EXTERNAL EXAMINATION

A mortuary tag, with appropriate patient identifying information, is attached to the ___ of the decedent.

A hospital identification armband, with appropriate patient identifying information, is attached to the __ of the decedent.

BODY HABITUS: The body is that of a well-developed, well-nourished __.

LENGTH: __ cm | __ ft __ in

WEIGHT: __ kg | __ pounds

RIGOR MORTIS: There is __ (of 3+) rigor mortis of the jaw, neck, and extremities.

LIVOR MORTIS: There is __ (of 3+) livor mortis of the dorsal dependent portions of the body.

SKIN: The skin is moderately elastic and unbroken. There is no significant edema or jaundice.

SCALP: The scalp is covered with __colored hair in a __ pattern of distribution.

SKULL: The skull is symmetrical and normally formed.

IRIDES: The irides are __ .

SCLERAE: The sclerae are __ .

PUPILS: The pupils are round, regular and equal, and measure __ mm in diameter.

NOSE: The nose is unremarkable.

EXTERNAL EARS: The external ears are unremarkable.

TEETH: The teeth are unremarkable.

TONGUE: The tongue is unremarkable.

ORAL MUCOSA: The oral mucosa is unremarkable.

FACIAL HAIR: There is no facial hair.

NECK: The neck is symmetrical with no abnormal masses.

CHEST: The chest is symmetrical and normal in configuration.

BREASTS: The breasts are not enlarged and there are no palpable masses.

ABDOMEN: The abdomen is symmetrical, protuberant, devoid of incisional scars and there are no palpable masses.

LYMPH NODES: The superficial lymph nodes are not enlarged.

EXTERNAL GENITALIA: The external genitalia are those of a normal adult __.

EXTREMITIES: The extremities are normally formed with no gross abnormalities.

IDENTIFYING MARKS:

EVIDENCE OF MEDICAL INTERVENTION:

INTERNAL EXAMINATION:

A standard Y-shaped thoracic and abdominal incision is used to open the body. The thoracic and abdominal muscles are dark red and moderately firm. The organs of the thorax and abdomen display the usual anatomic relationships.

SUBCUTANEOUS FAT:

Chest subcutaneous fat thickness: __ cm

Abdomen subcutaneous fat thickness: __ cm

PLEURAL CAVITIES: No abnormal adhesions are present.

Right pleural cavity: __ cc serous/serosanguineous/bloody fluid

Left pleural cavity: __ cc serous/serosanguineous/bloody fluid

PERITONEAL CAVITY: No abnormal adhesions are present. The peritoneal surfaces are smooth, glistening and transparent.

Peritoneal cavity: __ cc serous/serosanguineous/bloody fluid

PERICARDIUM: The pericardial sac is smooth, glistening, yellow and translucent.

Pericardium: __ cc serous/serosanguineous/bloody fluid

HEART: The heart size and weight are ___. The epicardium is smooth, glistening and pale gray. The subepicardial fat is normal in amount and distinct from the underlying myocardium. The myocardium is dark red and moderately firm without focal lesions. The papillary muscles and columnae carneae are small and round. The chambers are not dilated and the myocardial walls are not hypertrophied. The endocardium is thin, glistening and translucent throughout. The valves are normally formed. The leaflets of the tricuspid and mitral valves are thin, pliable and translucent. The chordae are intact, discrete and delicate. The cusps of the pulmonic and aortic valves are thin, semi-transparent and pliable. The foramen ovale is closed. There are no mural thrombi.

Heart weight: ___. Expected: ___(within normal limits)

Right ventricle thickness: ___. Expected: ___. (within normal limits)

Left ventricle thickness: ___. Expected: ___. (within normal limits)

Tricuspid valve: ___. Expected: ___. (within normal limits)

Pulmonary valve: ___. Expected: ___ (within normal limits)

Mitral valve: ___. Expected: ___. (within normal limits)

Aortic valve: ___. Expected: ___ (within normal limits)

CORONARY ARTERIES: The coronary arteries arise from the root of the aorta, are distributed in the usual manner, and display predominance of the right coronary artery. The coronary arteries are without significant atherosclerotic disease or evident intraluminal thrombosis.

