The scalp is then reflected forward, exposing the underlying skull. A bone saw is used to cut-out a piece of skull, thus allowing access to the underlying brain. In some instances, the bone can be removed without disturbing the underlying dura. In such cases, the skull cap actually peels off of the dura as it is being pulled off of the head. In other cases, the dura remains adherent to the inner aspect of the skull cap so that when the skull is removed, the dura is also removed, thus exposing the underlying brain. The brain is examined and is serially-sectioned in the “fresh” (non-fixed) state, although in some cases, the brain is fixed in formalin prior to sectioning. A section of “fresh” (non-fixed) brain at autopsy. Examination of the anterior (front) of the neck typically includes removal of the trachea the larynx, and the thyroid gland. Layer-by-layer anterior neck dissection. Spinal cord removal via an anterior (front) approach. An alternative method involves removing the spinal cord from a posterior (back) approach. A body following complete autopsy. Note the sutured Y-shaped incision. Also note that, after the scalp is reflected back into its original position, and the incision is stitched, it is impossible to detect from the front that the head has been autopsied. This allows for adequate viewing of bodies at funerals. Lividity, or livor mortis, represents the postmortem settling of blood within the dependent skin, due to gravitational forces. Note that areas of skin exposed to pressure do not develop lividity. After several hours, lividity becomes “fixed,” such that movement of a body from one position to another may become evident because the lividity pattern is inappropriate for the current body position. Lividity occurs in dependent portions of the skin, where dark, pinpoint Tardieu spots may form. If a body is in full rigor mortis, the presence of “inappropriate” rigor mortis may indicate that the body has been moved. The woman obviously did not die in this body position. The dark discoloration of the sclera (the white part of the eye) is a common early postmortem change, known as tache noire. One of the earliest signs of decomposition is green discoloration of the lower right abdominal quadrant, seen toward the right side of the photo. As decomposition proceeds, “marbling” of the skin may become apparent.