Transcript In Depth: Autopsy

In Depth: Autopsy Videoconference
An Introduction
& Pre-Visit Activities
Videoconference Details
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Date: Wed, April 4th, 2007
Time: 10:45 am – 12:40 pm
Place: Library
Introduction to Videoconference
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Along with students from 4 other schools,
you will be:
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Viewing a video of an autopsy recorded at The
Ohio State University Hospital Autopsy Services
Hearing live commentary with Dr. Larry R. Tate,
retired Forensic Pathologist
During the Videoconference
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You will be called upon to ask or answer
questions from Dr. Tate
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Dr. Tate will rotate through the schools. Be aware
of the rotation pattern. Our school will always
follow the same school.
Be at the microphone ready to speak when our
school’s turn comes.
Speak loudly and clearly (directly) into the
microphone.
Things to bring to the Videoconference
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Student guide to autopsy
Vocabulary list
Pencil to take notes
Questions to ask forensic pathologist
Overall Goal of Autopsy Program
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Students are to determine the cause of death
How?
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Complete pre-activities:
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Autopsy
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Pathology
Autopsy Plan
Organ measurements
Complete post-activities:
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Toxicology
Histology
Autopsy Report
Forensic Pathology: External Findings
Pathology Activity
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You will distinguish between healthy and
unhealthy organs
You will make observations about physical
characteristics of the organs
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Texture
Colour
Size
Autopsy Plan
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You will develop an autopsy plan in
accordance with the family wishes and based
on the medical history and case information
You will compare your plan to the
pathologist’s plan during the videoconference
Videoconference
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15 min: Dr. Tate will begin by:
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1 hour: Students will be:
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Discussing the student autopsy plans that have been submitted
Giving the results of the external exam of the deceased
Watching entire autopsy from external exam to examination of brain
Taking notes throughout entire autopsy
Listening to interviews from various professions associated with autopsies
15 min: Student questions
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Student questions will be answered in a round-robin fashion.
Please prepare at least 3 questions in advance. You may also ask questions
based on what you’ve seen in the autopsy
Dr. Tate will guide you towards a determination of cause of death, but he will
not directly answer this question.
Case
History
Autopsy Room
What is an Autopsy?
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A systematic external and internal examination of a dead body to
determine if any abnormalities are present
2 main methods:
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Prosector (person performing autopsy) will:
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Virchow Method – remove and examine organs one at a time
Rokitansky Method – remove organs (heart, liver, kidneys, urinary bladder,
prostate gland, etc.) at one block, separate and then dissect each organ
Make a Y-incision from the chest to the abdomen to examine heart, lungs and
abdominal organs
Use a Stryker saw which has a vibrating blade to cut through the bone ,
without damaging any surrounding soft tissue
Be mentally, emotionally and physically prepared to see somewhat
graphic images during autopsy
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Next 4 slides are photographs from various autopsies
Y-Incision
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First step to
open the body
cavity
Rokitansky
Method
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Organs removed as single
block
Organs will then be
separated
Each organ will be
dissected
Intermastoid Incision
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Made from behind each ear across the top of the head
Allows examination of brain
Removal of the Brain
Class Activity
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Working in groups of 4 – 5, research one of the following areas:
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Pathology Groups
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Pathology: Heart (slides 18 -21)
Pathology: Coronary artery (slides 22 – 24)
Pathology: Brain (slides 25 – 27)
Pathology: Lungs (slides 28 – 30)
Pathology: Kidneys (slides 31 – 33)
Autopsy plan
Each group has a copy of the student sheet with questions that must be answered.
Use the appropriate PowerPoint slides that follow as resources (contains images of organs
and websites)
Only study the diseases indicated on the PowerPoint slides
Develop a 5 – 10 minute PowerPoint presentation based on the information you have
collected. All presentations must include images of normal and healthy organs as well as
diseased organs so that students have pints of comparison while watching the autopsy.
Prepare a list of new vocabulary from your area of research
Autopsy Plan Group
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Follow procedure on Student sheet
Create an outline for a general autopsy
Develop criteria to decide which parts of body need to be examined during autopsy
Review patient case history.
Discuss and make notes about organs that you think might have abnormalities
Revise autopsy outline to reflect how this patient should be examined.
Discuss safety procedures.
Normal Heart
Images: Heart:
Cross section of a heart:
http://radiology.uchc.edu/eAtlas/CV/606.htm
Whole normal heart:
http://www-medlib.med.utah.edu/WebPath/CVHTML/CV001.html
Information on heart anatomy and physiology:
Gray’s Anatomy – Heart:
http://www.bartleby.com/107/138.html
Anatomy of the Human Heart:
http://www.tmc.edu/thi/anatomy.html
How Stuff Works:
http://health.howstuffworks.com/adam-200083.htm
Acute Myocardial Infarction
Dark area
shows
beginning
of healing –
increased
blood
supply
Lightcolored
tissue
indicates a
myocardial
infarction
Normal
fatty
tissue
Heart Cross Section
Old Myocardial Infarctions
Scar
tissue
from an
infarct at
least two
weeks old.
