | | - En toto | - Two or more blocks | | | | | | - Modified Virchow | | | | | | - By cavity or by system | +-----------------------------------+-----------------------------------+ EN MASSE TECHNIQUE (LE TULLE) {#en-masse-technique-le-tulle.TransSub-subtopic2} ----------------------------- - En Masse Technique- Thoracic, cervical, abdominal, and pelvic organs are removed en masse and subsequently **dissected into organ blocks.** - This is the **best technique for preserving the vascular supply and relationships between organs.** Another advantage is that the body can be made available to the undertaker quickly, without having to rush the dissection and risk obscuring findings or destroying important specimens. - The major disadvantage is that the organ mass is **often awkward to handle**, and the autopsy is **difficult to perform without an assistant.** - 🖊️ Because you have to carry the entire visceral organs and you need assistance to bring it to another table for proper examination and dissection. EN BLOCK TECHNIQUE (GHON) {#en-block-technique-ghon.TransSub-subtopic2} ------------------------- - Various modifications of the en bloc technique is widely used. Thoracic and cervical organs, abdominal organs, and the urogenital system are removed in **functionally related blocks.** - This procedure is a compromise between the Virchow and en masse techniques, preserving anatomical relationships sufficiently for most cases while being simpler for one person to execute.  **Figure 5.** En Toto Removal of Organs (Ghon or Le Tulle) D. SYSTEMIZED REMOVAL OF ORGANS (VIRCHOW) {#d.-systemized-removal-of-organs-virchow.TransSubtopic1} ----------------------------------------- - The organs are removed one by one and dissected as removed. This approach is good for demonstrating **pathological change in individual organs**, especially in **high-risk autopsies** or where permission is limited to one organ. - The disadvantage of this technique is that **relationships between various organs may be hard to interpret.** - 🖊️ You remove one organ, example the heart, if you are suspecting myocardial infarction. You remove the lungs if you are suspecting pneumonia. It depends on the organ that you will focus on during the autopsy. - 🖊️ Any case - 🖊️ Histopathology is necessary - 🖊️ Takes a minimum of 80 minutes DISSECTION OF THE HEAD {#dissection-of-the-head.TransSub-subtopic2} ---------------------- **Figure 6.** Dissection of the head - 🖊️ The scalp is cut from ear to ear then you flip it over forward, and then you use electric saw to cut the parietal and occipital bones as well as the temporal. You expose already the dura mater and, slowly you remove it and examine the brain.  **Figure 7.** Removal of the brain - 🖊️ Once the cranium is already open, you slowly lift the brain tissue, cutting slowly on the different attachments, particularly the cranial nerves, then slowly dissecting the **inferior portion** where the **blood vessels are located particularly the Circle of Willis**. Now you can see the cranial bone there. E. NORMAL WEIGHT OF HUMAN ORGANS IN GRAMS {#e.-normal-weight-of-human-organs-in-grams.TransSubtopic1} ----------------------------------------- - 🖊️ During autopsies you remove those different internal organs and just to give you an idea of the different/average normal weight of human organs in grams **Table 3.** Normal Weight of Human Organs in Grams ----------------------------------------------------- ----------- **ORGAN** **GRAMS** Brain 1300 Heart 300 Kidney 150 Liver  1500 Lungs 550/450 Uterus 50/100 Ovary 10 Prostate 20 Pancreas 100 Pituitary 0.7 Spinal Cord 25 Spleen 150 AN AUTOPSY MAY BE: {#an-autopsy-may-be.TransSub-subtopic2} ------------------ - Complete - Brain, thoracoabdominal: *when you open the cranium and then the thorax or the abdominal cavity* - Routine - Thoraco-abdominal - Partial - Thorax only, abdomen only, a particular organ only 🖊️ but we don't usually do a partial autopsy - When you open a certain cavity only ⭐ **GENERAL RULE: *A FORENSIC AUTOPSY IS ALWAYS A COMPLETE AUTOPSY*** GENERAL KINDS OF AUTOPSIES {#general-kinds-of-autopsies.TransOutline} ========================== A. MEDICO-LEGAL AUTOPSY/ FORENSIC/ CORONER'S AUTOPSIES {#a.