BOOK
Autopsy Pathology: A Manual and Atlas E-Book
Andrew J Connolly | Walter E. Finkbeiner | Philip C. Ursell | Richard L. Davis
(2015)
Additional Information
Book Details
Abstract
A mainstay for pathology residents, Autopsy Pathology is designed with a uniquely combined manual and atlas format that presents today’s most complete coverage of performing, interpreting, and reporting post-mortem examinations. This lasting and useful medical reference book offers a practical, step-by-step approach to discussing not only the basics of the specialty, but the performance of specialized autopsy procedures as well.
- Material is divided into two sections for ease of use : a manual covering specific autopsy procedures, biosafety, generation of autopsy reports, preparation of death certificates, and other essential subjects; and an atlas, organized by organ system, which captures the appearance of the complete spectrum of autopsy findings.
- Covers forensic pathology in a chapter introducing the subspecialty.
- Offers expanded coverage of microscopic anatomy.
- Includes a chapter on performing special dissection procedures that may not be covered during a typical residency.
- Examines important techniques, such as autopsy photography and radiology, microscopic examination, supplemental laboratory studies, and other investigative approaches.
- Addresses the latest legal, social, and ethical issues relating to autopsies, as well as quality improvement and quality assurance.
- Presents more than 600 full-color photographs depicting common gross and microscopic autopsy findings for every part of the body.
- Correlates pathologic findings with their clinical causes to enhance diagnostic accuracy.
- Improved images in the Atlas section provide greater visual understanding.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| Inside Front Cover | ifc1 | ||
| Autopsy Pathology: A Manual and Atlas | i | ||
| Copyright Page | iv | ||
| Dedication | v | ||
| Preface | vi | ||
| Table Of Contents | vii | ||
| 1 The Autopsy—Past and Present | 1 | ||
| The Autopsy in Antiquity | 1 | ||
| The Autopsy Post-Renaissance | 3 | ||
| The Autopsy in the Twentieth Century | 6 | ||
| The Autopsy Today | 8 | ||
| The Objectives of the Autopsy | 8 | ||
| Benefits to Physicians and Health Care Organizations | 9 | ||
| Benefits to the Family of the Deceased | 9 | ||
| Benefits to Public Health | 9 | ||
| Benefits to Medical Education | 10 | ||
| Benefits to Medical Discovery and Applied Clinical Research | 10 | ||
| Benefits to Basic Biomedical Research | 10 | ||
| Benefits to Law Enforcement and Jurisprudence | 10 | ||
| References | 10 | ||
| 2 Legal, Social, and Ethical Issues | 15 | ||
| Autopsy Authorization | 15 | ||
| Identification and Disposition of the Deceased | 17 | ||
| Medical Examiner/Coroner Cases | 18 | ||
| Public Health, Public Records, and Patients’ Confidentiality | 18 | ||
| Organ and Tissue Donation | 19 | ||
| Request for Human Tissue for Research | 20 | ||
| Religious and Cultural Issues | 20 | ||
| Judaism | 20 | ||
| Christianity | 21 | ||
| Native Americans | 21 | ||
| Islam | 21 | ||
| Eastern Religions | 21 | ||
| Mortician and Funeral Issues | 21 | ||
| Obligations of the Autopsy Pathologist | 22 | ||
| References | 22 | ||
| 3 Autopsy Biosafety | 24 | ||
| Autopsy Infection Control Precautions | 24 | ||
| General Autopsy Biosafety Practices | 24 | ||
| General Rules | 24 | ||
| Attire | 24 | ||
| Use of Sharp Instruments | 25 | ||
| Limiting Aerosols | 25 | ||
| Photography | 25 | ||
| Tissue Fixation | 26 | ||
| Decontamination of Equipment, Work Surfaces, and Laundry | 26 | ||
| Remains | 26 | ||
| Storage and Transportation of Tissue and Waste | 26 | ||
| Handling of Spills | 26 | ||
| Hand Washing | 26 | ||
| Employee Health | 26 | ||
| Isolation Procedures | 26 | ||
