An autopsy is the sort of thing you see on television surprisingly often, particularly if you have an

interest in crime drama or medical drama, and yet those television autopsies aren’t often all that
accurate. There are two types of autopsy; medical and investigative. In both cases the target is of
course to understand the cause of death, but in some cases this is done as part of medical training or
before donating organs. Regardless of the reason for the autopsy the process is a fascinating one.
Of course – you must be a licenced coroner or medical student with a licenced supervisor in order to
legally perform an autopsy on a human. Failure to meet these requirements means that you are not
performing an autopsy in the eyes of the law, but performing mutilation of the deceased, which is a
crime.
The Equipment;
Start by gathering the equipment you will need; and there is a lot of it. To prevent your equipment
for tampering with any evidence, particularly if you’re performing an investigative autopsy which
may reveal evidence as to the identity of a murderer, then you’re going to need to ensure that any
medical equipment you use is sterile. Things like a voice recorder (it is very hard to write down
physical notes while performing an autopsy, it is much easier to record the process and findings
verbally and write them up after the autopsy). You will also need a camera, photographic evidence
can be invaluable in many circumstances, particularly if a closed case is being reinvestigated or the
findings are being submitted as part of medical research.
A dissecting knife, brain knife, scissors, saws, skull key, scalpels, forceps, chisels and mallet could all
be needed, however; fingers are often much easier to work with than forceps, skull keys and brain
knives will also only be needed if opening the skull and dissecting the brain, which is not often
included in the process. You will also find that scalpels are not often used, as the dissecting knife
does the job particularly well. You’ll also need the typical things to ensure a cleaner and easier
environment; autopsy table, body block, appropriate drainage, gloves, goggles and so on and so
forth.
External Examination;
So; to start with you have a body. Still clothed and probably fresh out of the plastic bag. Now – for a
medical autopsy you probably don’t need to concern yourself too much with their clothing, chances
are they passed away in a hospital gown that contains no real evidence as to the cause of death.
However, for an investigative autopsy you will need to concern yourself much more with the
clothing. Everything needs to be closely inspected and recorded, as you have much more time and
flexibility for checking these than the investigators and officers that were on the scene.
You will already have some idea as to what happened, so you may be looking for blood or other
DNA that could have been from the criminal, such as hair or skin samples on the clothing. DNA
samples over the fingernails if there is reason to believe that your victim may have has a physical
struggle with the attacker. Clothing fibres, paint, gunpowder residue and other such deposits can
also be helpful hints that allow you to understand a little more of what happened at the crime scene.
Photograph the body from as many different angles as possible, with close ups on any areas that
may be of interest – such as blood stains, suspected paint chips etc. Ensure photographic evidence is
complete before removing the clothing then send clothing for further study if required.
Once you’ve removed the suspects clothes you take note of any distinctive features; physical
characteristics such as height, weight, eye colour, hair colour, ethnicity, gender, age, tattoos and
scars, then you explain any externally visible symptoms that may be related to the cause of death.
Open wounds, bruises, scratches, needle marks, burns and so on will be listen, with their locations,
severity and estimated age being listed as you go. Now you should take X-Rays, which will indicate
any bone abnormalities, or the location of objects within the body; particularly useful if the victim
has been shot. Of course, depending on the reason for the autopsy and the condition of the body
the X-Ray may not be required.
Most autopsies will, at this stage, take hair, nail, saliva and blood samples – some will also take
fingerprints and dental records, particularly true of investigative autopsies. Then you need to take
the photographs again. Again the photographs should be taken from lots of angles, with close up
shots of anything that may be considered to be of interest either in regards to the cause of death or
identifying a criminal.
Internal Examination;
With everything on the inside dealt with you can now open up your body to take a close look at the
insides. This is relatively common when it comes to investigative autopsies, but is not always needed
with medial autopsies, depending on where the cause of death is known and what it was. A medical
autopsy can not only help us to understand the cause of death, but also help us to understand the
lesser known diseases, the damage they cause to the body, the process of the disease that causes
death, which makes finding cures and preventative measures a much easier process.
The first thing to do is, of course, open the torso. It is not as likely that you will need to perform
dissection on the brain, and very unusual that the face, arms, hands or legs need to be internally
examined. While most of your television autopsies do show the characteristic ‘Y’ shape incision that
is used to access the internal organs it is less often that they show this correctly. The arms of the ‘Y’
should reach each shoulder, and the stem should run all the way down to the pubic region. As the
heart is no longer beating the amount of blood shouldn’t be too much, depending on how long the
person has been dead, which means that the main thing you’ll have to deal with is the leakage of
other such body fluids, which may vary depending on the cause of death.
One of the common mistakes on TV is how to handle the area of the torso that is obscured by the
breasts, while most of the television autopsies opt for the straight lines above the breasts it is
actually supposed to curve around, under the breasts, as this makes the torso easier to lift out of the
to open the chest. This type of incision is known as the trunk incision, and is one of the easiest ways
of gaining access to the internal organs.
Of course, once you have opened the torso you need to push the skin to the side, without causing
any additional damage as this all has to be put back when you’re done. If the incision was done
correctly the skin will peel back rather easily, you might have to use some force to tear connections
to the muscle or slide along the inside of the slabs with the dissection knife to cleanly pull the skin
away from the organs. These will be heavy enough to keep themselves peeled back without getting
in your way too much.