-medico-legal-autopsy-forensic-coroners-autopsies.TransSubtopic1} ------------------------------------------------------ - Seek to find the cause and manner of death and to identify the decedent. They are generally performed, as prescribed by applicable law, in cases of violent, suspicious or sudden deaths, deaths without medical assistance or during surgical procedures. **No consent in needed.** - 🖊️ The **consent of the relatives is not needed**. Usually, the autopsy is done without the relatives knowing them or when they arrive in the morgue, the autopsy has been performed already. It's the law that allows the medico-legal officer to do the autopsy. B. CLINICAL OR PATHOLOGICAL AUTOPSIES {#b.-clinical-or-pathological-autopsies.TransSubtopic1} ------------------------------------- - Are performed to diagnose a particular disease or for research purposes. They aim to determine, clarify, or confirm **medical diagnosis** that remained unknown or unclear prior to the patient\'s death. **Needs consent.** - 🖊️ Before any pathological autopsy can be done, they **need the consent of the relatives.** C. ANATOMICAL OR ACADEMIC AUTOPSIES {#c.-anatomical-or-academic-autopsies.TransSubtopic1} ----------------------------------- - Are performed by students of anatomy for study purposes only. - 🖊️ when you are on your first year, you have your first exposure to the anatomy lab and you are required to do autopsies or let's say anatomical dissection of the cadavers. One of the most exciting in the first year. D.VIRTUAL OR MEDICAL IMAGING AUTOPSIES {#d.virtual-or-medical-imaging-autopsies.TransSubtopic1} -------------------------------------- - Are performed by **utilizing imaging technology only**, primarily **magnetic resonance imaging (MRI) and computed tomography (CT).** E. PHYSIOLOGICAL AUTOPSIES {#e.-physiological-autopsies.TransSubtopic1} -------------------------- - 🖊️ There are cases wherein expert pathologists or expert medical examiners usually perform psychological autopsy. - Taking the **history of the case** why death occurred. - E.g., Suicidal deaths, overdose of drugs. - 🖊️ The pathologist or the medico-legal officer will conduct an investigation based on the background, and the history of the disease, and from there, he could make a conclusion why the person committed suicide. - 🖊️ For example, the case of Hollywood star, Marilyn Monroe, Dr. Henry Lee was the one who performed the psychological history. Based on the history, the actress was suffering from depression, and she was hooked on barbiturates. When the actual autopsy was done, there was a presence of high doses of this barbitone. WHY AUTOPSIES SHOULD BE PERFORMED {#why-autopsies-should-be-performed.TransOutline} ================================= - To determine the cause, manner, and mechanism of death. - 🖊️ Additionally, to approximate the time of death - To determine the extent of injuries sustained by the victim that cause the death - 🖊️ Based on the internal and external injuries, a medico-legal officer may evaluate what particular injuries sustained by the victim resulted to the cause of death. - To determine if there was foul play involved in undetermined deaths or alleged suicides. - In violent deaths, it is mandatory for an autopsy to be performed to rule out foul play - For purposes of insurance claims - 🖊️ If the victim that was discovered was insured, the insurance agencies will be requiring an autopsy to be performed to determine if the victim died from a violent death or from other natural deaths, because in suicidal deaths, they would not give the next of kin any insurance benefits. In cases only of death by violence or natural death, the autopsy is needed by the insurance agencies so the next of kin can claim the benefits. MANDATORY AUTOPSY SHOULD BE PERFORMED IN THE FOLLOWING: {#mandatory-autopsy-should-be-performed-in-the-following.TransOutline} ======================================================= - Suicide - 🖊️To rule out any foul play. - Sudden Death of a person who is apparently in good health - 🖊️ A person who is jogging or engaging physical activities then suddenly collapsed. - Accidental Death - 🖊️The victim was walking then hit by a vehicle. - Death unattended by physician - 🖊️A neighbor reported that there was foul odor emanating from the room. During the death investigation, it was discovered there