(h) Examine the neck after the thoracic organs and brain have been removed and the neck vessels have been drained. Remove the neck organs, including the tongue, under direct vision having reflected the skin of the front of the neck. Take care not to fracture the hyoid bone or thyroid cartilage. Dissect and describe any injuries. Check the mucosa of the larynx, pyriform sinuses and oesophagus, and note any petechiae, oedema, or burns caused by corrosive substances. Note any articles or substances within the lumina of these structures. Examine the thyroid gland. Separate and examine the parathyroid glands, if they are readily identifiable (i) Dissect the neck muscles, noting any haemorrhage. Dissect the muscles from, and note any fractures of, the hyoid bone or thyroid or cricoid cartilages. Consider also a posterior neck disSection if it is at all possible; there may be soft tissue or skeletal injuries there (j) Examine the cervical, thoracic and lumbar spine. Examine the vertebrae from their anterior aspects and note any fractures, dislocations, compressions or haemorrhages. Examine the vertebral bodies (k) In cases in which spinal injury is suspected, dissect and describe the spinal cord. Examine the cervical spine anteriorly and note any haemorrhage in the paravertebral muscles. The posterior approach is best for evaluating high cervical injuries. Open the spinal canal and remove the spinal cord. Make transverse sections every 0.5 cm and note any abnormalities. 5. Further testing 262. The autopsy is a specialized medical investigation that includes the collection of samples, tissues and fluid for further testing.115 The specimens and the manner of collecting them, together with their storage and transport and period of retention, should be agreed with the laboratory that will be undertaking the further testing. If there is no such laboratory, samples, tissues and fluid should still be retained, as testing may be organized later. 115 263. After the autopsy has been completed, saved specimens must be recorded and listed in the report. Label all specimens with the name of the deceased, the autopsy identification number, the date and time of collection, the name of the prosector (if applicable), and the contents. Carefully secure all evidence and begin the chain of custody record with the appropriate release forms. There should be agreement with the investigating officer about how the samples will be stored and then transported to the laboratory undertaking the analysis. The transport of such samples is usually a police responsibility exercised following full chain of custody requirements which ensure the security of the samples. (a) Large organ and tissue specimens: Very occasionally, large organ and tissue specimens may be retained by the forensic doctor for: (i) Better examination of an organ of particular importance in the case (e.g. the brain) (ii) Further examination by an expert, including one acting for an accused person (iii) Use as direct evidence. The next of kin should be informed and preferably their consent to the retention obtained. If consent is not provided, and the retention is still regarded as being necessary, then formal authorization of the retention should be obtained. Such retention must be in accordance with local law and ethical guidelines, and take into account the family’s preferences for the burial or disposal of such organs and tissues. (b) Histology: In all cases of potentially unlawful death, small representative samples of all major organs, including areas of normal and any abnormal tissue, should be retained in 10% formalin, processed histologically and stained with haematoxylin and eosin (and other stains as indicated). The wet tissue, paraffin blocks and slides should be kept indefinitely. Many forensic doctors are not trained to evaluate histology material. Arrangements should be made for a suitable histopathologist, preferably one with forensic training and experience, to report on the histology. This should be done in consultation: the histopathologist needs to understand the history and findings from the autopsy; and the forensic doctor needs to understand the conclusions, and any limitations, of the histopathologist This Section relates to the collection of samples, tissues and fluid. It draws heavily on Section 5.6 “Special Investigations” of Forensic Autopsy: Manual for Forensic Pathologists, UN Office on Drugs and Crime. This manual should be consulted for any further assistance required. 43