Info

Synonym Dissecting aortic aneurysm dissecting aortic hematoma. Record and photograph abnormal features (see right-hand column). Prepare chest roentgenogram. Record appearance and volume of contents. Remove heart and major arteries attached to intact aorta. Open aorta along posterior midline. Photograph intimal tears and record their location and size. Record external rupture site, if possible, and extent of mediastinal or retroperitoneal hemorrhage. Record location and volume of blood in false...

And Removal Of Bone Specimens

Routine preparation of gross and microscopic bone specimens can be carried out only on a limited scale. However, portions of rib with costochondral junction, sternum, vertebral body, or iliac crest, and sternoclavicular joint should be removed and permanently saved in every autopsy. Specimens suggested for study in cases of metabolic or other systemic bone and joint diseases are indicated below. The site of a circumscribed neo-plastic or inflammatory bone lesion can be determined from clinical...

A

Synonyms and Related Terms Acanthocytosis Bassen-Kornzweig syndrome. NOTE Autopsies on patients with this rare genetic disease (1,2) should be considered research procedures. Possible Associated Conditions Hemolytic anemia * malabsorption syndrome.* External examination Record body weight and length. Prepare chest roentgenogram (frontal and lateral view). Blood Submit for serum lipid analysis. Brain, spinal cord, peripheral nerves 1. Case records of the Massachussetts General Hospital. Case...

Postmortem Chemical Changes in Pathological Conditionsa

Diabetes mellitus Endocrine disorders Inborn errors of metabolismc Liver diseases (See also Hepatic coma) Postmortem change unrelated to clinical disease Vitreous (decomposition pattern) Uremia Vitreous Postmortem measurements of pH values probably not reliable. For ketoacidosis, see Diabetes mellitus. High sodium (> 155 meq L) and chloride (> 135 meq L) values with moderate increase (above 40 mg dL) of urea nitrogen concentration. High glucose (> 200 mg dL or > 11.1 mmol L) and ketone...

Medicolegal Forms With Legal Analysis P-47

Within 1 h after consumption of diluted alcohol (approx 15 ) on an empty stomach, assuming body weight of 140-180 pounds (63.6-81.7 kg) reproduced from (11) with permission. ounce (about 30 mL) of whiskey or 12 oz (about 355 mL) of beer. Within 1 h after consumption of diluted alcohol (approx 15 ) on an empty stomach, assuming body weight of 140-180 pounds (63.6-81.7 kg) reproduced from (11) with permission. ounce (about 30 mL) of whiskey or 12 oz (about 355 mL) of beer. What Is the Toxicity...

Mounting Of Specimens

USE OF JARS AND PLASTIC BAGS In the past, only thick-walled glass jars were used and these still can be recommended. They are inert to fixatives and aggressive mounting fluids such as oil of wintergreen (used for cleared specimens), which dissolves plastics. However, glass jars are heavy and not always available in the desired shape and size they also break easily. Currently, acrylic resins are the material of choice. Excellent optical properties, low weight, minimal breakability, and chemical...

Quantitative Measurements Of The Heart

HEART WEIGHT Total heart weight is the most reliable single measurement at autopsy for correlation with cardiac disease states (7). The assessment must take into account the size of the patient. Other described measurements such as linear external dimensions, surface areas, and volume of the entire heart or myocardium (7) are less useful than the total heart weight. Hearts are weighed after the parietal pericardium has been removed, the great vessels have been trimmed to about 2 cm in length,...

E

NOTE (1) Collect all tissues that appear to be infected. (2) Usually, cultures are not required, only direct examination for parasites. (3) Request Giemsa stain for parasites (p. 172). (4) Special precautions should be exercised in removing the cysts, as the contents are highly infectious (p. 146). (5) Serologic studies are available from the Center for Disease Control and Prevention, Atlanta, GA (p. 135). (6) This is not a reportable disease. If the liver is the site of involvement, prepare...