was a decomposing body already so an autopsy should be performed. Or in cases that involve what we call **summary execution**, like finding a dead body on a dumpsite. - Death in hospitals or clinics (DOA or Dead on Arrival) wherein a physician was not able to arrive at a clinical diagnosis as the cause of death. - Death occurring in an unnatural manner - 🖊️A person is just seated during a class, feel asleep, then after class he is still asleep or already cold or stiff. - Undetermined deaths - 🖊️Bangungot PERSONS WHO ARE AUTHORIZED TO PERFORMED AUTOPSIES (**P.D. 856, SEC. 95, CODE OF SANITATION)** {#persons-who-are-authorized-to-performed-autopsies-p.d.-856-sec.-95-code-of-sanitation.TransOutline} ============================================================================================= 🖊️ Autopsy falls under ⭐ **P.D. 856, Sec. 95, Code of Sanitation.** This section states who are the persons authorized to perform autopsies. There are three groups of individuals who are authorized: - **Health officers** - Provincial Health Officer (PHO)/ City Health Officer (CHO)/ District Health Officer - Municipal Health Officer (MHO) - 🖊️ More often, they only perform post-mortem examinations - **Medical officers of Law Enforcement Agencies** - PNP Crime Lab. MELO - NBI MELO - **Members of the Medical Staff of Accredited Hospitals** - Resident Pathologists - 🖊️ There is no Commission on Human Rights Doctor, there is no Department of Justice MELO. Those who are conducting autopsies that do not belong to this group of people are already violating P.D. 856, Sec. 95, Code of Sanitation. \*P.D. (Presidential Decree) \*MELO (Medico-legal officer) WHEN SHALL AUTOPSY BE PERFORMED ON A DEAD BODY {#when-shall-autopsy-be-performed-on-a-dead-body.TransOutline} ============================================== - Whenever required by **special laws** - Upon order of a **competent court, a mayor and a provincial or city fiscal** - Upon written request of **police authorities** - 🖊️ When you see SOCO arriving in a crime scene with a suspected death, that is coming from the request of police authorities. - Whenever the **Solicitor General**, Provincial or city fiscal as authorized by existing laws, shall deem it necessary to dissenter and take possession of the remains for examination to determine the cause of death - 🖊️ When you have an OCW (Overseas contract worker) that was suspected to have died from unknown causes in a different country, and immediately they are buried in the hometown or provinces, the solicitor general or provincial city fiscal may authorize the medico-legal officer to exhume the body and do an autopsy to determine the cause of death. - Whenever the **nearest kin** shall request in writing the authorities concerned in order to ascertain the cause of death. - 🖊️ In cases of alleged suicide the nearest kin may request any law enforcement agency just to ascertain the cause of death MISTAKES IN AUTOPSIES {#mistakes-in-autopsies.TransOutline} ===================== - Error or Omission in the **collection of evidence** for identification - 🖊️ Omitted taking photograph of the corpse - Checking for evidence of identification - Doing fingerprint identification - Dental identification - Collecting DNA sample for identification. - Error or Omission in the collection of evidence required for **establishing the time of death** - 🖊️Can be done by taking the temperature of the body as well as examining the condition of the body. If there is already rigor mortis, presence of lividity and so forth. - Errors or Omission in the **collection of evidence required for other medico-legal examination** - 🖊️Collection of blood and other body fluid for further analysis. - Errors or Omission result in the **production of undesirable artifacts or the destruction of valid evidence** - 🖊️ For example, when looking for bullets and you are not familiar with the bullet/slug, then you only recovered the bone fragments because its already enveloped by blood or other tissues, an inexperienced doctor will mistake it as a bullet or slug. - 🖊️ Metallic fragments inside the body may be lost during the conduct of autopsies. NEGLIGENT AUTOPSY {#negligent-autopsy.TransOutline} ================= - ⭐ An autopsy wherein no cause of death is found on account of imprudence, negligence, lack of skill or lack of foresight. - Failure to have an adequate history or facts and circumstances surrounding the death - Failure to make a thorough external examination - Inadequate or improper internal examination - Improper histological examinations - Lack of toxicological or other laboratory aids - Pathologists' incompetence NEGATIVE AUTOPSIES {#negative-autopsies.TransOutline} ================== - An autopsy if after all efforts, including gross and microscopic studies and toxicological analysis**, fail to reveal a cause of death.