field of medicine concerned with identifying disease forensic pathology – subspecialty of...
TRANSCRIPT
![Page 1: Field of Medicine concerned with identifying disease Forensic Pathology – subspecialty of pathology concerned with identification of human remains](https://reader034.vdocuments.net/reader034/viewer/2022051516/56649edb5503460f94beb1ab/html5/thumbnails/1.jpg)
FORENSIC PATHOLOGY AND AUTOPSY
![Page 2: Field of Medicine concerned with identifying disease Forensic Pathology – subspecialty of pathology concerned with identification of human remains](https://reader034.vdocuments.net/reader034/viewer/2022051516/56649edb5503460f94beb1ab/html5/thumbnails/2.jpg)
Pathology
Field of Medicine concerned with identifying disease
Forensic Pathology – subspecialty of pathology concerned with identification of human remains and determination of the cause and manner of death
The Field that performs an after death investigation of sudden or unexpected death or injury
![Page 3: Field of Medicine concerned with identifying disease Forensic Pathology – subspecialty of pathology concerned with identification of human remains](https://reader034.vdocuments.net/reader034/viewer/2022051516/56649edb5503460f94beb1ab/html5/thumbnails/3.jpg)
What Do They See
Deaths with violence – accidents, suicides, homicides
Suspicious Deaths Sudden, unexpected deaths, Deaths without a physician in attendance Deaths in a prison or jail
![Page 4: Field of Medicine concerned with identifying disease Forensic Pathology – subspecialty of pathology concerned with identification of human remains](https://reader034.vdocuments.net/reader034/viewer/2022051516/56649edb5503460f94beb1ab/html5/thumbnails/4.jpg)
Goals
Identify: Cause – The event/ injury that starts the
process towards death Manner - Mechanism – the normal body function that
results in death Whether Time of death is consistent with
proposed time
![Page 5: Field of Medicine concerned with identifying disease Forensic Pathology – subspecialty of pathology concerned with identification of human remains](https://reader034.vdocuments.net/reader034/viewer/2022051516/56649edb5503460f94beb1ab/html5/thumbnails/5.jpg)
Definition of Death
Formerly not a problem End of heart and/or lung function
No oxygen or blood = no life Brain death
Individuals may be kept alive by artificial means through machines that breathe as lungs would or that pump as a heart would
![Page 6: Field of Medicine concerned with identifying disease Forensic Pathology – subspecialty of pathology concerned with identification of human remains](https://reader034.vdocuments.net/reader034/viewer/2022051516/56649edb5503460f94beb1ab/html5/thumbnails/6.jpg)
Cause of Death
The process that starts the chain of events leading to death Atherosclerosis Heart Attack GSW to Chest infection of lungs Car Accident death during surgery 10 years
later Blunt Force injury to head not swallowing
correctly Choke
![Page 7: Field of Medicine concerned with identifying disease Forensic Pathology – subspecialty of pathology concerned with identification of human remains](https://reader034.vdocuments.net/reader034/viewer/2022051516/56649edb5503460f94beb1ab/html5/thumbnails/7.jpg)
Manner of Death
Natural Accident Suicide Homicide Undetermined
![Page 8: Field of Medicine concerned with identifying disease Forensic Pathology – subspecialty of pathology concerned with identification of human remains](https://reader034.vdocuments.net/reader034/viewer/2022051516/56649edb5503460f94beb1ab/html5/thumbnails/8.jpg)
Natural Deaths
Atherosclerosis Pneumonia Cancer Long term Alcohol/Drug abuse
![Page 9: Field of Medicine concerned with identifying disease Forensic Pathology – subspecialty of pathology concerned with identification of human remains](https://reader034.vdocuments.net/reader034/viewer/2022051516/56649edb5503460f94beb1ab/html5/thumbnails/9.jpg)
Accident
Car Accident Alcohol/ Drug overdose Drowning Suffocation
![Page 10: Field of Medicine concerned with identifying disease Forensic Pathology – subspecialty of pathology concerned with identification of human remains](https://reader034.vdocuments.net/reader034/viewer/2022051516/56649edb5503460f94beb1ab/html5/thumbnails/10.jpg)
Homicide/Suicide