Take a urine sample from the bladder and a blood sample directly from the heart while you have the
torso open. These should be easy enough to access, and will provide you with valuable sources of
testing, indicating the interference drugs or alcohol may have had on the cause of death. Once you
have these samples you may want to take more photographs for reference before beginning to
remove organs. You have two options with the ribs; a saw or rib cutter will get them out of the way
with a bit of work; you need to be sure to cut between the ribs and the cartilage connected to the
breast bone. Of course if you want a cleaner removal you can cut the sides of the chest cavity and
leave the ribs attached to the breastbone, allowing you to remove the whole chest plate as a single
piece.
When it comes to the removal of organs there are two options to choose from; Virchow technique
or Rokitansky technique. If time is limited go with Rokitansky, this clears up the body for cleaning
and funeral preparation much faster, however for a more in-depth, detailed and time consuming
analysis of the organs the Virchow technique would generally be the preferred selection.
Removal & Dissection of Organs;
Virchow – this technique involves removing each of the organs individually. Usually this stars with
removing the intestines by severing the attachment tissue. During this process each of the organs
will be inspected carefully before, during and after removal, making it a more common option when
the cause of death is not yet known at the time of organ removal or where one organ is known to
have been effected by or during the death more than the others, as this can be removed and
dissected immediately.
Rokitansky – this technique removes all of the organs as a connected group. The basic principle is
simply to disturb the connections between the organs as little as possible, dissection of the organs
are then done later. This doesn’t introduce any artificial injuries to the organs as a result of the
autopsy, this also makes it a preferable method with regards to many religious sentiments where
these may be a concern. This is of course a difficult process and does require more experience, as
the coroner needs to be able to recognise abnormalities in the organs.
Letulle – this technique is not as frequently used and is similar in aspects to Rokitansky. This is the
best technique for preserving the vascular supply and the relationship between the organs, with the
thoracic, cervical, abdominal and pelvic organs dissected into organ blocks after removal of the
entire unit. This is one of the faster processes, making it a more popular option for grieving relatives
who are eager to have the body released for funeral / cremation, particularly as this can actually
improve the embalming process. Of course this is very difficult to manage alone, due to the mass of
the organ block, and it is very difficult to put the organs back in their respective locations after
removal, which makes additional autopsies difficult.
Ghon – this technique is another en masse / en bloc technique (like Rokitansky and Letulle) but
there are various variations of this method. This is more common for medical study and maintains all
of the connections between the organs to preserve the anatomical relationships. This is a fantastic
way of performing a full autopsy and getting as much information as possible when dealing with a
sudden death, however it does take a great deal of anatomical knowledge and skill to complete and
it does take a considerable amount of time.
Should dissection of the brain you will need to cut across the crown of the skull, creating a line from
the bone bump behind one ear to the bump behind the other. The cranium with then be opened
using a special saw that cuts through the bone but leaves the soft tissue undamaged. One problem
with dissection of the brain is its natural consistency, which is a very soft, gooey texture, resembling
tofu. This can be difficult to dissect easily because of this natural texture, however those who have a
little more time and a particular desire to see the brain clearly (for example those using the organs
for medical research, education or training) may want to treat it and make it easier to dissect before
working on it. A few weeks in a fixative formalin will not only preserve the brain, but help to make
the consistence and firmness something that is easier to handle and work with.
During the process of removing the organs there are other tests and samples that can be and
generally are take. Tissues samples from most of the organs are taken during the removal or
dissection of the organs, depending on the technique that has been used. Should any of the organs
be retained for study or research, of any kind they, can be placed in a fixative formalin much like the
brain, to keep them well preserved and firm.
The End of the Autopsy;
You should conclude your autopsy by declaring your conclusion; summarise the items of evidence
and points of interest that you discovered during the process (which you should have already
recorded as of course you should have been dictating the process and discoveries as you went),
explain the conclusion that this evidence brought you to and why. Ensure that you explain the cause
of death clearly, pointing out any factors that might be specific to cause of death, as these may be
relevant to an investigation. For example; if the victim was shot, rather than stating simply that the
cause of death was a gun-shot wound you should explain the specifics, so you would state that it
was a single gunshot wound to the lower left abdomen, with the bullet penetrating the left kidney
and lodging in the muscle of the lower back, injury caused severe kidney trauma and damage to the
blood supply, causing the victim to go into shock and lose consciousness. Death occurred
approximately 45 minutes later as a result of blood loss.
This ensures that the investigative sources have as much information as they could need to come to
an educated decision. The more thoroughly you provide the information and reasoning the better.
This is just as true when it comes to the progression of a disease as a murder, as it is important
information is given clearly to allow future research to continue effectively. Once the autopsy and
results are completed in full, you can begin the process of reconstituting the body.
You will of course need to replace the organs, unless these are being retained for study. These can
be difficult to place back into their respective locations, often if not all of the organs are being
replaced in the body those that are will be placed in plastic bags, so as to ensure that the organs
don’t leak, and the extra space is packed with cotton wool. One of the most important things is of
course to replace the chest plate, as this will support the torso flesh when it is replaced. With
everything that needs to be back inside the body you can close the body, using the characteristic
baseball stitch.
The body will then be washed and dressed for the funeral and cremation.

Kate Critchlow is a freelance writer working with a variety of clients to provide interesting and useful
resources, including medical suppliers of various products from dissection tools to bespoke needles.