** - It is an autopsy which after a meticulous examination with the aid of other examinations does not yield any definite cause of death. GUIDE QUESTIONS {#guide-questions.TransOutline} =============== **1. What is the role of the autopsy in death investigations?** - To determine the cause, manner, and mechanism of death - To determine the extent of injuries sustained by the victim that caused the death - To determine if there was foul play involved in undetermined deaths or alleged suicides - In violent deaths, it is mandatory for an autopsy to be performed to rule out foul-play - For purposes of insurance claims **2. What is the difference between medicolegal and medical autopsies?** - Medico-legal autopsies - Seek to find the cause and manner of death and to identify the decedent. They are generally performed, as prescribed by applicable law, in cases of violent, suspicious or sudden deaths, deaths without medical assistance or during surgical procedures. - Consent of the relatives is not needed - Clinical/ Pathological autopsy - Are performed to diagnose a particular disease or for research purposes. They aim to determine, clarify, or confirm medical diagnosis that remained unknown or unclear prior to the patient\'s death. - Needs the consent of relatives **3. Who is authorized to perform autopsies?** - Health officers - (PHO)/ (CHO)/ District Health Officer - Municipal Health Officer (MHO) - Medical officers of Law Enforcement Agencies - PNP Crime Lab. MELO - NBI MELO - Members of the Medical Staff of Accredited Hospitals - Resident Pathologists **4. When is autopsy required?** - Whenever required by special laws - Upon order of competent court, a mayor and a provincial or city fiscal - Upon written request of police authorities - Whenever the Solicitor General, Provincial or city fiscal as authorized by existing laws, shall deem it necessary to dissenter and take possession of the remains for examination to determine the cause of death - Whenever the nearest kin shall request in writing the authorities concerned in order to ascertain the cause of death. **5. How is autopsy done?** - Identification of the Body - Photography - External examination - Clothing - Inspection of the body - Height - Rigor, algor, livor mortis - Physical injuries - Marks of therapy - \*Internal Examination **6. What are the ancillary tests commonly done with autopsy?** - The commonly considered autopsy ancillary investigations include: - Chemical/toxicological analysis of body viscera and fluids - Histopathological/microscopic examination of various organs. - The other ancillary investigations (not an inclusive list) include the examination of: - Blood for grouping - Viscera and blood for microbiological culture - Body fluids for postmortem chemistry (thanatochemistry) - For example, evaluation of the potassium levels in the vitreous humor is useful in estimating the time since death during an autopsy in the early postmortem period. - Vaginal swabs, anal swabs, swabs from bite marks, etc. - Stains on the skin or fabric/clothing - Material for DNA typing **7. How is an autopsy report written?