color atlas of autopsy.pdf

AUTOPSYTH

ECOLOR ATLAS OF

CRC PR ESSBoca Raton London New York Washington, D.C.

AUTOPSYScott A. Wagner

TH

ECOLOR ATLAS OF

This edition published in the Taylor & Francis e-Library, 2005.

“To purchase your own copy of this or any of Taylor & Francis or Routledge’scollection of thousands of eBooks please go to www.eBookstore.tandf.co.uk.”

ISBN 0-203-49438-5 Master e-book ISBN

ISBN 0-203-58667-0 (Adobe eReader Format)

Preface

Acknowledgments

About the Author

Introduction

Contents

1

1 Approach to the Autopsy: Purpose and Philosophy

WHAT IS AN AUTOPSY?

TYPES OF AUTOPSIES: HOSPITAL AND MEDICAL–LEGAL

2 Color Atlas of the Autopsy

WHAT IS THE PURPOSE OF THE AUTOPSY?

CASES THAT USUALLY REQUIRE AN AUTOPSY

Approach to the Autopsy: Purpose and Philosophy 3

NATURAL DEATHSUNNATURAL DEATHS

Homicides

4 Color Atlas of the Autopsy

Suicides

Accidents

THE AUTOPSY: ASSEMBLING A PUZZLE

Approach to the Autopsy: Purpose and Philosophy 5

WHAT IS A FORENSIC PATHOLOGIST?

7

2 Circumstantial and Medical History

IDENTIFY THE PROBLEM AND “CHIEF COMPLAINT”

