2.

PATHOLOGICAL, HOSPITAL OR CLINICAL:

Done by pathologists to diagnose the cause of death or to
confirm a diagnosis. Physicians cannot order these
autopsies without the consent signed by the next of kin.
3. MEDICO-LEGAL:
Type of scientific examination of a dead body carried out
under the laws of the State for the protection of rights of
citizens. The basic purpose of this autopsy is to establish
the cause and manner of death.
• It is said the only thing worse than no autopsy is a partial
autopsy. In every case, the autopsy must be complete, i.e. all
the body cavities should be opened, and every organ must be
examined. Partial autopsies have no place in forensic pathologic
practice.
• The autopsy should be carried out by the registered medical
practitioner, preferably with training in forensic medicine. The
doctor should remove the organs himself. The attendant should
prepare the body and help the doctor where required, such as
sawing the skull cap, reconstructing the body, etc. As the
autopsy is proceeded with, details of the examination should be
taken down verbatim by an assistant.
• The person responsible for handling, moving and cleaning the
body is often called a diener (German, servant).
• Autopsy (Greek autos—self, opis—view)—to see for oneself;
also called necropsy (Greek necros—dead, opis—view) or
postmortem examination (post—after, mortem—death).
• Virtopsy (combination of 'virtual' and 'autopsy') is a bloodless
and minimally invasive procedure to examine a body for
cause of death. It utilizes imaging techniques (CT and MRI),
photogrammetry and 3-D optical measuring techniques to
get a reliable, accurate geometric presentation of all findings
(the body surface as well as the interior).
• Psychological autopsy is an investigative procedure of
reconstructing a person's state of mind prior to death. This is
based upon information gathered from personal documents,
police and medical records and interviews with survivors of
the deceased-families, friends and others who had contact
with the person. The typical case is one which there is some
doubt as to whether death was accidental, self-inflicted or
malicious, and whether the deceased played an active role in
his or her own demise. Such matters can be especially
important in life insurance claims that are void if death was
suicidal.
5. In case of fatal wounding, to determine the volitional activity
possible after such trauma and survival time.
6. To determine approximate time of death, age of injuries and
place of death.
7. In case of newborns, to determine the question of live birth
and viability of the baby.
8. In case of mutilated or skeletal remains, to determine if they
are human and if human, whether they belong to one or more
than one person, the probable cause of death and
approximate time since death.
6. It should be performed as soon as possible after receiving the
requisition, without undue delay. The requisition is
accompanied with a copy of the inquest or the preliminary
investigation report, a dead-body challan which includes the
name, age, sex, identification marks and religion of the
deceased, apparent cause of death and any other paper of
importance. Before starting the autopsy, the doctor should go
through the inquest report and the requisition thoroughly and
put his signature on all the papers after marking them serially.
7. The autopsy should be conducted in daylight because color
changes, such as jaundice, changes in bruises and postmortem
staining cannot be appreciated in the artificial light.
8. Sometimes, if the body is received in the mortuary at night, it
is preserved at 4°C after a preliminary examination is done to
note external appearances, body temperature, extent of
postmortem staining and rigor mortis. The actual postmortem
is conducted on the next day.
9. Identification: A police officer or any other authorized person
and two relatives should identify the dead body, in front of
the autopsy surgeon. The names of those who identify the
body must be recorded. In unidentified bodies, the marks of
identification, race, religion, sex, age, dental formula,
photographs and fingerprints should be taken.
10. Medico-legal autopsy does not require any consent from the
relatives of the deceased.
11. Both positive and negative findings should be recorded.
12. Nothing should be erased and all alterations should be
initialed in the report.
13. Chain of evidence: It is absolutely essential to preserve the
chain of evidence by identifying the body and maintaining
absolute control of specimens removed at autopsy.
14. List of articles: A list is made of all the articles removed from
the body, e.g. clothes, jewelry, bullets, etc. They are labeled,
sealed, mentioned in the report and handed over to the
police constable after obtaining a receipt.
15. After completion of autopsy, the body is stitched, washed and
restored to the best possible cosmetic appearance and then
handed over to the police constable/IO.
16. Visit to the scene of crime: If a visit to the scene of crime can
be arranged, it is well worth undertaking in certain cases,
such as murder, poisoning, traffic accidents, firearm injuries
and sexual offences.
• If they cannot be removed intact, they should be cut in an
area away from any bullet hole or cuts, along the seam of the
garment.
• After autopsy, wet clothing should be sun-dried, packed,
sealed in paper bags and handed over to the police.
2.The whole surface of the body should be carefully examined
before and after washing from head to foot, and back and
front, and the details noted.
3.Body length, weight, sex, race, head hair, eyes, dentition,
general state, built, development and nourishment is noted. It
should include all surgical procedures, dressings and other
diagnostic and therapeutic measures.
5. Face: Cyanosis, petechial hemorrhages, pallor, protrusion or
biting of the tongue, state of lips, gums, teeth, marks of
corrosion and injuries inside the lips and cheeks.
6. Eyes: Condition of the eyelids, conjunctivae, softening of the
eyeball, color of sclera, state and color of pupils, contact
lenses, petechiae, opacity of the cornea, lens and artificial
eyes (which may contribute in road traffic accidents).
7. Natural orifices, i.e. nose, mouth, ears, urethra, vagina and
anus should be observed for any discharges, injuries and
foreign body. Leakage of blood or CSF from ears, mouth or
nostrils is noted. Samples of discharges should be taken on
swabs or smears prepared on slides.
8. Neck: Bruises, fingernail abrasions, ligature marks or any
other abnormalities.
9. Thorax: Symmetry, general outline, injuries.
10. Abdomen: Presence or absence of distension or retraction,
striae gravidarum.
11. Back: Bedsores, spinal deformity, injuries.
12. External genitalia: General development, edema, local
infection, position of testes.
13. Hands: Injuries, defense wounds, electric marks, and in
clenched hands, if anything is grasped.
14. Fingernails: Presence of tissue, blood, dust or other foreign
matter, may be indicative of struggle.
15. Limbs and other parts: Fracture and dislocation.
9. Vital reaction.
10. Collect foreign materials, e.g. hair, grass, fibres, etc.
11. If the injuries are obscured by hair, it should be shaved.
12. Deep or penetrating wounds should not be probed until the
body is opened.
• In burns, their character, position, body surface area involved
and degree should be mentioned.
• Concealed punctured wounds, bruising of frenulum of lips and
injection marks should be searched for, if indicated.
• The use of printed body sketches is very useful. The position of
the injuries should be pictographically depicted on the skeleton
diagrams.
• Photographic documentation of major injuries is now
considered as standard practice. Identifying markers bearing the
unique autopsy number, with a measurement scale should be
included to ensure that the photos correspond to the specific
case.
• Special procedures utilized during external examination include
photography for the purposes of identification and
documentation. Infrared and UV photography will enhance
trace materials, tattoos, bruises and patterned injuries.
• High contrast black-white photography or computer directed
image enhancement can be used to enhance patterned injuries.
• Radiological examination assists in identification, locating
foreign objects such as projectiles and documenting old and
recent bony injury.