| Practices to Reduce Transmission by Infective Aerosols | 27 | ||
| Practices Specific to Autopsies If a Prion Disorder Is Suspected | 27 | ||
| Exposure to Other Biohazards at Autopsy | 27 | ||
| Formaldehyde | 27 | ||
| Radioactivity | 28 | ||
| Implantable Cardioverter-Defibrillator | 29 | ||
| Foreign Bodies and Occult Medical Devices | 30 | ||
| Bullet Recovery | 30 | ||
| Needle Fragments and Other Sharp Objects | 31 | ||
| Cyanide Exposure | 31 | ||
| Conclusion | 31 | ||
| References | 31 | ||
| 4 Basic Postmortem Examination | 33 | ||
| External Inspection | 33 | ||
| Identification | 33 | ||
| Inspection and Palpation | 33 | ||
| Initial Dissection and Internal Examination | 34 | ||
| Letulle Method | 36 | ||
| Organ Removal | 36 | ||
| Inspection of the Body Cavities and Removal of the Testes | 37 | ||
| Initial Dissection and Separation of the Organ Blocks | 37 | ||
| Examination of the Neck and Thoracic Organs | 39 | ||
| Lungs | 39 | ||
| Neck and Anterior Mediastinal Organs | 40 | ||
| Heart | 40 | ||
| Examination of the Genitourinary Organs | 41 | ||
| Kidneys and Ureters | 41 | ||
| Lower Genitourinary Tract (Male) | 42 | ||
| Testis | 42 | ||
| Lower Genitourinary Tract (Female) | 42 | ||
| Male and Female External Genitalia | 42 | ||
| Examination of the Remaining Abdominal Organs | 43 | ||
| Spleen | 43 | ||
| Upper Gastrointestinal Organs and Biliary Tract | 43 | ||
| Pancreas | 44 | ||
| Liver | 44 | ||
| Aorta, Diaphragm, and Mesentery | 44 | ||
| Intestines | 44 | ||
| Virchow Method of Organ Removal | 45 | ||
| Thoracic Organs | 45 | ||
| Neck Organs | 45 | ||
| Abdominal Organs | 46 | ||
| Aorta, Adrenal Glands, Kidneys, and Pelvic Organs | 46 | ||
| Removing the Brain and Spinal Cord | 47 | ||
| Brain Cutting—General and Specific | 50 | ||
| Examination of the Vertebral Column and Bone Marrow | 53 | ||
| A Final Word about Examining Organs | 53 | ||
| References | 53 | ||
| 5 Postmortem Examination of Fetuses and Infants | 55 | ||
| Facilities and Equipment | 55 | ||
| Postmortem Examination | 55 | ||
| External Examination | 56 | ||
| Internal Examination and Evisceration | 57 | ||
| Separation of the Organ Blocks | 59 | ||
| Dissection of Organs after Evisceration | 60 | ||
| Brain and Spinal Cord Removal and Examination | 62 | ||
| Examination of the Placenta | 63 | ||
| Examination of the Fragmented Fetus | 64 | ||
| Conclusion | 64 | ||
| References | 64 | ||
| 6 Special Dissection Procedures | 66 | ||
| Special Examinations of the Heart | 66 | ||
| Dissection of Hearts with Developmental Malformations | 66 | ||
| Dissection of Hearts with Medical Devices | 67 | ||
| Coronary Artery Stents | 67 | ||
| Ventricular Assist Devices | 67 | ||
| Valve Implants | 67 | ||
| Electronic Medical Devices, Including Pacemakers and Defibrillators | 68 | ||
| Detection of Air Emboli | 70 | ||
| Detection of Pneumothorax | 70 | ||
| Special Examinations of the Neuromuscular System | 70 | ||
| Examination of the Middle and Inner Ear | 71 | ||
| Examination of the Eyes | 72 | ||
| Anterior or External Removal | 72 | ||
| Posterior or Internal Removal | 73 | ||
| Fixation and Dissection of the Eye | 73 | ||
| Examination of the Paranasal Sinuses and Skull Base | 74 | ||
| Examination of Nasopharynx, Mandible, Maxilla, and Teeth | 75 | ||
| Examination of the Neck and Cervical Spine | 75 | ||
| Examination of the Thoracic Duct and Cisterna Chyli | 76 | ||
| Examination of Bones and Joints | 76 | ||
| The Maternal Autopsy | 76 | ||
| Conclusion | 77 | ||
| References | 79 | ||
| 7 Autopsy Photography and Radiology | 80 | ||
| Autopsy Photography | 80 | ||
| Photographic Equipment and Supplies | 80 | ||
| Camera | 80 | ||
| Photographic Stand and Specimen Box | 80 | ||
| Background | 81 | ||
| Photographic Technique | 81 | ||
| Specimen Preparation | 82 | ||
| Composition | 82 | ||