IDENTIFICATION OF THE BODY

DIRECT IDENTIFICATION BY FAMILY MEMBERS

PERSONAL FEATURES

8 Color Atlas of the Autopsy

OBJECTS IN THE BODY

HIGHER-ORDER IDENTIFICATION

Fingerprints

Dental Identification

Deoxyribonucleic Acid

INVESTIGATIVE QUESTIONS

BASIC DEMOGRAPHIC QUESTIONS

QUESTION OF OCCUPATION

QUESTION OF MEDICAL HISTORY

Circumstantial and Medical History 9

QUESTION OF MEDICATIONS

QUESTION OF MENTAL HEALTH HISTORY

QUESTION OF ILLICIT DRUG USE

QUESTION OF ETHANOL USE

QUESTION OF HISTORY WITH LAW ENFORCEMENT OR INCARCERATION

OTHER INVESTIGATIVE QUESTIONS

10 Color Atlas of the Autopsy

FIGURE 2.1

FIGURE 2.2

FIGURE 2.3

FIGURE 2.4

Circumstantial and Medical History 11

FIGURE 2.5

FIGURE 2.6

FIGURE 2.7

12 Color Atlas of the Autopsy

FIGURE 2.8

FIGURE 2.9FIGURE 2.10

Circumstantial and Medical History 13

FIGURE 2.11

FIGURE 2.12

FIGURE 2.13

15

3 External Examination:The Preliminary Examination

SUITING UP: UNIVERSAL PRECAUTIONS

OPENING THE BODY BAG

CLOTHING AND VALUABLES

16 Color Atlas of the Autopsy

BODY STORAGE

TRACE EVIDENCE

FOUR SIGNS OF DEATH

RIGOR MORTIS

ALGOR MORTIS

LIVOR MORTIS

External Examination: The Preliminary Examination 17

DECOMPOSITION

FOCUS ON WHAT IS NOT OBVIOUS

DOCUMENTING TRAUMATIC INJURIES: DIAGRAMS AND DESCRIPTIONS

18 Color Atlas of the Autopsy

RADIOLOGY AND IMAGING

PHOTOGRAPHY AND VIDEO AS DOCUMENTATION TOOLS

SCARS, TATTOOS, AND OTHER UNIQUE MARKS

External Examination: The Preliminary Examination 19

ARTIFACTS OF MEDICAL INTERVENTION

20 Color Atlas of the Autopsy

FIGURE 3.1

FIGURE 3.2

FIGURE 3.3

External Examination: The Preliminary Examination 21

FIGURE 3.4

FIGURE 3.5

FIGURE 3.6

22 Color Atlas of the Autopsy

FIGURE 3.7

FIGURE 3.8

FIGURE 3.9

External Examination: The Preliminary Examination 23

FIGURE 3.10

FIGURE 3.11

FIGURE 3.12

24 Color Atlas of the Autopsy

FIGURE 3.13

External Examination: The Preliminary Examination 25

FIGURE 3.14

A

FIGURE 3.15

BB

26 Color Atlas of the Autopsy

FIGURE 3.16FIGURE 3.17

FIGURE 3.18

FIGURE 3.19

External Examination: The Preliminary Examination 27

FIGURE 3.20

FIGURE 3.21

FIGURE 3.22

FIGURE 3.23

28 Color Atlas of the Autopsy

FIGURE 3.26

FIGURE 3.25

FIGURE 3.24

FIGURE 3.27

External Examination: The Preliminary Examination 29

FIGURE 3.28

FIGURE 3.29

FIGURE 3.30

FIGURE 3.31

30 Color Atlas of the Autopsy

FIGURE 3.32 FIGURE 3.33

FIGURE 3.34

FIGURE 3.35

External Examination: The Preliminary Examination 31

FIGURE 3.36

FIGURE 3.37

32 Color Atlas of the Autopsy

FIGURE 3.38

FIGURE 3.39

FIGURE 3.40

External Examination: The Preliminary Examination 33

FIGURE 3.41FIGURE 3.42

FIGURE 3.43

34 Color Atlas of the Autopsy

FIGURE 3.44

FIGURE 3.45

FIGURE 3.46

External Examination: The Preliminary Examination 35

FIGURE 3.47

A

FIGURE 3.48

B

37

4 External Examination: Specific Injuries

FORENSIC INJURIES AND DEFINITIONS

BLUNT FORCE INJURIES

Laceration

Abrasion

Contusion

Avulsion

38 Color Atlas of the Autopsy

SHARP FORCE INJURIES

Stab Wounds

Incised Wounds

Defense Wounds

Puncture Wounds

Chopping Wounds

Gunshot Wounds

External Examination: Specific Injuries 39

40 Color Atlas of the Autopsy

AFIGURE 4.1

B

FIGURE 4.2

External Examination: Specific Injuries 41

FIGURE 4.3

FIGURE 4.4

42 Color Atlas of the Autopsy

FIGURE 4.5

FIGURE 4.6

External Examination: Specific Injuries 43

FIGURE 4.7

FIGURE 4.8

44 Color Atlas of the Autopsy

FIGURE 4.9

FIGURE 4.10 FIGURE 4.11

External Examination: Specific Injuries 45

FIGURE 4.12

FIGURE 4.13

FIGURE 4.14

46 Color Atlas of the Autopsy

FIGURE 4.15

External Examination: Specific Injuries 47

FIGURE 4.17

FIGURE 4.16

48 Color Atlas of the Autopsy

FIGURE 4.19

FIGURE 4.18

External Examination: Specific Injuries 49

FIGURE 4.21

FIGURE 4.20

51

5 External Examination: Specific Body Areas

OVERALL “GESTALT”

