Internal examination

As explained by Dr Cordner in the previous lesson, autopsy consists of two types of examination i.e. external and internal examination. Read this article to further understand the steps involved in a complete internal examination.

External examination is a detailed examination of the visible marks, injuries, etc found externally on the body. Internal examination is an in-depth examination of the body cavities and the abnormalities that may exist within them. As per the Minnesota Protocol, the aim of the internal examination is to “clarify and augment the external examination insofar as injuries are concerned” as well as to “identify and characterize any and all natural disease present”. An internal examination can be as limited or extensive as required. However, in cases of potential unlawful death, it is important to rule out all the other possible causes of death and therefore, a complete examination should be carried out.

Steps for internal examination

1. The brain is removed from the skull and examined.
2. Examination of the chest and abdominal cavity, and the removal of organs for further examination.
3. Examination of external and internal genitalia is carried out especially in sexual violence cases.
4. Dissection of the neck and the internal organs.
5. Specimens collected for further testing such as toxicology, radiology, histology, microbiology, etc.
6. Remains of the deceased are reconstructed after examination has been completed and the body handed over to the next of kin.

What should be recorded as part of an internal examination?

Internal examination involves opening of the body cavities to examine the internal organs. This involves noting the presence of gas, fluids, blood in the body cavities and measuring their volume. The location and the external appearance of all the organs are observed and noted. Once the internal organs are removed, all the surfaces of the organs are observed once again and description noted down before further dissection. Weights and measurements are taken for all major organs. All organs that are hollow like the stomach, intestines, etc. are opened and their contents observed and noted down. During the internal examination, organs are removed and dissected for evaluating disease or injury. All abnormalities and injuries observed are recorded along with their location and measurements.