GSW Stab Wound Drug Overdose Drowning Car Accident Asphyxia
![Page 11: Field of Medicine concerned with identifying disease Forensic Pathology – subspecialty of pathology concerned with identification of human remains](https://reader034.vdocuments.net/reader034/viewer/2022051516/56649edb5503460f94beb1ab/html5/thumbnails/11.jpg)
Undetermined
Not enough information about circumstances surrounding death Drug overdose – accidental overmedication or
suicide Cause of death unknown
Skeletonized remains No anatomical or toxicological explanation
![Page 12: Field of Medicine concerned with identifying disease Forensic Pathology – subspecialty of pathology concerned with identification of human remains](https://reader034.vdocuments.net/reader034/viewer/2022051516/56649edb5503460f94beb1ab/html5/thumbnails/12.jpg)
Scene investigation
Medical and legal conclusions rely on thorough scene investigation
Identity Approximate time of death Evidence and clues to circumstances
around death Was the house locked? Were there signs of struggle Position of body Suicide notes
![Page 13: Field of Medicine concerned with identifying disease Forensic Pathology – subspecialty of pathology concerned with identification of human remains](https://reader034.vdocuments.net/reader034/viewer/2022051516/56649edb5503460f94beb1ab/html5/thumbnails/13.jpg)
Identification of remains
Visual by family/friends Location of body – in their home? ID – driver’s license, distinctive feature –
tattoo Comparing x-rays Dental Records DNA Fingerprints
![Page 14: Field of Medicine concerned with identifying disease Forensic Pathology – subspecialty of pathology concerned with identification of human remains](https://reader034.vdocuments.net/reader034/viewer/2022051516/56649edb5503460f94beb1ab/html5/thumbnails/14.jpg)
Mechanism of Death
The immediate activity that results in death. Hemorrhage Widespread infection Heart Attack
![Page 15: Field of Medicine concerned with identifying disease Forensic Pathology – subspecialty of pathology concerned with identification of human remains](https://reader034.vdocuments.net/reader034/viewer/2022051516/56649edb5503460f94beb1ab/html5/thumbnails/15.jpg)
Time of Death
Important for time of the murder, eliminate or suggest suspects, confirm or disprove alibi
Most methods are to a degree unreliable and inaccurate.
The longer the time between death and the attempt to estimate the time of death, the less precise the estimate of the interval
![Page 16: Field of Medicine concerned with identifying disease Forensic Pathology – subspecialty of pathology concerned with identification of human remains](https://reader034.vdocuments.net/reader034/viewer/2022051516/56649edb5503460f94beb1ab/html5/thumbnails/16.jpg)
Estimation methods
Body temperature – 98.6 – rectal temp /1.5
Insect action Stomach contents – stage of digestion Last known activity – newspaper/ mail,
phone conversation/ text
![Page 17: Field of Medicine concerned with identifying disease Forensic Pathology – subspecialty of pathology concerned with identification of human remains](https://reader034.vdocuments.net/reader034/viewer/2022051516/56649edb5503460f94beb1ab/html5/thumbnails/17.jpg)
Livor and Rigor
Livor Mortis is a reddish/ purple coloration due to accumulation of blood in the small vessels of the gravity dependent areas. Occurs 30 min to 2 h after death Fixed at 8-12 h Important to determine position of body
Rigor – stiffening of the body due to disappearance of muscle energy Usually appears 2-4h after death, fully develops 6-
12 h after death Classically
Jaw arms -> legs
![Page 18: Field of Medicine concerned with identifying disease Forensic Pathology – subspecialty of pathology concerned with identification of human remains](https://reader034.vdocuments.net/reader034/viewer/2022051516/56649edb5503460f94beb1ab/html5/thumbnails/18.jpg)
![Page 19: Field of Medicine concerned with identifying disease Forensic Pathology – subspecialty of pathology concerned with identification of human remains](https://reader034.vdocuments.net/reader034/viewer/2022051516/56649edb5503460f94beb1ab/html5/thumbnails/19.jpg)
Time of Death
Body Temperature Time since death = (98.6°F – Rectal Temp) / 1.5 Based on assumption body temp is normal at death
