Đang tải... (xem toàn văn)
(BQ) Part 2 book Color atlas of the autopsy has contents: Organ and tissue removal, individual organ examination, examination of the head, skull, brain, and spinal cord, microscopic examination, postmortem laboratory analysis of drugs, chemicals, and microorganisms,... and other contents.
7 Organ and Tissue Removal ,QWKH9LUFKRZDXWRSV\PHWKRGWKHRUJDQVDUHUHPRYHG RQHDIWHUDQRWKHULQDQRUJDQL]HGDQGORJLFDOIDVKLRQLH WKH QHFN RUJDQV DUH UHPRYHG DIWHU WKH YLVFHUD WR QHJDWH WKHDUWLIDFWXDODSSHDUDQFHRIKHPRUUKDJHRIWHQSURGXFHG E\FRQJHVWLRQ2WKHURUJDQUHPRYDOPHWKRGVLQFOXGHWKH *RKQ/HWXOOHRUPRGLÀHG5RNLWDQVN\PHWKRGVLQZKLFK WKH RUJDQV DUH UHPRYHG HQ EORF DOO WRJHWKHU 7KLV W\SH RI UHPRYDO DOORZV WKH LQWHUQDO YLVFHUD WR EH H[DPLQHG ZKLOHWKH\DUHVWLOOFRQQHFWHGWRJHWKHU6RPHSDWKRORJLVWV DOZD\VUHPRYHRUJDQVHQEORF7KHDXWKRUKDVIRXQGWKH *RKQPHWKRGXVHIXOZKHQH[DPLQLQJLQIDQWVZLWKPXOWL SOH FDUGLDF DQG RWKHU ELUWK GHIHFWV 7KHUH LV QR ULJKW RU ZURQJPHWKRGRIGLVVHFWLRQ WKHDLPLVVLPSO\WRSHUIRUP DFRPSOHWHDXWRSV\DQGWRSURYLGHDGHWDLOHGGHVFULSWLRQ RIWKDWDXWRSV\ 99 100 Color Atlas of the Autopsy HEART EXCISION FIGURE 7.1 $ ² & +HDUWUHPRYDOFXWWLQJWKHLQIHULRUYHQDFDYD7KHLQIHULRUYHQDFDYDLVFXWDV DUHWKHSXOPRQDU\YHLQVSXOPRQDU\DUWHULHVDQGDRUWD7KHKHDUWLVKHOGLQWKHOHIWKDQGLQWKHVHÀJXUHV %ORRGÁRZVIURPWKHFXWYHVVHOVLIWKHEORRGLVQRWFORWWHGGHFRPSRVHGRUPRVWO\DEVHQWIURPWKHERG\ ,QFDVHVRIVHYHUHKHPRUUKDJHWKHUHLVDQRWDEOHDEVHQFHRIEORRGDWWKLVPRPHQWRIWKHDXWRSV\ Organ and Tissue Removal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olor Atlas of the Autopsy NECK DISSECTION FIGURE 7.48 $ ² & 1HFNGLVVHFWLRQH[SRVLQJPXVFOHV7KHQHFNLVGLVVHFWHGDIWHUWKHYLVFHUDKDYHEHHQUHPRYHG:KLOH DSSO\LQJWUDFWLRQWRWKHXSSHUFKHVWVNLQDQGVRIWWLVVXHÁDSWKH´VWUDSµPXVFOHJURXS PLGOLQH DQGVWHUQRFOHLGRPDVWRLG ODWHUDO DUHUHYHDOHGGXULQJFDUHIXOGLVVHFWLRQ7KHPDLQIRFXVRIWKHGLVVHFWLRQLVWRORRNIRUKHPRUUKDJH,IKHPRUUKDJHLVGLVFRYHUHG DWDQ\VWHSWKHGLVVHFWLRQLVSKRWRJUDSKHGDVLWSURJUHVVHV6XVSHFWHGVWUDQJXODWLRQFDVHVDUHLPSDUWHGDQHYHQPRUHGHWDLOHG GLVVHFWLRQWKDQGHSLFWHGKHUH Organ and Tissue Removal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olor Atlas of the Autopsy FIGURE 7.51 $ ² & 1HFNGLVVHFWLRQFXWWLQJWKHWUDFKHD7KHWUDFKHDDQGHVRSKDJXVDUHFXWZKLOHWUDFWLRQLVSODFHGZLWK WKHOHIWKDQG7KHSDWKRORJLVWLVFDUHIXOWRFXWDZD\WKHWLVVXHZLWKRXWFXWWLQJWKHFDURWLGDUWHULHVVLQFHWKHHPEDOPHUXVHVWKH FDURWLGDUWHULHVWRHPEDOPWKHKHDG&XWWLQJWKHFDURWLGVPDNHVWKHPGLIÀFXOWIRUWKHHPEDOPHUWRÀQG Organ and Tissue Removal 143 FIGURE 7.52 &DURWLG DUWHU\ UHODWLRQVKLSV 7KH FDURWLG DUWHU\ LV VKRZQE\WKHIRUFHSV7KHQHFNRUJDQVKDYHEHHQUHPRYHG7KHFHUYLFDO YHUWHEUDH DUH MXVW EHORZ WKH DUWHU\ 6LJQLÀ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olor Atlas of the Autopsy FIGURE 7.54 $ % ... KSHUWHQVLYHKHDUWGLVHDVH Color Atlas of the Autopsy Organ and Tissue Removal LUNG EXCISION FIGURE 7.5 $ ² & ([FLVLRQRIWKHOXQJV7KHOXQJVDUHUHPRYHGDWWKHKLOXPRUFHQWHURIDWWDFKPHQW 103 104 Color Atlas of. .. ZURQJPHWKRGRIGLVVHFWLRQ WKHDLPLVVLPSOWRSHUIRUP DFRPSOHWHDXWRSVDQGWRSURYLGHDGHWDLOHGGHVFULSWLRQ RIWKDWDXWRSV 99 100 Color Atlas of the Autopsy HEART EXCISION FIGURE 7.1 $ ² & +HDUWUHPRYDOFXWWLQJWKHLQIHULRUYHQDFDYD7KHLQIHULRUYHQDFDYDLVFXWDV... DQGFRQWXVLRQVDPRQJRWKHUFRQGLWLRQV7KHGLDSKUDJPLVWKHGRPHVKDSHGVWUXFWXUHLQWKHORZHU FHQWHURIWKHSLFWXUH 106 Color Atlas of the Autopsy LIVER EXCISION FIGURE 7.9 $ % )UHHLQJ WKH OLYHU IURP WKH GLDSKUDJP7KH