Postmortem

(post-mor'tem). I. Occurring after death. 2. An examination of the body after death; an autopsy. The general technique of a postmortem is as follows: First, the appearance of the body is described, including sex, height, apparent age, discoloration of the skin, rigor mort is, state of the nutrition, injuries, deformities, and any peculiarities that may be observed. An incision is then made from the top of the sternum to the pubic symphysis, the abdomen being the cavity first opened. Then the position of the viscera, their condition, the presence of hernia, if it exist, the state of the peritoneum, and the quantity of fluid are noted, but all without disturbing the relation of the contents. The thorax is now opened. In order to do this, the ribs are divided at the cos to-chondral junction, and the sternum and clavicles disarticulated. The relation of the structures exposed on lifting up the separated portion of sternum and ribs is noted the presence of fluid in the pleural cavity, pleural adhesions, the extent to which the lung covers the pericardium. The pericardial sac is next opened, and its condition and the quantity of fluid recorded. The opening of the heart is the next step. This may be done in several ways; one of the best is Virchow's method, q. v. After noting the character of the blood and clots in the chambers, the heart is excised, close to the origin of the great ve els. After completing the incisions, the state of the valves of the muscle, especially its firmne , and the size of the walls of the two ventricles, are carefully observed and measured. The lungs are next removed, usually the left first. Section of these organs is made by a long sweep of the knife in the case of the left preferably from the apex to the base; in the case of the right, from the base to the apex. Attention is now directed to the abdomen, the spleen being the first organ removed. Next come the suprarenals and the kidneys. In order to gain acce to these, it is wise to di ect off, bya few quick cuts, the entire colon from the sigmoid flexure to the al valve. A double ligature is placed around the sigmoid, and the gut divided between the ligatures. The W moval of the kidneys is further facilitated In cutting the diaphragm loose from its costal attachments and throwing it upward, with the liver, into the thoracic cavity. The adrenals and kidneys are then exposed; the course and condition of the ureters arc noted.