Left main coronary artery: __ % luminal stenosis

Left anterior descending coronary artery: __ % luminal stenosis

Left circumflex coronary artery: __ % luminal stenosis

Right coronary artery: __ % luminal stenosis

AORTA: The aorta and its major proximal branches are patent. The aorta has minimal atherosclerotic disease.

RIGHT and LEFT LUNGS: The pleural surfaces are pink, smooth and glistening. No adhesions are present. The lungs are soft, pink, crepitant and elastic. The lungs are without macroscopic evidence of hemorrhage, consolidation or tumor. The tracheobronchial tree is clear. The tracheal and bronchial mucosa is gray, smooth and glistening. The pulmonary arteries and veins are patent and have smooth intimal surfaces. There are no thrombi. The hilar lymph nodes are small and gray-black.

Right lung: ___. Expected: ___. (within normal limits)



Left lung: ___. Expected: ___. (within normal limits)




LARYNX: There are no lesions or obstructing materials in the larynx. The vocal folds are symmetrical and covered by intact, smooth, pale mucosa. There is no evidence of swelling or tumor.

THYROID GLAND: The thyroid is bilobed, symmetrical and non-nodular. The cut surfaces of the thyroid gland are tan, glistening and firm without focal lesions.

Thyroid: ___. Expected: ___. (within normal limits)



ESOPHAGUS: The esophagus is elastic and lined by longitudinally folded light gray mucosa. There are no focal lesions.

STOMACH: The gastric serosa is smooth, pale gray and glistening. The stomach contains thin, flocculent material. The mucosa is pale pink-gray and displays the usual rugal pattern. There are no ulcers or tumors. The pylorus is of normal structure and circumference.

INTESTINES: There are no focal lesions of the duodenum, jejunum or ileum. The appendix is normally located, small, firm and pink. The colon is of normal structure and contains soft feces. The colonic mucosa is intact throughout. There are no tumors, focal lesions or obstruction. The mesenteric vessels are patent.

LIVER: The capsule of the liver is intact. The external surfaces are smooth, glistening and brown-red. The liver is moderately firm. On cut sections, the liver surfaces bulge slightly, are lobulated, dark brown, and finely mottled with red. There are no focal lesions.

Liver: ___. Expected: ___. (within normal limits)



GALLBLADDER: The gallbladder is smooth, glistening, gray-green, thin-walled and contains viscid dark green fluid. The mucosa is pale green and velvety. There are no choleliths or tumors. The extrahepatic biliary tree is patent to the ampulla of Vater.

Gallbladder contains: __ cc

PANCREAS: The pancreas has a normal anatomic location and configuration. The cut surfaces are tan, lobulated and moderately firm. There are no focal lesions.

KIDNEYS: The renal architecture is intact. The renal capsules strip without difficulty. The cortical surfaces are smooth, glistening and brown. The cut surfaces bulge slightly and are smooth, glistening and red. The corticomedullary portions are distinct. There are no focal lesions or calculi. The renal pelves and calyces are of normal structure and are lined by smooth, glistening, gray mucosa. The ureters are straight, elastic, tubular structures without focal lesions or evidence of obstruction.

Right kidney: ___. Expected: ___. (within normal limits)



Right kidney cortex thickness: __ cm
Right kidney parenchyma thickness: __ cm


Left kidney: ___. Expected: ___. (within normal limits)



Left kidney cortex thickness: __ cm
Left kidney parenchyma thickness: __ cm


URINARY BLADDER: The bladder contains no urine. The bladder mucosa is finely trabeculated, smooth, glistening, gray and opaque. No focal lesions are identified.

ADRENAL GLANDS: The irregularly folded yellow cortices are distinct from the gray medullae. There is no significant pathologic abnormality.

Right adrenal gland weight: __ g

Left adrenal gland weight: __ g

Combined adrenal gland weight: __ g (normal combined weight: 11.5, 8.3 – 16.7)

SPLEEN: The capsule is intact, finely wrinkled, purple and glistening. On cut sections, the surfaces are slightly bulging, soft, dark red and mottled with fine gray strands. No focal lesions are present.

Spleen: ___. Expected: ___. (within normal limits)




LYMPH NODES: The tracheobronchial and bronchopulmonary lymph nodes are small, soft and tan-brown. The para-aortic and mesenteric lymph nodes are small, soft and tan-brown throughout.

MUSCULOSKELETAL SYSTEM: There are no focal abnormalities identified.