Decomposition (Decomp) Breakdown of Cells and Organs by chemical process Breakdown by bacteria and fermentation
1. Green discoloration of abdomen (24-36h)2. Green spreads to head, neck and shoulders3. Swelling of the face and abdomen due to gas formation4. Marbling – breakdown of blood gives green/black color of blood
vessels5. Generalized bloating (60-72 h)6. Skin slippage7. Dry/ skeleton phase – 2 weeks in hot humid temps, months in
snow
![Page 20: Field of Medicine concerned with identifying disease Forensic Pathology – subspecialty of pathology concerned with identification of human remains](https://reader034.vdocuments.net/reader034/viewer/2022051516/56649edb5503460f94beb1ab/html5/thumbnails/20.jpg)
Entomology
Different insects are attracted at different stages after death
Flies are the most common form of insect associated with dead bodies
Lay eggs in orifices and open wounds Eggs generally are deposited immediately
after death in the day time Only eggs on the body = 1-2 days Maggots grow excessively larger in different
stages each about 1 day Adult flies emerge at 12 -18 days
![Page 21: Field of Medicine concerned with identifying disease Forensic Pathology – subspecialty of pathology concerned with identification of human remains](https://reader034.vdocuments.net/reader034/viewer/2022051516/56649edb5503460f94beb1ab/html5/thumbnails/21.jpg)
![Page 22: Field of Medicine concerned with identifying disease Forensic Pathology – subspecialty of pathology concerned with identification of human remains](https://reader034.vdocuments.net/reader034/viewer/2022051516/56649edb5503460f94beb1ab/html5/thumbnails/22.jpg)
External Exam
General Size and Appearance Clothing /personal belongings Major Injuries – cause of death signs Medical Intervention Signs of struggle – Frenulum, broken bones,
scratches around the hands Bruises, cuts, petechiae Scars, tattoos Livor, Rigor Teeth, eyes, hair Blood, eye fluid, urine
![Page 23: Field of Medicine concerned with identifying disease Forensic Pathology – subspecialty of pathology concerned with identification of human remains](https://reader034.vdocuments.net/reader034/viewer/2022051516/56649edb5503460f94beb1ab/html5/thumbnails/23.jpg)
Trauma to the Human Body
1. Determine type of wound
2. Measure the dimensions (length, width, depth)
3. Position relative to anatomical landmarks
4. Determine initial location if wound involves cutting, slashing, etc.
5. Determine height from heel
![Page 24: Field of Medicine concerned with identifying disease Forensic Pathology – subspecialty of pathology concerned with identification of human remains](https://reader034.vdocuments.net/reader034/viewer/2022051516/56649edb5503460f94beb1ab/html5/thumbnails/24.jpg)
Types of Wounds 1. Lacerations
2. Incised Wound
3. Puncture
4. Abrasion
5. Contusion
6. Gunshot
![Page 25: Field of Medicine concerned with identifying disease Forensic Pathology – subspecialty of pathology concerned with identification of human remains](https://reader034.vdocuments.net/reader034/viewer/2022051516/56649edb5503460f94beb1ab/html5/thumbnails/25.jpg)
Lacerations
![Page 26: Field of Medicine concerned with identifying disease Forensic Pathology – subspecialty of pathology concerned with identification of human remains](https://reader034.vdocuments.net/reader034/viewer/2022051516/56649edb5503460f94beb1ab/html5/thumbnails/26.jpg)
Incised Wounds Slash Stab
Puncture – penetrating injury due to an object with no blade
![Page 27: Field of Medicine concerned with identifying disease Forensic Pathology – subspecialty of pathology concerned with identification of human remains](https://reader034.vdocuments.net/reader034/viewer/2022051516/56649edb5503460f94beb1ab/html5/thumbnails/27.jpg)
Abrasions
![Page 28: Field of Medicine concerned with identifying disease Forensic Pathology – subspecialty of pathology concerned with identification of human remains](https://reader034.vdocuments.net/reader034/viewer/2022051516/56649edb5503460f94beb1ab/html5/thumbnails/28.jpg)
ContusionsColor changes a bruise goes through can give rough estimate of time of injury• Dark blue/purple (1-18 hours)
•Blue/brown (~1 to 2days)
•Green (~ 2 to 3 days)
•Yellow (~3 to 7 days)
Assumes person is healthy.
