Autopsy discussion
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Date: Tue, 10 Nov 1998 18:26:58
From: Davide Mana

There's something I hope the medicine doctors on the list will help me with.

Q1: in which cases (if any) is the brain mass weighted during an authopsy?

Q2: what other organs are normally examined in a quantitative way (lenght and weight, therefore) during a routine authopsy?

[Jolly subject, what?]

I'm doing a bit of research for a fiction piece (yes, it has to do with DG), and I'd hate to be led astray by old "Quincy" episodes or Lombroso studies and the like.


Date: Mon, 9 Nov 1998 14:57:55 -0500
From: Graeme Price

There's something I hope the medicine doctors on the list will help me with.

Well, not quite medical…. but I'll give it a shot until Roberto picks up.

Q1: in which cases (if any) is the brain mass weighted during an authopsy?

All cases as far as I am aware (which arguably isn't very far…)

Q2: what other organs are normally examined in a quantitative way (lenght and weight, therefore) during a routine authopsy?

All of them… well, the big ones anway.

[Jolly subject, what?]
I'm doing a bit of research for a fiction piece (yes, it has to do with DG), and I'd hate to be led astray by old "Quincy" episodes or Lombroso studies and the like.

Ah, why didn't you say so. In fact, I have been doing some scenario research myself (I promise, when I finally finish my ghoul prion scenario I will let everyone know!!) and found the rather sparkling website:

http://www.neosoft.com/~uthman/Autop.html

Entitled the "Screenwriter's guide to the Autopsy"… which is just (ahem) what the doctor ordered (dodges hail of rotten fruit!). Seriously, check it out: very useful indeed.


Date: Mon, 09 Nov 1998 22:04:53 -0400
From: "Roberto L. Vargas"

Q1: in which cases (if any) is the brain mass weighted during an authopsy?

Always. The neuropathologic report is an integral part of every autopsy. At the time of organ removal, the skull is opened and the brain taken out from the lowest part you can reach of the brain stem. So you pull everything, from the cortex, pons, cerebellum and lower to the medulla oblongata, at least where all the cranial nerves go out.

At that point some people choose to weight it.

The brain is a very mushy organ and placing it in a scale at this time usually dents it somewhat. So many neuropathologists prefer to weight it after fixation. The brain should be left suspended in a 10% formaline solution for 7-10 days, after which you can manipulate and cut it without it turning into puree.

The standard procedure is to do a coronal cut along the hippocampus (the structure related to memory and where you usually look for changes of Alzheimer and many times of ischemic disease). From then on you separate the brain stem and the cerebellum from the diencephalon and cortex, and continue doing coronal cuts every cm or so.

Then samples are taken for microscopy. Usually they come from the left frontal lobe of the cerebral cortex, the basal ganglia (part of the diencephalon) the cerebral peduncles (to look for the substantia nigra; which shows changes in Parkinson and other related diseases), pons, cerebellum and medulla oblongata with a couple of stem nucleus.

Q2: what other organs are normally examined in a quantitative way (lenght and weight, therefore) during a routine authopsy?

Regular autopsies usually follow one of two protocols. The most common by far (and easiest) is the Rokitanski method. After the outside description, which is a common denominator of all methods, a y-shaped incision is done from aproximately the lateral aspects of the claviculae down to the lower part of the sternum (the xiphoid process) and from then one straight cut to the symphisis pubis (that bone in the groin).

Then the whole block of organs, from the trachea and esophagus to the rectum and including every system in the cavity, is taken out.

A big block including the GI, respiratory, urinary and a large part of the cardiovascular systems. From that every organ in there is dissected.

They include, the trachea, bronchi, lungs, esophagus, stomach, small and large intestines, pancreas, liver, gallbladder, spleen, kidneys, ureters, bladder, prostate or uterus and ovaries, aorta, heart, suprarenal glands, thyroid and parathyroids. Each one of those is weighted (except ureters, trachea, bronchi and aorta) and described grossly. Then you dissect the organs. Afterwards they are left in a 10%formaline solution for fixation a few days and then samples are taken for microscopy.

The other protocol takes much more time. It is called the Virschow method and every organ is taken from the body and dissected individually. It is used when certain types of pathological findings are expected.

Many variations exist and depending on the case other things will be examined also. This is the core and it is done every time. In special cases you may sample muscle, skin, lesions, teeth, gums, nasopharynx, nails, etc. Oh, and you always take serum and freeze it in case you need it later. In some cases, a sample of humor vitreo (the liquid inside the eyeball) is taken as it helps in estimating the time of death.

If you need more detail, just ask. I can give you a template of the standard autopsy report used in the medical center here, if you want.


Date: Mon, 09 Nov 1998 22:34:21 -0400
From: "Roberto L. Vargas"

Q2: what other organs are normally examined in a quantitative way (lenght
and weight, therefore) during a routine authopsy?

All of them… well, the big ones anway.

Well, the problem with this is that any group of tissues which serve a common function is called an organ.

Hence the skin, tongue, eyes, etc. are organs and it is not feasable to disect everything in every case.

Entitled the "Screenwriter's guide to the Autopsy"… which is just (ahem)what the doctor ordered (dodges hail of rotten fruit!). Seriously, check it out: very useful indeed.

Excellent document. I do have some observations.