SKIN

HAIR

SCALP

FACE

EYES

52 Color Atlas of the Autopsy

NOSE

MOUTH

NECK

CHEST

BREASTS

ABDOMEN

EXTREMITIES, HANDS, FINGERS, NAILS

BACK

External Examination: Specific Body Areas 53

GENITALIA

RECTUM/ANUS

54 Color Atlas of the Autopsy

FIGURE 5.1

External Examination: Specific Body Areas 55

FIGURE 5.2

FIGURE 5.3FIGURE 5.4

56 Color Atlas of the Autopsy

FIGURE 5.5

FIGURE 5.6

External Examination: Specific Body Areas 57

FIGURE 5.7

FIGURE 5.8

FIGURE 5.9

58 Color Atlas of the Autopsy

FIGURE 5.10

External Examination: Specific Body Areas 59

FIGURE 5.11

60 Color Atlas of the Autopsy

FIGURE 5.12

External Examination: Specific Body Areas 61

FIGURE 5.13

62 Color Atlas of the Autopsy

FIGURE 5.14

External Examination: Specific Body Areas 63

A B

FIGURE 5.15

64 Color Atlas of the Autopsy

A

B

FIGURE 5.16

External Examination: Specific Body Areas 65

A

FIGURE 5.17

FIGURE 5.18

67

6 Internal Examination: Opening of Body Cavities and Initial Assessment

68 Color Atlas of the Autopsy

DISSECTION OF THE SKIN AND OPENING OF THE CHEST AND ABDOMEN

FIGURE 6.1

FIGURE 6.2

Internal Examination: Opening of Body Cavities and Initial Assessment 69

B

C

FIGURE 6.2 (CONTINUED)

70 Color Atlas of the Autopsy

A

FIGURE 6.4

FIGURE 6.3

Internal Examination: Opening of Body Cavities and Initial Assessment 71

B

C

FIGURE 6.4 (CONTINUED)

72 Color Atlas of the Autopsy

FIGURE 6.5

A

FIGURE 6.6

Internal Examination: Opening of Body Cavities and Initial Assessment 73

C

B

FIGURE 6.6 (CONTINUED)

74 Color Atlas of the Autopsy

FIGURE 6.7

FIGURE 6.8

Internal Examination: Opening of Body Cavities and Initial Assessment 75

FIGURE 6.9

FIGURE 6.10

76 Color Atlas of the Autopsy

C

FIGURE 6.10 (CONTINUED)

Internal Examination: Opening of Body Cavities and Initial Assessment 77

FIGURE 6.11

78 Color Atlas of the Autopsy

FIGURE 6.11 (CONTINUED)