Removal Of Spinal Cord In Adults

Removal of the spinal cord has been traditionally neglected by general pathologists but can be accomplished very easily within 10-15 min by the use of an oscillating saw, as described below. This should be part of every autopsy. POSTERIOR APPROACH The body should be placed in the prone position with blocks under the shoulders. The head is rotated forward in a flexed position. Towels are placed under the face to avoid damage. A midline incision is placed over the spinous processes, muscles are...

Current Routine Autopsy Techniques

GENERAL POLICIES Autopsy techniques are learned from a preceptor in the autopsy room. This time-honored method still is integrated in the training of all anatomic pathologists and therefore, printed or audiovisual teaching aids, referenced in the earlier editions of this book, have played no appreciable role. Thus, a detailed description of autopsy techniques is beyond the scope of this book. Nevertheless, some recent guidelines may be helpful (2,4,5). Pathologists generally achieve the best...

Removal Of Brain In Adults

Coronal Mastoid Incision

INCISION OF SCALP The head is elevated slightly with a wooden block or a metal headrest attached to the autopsy table. The hair is parted with a comb along an imaginary coronal plane connecting one mastoid with the other over the convexity Fig. 6-1 . A sharp scalpel blade can then be used to cut through the whole thickness of the scalp from the outside. The incision should start on the right side of the head the viewing-side in most American funeral parlors just behind the ear-lobe, as low as...

Kaiserlings Solutions

Kaiserling I 85 g potassium acetate, 45 g potassium nitrate KNO3 , 4,800 mL formalin solution 3-4 . b.Kaiserling II ethyl alcohol, 80-95 . c. Kaiserling III 200 g potassium acetate, 300 mL glycerin, 900 mL tap water. 2. Procedure. Fix specimen for 1-5 d in Kaiserling I. Fixation time will vary with the thickness of the organ. Excessive perfusion with Kaiserling I solution causes loss of natural color because too much blood is rinsed out. Transfer to Kaiserling II for a few hours. Acid...

Carnoys Fixative

Preservation of nuclei and other structures rich in nucleic acids, protein sulfhydryl groups, and gly-cogen. 2. Composition. 640 mL absolute ethyl alcohol, 120 mL chloroform, 40 mL glacial 99.7 acetic acid. 3. Procedure. Slices up to 1.5 cm in thickness can be fixed. The fixation time will vary from 2-20 h. Transfer into absolute ethyl alcohol. 4. Storage. Fixed tissue should be stored in cedar oil reagent grade or USP or lightweight liquid petrolatum. Formalin Solutions...

Dissection Methods Of The Heart

Left Ventricular Hypertrophy Dissection

Many older methods 7 are impractical for routine diagnostic pathology. Only the inflow-outflow and short axis bread slice methods have withstood the test of time the latter technique is applicable to virtually any form of heart disease. In addition, some recently described methods are useful for teaching purposes and correlations with current cardiac imaging 8-14 . INFLOW-OUTFLOW METHOD OF CARDIAC DISSECTION This technique is suitable primarily for normal hearts. For each side of the heart, the...

Dissection Of Brain And Spinal Cord

Brain weight in the fresh and fixed state should be recorded. It is not necessary to use a very large knife to dissect the brain. We prefer a single-blade autopsy knife about 25 cm long and 2 cm wide. DISSECTION OF FRESH BRAIN IN ADULTS The most exacting examination of brain in terms of recognition of lesions and correlation of their topography with clinical symptoms and images generated by computerized trans-axial tomography CT or magnetic resonance imaging MRI techniques can be achieved only...

Special Autopsy Techniques

POSTOPERATIVE AUTOPSIES Few autopsies present more difficulties because the pathologist is rarely familiar with all operative techniques that may have been used, the complications that were encountered, including anesthesia-related and drug-induced mishaps, and the postoperative events that may completely obscure the immediate surgical results. Possible medicolegal implications must be considered also 16 . The following general guidelines should be observed. 1. In any team, the most experienced...