Beginning an Autopsy

Now, with the scalpel, and with the belly of the blade not the tip, I'll make the primary incision from the tip of the acromian down, similarly from this meeting at one point and then straight down with a little twist around the umbilicus. Then, with a heavy cartilage knife, we will start reflecting the tissues. So with the heavy knife we have reflected the tissues up to the neck and over the chest. And now, for the abdomen, one has to carefully go layer by layer so as not to perforate the bowel. After incising the peritoneum one puts the two fingers in the form of a V raising the abdominal wall towards one so that the organs fall away and will not be cut and keeping the fingers spread, carefully with the scalpel, follow the primary incision which will then open the abdomen. Then taking the heavy cartilage knife, reflect the rest of the chest wall. Then with the heavy cartilage knife, one cuts through the sternoclavicular joints and saws through the costal cartilages with heavy pressure close to the ribs. This is easy in young people but if the costal cartilages are calcified in older people then one will have to use the saw. After having sawed this we will exert upwards tension whilst cutting with the knife flush with the posterior surface of the sternum. This will give us exposure to the chest cavity. Now exerting tension on this flap we dissect taking the neck organs, now we will cut close to the spine and as we go along we inspect the thoracic cavity. There are very fine adhesions, which I just broke, and reflect the lung and take a look into the cavity. There are no fluids present. Similarly, on the other side there are fine adhesions between the lungs, visceral and parietal pleura and these are broken. There is no fluid. And now, by mere tension, I can strip off the posterior mediastinal organs from the spine. And that's the reflected view of the thoracic organs.