In every program I've visited (4 in all) the man who does th cutting is not called a 'dieter' but a 'morgan' (short for morgue technician) and invariably they have been cheery people, very talkative (in fact you cannot shut them up and they will yak and yak about anything and everything) and like he said, everyone is male. Also, no prosector will loose his appetite on account of the smells (admittedly very unpleasant) or the content of the undigested food in the stomach which usually looks like albino ground beef with recognizable bits of the last meal. The slides are usually kept if they have something interesting and here you only have to keep them for 10 years by law. "Save jars" are not used anymore, unless the hospital is way back. Small plastic cases which can be easily labeled are used.

And what is his thing with the bread knife!! Forget about that!!

Microscopy sections have to be cut with a scalpel or the thing will be damaged.

The liver is cut with a LARGE knife, not unlike the ones used for cutting up meat. It is true that many pathologist do have their own instruments, but as far as I know they usually keep them at lockers in the autopsy room.

These are large and very sharp things.

I am assuming Dr. Urthman trained at an old insitution or that he has a different idea of what a bread knife is.

All in all, an excellent resource.


Date: Mon, 09 Nov 1998 22:36:57 -0400
From: "Roberto L. Vargas"

They include, the trachea, bronchi, lungs, esophagus, stomach, small and large intestines, pancreas, liver, gallbladder, spleen, kidneys, ureters, bladder, prostate or uterus and ovaries, aorta, heart, suprarenal glands, thyroid and parathyroids. Each one of those is weighted (except ureters, trachea, bronchi and aorta) and described grossly. Then you dissect the organs.

Forgot the testicles. They are weighted and smaples for microscopy are taken.

Oh well…


Date: Mon, 9 Nov 1998 23:13:05 -0500 (EST)
From: "Andrew D. Gable"

Q1: in which cases (if any) is the brain mass weighted during an authopsy?

from the cortex, pons, cerebellum and lower to the medulla oblongata,
at least where all the cranial nerves go out.

Please forgive the gratuitous Waterboy joke. A doctor does one of these neuropathological dissections and cries, "There's something wrong with his medulla oblangata."

At that point some people choose to weight it.

Evil idea which occurred to me just now: how about a shan-infested person who died and for some reason the shan was not aware of it? Imagine the looks of horror on the faces of the attending coroners as a pigeon-size beetle crawls out o' the guy's head. <Uggh> Although to my understanding, the shan should be aware of the death and die along with the host, if it's a conventional parasite anyway. Dunno abt. parasites from Shaggai, though…

Editor's Note: more on the Insects from Shaggai is available in another section of the Ice Cave

BTW, as a further question: to my understanding there is usually more than one coroner/doctor present. Am I correct in saying this? Admittedly, I'm basing it on the atrocious Alien Autopsy video, but…


Date: Wed, 11 Nov 1998 00:15:37 +1100
From: Rob Shankly

If you need more detail, just ask. I can give you a template of the standard
autopsy report used in the medical center here, if you want.

Who are you kidding? WE ALL WANT IT! (So to speak… :-/ )

Editor's Note: the template is available in a separate document


Date: Tue, 10 Nov 1998 16:28:36 -0400
From: "Roberto L. Vargas" <ten.iuqoc|sagravlr#ten.iuqoc|sagravlr>

Please forgive the gratuitous Waterboy joke. A doctor does one of these
neuropathological dissections and cries, "There's something wrong with his
medulla oblangata."

Unlikely. When the medulla oblongata doesn't work well people usually die. Maybe they just like the way it sounds. In fact, the area where that structure and the pons lie is the place to aim for if you are a sniper. A shot to this part of the brain stem is incompatible with life automaticly (at least in theory). A shot to the cortex of the brain, is usually deadly too, but the person stays alive for some time while he bleeds, shocks to death and his chances of surviving are much better (at least he has a chance). In any diagram you can find look for the structures directly anterior to the cerebellum. That is the spot I'm talking about.

Forget about shots to the forehead. Aim for the bridge of the nose and hope your bullet can go through bone.

<some snippage>

BTW, as a further question: to my understanding there is usually more than
one coroner/doctor present. Am I correct in saying this? Admittedly, I'm
basing it on the atrocious Alien Autopsy video, but…

Well, there doesn't need to be. The prosector can do it alone. He can do everything the morgan usually does, but it's a lot of work and the morgan is better at it. So, depending on the situation, in most autopsies it's just the prosector (resident or attending) and the morgan.

Since I'm a lowly medical student a resident has to be present, although they usually come in and out of the room all the time. In some special cases the attending oversees what the resident is doing. If a particular physician has special interest in the case he can ask the attending if he can be there for the procedure. In fact, the physician who cared for the patient should be present, but they rarely are. That said, for some extremely interesting autopsies, attending pathologists gather around the table while the procedure is being done. This is most intimidating since they won't shut up and continually pester you with questions.

I'm not sure of the translation, but I believe the coroner is a forensic pathologist who works for the government and works with violent, unnatural or legal cases. I explained a while back how to reach this level of academia (it's in the Ice Cave). 'Regular' hospital autopsies are performed by an anatomic pathologist in the hospital, while the coroner works in his own facilities (which are sometimes adjacent to hospitals, specially for teaching hospitals where the forensic fellowship is offered).

Warning: Nit-picking ahead

It should be alien necropsy, since an autopsy is a post-mortem examinatinon of a member of your own species. Mi-Go don't do autopsies on humans either, they perform necropsies, or worse.

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