Internal Examination: Opening of Body Cavities and Initial Assessment 79

SURVEY OF CHEST TISSUES AND ORGANS

FIGURE 6.12

FIGURE 6.13

80 Color Atlas of the Autopsy

FIGURE 6.14

FIGURE 6.15

Internal Examination: Opening of Body Cavities and Initial Assessment 81

FIGURE 6.16

82 Color Atlas of the Autopsy

FIGURE 6.17

FIGURE 6.18

Internal Examination: Opening of Body Cavities and Initial Assessment 83

FIGURE 6.19

FIGURE 6.20

84 Color Atlas of the Autopsy

FIGURE 6.21

Internal Examination: Opening of Body Cavities and Initial Assessment 85

FIGURE 6.22 FIGURE 6.23

FIGURE 6.24

86 Color Atlas of the Autopsy

FIGURE 6.25

Internal Examination: Opening of Body Cavities and Initial Assessment 87

SURVEY OF ABDOMINAL ORGANS

FIGURE 6.26

88 Color Atlas of the Autopsy

FIGURE 6.27

FIGURE 6.28

Internal Examination: Opening of Body Cavities and Initial Assessment 89

FIGURE 6.29

FIGURE 6.30

90 Color Atlas of the Autopsy

FIGURE 6.31

Internal Examination: Opening of Body Cavities and Initial Assessment 91

FIGURE 6.32

FIGURE 6.33

92 Color Atlas of the Autopsy

FIGURE 6.34

Internal Examination: Opening of Body Cavities and Initial Assessment 93

FIGURE 6.35

94 Color Atlas of the Autopsy

FIGURE 6.36

Internal Examination: Opening of Body Cavities and Initial Assessment 95

COLLECTING BLOOD, URINE, BILE, AND VITREOUS SPECIMENS FOR TOXICOLOGY

FIGURE 6.37

96 Color Atlas of the Autopsy

FIGURE 6.38

FIGURE 6.39

Internal Examination: Opening of Body Cavities and Initial Assessment 97

FIGURE 6.40

99

7 Organ and Tissue Removal

100 Color Atlas of the Autopsy

HEART EXCISION

FIGURE 7.1

Organ and Tissue Removal 101

FIGURE 7.2

FIGURE 7.3

102 Color Atlas of the Autopsy

FIGURE 7.4

Organ and Tissue Removal 103

LUNG EXCISION

FIGURE 7.5

104 Color Atlas of the Autopsy

FIGURE 7.6

Organ and Tissue Removal 105

FIGURE 7.7

FIGURE 7.8

106 Color Atlas of the Autopsy

LIVER EXCISION

FIGURE 7.9

FIGURE 7.10

Organ and Tissue Removal 107

FIGURE 7.11

108 Color Atlas of the Autopsy

FIGURE 7.11 (CONTINUED)

Organ and Tissue Removal 109

FIGURE 7.12

110 Color Atlas of the Autopsy

FIGURE 7.13

Organ and Tissue Removal 111

SPLEEN EXCISION

FIGURE 7.14

112 Color Atlas of the Autopsy

FIGURE 7.15

Organ and Tissue Removal 113

SMALL AND LARGE BOWEL EXCISION

FIGURE 7.16

114 Color Atlas of the Autopsy

FIGURE 7.17

Organ and Tissue Removal 115

FIGURE 7.18

116 Color Atlas of the Autopsy

FIGURE 7.19

Organ and Tissue Removal 117

FIGURE 7.20

118 Color Atlas of the Autopsy

FIGURE 7.21

Organ and Tissue Removal 119

FIGURE 7.22

120 Color Atlas of the Autopsy

FIGURE 7.23

Organ and Tissue Removal 121

FIGURE 7.24

122 Color Atlas of the Autopsy

FIGURE 7.25

FIGURE 7.26

Organ and Tissue Removal 123

ADRENAL GLAND AND KIDNEY REMOVAL

FIGURE 7.27

124 Color Atlas of the Autopsy

FIGURE 7.28

FIGURE 7.30

FIGURE 7.29

Organ and Tissue Removal 125

FIGURE 7.31

126 Color Atlas of the Autopsy

FIGURE 7.32

FIGURE 7.33

Organ and Tissue Removal 127

FIGURE 7.34

128 Color Atlas of the Autopsy

FIGURE 7.35

Organ and Tissue Removal 129

FIGURE 7.36

130 Color Atlas of the Autopsy

FIGURE 7.37

FIGURE 7.38

Organ and Tissue Removal 131

AORTA EXAMINATION

FIGURE 7.39

132 Color Atlas of the Autopsy

FIGURE 7.39 (CONTINUED)

Organ and Tissue Removal 133

FIGURE 7.40

134 Color Atlas of the Autopsy

FIGURE 7.41

FIGURE 7.42

Organ and Tissue Removal 135

FIGURE 7.43

FIGURE 7.44

136 Color Atlas of the Autopsy

FIGURE 7.45

Organ and Tissue Removal 137

UTERUS REMOVAL

FIGURE 7.46

138 Color Atlas of the Autopsy

BLADDER REMOVAL

FIGURE 7.47

Organ and Tissue Removal 139

FIGURE 7.47 (CONTINUED)

