Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
In this Article
- Autopsy facts
- What is an autopsy?
- Who determines whether an autopsy is performed?
- How is an autopsy performed?
- What other special studies may be done as part of the autopsy?
- What is the autopsy report?
- Why is the autopsy rate declining?
- What are the benefits of autopsies?
- Who pays for autopsies?
- What is the history of the autopsy?
- Should the autopsy be revived?
How is an autopsy performed?
The extent of an autopsy can vary from the examination of a single organ such as the heart or brain, to a very extensive examination. Examination of the chest, abdomen, and brain is probably considered by most pathologists as the standard scope of the autopsy.
The autopsy begins with a complete external examination. The weight and height of the body are recorded, and identifying marks such as scars and tattoos also are recorded.
The internal examination begins with the creation of a Y or U- shaped incision from both shoulders joining over the sternum and continuing down to the pubic bone. The skin and underlying tissues are then separated to expose the rib cage and abdominal cavity. The front of the rib cage is removed to expose the neck and chest organs. This opening allows the trachea (windpipe), thyroid gland, parathyroid glands, esophagus, heart, thoracic aorta and lungs to be removed. Following removal of the neck and chest organs, the abdominal organs are cut (dissected) free. These include the intestines, liver, gallbladder and bile duct system, pancreas, spleen, adrenal glands, kidneys, ureters, urinary bladder, abdominal aorta, and reproductive organs.
To remove the brain, an incision is made in the back of the skull from one ear to the other. The scalp is cut and separated from the underlying skull and pulled forward. The top of the skull is removed using a vibrating saw. The entire brain is then gently lifted out of the cranial vault. The spinal cord may also be taken by removing the anterior or posterior portion of the spinal column.
The organs are first examined by the pathologist to note any changes visible with the naked eye. Examples of diseases that may produce changes readily recognizable in the organs include atherosclerosis, cirrhosis of the liver, and coronary artery disease in the heart.
After the organs are removed from the body, they usually are separated from each other and further dissected to reveal any abnormalities, such as tumors, on the inside. Small samples are typically taken from all organs to be made into slide preparations for examination under a microscope. At the end of an autopsy, the incisions made in the body are sewn closed. The organs may be returned to the body or may be retained for teaching, research, and diagnostic purposes. Performance of an autopsy does not interfere with an open casket funeral service, as none of the incisions made in order to accomplish the autopsy are apparent after embalming and dressing of the body by the mortician.
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