Myocardial Infarction
Images: Myocardial infarction:
Infarction as shown on a cross section of a heart (tan=infarction):
http://www-medlib.med.utah.edu/WebPath/CVHTML/CV021.html
Infarction in the left ventricular wall of the heart:
http://www-medlib.med.utah.edu/WebPath/CVHTML/CV020.html
Information on myocardial infarctions:
Medline Plus Medical Encyclopedia:
http://www.nlm.nih.gov/medlineplus/ency/article/000195.htm
MedicineNet.com:
http://www.medicinenet.com/heart_attack/article.htm
Normal Coronary Artery
Images: Coronary artery:
Microscopic image of a cross section of a coronary artery:
http://www-medlib.med.utah.edu/WebPath/CVHTML/CV004.html
Information on coronary artery anatomy and physiology:
Cleveland Clinic Heart Center:
http://www.clevelandclinic.org/heartcenter/pub/guide/disease/cad/cad_arteries.htm
Cardiovascular Consultants:
http://www.cardioconsult.com/Anatomy/
Coronary Artery Thrombosis
Thrombosis
or blood clot
Atheroscleros
is
or build up of
artery wall
Coronary Artery Disease or Atherosclerosis
Images: Coronary artery disease:
Microscopic cross section of narrowed coronary artery:
http://www-medlib.med.utah.edu/WebPath/CVHTML/CV007.html
Gross cross section of atherosclerotic coronary artery:
http://www-medlib.med.utah.edu/WebPath/CVHTML/CV108.html
Information on coronary artery disease:
Medline Plus Medical Encyclopedia:
http://www.nlm.nih.gov/medlineplus/ency/article/000171.htm
How Stuff Works:
http://health.howstuffworks.com/adam-200034.htm - Atherosclerosis
http://health.howstuffworks.com/adam-200138.htm - Coronary bypass surgery
http://health.howstuffworks.com/adam-200082.htm - Coronary artery blockage
Normal Brain
Images: Brain cross sections:
Horizontal through the top of the skull:
http://wwwmedlib.med.utah.edu/WebPath/HISTHTML/ANATOMY/VHM1080R.html
Horizontal through the midbrain:
http://wwwmedlib.med.utah.edu/WebPath/HISTHTML/ANATOMY/VHM1120R.html
Information on brain anatomy and physiology:
Gray’s Anatomy – Brain:
http://www.bartleby.com/107/189.html
How Stuff Works:
http://health.howstuffworks.com/brain.htm
Brain Stroke
Hemorrhage
Brain Cross Section (Vertical)
Brain Stroke
Images: Brain stroke:
Stroke shown on a vertical cross section of a brain:
http://www-medlib.med.utah.edu/WebPath/CNSHTML/CNS223.html
Information on brain strokes:
Medline Plus Medical Encyclopedia:
http://www.nlm.nih.gov/medlineplus/ency/article/000761.htm
National Institute of Neurological Disorders and Stroke:
http://www.ninds.nih.gov/disorders/stroke/stroke.htm
Normal Lungs
Images: Lung:
Lung cross section:
http://www.meddean.luc.edu/lumen/bbs/p/ppi2.html
Normal lungs and heart:
http://www.meddean.luc.edu/lumen/bbs/p/ppi1.html
Information on lung anatomy and physiology:
Gray’s Anatomy – Lungs:
http://www.bartleby.com/107/240.html
The Candian Lung Association:
http://www.lung.ca/copd/anatomy/normal.html
Cancerous Lung
Lung Cancer
Images: Lung cancer:
Gross cross section:
http://www-medlib.med.utah.edu/WebPath/LUNGHTML/LUNG068.html
Multiple masses:
http://www-medlib.med.utah.edu/WebPath/LUNGHTML/LUNG078.html
Quit Smoking Support (multiple types of diseased lungs pictured):
http://www.quitsmokingsupport.com/lungphotos.htm
Information on lung cancer:
Medline Plus Medical Encyclopedia:
http://www.nlm.nih.gov/medlineplus/ency/article/000122.htm
American Lung Association:
http://www.lungusa.org/site/pp.asp?c=dvLUK9O0E&b=35427
Normal Kidney
Images: Kidney cross section:
http://wwwmedlib.med.utah.edu/WebPath/RENA
HTML/RENAL116.html
Information on kidney anatomy and
physiology:
Gray’s Anatomy – Kidneys
http://www.bartleby.com/107/253.html
National Kidney and Urologic
Diseases Information Clearinghouse:
http://kidney.niddk.nih.gov/kudiseases/
pubs/yourkidneys/
Renal Cell Carcinoma
Kidney
Tumor
Renal Cell Carcinoma
Images: Renal Cell Carcinoma:
Gross cross section of a carcinoma:
http://www-medlib.med.utah.edu/WebPath/RENAHTML/RENAL053.html
Kidney with very large carcinoma:
http://www-medlib.med.utah.edu/WebPath/RENAHTML/RENAL052.html
Information on Renal Cell Carcinoma:
Medline Plus Medical Encyclopedia:
http://www.nlm.nih.gov/medlineplus/ency/article/000516.htm
Ellis Fischel Cancer Center:
http://www.ellisfischel.org/urologic/kidney.shtml