Autopsy - Internal exam #path

- double 'Y' incision, start from neck to identify carotid artery - jugular vein and nerve -

Neck dissection - carotid sheath (start on the right side; identify the right subclavian artery since the left will be on the aortic arch) - follow down to thymus to identify or dissect away (the head of the thymus at least) - stop here to continue later

Abdomen - use umbilical stump to grip and reflect after making the lower half of the 'double Y' incision - dissect and reveal the umbilical vein (carries oxygenated blood in) and the buried left and right arteries → important to correlate if there's only one artery - inspect urinary bladder, uterine fundus visible first with ovaries roughly half the size of the uterus, may show yellow/straw color (to help identify) - inspect position of organs below diaphragm and note any defect in diaphragm (organs would herniate into the thoracic cavity, compressing and pushing - this often happens on the left side more than right side) - begin dissection, divide at rectom/distal sigmoid (note presence of meconium) dissect to lay out from flexures, appendix, small bowel up to stomach → lay out and set aside - identify gallbladder and compress to confirm no biliary tree obstruction - note any malrotation of the bowel or other organs. spleen and pancreas can be identified and set aside, then liver. - open stomach and gently probe (for meconium or other obstruction; will probe airways and esophagus again later) - inspect adrenals and kidneys, follow ureters to the bladder - remove both adrenals and kidneys, dissect off anterior fascia if present, leave a significant length of the left ureter attached to maintain laterality after removal