BONE MARROW: The vertebral bone marrow is hard, granular, dark red and homogenous.

Heart weights by height

height (cm)	male (+/- 40g)	female (+/- 30g)
135	254	219
136	256	220
137	258	222
138	260	224
139	262	226
140	264	227
141	266	229
142	268	231
143	270	233
144	272	235
145	273	236
146	275	238
147	277	240
148	279	242
149	281	243
150	283	245
151	285	247
152	287	249
153	289	251
154	291	252
155	292	254
156	294	256
157	296	258
158	298	259
159	300	261
160	302	263
161	304	265
162	306	267
163	308	268
164	310	270
165	311	272
166	313	274
167	315	275
168	317	277
169	319	279
170	321	281
171	323	283
172	325	284
173	327	286
174	329	288
175	330	290
176	332	291
177	334	293
178	336	295
179	338	297
180	340	299
181	342	300
182	344	302
183	346	304
184	348	306
185	349	307
186	351	309
187	353	311
188	355	313
189	357	315
190	359	316
191	361	318
192	362	320
193	365	322
194	367	323
195	368	325
196	370	327
197	372	329
198	374	331
199	376	332
200	378	334

Heart weights by body weight

body weight (kg)	body weight (lbs)	female heart mean (g)	female heart range (g)	male heart mean (g)	male heart range (g)
30	66	196	133-287	213	162-282
32	71	201	137-295	220	167-291
34	75	206	141-302	227	172-300
36	79	211	144-310	234	177-309
38	84	216	148-317	240	182-317
40	88	221	151-324	247	187-325
42	93	226	154-331	253	191-334
44	97	230	157-337	259	196-341
46	101	234	160-344	265	200-349
48	106	239	163-350	270	205-357
50	110	243	166-356	276	209-364
52	115	247	169-362	281	213-271
54	119	251	171-368	287	217-379
56	123	255	174-374	292	221-386
58	128	259	177-379	297	225-392
60	132	262	179-385	302	229-399
62	137	266	182-390	307	233-406
64	141	270	184-395	312	237-412
66	146	273	187-401	317	240-419
68	150	277	189-406	322	244-425
70	154	280	191-411	327	248-431
72	159	284	194-416	331	251-437
74	163	287	196-420	336	255-444
76	168	290	198-425	341	258-450
78	172	293	200-430	345	261-455
80	176	297	202-435	349	265-461
82	181	300	205-439	354	268-467
84	185	303	207-444	358	271-473
86	190	306	209-448	362	275-478
88	194	309	211-453	367	278-484
90	198	312	213-457	371	281-489
92	203	315	215-461	375	284-495
94	207	318	217-465	379	287-500
96	212	320	219-470	383	290-506
98	216	323	221-474	387	293-511
100	220	326	222-478	391	296-516
102	225	329	224-482	395	299-521
104	229	331	226-486	399	302-526
106	234	334	228-490	403	305-531
108	238	337	230-494	406	308-536
110	243	339	232-497	410	311-541
112	247	342	233-501	414	314-546
114	251	345	235-505	418	316-551
116	256	347	237-509	421	319-559
118	260	350	239-513	425	322-561
120	265	352	240-516	429	325-566
125	275	359	244-525	437	331-577
130	287	364	249-534	446	338-589
135	297	370	252-542	455	345-600
140	309	376	257-551	463	351-611
145	320	382	260-560	472	357-622
150	331	387	264-567	479	363-633