140 Color Atlas of the Autopsy

NECK DISSECTION

FIGURE 7.48

Organ and Tissue Removal 141

FIGURE 7.49

FIGURE 7.50

142 Color Atlas of the Autopsy

FIGURE 7.51

Organ and Tissue Removal 143

FIGURE 7.52

FIGURE 7.53

144 Color Atlas of the Autopsy

FIGURE 7.54

Organ and Tissue Removal 145

FIGURE 7.55

FIGURE 7.56

147

8 Individual Organ Examination

148 Color Atlas of the Autopsy

HEART

FIGURE 8.1

FIGURE 8.2

Individual Organ Examination 149

FIGURE 8.3

FIGURE 8.4

150 Color Atlas of the Autopsy

FIGURE 8.5

Individual Organ Examination 151

FIGURE 8.6

FIGURE 8.7

152 Color Atlas of the Autopsy

FIGURE 8.8

FIGURE 8.10

FIGURE 8.9

Individual Organ Examination 153

FIGURE 8.11

FIGURE 8.12

154 Color Atlas of the Autopsy

A

FIGURE 8.13

Individual Organ Examination 155

FIGURE 8.14

FIGURE 8.15

156 Color Atlas of the Autopsy

FIGURE 8.16

Individual Organ Examination 157

FIGURE 8.17

FIGURE 8.18

158 Color Atlas of the Autopsy

FIGURE 8.19

FIGURE 8.20

Individual Organ Examination 159

FIGURE 8.21

160 Color Atlas of the Autopsy

FIGURE 8.22

FIGURE 8.23

Individual Organ Examination 161

FIGURE 8.24

FIGURE 8.25 FIGURE 8.26

162 Color Atlas of the Autopsy

FIGURE 8.27

Individual Organ Examination 163

LUNG

FIGURE 8.28

164 Color Atlas of the Autopsy

FIGURE 8.29

Individual Organ Examination 165

FIGURE 8.30

166 Color Atlas of the Autopsy

FIGURE 8.31

Individual Organ Examination 167

FIGURE 8.33

FIGURE 8.32

168 Color Atlas of the Autopsy

FIGURE 8.34

FIGURE 8.36

FIGURE 8.35

Individual Organ Examination 169

FIGURE 8.37

FIGURE 8.38

170 Color Atlas of the Autopsy

FIGURE 8.39

Individual Organ Examination 171

FIGURE 8.40

FIGURE 8.41

172 Color Atlas of the Autopsy

FIGURE 8.43

FIGURE 8.42

Individual Organ Examination 173

NECK ORGANS: EPIGLOTTIS, VOCAL CORDS, TRACHEA, THYROID, CARTILAGE, STRAP MUSCLES, HYOID BONE

FIGURE 8.44

174 Color Atlas of the Autopsy

FIGURE 8.45

Individual Organ Examination 175

FIGURE 8.46

176 Color Atlas of the Autopsy

FIGURE 8.47

FIGURE 8.48

Individual Organ Examination 177

FIGURE 8.49

FIGURE 8.50

178 Color Atlas of the Autopsy

FIGURE 8.51

FIGURE 8.52

Individual Organ Examination 179

FIGURE 8.53

FIGURE 8.54

180 Color Atlas of the Autopsy

FIGURE 8.55

Individual Organ Examination 181

FIGURE 8.56

182 Color Atlas of the Autopsy

FIGURE 8.57

Individual Organ Examination 183

LIVER

FIGURE 8.58

FIGURE 8.59

FIGURE 8.60

184 Color Atlas of the Autopsy

FIGURE 8.61

FIGURE 8.62

Individual Organ Examination 185

FIGURE 8.63

186 Color Atlas of the Autopsy

FIGURE 8.64

Individual Organ Examination 187

FIGURE 8.65

188 Color Atlas of the Autopsy

SPLEEN

FIGURE 8.66

FIGURE 8.67

Individual Organ Examination 189

FIGURE 8.68

190 Color Atlas of the Autopsy

URINARY TRACT: KIDNEYS, BLADDER, URETER, PROSTATE

FIGURE 8.69

FIGURE 8.70

Individual Organ Examination 191

FIGURE 8.71

FIGURE 8.72

192 Color Atlas of the Autopsy

FIGURE 8.73

FIGURE 8.74

Individual Organ Examination 193

FIGURE 8.75

194 Color Atlas of the Autopsy

FIGURE 8.77

FIGURE 8.76

Individual Organ Examination 195

