Wednesday, March 12, 2014

M.B.B.S 3rd year practical exams in Forensic Medicine (Autopsy Instruments)

Autopsy instruments might be placed in spotting or may be given to you during viva & asked to identify that particular instrument and comment about its use during autopsy. You'll have to identify these instruments & know these few things regarding them.

These large scissors are used for opening the intestines. The bulb-ended blade is inserted into the lumen (the hollow inside) of the gut, and the instrument is smoothly stripped down the length of the intestine. The blunt bulb keeps the internal blade from perforating the gut from the inside.
Skull chisel
After scoring the calvarium (the vault-like part of the skull that holds the brain) with the vibrating saw or hand saw, the chisel is used to gently finish the separation of the top of the calvarium from the lower skull, thus exposing the brain and its coverings (meninges).
Hagedorn needle
Also called the sailmaker's needle, this is a large needle with an eye for suturing the body after the autopsy is finished. Heavy twine, which is much coarser than suture, is used for the procedure.

Rib cutters
These look like small pruning shears and are used to cut through the ribs prior to lifting off the chest plate.
Hammer with hook
The hammer  is used with the chisel to separate the calvarium from the lower skull. The hook is handy to pull the calvarium away.
Also referred to simply as the "long knife," this is used to smoothly cut solid organs into slices for examination, display, and photography of the organs' cut surfaces, including stripping the gut from the mesentery and opening the heart chambers with this large, unlikely-looking blade
This differs from the surgeon's scalpel in having a longer handle for reaching deeper into body cavities. The disposable blade is usually a #22 size, which is the largest commonly available.
Toothed forceps
The teeth on these "pickups" lend strength in gripping heavy organs for removal. In surgical pathology, teeth are a liability in that they increase the risk of cross contamination between specimens, so untoothed forceps are used there.
These are otherwise unremarkable scissors used for opening hollow organs (such as the gallbladder) and trimming off tissues. They can also be used for blunt dissection by means of an "opening" motion, rather than the more familiar "closing" motion used in cutting.
Bone saw
This hand saw is rarely used today, most often by pathologists who fear infection from aersols thrown up by the much more vigorous vibrating saw. The hand saw can be used to saw through the skull, but it's very slow-going compared to the vibrating saw.
Vibrating saw
The vibrating saw, also referred to eponymously as the "Stryker saw," is the instrument of choice for opening the skull & removing the brain. The blade reciprocates rapidly with a small amplitude. This action prevents the saw from cutting soft tissues, notably the prosector's hand. The disadvantage of vibrating saws is that they throw up more potentially infectious aerosols than do hand saws.