13-6
REVIEW TEST
DIRECTIONS Retype the following marerial into a hospital autopsy protocol by using the basic block formar et op
the patient's name and other statistical data as you desire. Use a current date and correct punctuation. The dieta
is Dr Susan Rt. Poster, chief pathologist. See p. 102 for block format. Note that the main tople and subropics vary
from those shown in Figure 13-10.
I performed an autopsy on the body of Phyllis B. Dexter, Parient No. 65-43-90, at the College
Hospital. Clinical Diagnosis: Congenital heart defect.
13
General Examination: The body is that of a well developed and well nourished newborn female
infant, having been embalmed prior to examination through a thoracic incision and cannuliza-
tion of the heart. The recorded birth weight is 7 pounds 2 ounces. Thorax opened: Consider
able blood is present around the heart incident to the embalming procedure, and two incisions
in the cardiac muscle are evident but the valves and great vessels do not appear to have been
injured by the embalming procedure. Examination discloses a massive heart lying transversely in
the midanterior thorax, the distended right ventricle exceeding in volume the ventricular mass
Examination discloses no enlargement of the ductus arteriosus or any significant deviation of
the size of the great vessels. On exploration of the heart there is found to be a completely imper
forate pulmonary artery at the level of the pulmonary valve, all 3 cusps of which appear to be
adequately formed but fused by scar tissue slightly proximal to the free margins of the cusps
It is impossible to probe the existence of any opening in this area. The right heart is markedly
hypertrophic, approximating three times the muscle mass of the normal infant heart. There is no
evidence of an interventricular defect. There is a sacculation adjacent to the valve of the inferior
vena cava as it enters the inferior right auricle and in the dome of this sacculated area the fora
men ovale is demonstrated. The foramen is unusually small in diameter (estimated to be no more
than 4 mm in diameter) and this is covered by a plica. It would appear that the pressure of the dis
tended right aurice would further compromise the capacity of the foramen to transmit blood. In
the absence of any interventricular defect, this would be the only way that blood could get from
the right to the left side of the heart. The lungs are heavy and poorly serrated and the bronchial
free contains some yellowish fluid which, in the absence of feeding by mouth, must be assumed
6212 80007 1907 1941 194 1979 by R