![Page 29: Field of Medicine concerned with identifying disease Forensic Pathology – subspecialty of pathology concerned with identification of human remains](https://reader034.vdocuments.net/reader034/viewer/2022051516/56649edb5503460f94beb1ab/html5/thumbnails/29.jpg)
Gunshot Wounds
Things for pathologist to learn:• type of firearm
• distance of gun to victim
• entrance vs exit wounds
• track of projectile
![Page 30: Field of Medicine concerned with identifying disease Forensic Pathology – subspecialty of pathology concerned with identification of human remains](https://reader034.vdocuments.net/reader034/viewer/2022051516/56649edb5503460f94beb1ab/html5/thumbnails/30.jpg)
Gunshot Wounds
Starring of a contact wound – barrel touching the skin
Stippling – powder burns on the skin when the gun is inches to a few feet from the victim
![Page 31: Field of Medicine concerned with identifying disease Forensic Pathology – subspecialty of pathology concerned with identification of human remains](https://reader034.vdocuments.net/reader034/viewer/2022051516/56649edb5503460f94beb1ab/html5/thumbnails/31.jpg)
Autopsy
Y incision
![Page 32: Field of Medicine concerned with identifying disease Forensic Pathology – subspecialty of pathology concerned with identification of human remains](https://reader034.vdocuments.net/reader034/viewer/2022051516/56649edb5503460f94beb1ab/html5/thumbnails/32.jpg)
Internal Exam
Y Shaped insicision Remove Sternum Exam any signs of injury internally
(gunshot hole, stab wound) Exam for signs of blood inside
![Page 33: Field of Medicine concerned with identifying disease Forensic Pathology – subspecialty of pathology concerned with identification of human remains](https://reader034.vdocuments.net/reader034/viewer/2022051516/56649edb5503460f94beb1ab/html5/thumbnails/33.jpg)
![Page 34: Field of Medicine concerned with identifying disease Forensic Pathology – subspecialty of pathology concerned with identification of human remains](https://reader034.vdocuments.net/reader034/viewer/2022051516/56649edb5503460f94beb1ab/html5/thumbnails/34.jpg)
Organs
Exam each organ, weigh them, cut them open, take pieces for microscope exam
Heart Lungs Kidneys Liver Spleen Bladder Brain
![Page 35: Field of Medicine concerned with identifying disease Forensic Pathology – subspecialty of pathology concerned with identification of human remains](https://reader034.vdocuments.net/reader034/viewer/2022051516/56649edb5503460f94beb1ab/html5/thumbnails/35.jpg)
Natural Deaths
Heart Attack
![Page 36: Field of Medicine concerned with identifying disease Forensic Pathology – subspecialty of pathology concerned with identification of human remains](https://reader034.vdocuments.net/reader034/viewer/2022051516/56649edb5503460f94beb1ab/html5/thumbnails/36.jpg)
![Page 37: Field of Medicine concerned with identifying disease Forensic Pathology – subspecialty of pathology concerned with identification of human remains](https://reader034.vdocuments.net/reader034/viewer/2022051516/56649edb5503460f94beb1ab/html5/thumbnails/37.jpg)
![Page 38: Field of Medicine concerned with identifying disease Forensic Pathology – subspecialty of pathology concerned with identification of human remains](https://reader034.vdocuments.net/reader034/viewer/2022051516/56649edb5503460f94beb1ab/html5/thumbnails/38.jpg)
![Page 39: Field of Medicine concerned with identifying disease Forensic Pathology – subspecialty of pathology concerned with identification of human remains](https://reader034.vdocuments.net/reader034/viewer/2022051516/56649edb5503460f94beb1ab/html5/thumbnails/39.jpg)
![Page 40: Field of Medicine concerned with identifying disease Forensic Pathology – subspecialty of pathology concerned with identification of human remains](https://reader034.vdocuments.net/reader034/viewer/2022051516/56649edb5503460f94beb1ab/html5/thumbnails/40.jpg)
![Page 41: Field of Medicine concerned with identifying disease Forensic Pathology – subspecialty of pathology concerned with identification of human remains](https://reader034.vdocuments.net/reader034/viewer/2022051516/56649edb5503460f94beb1ab/html5/thumbnails/41.jpg)
![Page 42: Field of Medicine concerned with identifying disease Forensic Pathology – subspecialty of pathology concerned with identification of human remains](https://reader034.vdocuments.net/reader034/viewer/2022051516/56649edb5503460f94beb1ab/html5/thumbnails/42.jpg)
![Page 43: Field of Medicine concerned with identifying disease Forensic Pathology – subspecialty of pathology concerned with identification of human remains](https://reader034.vdocuments.net/reader034/viewer/2022051516/56649edb5503460f94beb1ab/html5/thumbnails/43.jpg)
![Page 44: Field of Medicine concerned with identifying disease Forensic Pathology – subspecialty of pathology concerned with identification of human remains](https://reader034.vdocuments.net/reader034/viewer/2022051516/56649edb5503460f94beb1ab/html5/thumbnails/44.jpg)