| Orientation | 82 | ||
| Cropping | 82 | ||
| Distracters | 82 | ||
| Specular Highlights | 83 | ||
| Photography at the Autopsy Table | 83 | ||
| Manipulation of Digital Photographic Images | 84 | ||
| Autopsy Radiology | 84 | ||
| Postmortem Radiographs | 84 | ||
| Forensic Radiology | 85 | ||
| Angiography of Dissected Specimens | 85 | ||
| Other Radiographic Contrast Studies | 86 | ||
| Postmortem Cross-Sectional Imaging | 86 | ||
| References | 88 | ||
| 8 Microscopic Examination | 90 | ||
| Brightfield Microscopy | 90 | ||
| Tissue Fixation | 90 | ||
| Decalcification | 91 | ||
| General Guidelines for Microscopic Sampling of Tissues | 91 | ||
| Specialized Microscopic Examination of the Brain in Dementia Cases | 94 | ||
| Specialized Microscopic Examination of the Heart | 94 | ||
| Examination of Cardiac Valves | 94 | ||
| Examination of the Myocardium | 94 | ||
| Examination of Coronary Arteries and Coronary Artery Bypass Grafts | 94 | ||
| Dissection and Examination of the Cardiac Conduction System | 95 | ||
| Sinoatrial Node. | 95 | ||
| Atrioventricular Node. | 95 | ||
| Tissue Processing, Sectioning, and Staining | 98 | ||
| Polarized Light Microscopy | 99 | ||
| Immunohistochemistry | 101 | ||
| In situ Hybridization | 102 | ||
| Frozen Sections, Needle Biopsies, Cytology, and Smears | 103 | ||
| Immunofluorescence Microscopy | 104 | ||
| Electron Microscopy | 104 | ||
| Transmission Electron Microscopy | 104 | ||
| Specialized Electron Microscopic Techniques | 104 | ||
| References | 106 | ||
| 9 Microscopic Findings | 108 | ||
| Cardiovascular System | 108 | ||
| Respiratory System | 113 | ||
| Gastrointestinal System | 119 | ||
| Hepatobiliary System and Pancreas | 122 | ||
| Urinary Tract System | 125 | ||
| Reproductive Systems | 127 | ||
| Endocrine System | 128 | ||
| Hematopoietic System | 129 | ||
| Other Findings | 130 | ||
| 10 Supplemental Laboratory Studies | 132 | ||
| Collection of Samples | 132 | ||
| Blood | 132 | ||
| Vitreous Humor | 132 | ||
| Synovial Fluid | 132 | ||
| Urine | 133 | ||
| Cerebrospinal Fluid | 133 | ||
| Bile | 133 | ||
| Gastric Contents | 133 | ||
| Hair and Fingernails | 133 | ||
| Fibroblasts for Tissue Culture | 133 | ||
| Tissues for Metabolic Studies and Nucleic Acid Analysis | 133 | ||
| Postmortem Microbiology | 133 | ||
| Postmortem Cytogenetic and Molecular Studies | 134 | ||
| Genetic/Metabolic Disease Autopsy | 134 | ||
| Postmortem Chemistry | 135 | ||
| Carbohydrates and Related Metabolites | 135 | ||
| Glucose | 135 | ||
| Ketones and Lactic Acid | 136 | ||
| Electrolytes and Trace Elements | 136 | ||
| Sodium, Chloride, and Potassium | 136 | ||
| Carbon Dioxide Content | 136 | ||
| Calcium, Magnesium, Phosphorus, and Sulfur | 136 | ||
| Trace Elements | 138 | ||
| Nitrogenous Compounds | 138 | ||
| Urea Nitrogen and Creatinine | 138 | ||
| Other Nitrogenous Compounds | 138 | ||
| Cholesterol and Other Lipids | 138 | ||
| Proteins | 138 | ||
| Serum Proteins | 138 | ||
| Enzymes | 138 | ||
| Other Proteins | 139 | ||
| Bile Pigments and Other Indicators of Hepatic Function | 139 | ||
| Hormones | 139 | ||
| Postmortem Toxicology | 139 | ||
| References | 140 | ||
| 11 The Autopsy Report | 143 | ||
| Overview of the Autopsy Report | 144 | ||
| Final Anatomic Diagnosis | 145 | ||
| Overall Organization | 145 | ||
| FAD by Pathogenetic Themes | 145 | ||
| FAD by Organ Systems | 145 | ||
| FAD by Organ System With Systemic Integration as Needed | 145 | ||
| FAD by Cause of Death, With Inclusion of Clinical Diagnoses | 145 | ||
| Format of Diagnoses | 146 | ||
| FAD Using Only Coding-Ready Anatomic Terms | 146 | ||
| FAD Using Conversational Style for Anatomic Findings | 146 | ||
| Pediatric FAD With Emphasis on Developmental Context | 146 | ||
| FAD With Mention of Procedures | 146 | ||
| Less Important Diagnoses | 146 | ||