FIGURE 8.78

196 Color Atlas of the Autopsy

FIGURE 8.79

FIGURE 8.80

Individual Organ Examination 197

ESOPHAGUS AND STOMACH

FIGURE 8.81

FIGURE 8.82

198 Color Atlas of the Autopsy

FIGURE 8.83

Individual Organ Examination 199

FIGURE 8.84

FIGURE 8.85

200 Color Atlas of the Autopsy

UTERUS AND OVARIES

FIGURE 8.86

FIGURE 8.87

FIGURE 8.88

Individual Organ Examination 201

FIGURE 8.89

202 Color Atlas of the Autopsy

FIGURE 8.90

203

9 Examination of the Head, Skull, Brain, and Spinal Cord

204 Color Atlas of the Autopsy

SCALP EXAMINATION AND EXCISION OF THE BRAIN

FIGURE 9.1

Examination of the Head, Skull, Brain, and Spinal Cord 205

FIGURE 9.2

206 Color Atlas of the Autopsy

FIGURE 9.3

Examination of the Head, Skull, Brain, and Spinal Cord 207

FIGURE 9.4

FIGURE 9.5

208 Color Atlas of the Autopsy

FIGURE 9.6

Examination of the Head, Skull, Brain, and Spinal Cord 209

FIGURE 9.7

210 Color Atlas of the Autopsy

FIGURE 9.8

FIGURE 9.9

Examination of the Head, Skull, Brain, and Spinal Cord 211

FIGURE 9.10

FIGURE 9.11

212 Color Atlas of the Autopsy

FIGURE 9.12

FIGURE 9.13

Examination of the Head, Skull, Brain, and Spinal Cord 213

FIGURE 9.14

FIGURE 9.16

FIGURE 9.15

214 Color Atlas of the Autopsy

FIGURE 9.17

FIGURE 9.18

Examination of the Head, Skull, Brain, and Spinal Cord 215

FIGURE 9.19

FIGURE 9.20

216 Color Atlas of the Autopsy

FIGURE 9.21

FIGURE 9.22

Examination of the Head, Skull, Brain, and Spinal Cord 217

FIGURE 9.23

218 Color Atlas of the Autopsy

FIGURE 9.24

FIGURE 9.25

Examination of the Head, Skull, Brain, and Spinal Cord 219

FIGURE 9.26

221

10 Microscopic Examination

222 Color Atlas of the Autopsy

FIGURE 10.1

FIGURE 10.2

Microscopic Examination 223

FIGURE 10.3

A

FIGURE 10.4

B

B

224 Color Atlas of the Autopsy

FIGURE 10.5

FIGURE 10.7 FIGURE 10.8

FIGURE 10.6

Microscopic Examination 225

FIGURE 10.9

FIGURE 10.11

BB

FIGURE 10.10

226 Color Atlas of the Autopsy

FIGURE 10.12

FIGURE 10.14 FIGURE 10.15

FIGURE 10.13

Microscopic Examination 227

FIGURE 10.16

FIGURE 10.18

FIGURE 10.19

FIGURE 10.17

228 Color Atlas of the Autopsy

FIGURE 10.20

FIGURE 10.22 FIGURE 10.23

FIGURE 10.21

229

11 Postmortem Laboratory Analysis of Drugs, Chemicals, and Microorganisms

THE SCENE AND THE BODY

230 Color Atlas of the Autopsy

SPECIMENS TO OBTAIN AT AUTOPSY

BLOOD

URINE

VITREOUS HUMOR

GASTRIC CONTENTS

BILE

TISSUES AND OTHER SPECIMENS

Postmortem Laboratory Analysis of Drugs, Chemicals, and Microorganisms 231

FIGURE 11.1

FIGURE 11.3

FIGURE 11.2

232 Color Atlas of the Autopsy

FIGURE 11.4

FIGURE 11.5

Postmortem Laboratory Analysis of Drugs, Chemicals, and Microorganisms 233

FIGURE 11.6

235

12 Review Questions:Putting It All Together

ANSWER THE FOLLOWING QUESTIONS. CHOOSE:

236 Color Atlas of the Autopsy

CHOOSE THE BEST ANSWER.

Review Questions: Putting It All Together 237

ANSWERS

239

References and Suggested Reading

241

Index

A

B

C

242 Color Atlas of the Autopsy

D

E

F

G

H

Index 243

I

J

K

L

M

N

244 Color Atlas of the Autopsy

O

P

R

S

T

Index 245

U

V

W

Y