Valve circumferences age 1-19

age (yr)	AV: female	range	male	range	MV: female	range	male	range	PV: female	range	male	range	TV: female	range	male	range
0	2.2	1.33-3.00	2.2	1.35-3.02	2.8	1.31-4.31	2.6	0.83-4.44	2.2	1.13-3.23	2.1	0.83-3.32	3	1.11-4.88	2.5	0.66-4.38
1	3.0	2.11-3.79	3	2.20-3.87	4.1	2.57-5.57	4.1	2.24-5.86	3	1.97-4.07	3.0	1.78-4.27	4.7	2.80-6.56	4.5	2.67-6.39
2	3.4	2.53-4.21	3.5	2.65-4.32	4.7	3.25-6.24	4.8	3.00-6.62	3.5	2.42-4.52	3.5	2.29-4.78	5.6	3.70-7.46	5.6	3.75-7.47
3	3.7	2.82-4.50	3.8	2.96-4.63	5.2	3.71-6.70	5.3	3.52-7.13	3.8	2.72-4.82	3.9	2.64-5.13	6.2	4.31-8.08	6.3	4.48-8.20
4	3.9	3.04-4.72	4.0	3.20-4.87	5.6	4.06-7.06	5.7	3.91-7.53	4.0	2.96-5.06	4.2	2.91-5.40	6.7	4.78-8.55	6.9	5.04-8.77
5	4.1	3.22-4.89	4.2	3.39-5.06	5.8	4.34-7.34	6.0	4.23-7.85	4.2	3.14-5.24	4.4	3.12-5.61	7.1	5.17-8.93	7.4	5.50-9.22
6	4.2	3.37-5.04	4.4	3.55-5.22	6.1	4.58-7.58	6.3	4.50-8.12	4.4	3.30-5.40	4.6	3.30-5.79	7.4	5.48-9.25	7.7	5.88-9.60
7	4.3	3.49-5.17	4.5	3.69-5.36	6.3	4.79-7.78	6.5	4.73-8.35	4.5	3.49-5.54	4.7	3.46-5.95	7.6	5.76-9.53	8.1	6.21-9.93
8	4.5	3.61-5.28	4.7	3.81-5.48	6.5	4.97-7.96	6.7	4.93-8.55	4.6	3.56-5.66	4.8	3.59-6.08	7.8	6.00-9.77	8.4	6.50-10.2
9	4.6	3.71-5.38	4.8	3.92-5.59	6.6	5.13-8.13	6.9	5.12-8.73	4.7	3.67-5.77	5.0	3.71-6.21	8.1	6.22-9.98	8.6	6.75-10.5
10	4.6	3.88-5.47	4.9	4.02-5.69	6.8	5.27-8.27	7.1	5.28-8.89	4.8	3.76-5.86	5.1	3.82-6.32	8.3	6.41-10.2	8.9	6.99-10.7
11	4.7	3.92-5.56	4.9	4.11-5.78	6.9	5.40-8.40	7.2	5.43-9.04	4.9	3.85-5.95	5.2	3.92-6.42	8.5	6.59-10.3	9.1	7.20-10.9
12	4.8	3.96-5.63	5.0	4.19-5.86	7.0	5.53-8.52	7.4	5.56-9.18	5.0	3.93-6.03	5.3	4.02-6.51	8.6	6.75-10.5	9.3	7.39-11.1
13	4.9	4.03-5.70	5.1	4.27-5.93	7.1	5.64-8.64	7.5	5.69-9.31	5.1	4.01-6.11	5.4	4.10-6.59	8.8	6.90-10.7	9.4	7.57-11.3
14	4.9	4.09-5.77	5.2	4.34-6.00	7.2	5.74-8.74	7.6	5.81-9.42	5.1	4.07-6.17	5.4	4.18-6.67	8.9	7.04-10.8	9.6	7.74-11.5
15	5.0	4.15-5.83	5.2	4.40-6.07	7.3	5.84-8.84	7.7	5.92-9.53	5.2	4.14-6.24	5.5	4.25-6.74	9.1	7.17-10.9	9.8	7.89-11.6
16	5.1	4.21-5.89	5.3	4.46-6.13	7.4	5.93-8.93	7.8	6.02-9.64	5.3	4.20-6.30	5.6	4.32-6.81	9.2	7.29-11.1	9.9	8.04-11.8
17	5.1	4.26-5.94	5.4	4.52-6.19	7.5	6.02-9.02	7.9	6.12-9.73	5.3	4.26-6.36	5.6	4.39-6.88	9.3	7.41-11.2	10.0	8.18-11.9
18	5.2	4.32-5.99	5.4	4.58-6.25	7.6	6.10-9.10	8.0	6.21-9.83	5.4	4.31-6.41	5.7	4.45-6.94	9.4	7.52-11.3	10.2	8.31-12.0
19	5.2	4.36-6.04	5.5	4.63-6.30	7.7	6.18-9.17	8.1	6.30-9.91	5.4	4.36-6.46	5.8	4.51-7.00	9.5	7.62-11.4	10.3	8.43-12.1