| Summary Statement With Cause of Death, After FAD | 146 | ||
| Clinical Summary | 146 | ||
| Gross Findings | 147 | ||
| Microscopic Findings | 148 | ||
| Additional Findings | 148 | ||
| Case Discussion | 148 | ||
| Conclusion | 148 | ||
| References | 149 | ||
| 12 Sudden Death Due to Natural Causes | 150 | ||
| Preparing for the Autopsy | 150 | ||
| The Approach to Autopsy in Cases of Sudden Death Due to Natural Causes | 151 | ||
| Pathologic Findings on External Body Surface | 152 | ||
| Pathologic Findings in the Body Cavity | 152 | ||
| Cardiovascular Disease | 152 | ||
| Ischemic Heart Disease | 152 | ||
| Hypertrophy of the Heart | 153 | ||
| Inflammatory Heart Disease | 154 | ||
| Malformations of the Heart | 154 | ||
| Cardiomyopathy | 154 | ||
| Normal-Appearing Hearts | 155 | ||
| Respiratory Disease | 156 | ||
| Central Nervous System | 157 | ||
| Sudden Unexpected Infant Death | 158 | ||
| Other Causes | 158 | ||
| Conclusion | 158 | ||
| References | 158 | ||
| 13 Multiple Organ Dysfunction and Sepsis | 161 | ||
| Sepsis | 161 | ||
| Multiple Organ Dysfunction | 161 | ||
| Preparing for the Autopsy | 162 | ||
| Pathologic Findings on the External Body Surface | 162 | ||
| Pathologic Findings in the Body Cavities | 163 | ||
| Pathologic Findings in the Respiratory Tract | 163 | ||
| Pathologic Findings in the Urinary Tract | 165 | ||
| Pathologic Findings in the Gastrointestinal Tract | 165 | ||
| Pathologic Findings in the Cardiovascular System | 165 | ||
| Pathologic Findings in the Hepatobiliary System | 165 | ||
| Pathologic Findings in the Central Nervous System | 166 | ||
| Pathologic Findings in Other Organs | 166 | ||
| The Autopsy Report | 166 | ||
| References | 166 | ||
| 14 Death Certification | 168 | ||
| The Death Certificate | 168 | ||
| Completing a Death Certificate | 172 | ||
| Medicolegal Issues | 173 | ||
| Therapeutic Complications and the Death Certificate | 175 | ||
| Fetal Death Certificates | 175 | ||
| Conclusion | 176 | ||
| References | 177 | ||
| 15 Quality Management | 178 | ||
| The Autopsy in Quality Management of Clinical Care | 178 | ||
| Quality Assurance of the Autopsy | 178 | ||
| Quality Improvement of the Autopsy | 182 | ||
| Continuing Medical Education | 182 | ||
| Autopsy Report Turnaround Time | 182 | ||
| Improving Autopsy Rates | 182 | ||
| Regional Autopsy Centers | 182 | ||
| Autopsy Training | 182 | ||
| Conclusion | 182 | ||
| References | 183 | ||
| 16 Atlas of Gross Autopsy Pathology | 186 | ||
| Outline | 186 | ||
| External Findings | 186 | ||
| Pericardial, Pleural, and Peritoneal Cavities | 191 | ||
| Cardiovascular System | 195 | ||
| Respiratory System | 209 | ||
| Gastrointestinal System | 223 | ||
| Hepatobiliary System | 235 | ||
| Pancreas | 242 | ||
| Urinary Tract | 243 | ||
| Reproductive System (Male) | 252 | ||
| Reproductive System (Female) | 255 | ||
| Endocrine System | 258 | ||
| Lymphoreticular System | 261 | ||
| Musculoskeletal System | 264 | ||
| Central Nervous System | 269 | ||
| Pediatric Pathology | 283 | ||
| Placenta and Umbilical Cord | 306 | ||
| Forensic Pathology | 310 | ||
| Appendix A Description of Gross Autopsy Findings | 320 | ||
| Appendix B Measures, Weights, and Assessment of Growth and Development | 356 | ||
| Outline | 356 | ||
| Adults | 356 | ||
| Fetal | 361 | ||
| Children | 368 | ||
| Percentile Curves for Children, Birth to Teens | 373 | ||
| References | 381 | ||
| Index | 382 | ||
| A | 382 | ||
| B | 383 | ||
| C | 383 | ||
| D | 384 | ||
| E | 385 | ||
| F | 385 | ||
| G | 386 | ||
| H | 386 | ||
| I | 387 | ||
| J | 387 | ||
| K | 387 | ||
| L | 387 | ||
| M | 388 | ||
| N | 388 | ||
| O | 389 | ||
| P | 389 | ||
| Q | 390 | ||
| R | 390 | ||
| S | 391 | ||
| T | 392 | ||
| U | 392 | ||
| V | 392 | ||
| W | 392 | ||
| Z | 392 | ||
| Inside Back Cover | ibc1 |