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Autopsy: aw'top-see. Origin - autopsia: seeing with one's own eyes

1. An examination of the organs of a dead body to determine the cause of death or to study the pathologic changes present. Syn: necropsy, thanatopsy.

2. In the terminology of the ancient Greek school of emperics, the intentional reproduction of an effect, event, or circumstance that occurred in the course of a disease and observation of its influence in ameliorating or aggravating the patient's symptoms. Syn: postmortem examination.

Rigor mortis

An unfortunate victim of suicide. Note that rigor mortis has maintained the position of his arms after the shotgun has been removed.

Rigor mortis occurs because metabolic activity continues in the muscle after death. Adenosine triphosphate (ATP) is needed to maintain the postmortem relaxation of the muscles. So long as the store of glycogen in a muscle is sufficient to permit the regeneration of ATP by the formation of lactic acid, the muscle remains lax. When its store of glycogen is exhausted, the concentration of ATP falls, and the muscle becomes rigid because of the formation of abnormal links between actin and myosin. The rigor mortis persists until these links are destroyed by advancing autolysis.

Suicide is a risk for people with depression. The cardinal signs and symptoms of depression are included in the pneumonic "SIG E CAPS" Increased, decreased or changes in S-sleep, I-interest, G-guilt, E-energy (low), C-concentration, A-appetite, P-psychomotor agitation or retardation, S-suicidal ideation.

Also, substance use, especially alcohol, is highly correlated with homicide and suicide. Note the beer cans in the background.

Bone marrow embolus.

This was secondary to bone fractures. Bone marrow emboli must be considered with any fracture, especially those of long bones. They can lead to pulmonary emboli, which can potentially be a life threatening complication.

The clinical signs and symptoms of pulmonary emboli ("PE") are: chest pain, shortness of breath, cough and hemoptysis. If a "PE" is suspected, one must order a ventilation/perfusion scan ("VQ scan") to help make the diagnosis. Early treatment with heparin or other thrombolytics can greatly reduce the morbidity and mortality.

Dislocated Knee -- 18 hours

I kept me leg elevated throughout the night, but was unable to get any rest secondary to the pain. By the next morning, my leg looked like this. Note the severe swelling and bruising starting at the foot extending to the upper leg. At this time I went imediately back to the hospital and an emergency MRI was performed to assess the integrity of the popliteal artery. A possible BKA (below the knee amputation) was pending the MRI results. Fortunately, the artery was still intact, but I had torn the anterior cruciate ligament, posterior cruciate ligament, lateral collateral, lateral arcuate, lateral coroner ligaments, and the ilio-tibial band.

I had the knee reconstructed in 1997, and now have cadaver ligaments (allograft).

Lipofuscin

Easily seen at the poles of the cardiac nuclei, brown-red in color. The faster a mammal's basal rate of metabolism, the faster it produces lipofuscin. But for some reason, lipofuscin is also the pigment in earwax, giving it a characterisitc yellow-brown color. As one ages, the amount of lipofuscin will continue to increase, especially in the heart. One can determine the whether a heart is relatively young or old, as a direct reflection of the amount of lipofuscin present.

Cholesterol crystals in an atherosclerotic plaque.

This picture shows the depths of a plaque. The cholesterol crystals appear to be needle-shaped. They are actually rectangles in cross-section. The surrounding tissue is all necrotic (dead) debris. When this material ruptures from the plaque into the bloodstream, it makes the blood clot. This causes myocardial infarcts, strokes, gangrene, etc.

Myocardial Cell Hypertrophy

Compare the nuclei of these huge myocardial cells to the little endothelial cell nuclei that lie between them. Obviously these have more than 92 chromosomes (normal for a sedentary person's heart).

Athletic hypertrophy is good, but hypertrophy due to high blood pressure is part of the problem.

Aspergillosis Fungus Ball

This was a mass of fungi from a cavity within the lung. There is no normal lung tissue here. The patient had mild diabetes, and this set him at risk.

The spores were inhaled, germinated, invaded a blood vessel, and infarcted a portion of lung.

Each individual fungal hypha is about 8 mm across. They branch at 45 degree angles and have septa.

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