![Page 45: Field of Medicine concerned with identifying disease Forensic Pathology – subspecialty of pathology concerned with identification of human remains](https://reader034.vdocuments.net/reader034/viewer/2022051516/56649edb5503460f94beb1ab/html5/thumbnails/45.jpg)
![Page 46: Field of Medicine concerned with identifying disease Forensic Pathology – subspecialty of pathology concerned with identification of human remains](https://reader034.vdocuments.net/reader034/viewer/2022051516/56649edb5503460f94beb1ab/html5/thumbnails/46.jpg)
![Page 47: Field of Medicine concerned with identifying disease Forensic Pathology – subspecialty of pathology concerned with identification of human remains](https://reader034.vdocuments.net/reader034/viewer/2022051516/56649edb5503460f94beb1ab/html5/thumbnails/47.jpg)
![Page 48: Field of Medicine concerned with identifying disease Forensic Pathology – subspecialty of pathology concerned with identification of human remains](https://reader034.vdocuments.net/reader034/viewer/2022051516/56649edb5503460f94beb1ab/html5/thumbnails/48.jpg)
Gunshot Wounds
Contact Muzzle imprint, star-like cuts if close to bone, gunpowder
and soot enter wound Close Range
Increased diameter of soot of tattooing around wound Particles of gunpowder around wound, soot on skin,
tattooing of skin Intermediate
Up to 3 feet Increase in diameter again of particles and stippling, no soot
Long Range No gunpowder, soot, tattoing Difficult to determine distance –6 feet not different from 16
feet
![Page 49: Field of Medicine concerned with identifying disease Forensic Pathology – subspecialty of pathology concerned with identification of human remains](https://reader034.vdocuments.net/reader034/viewer/2022051516/56649edb5503460f94beb1ab/html5/thumbnails/49.jpg)
GSW
Entrance Wounds Usually smaller than exit wounds May have star-like appearance Inward beveling of skull Ring of gunpowder and stippling
Exit wounds Usually larger than entrance due to deflection
by tissue Outward beveling No gunpowder, soot or skin injury
![Page 50: Field of Medicine concerned with identifying disease Forensic Pathology – subspecialty of pathology concerned with identification of human remains](https://reader034.vdocuments.net/reader034/viewer/2022051516/56649edb5503460f94beb1ab/html5/thumbnails/50.jpg)
![Page 51: Field of Medicine concerned with identifying disease Forensic Pathology – subspecialty of pathology concerned with identification of human remains](https://reader034.vdocuments.net/reader034/viewer/2022051516/56649edb5503460f94beb1ab/html5/thumbnails/51.jpg)
Asphyxia
Anything that interferes with oxygen uptake or utilization Suffocation
Failure of oxygen to reach blood Choking, drowning, carbon monoxide poisoing Compression of chest – heavy objects
Strangulation Usually cuts off blood supply to brain, not cutting
off air.
![Page 52: Field of Medicine concerned with identifying disease Forensic Pathology – subspecialty of pathology concerned with identification of human remains](https://reader034.vdocuments.net/reader034/viewer/2022051516/56649edb5503460f94beb1ab/html5/thumbnails/52.jpg)
Burns
Death due to smoke inhalation, incineration or infection
Establish – ID, whether the victim was alive at the time of fire
Cause of death Manner of death 75% of fire related deaths due to
inhalation of toxic smoke – carbon monoxide, cyanide
![Page 53: Field of Medicine concerned with identifying disease Forensic Pathology – subspecialty of pathology concerned with identification of human remains](https://reader034.vdocuments.net/reader034/viewer/2022051516/56649edb5503460f94beb1ab/html5/thumbnails/53.jpg)
Electrocution
Low voltage Burns present at entry and exit sites Death due to heart attack
High Voltage Electrical burns Charring Death due to hearth attack or paralysis of
breathing muscles
![Page 54: Field of Medicine concerned with identifying disease Forensic Pathology – subspecialty of pathology concerned with identification of human remains](https://reader034.vdocuments.net/reader034/viewer/2022051516/56649edb5503460f94beb1ab/html5/thumbnails/54.jpg)
Blunt force injury to head
Brain Contusion – coup occurs at site of blow to head
Bleeding under skull and into brain Tearing of arteries and veins that supply
the brain May kill immediately, or have slow
growth of blood in the brain that compresses brain and prevents brain function
![Page 55: Field of Medicine concerned with identifying disease Forensic Pathology – subspecialty of pathology concerned with identification of human remains](https://reader034.vdocuments.net/reader034/viewer/2022051516/56649edb5503460f94beb1ab/html5/thumbnails/55.jpg)
Car Accident
Patterned abrasions / bruises from steering wheel and seatbelt
Damage to liver and spleen