Valve circumferences age 20-60

circumference (cm)	male mean	male range	female mean	female range
aortic valve	6.7	6.0-7.4	6.3	5.7-6.9
pulmonary valve	6.6	6.1-7.1	6.2	5.7-6.7
mitral valve	9.6	9.4-9.9	8.6	8.2-9.1
tricuspid valve	11.4	11.2-11.7	10.6	10.2-10.9

Valve circumferences age 60+

circumference (cm)	male mean	male range	female mean	female range
aortic valve	8.3	8.1-8.5	7.6	7.3-7.9
pulmonary valve	7.3	7.2-7.5	7.1	6.8-7.4
mitral valve	9.5	9.2-9.8	8.6	8.2-9.0
tricuspid valve	11.6	11.4-11.8	10.5	10.0-11.1

heart wall thickness age 20+

thickness	mean (age 20-60)	range (age 20-60)	mean (age 60+)	range (age 60+)
left ventricle	1.25	1.00-1.50	1.15	1.05-1.25
right ventricle	0.40	0.25-0.50	0.38	0.35-0.40
ventricular septum	1.35	1.20-1.60	1.35	1.20-1.60
atrial muscle	0.20	0.10-0.30	0.20	0.10-0.30

Organ weights based on height

height (gender)	144-165 (male)	166-175 (male)	176-190 (male)	126-155 (female)	156-165 (female)	166-180 (female)
heart	344 ± 75	360 ± 75	381 ± 56	320 ± 88	308 ± 79	311 ± 67
right lung	616 ± 210	625 ± 207	741 ± 274	494 ± 202	545 ± 183	597 ± 243
left lung	523 ± 190	551 ± 178	658 ± 257	450 ± 146	472 ± 181	491 ± 204
liver	1455 ± 370	1637 ± 369	1831 ± 384	1275 ± 321	1496 ± 331	1624 ± 380
spleen	120 ± 51	150 ± 88	180 ± 90	122 ± 67	139 ±79	160 ± 82
pancreas	138 ± 35	143 ± 39	147 ± 39	111 ± 25	122 ± 35	138 ± 41
right kidney	150 ± 49	157 ± 36	170 ± 37	117 ± 32	137 ± 40	148 ± 36
left kidney	155 ± 53	164 ± 38	175 ± 38	120 ± 41	136 ± 35	148 ± 33
thyroid	25 ±7	25 ± 13	25 ± 9	20 ± 11	18 ± 6	20 ± 11

Organ weights based on BMI

BMI (gender)	14-21 (male)	22-24 (male)	25-34 (male)	13-20 (female)	21-24 (female)	25-40 (female)
heart	342 ± 58	370 ± 75	400 ± 69	287 ± 74	308 ± 68	362 ± 77
right lung	670 ± 249	651 ± 241	663 ± 217	536 ± 178	547 ± 203	561 ± 256
left lung	593 ± 224	579 ± 201	569 ± 221	450 ± 146	472 ± 181	491 ± 204
liver	1581 ± 372	1730 ± 405	1769 ± 390	1346 ± 328	1521±331	1609 ± 419
spleen	143 ± 83	157 ± 83	175 ± 93	126 ± 70	150 ± 93	152 ± 67
pancreas	131 ± 38	143 ± 34	162 ± 38	114 ± 33	129 ± 38	125 ± 32
right kidney	156 ± 40	163 ± 37	169 ± 37	126 ± 35	139 ± 40	144 ± 40
left kidney	158 ± 43	170 ± 41	174 ± 35	126 ± 32	139 ± 38	146 ± 38
thyroid	24± 11	25 ±7	28 ± 13	19 ± 7	19 ± 8	20 ± 11

Adult organ weights

organ (g)	male mean ± SD	range	female mean +/- SD	range
heart	365 ± 71	90-630	312 ± 78	174-590
right lung	663 ± 239	200-1593	546 ± 207	173-1700
left lung	583 ± 216	206-1718	467 ± 174	178-1350
liver	1677 ± 396	670-2900	1475 ± 362	508-3081
spleen	156 ± 87	30-580	140 ± 78	33-481
pancreas	144 ± 39	65-243	122 ± 35	60-250
right kidney	162 ± 39	53-320	135 ± 39	45-360
left kidney	160 ± 41	50-410	136 ± 37	40-300
thyroid	25 ± 11	12-87	20 ± 9	5-88