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Activity 1.3.

1 Autopsy Report
NOTE: This is only a partial autopsy report. You will be receiving the remainder of the autopsy report in pieces throughout the course.

Office of the Medical Examiner Metropolitan Government of Anytown


Case # 77 Decedent: Anna Garcia Age: 38 Weight: 165 Height: 64 Inches Race: Hispanic Sex: Female Date and Time of Autopsy: August 15, 2012 11:00 am Performed By: Dr. King

Laboratory Results:
Toxicology: 1. Preliminary Blood Results: o No evidence of alcohol BAC (% by volume), 0.015. o Trace amounts of acetylsalicylic acid present. o No evidence of overdose of non-prescription or prescription drugs.

External Examination
General Appearance: The body is that of a well-developed, well-nourished adult Hispanic female who appears to be her stated age of 38. Body height is 64 inches and body weight is 165 lbs. No evidence of post-mortem tampering is present and rigor mortis is generalized. Clothing and Valuables: The body is admitted to the morgue clothed and within a body bag. One ring is present on the right ring finger. Clothes are not torn but are stained with blood. A small amount of vomit is present on the shoulder area of the blouse.
2013 Project Lead The Way, Inc. PBS Activity 1.3.1 Autopsy Report Page 1

Head and Neck: The head is normally shaped with medium length, black hair. There is an injury to the right temple, including an open wound where pre-mortem bruising is evident. Neck shows no sign of injury. Trunk: The chest and torso are an appropriate size; no visible sign of trauma. Abdomen is distended. Extremities: The extremities are symmetrical and without abnormalities. The ankles are swollen and signs of edema are positive with moderate fluid accumulation. The fingernails show substantial graying, indicative of low oxygen. The right proximal humerus shows signs of a recently healed break, as does the left distal tibia. Inflamed, red injection sites on left thigh. Injuries: A head wound at the right temple, 2 cm in length, and 5 mm in depth at the center. Surrounding area bruised, limited bleeding evident. No skull fracture. Right elbow bruise, 2 cm in diameter, limited contusion. No other visible injuries.

Physical Examination Results:


1. Generalized pallor and evidence of oxygen deprivation. 2. Fingernails and toenails blue/gray color. 3. Evidence of vomit in oral cavity. 4. Blunt trauma to the head, wound indicative of a fall against a solid object, light bleeding suggesting lack of blood flow. 5. Edema of ankles visible. Manner of Death: Natural Causes Possible Causes of Death: A preexisting medical condition was the most likely cause of her sudden death.

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Human Body Systems


1. The Integumentary System - key structures: skin, hair, and nails. Functions include: providing the bodys external covering, protecting deeper tissue from injury, and regulating body temperature. 2. The Skeletal System - key structures: the bones and joints. Functions include: protecting and supporting the bodys organs, providing the framework for the muscles use to provide movement, and storing minerals. 3. The Nervous System - key structures: the brain, spinal cord, sensory receptors, and nerves. Functions include: responding to internal and external changes by activating the appropriate response and processing information. 4. The Muscular System - key structures: skeletal muscle, cardiac muscle, and smooth muscle. Functions include: moving the body and moving substances around the body, maintaining posture, and producing heat. 5. The Cardiovascular System - key structures: the heart and blood vessels. Functions include: pumping blood around the body; transporting oxygen, carbon dioxide, nutrients, and waste. 6. The Respiratory System - key structures: the lungs, the nasal cavity, the trachea, and the bronchus. Functions include: Assisting with gas exchange with the external environment, keeping blood supplied with oxygen, and removing carbon dioxide. 7. The Lymphatic and Immune System - key structures: lymph nodes, the spleen, the thymus, and bone marrow. Functions include: Filtering fluid in the body and preparing against attacks from foreign substances in the body. 8. The Digestive System key structures: oral cavity, the esophagus, the stomach, the small intestine, the large intestine, and the liver. Functions include: breaking down food into its nutrient molecules, absorbing nutrients, and ridding the body of waste. 9. The Urinary System key structures: the kidney, the bladder, and the ureter/urethra. Functions include: eliminating waste from the body and regulating the water balance in blood. 10. The Endocrine System key structures: the adrenal gland, the pituitary gland, the ovaries, and the testicles. Functions include: secreting hormones that regulate processes such as growth, reproduction, and metabolism.

2013 Project Lead The Way, Inc. PBS Activity 1.3.1 Autopsy Report Page 3