** - The medical autopsy is a postmortem external and internal examination of the human body, performed with the intention of identifying or confirming cause of death and underlying diseases. In addition, the medical autopsy is of major importance for bereavement follow-up, quality assurance of clinico-medical practice, monitoring of diseases and treatments, cause of death statistics and public health monitoring, rehearsal of medical procedures, education of medical students and other types of health personnel, and for research purposes. - Minimum documentation in final report: - ID of body, date of birth, date of death, consignor (name and address), date and time of autopsy, ID nr of autopsy, name of pathologist, and autopsy technician - Legal requirements (written consent, contact with police etc.). - Purpose of autopsy/clinical question - Clinical history - Type of autopsy (complete/partial) - External examination - Internal examination, including gross description - List of sampled organs and/or lesions - Location of tissue samples taken for microscopy and their identification (block ID) - Microscopic descriptions - Ancillary studies (toxicology, bacteriology etc.) and their results - Any photographic documentation - Any retained organs, with an explanatory note about the reasons for retainment - Other types of storage (fluids, tissues, or swabs) - An addendum should contain a reference to the relevant legislation and give a general description on the storage length and timeline of destruction of biological material and remnants from the autopsy REVIEW QUESTIONS {#review-questions.TransOutline} ================ The type of autopsy performed by students of anatomy for study purpose only Anatomical autopsy Academic autopsy B only A & B +-----------------------------------------------------------------------+ | **RATIONALE** | | | | ANSWER: D. ANATOMICAL OR ACADEMIC AUTOPSY | +-----------------------------------------------------------------------+ Kind of autopsy in which consent of relatives is not needed. Clinical autopsy Virtual autopsy Forensic autopsy Psychological autopsy +-----------------------------------------------------------------------+ | **RATIONALE** | | | | ANSWER: D. FORENSIC AUTOPSY/ MEDICO-LEGAL AUTOPSY/ CORONER'S AUTOPSY | | | | - This kind of autopsy seeks to find the cause and manner of death | | and to identify the decedent. They are generally performed, as | | prescribed by applicable law, in cases of violent, suspicious or | | sudden deaths, deaths without medical assistance or during | | surgical procedures. | +-----------------------------------------------------------------------+ An autopsy in which there is no indication that the death was caused by recklessness, negligence, skill lessness, or lack of forethought. Negative autopsy Negligent autopsy AOTA NOTA +-----------------------------------------------------------------------+ | **RATIONALE** | | | | ANSWER: B. NEGLIGENT AUTOPSY | | | | - An autopsy wherein no cause of death is found on account of | | imprudence, negligence, lack of skill or lack of foresight | +-----------------------------------------------------------------------+ T/F. The En-Masse technique is the best technique for preserving the vascular supply and relationships between organs during autopsies. +-----------------------------------------------------------------------+ | **RATIONALE** | | | | ANSWER: TRUE | +-----------------------------------------------------------------------+ T/F. In the Rokitansky technique, the organs are removed one by one and dissected as removed. This approach is good for demonstrating pathological change in individual organs, especially in high-risk autopsies or where permission is limited to one organ. +-----------------------------------------------------------------------+ | **RATIONALE** | | | | ANSWER: FALSE (VIRCHOW TECHNIQUE) | | | | - Rokitansky technique or in-situ examination: This procedure is | | characterized by **in situ dissection**, in part combined with en | | bloc removal. There is removal of the notable organs. | +-----------------------------------------------------------------------+ REFERENCES {#references.TransOutline} ========== - Dr. Vladimir Villasenor's PPT and video lecture - Alfsen, G. C., Gulczyński, J., Kholová, I., Latten, B., Martinez, J., Metzger, M., Michaud, K., Pontinha, C. M., Rakislova, N., Rotman, S., Varga, Z., Wassilew, K., & Zinserling, V. (2021). Code of practice for medical autopsies: a minimum standard position paper for pathology departments performing medical (hospital) autopsies in adults. *Virchows Archiv*, *480*(3), 509--517. Retrieved August 18, 2024, from - Reference: Menezes, R. G. (2023, September 4). *Forensic autopsy*. StatPearls \[Internet\]. Retrieved August 18, 2024, from APPENDIX ======== - No Appendices A painting of a person lying on a bed Description automatically generated