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CVS - Forensic Science > 1 - Investigation of Death > Flashcards

1 - Investigation of Death Flashcards

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1
Q

What is death

A

Complete, irreversible and persistent cessation of circulation, respiration and nervous system, with failure of body to act as an integrated system

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2
Q

What can cause difficulties in death confirmation

A
  • Drugs: Sedatives, Hypnotics, Tranquilizers, etc.
  • Apparently dead: Deep Coma, Electrocution,
    Drowning, Hypothermia, Cachexia, etc.
  • Advances in resuscitation techniques
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3
Q

What criteria are needed to diagnose death?

A
  • Listen to lungs and heart sounds for 2-5 minutes
  • Feel radial, then carotid pulses
  • Check light reaction in both pupils
  • U n-recordable arterial B.P.
  • Flat ECG & EEG
  • Examine retina with Ophthalmoscope (trucking)
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4
Q

What is meant by the manner of death

A

natural or unnatural (suicide, homicide or accident)

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5
Q

What is meant by the cause of death

A

underlying lesion(s) responsible for death

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6
Q

What is meant by the mechanism of death

A

terminal pathophysiologic event

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7
Q

What is the mechanism and manner of death for coronary atherosclerosis, IHD, MI?

A

Mechanism: cardiac arrhythmias, LV failure
Manner: natural

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8
Q

What is the mechanism and manner of death for stab/gunshot wounds

A

Mechanism: hypovolemic shock
Manner: homicide, suicide, or accident

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9
Q

What is the mechanism and manner of death for hanging

A

Mechanism: asphyxia, reflex cardiac inhibition, cerebral ischemia
Manner: suicide

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10
Q

What is the mechanism and manner of death for fire death

A

Mechanism: CO intoxication*, hypovolemic shock, injury to vital organs
Manner: accident

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11
Q

What are the immediate, early and late post-mortem changes?

A

Immediate: clinical signs of death
Early: primary flaccidity, contact flattening and pallor, cooling, PM rigidity, hypostasis
Late: decomposition

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12
Q

What is post-mortem cooling?

A
  • No further heat production
  • Initial plateau 1-2 hours (almost no fall)
  • Steady fall (1-1.5 degrees per hour)
  • Slower fall the final few hours
  • Hot Climate (No Cooling!)
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13
Q

What does this image show

A

Hypostasis (lividity)
Contact pallor

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14
Q

What does the precipitation of blood inside dependant BV indicate

A

body position during early hours of death (~ up to 10 hours) and if ever changed

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15
Q

What does dual distribution of blood precipitation indicate

A

body movement post-mortem

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16
Q

What colour does blood precipitate as

A

Deep purple

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17
Q

What does a blue colour indicate

A

asphyxia

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18
Q

what does a pink colour indicate

A

CO or CN

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19
Q

What does a faint colour indicate

A

Hemorrhage

20
Q

When is the onset of blood percipitaion

A

1-2hrs

21
Q

When does blood complete precipitation

A

8-12hrs, then do not redistribute

22
Q

What is post-mortem rigidity (rigor mortis)

A

Progressive muscular rigidity affecting both voluntary
and involuntary muscles and replacing primary flaccidity

23
Q

What causes post-mortem rigidity

A

Depletion of ATP in the muscles

24
Q

When is the onset, completion, and depletion of post-mortem rigidity

A

onset: 2-3 hrs
complete: 8-10 hrs
disappear: 18-24 hrs

25
Q

What does post-mortem rigidity depend on

A
  • temperature
  • muscle activity
  • age
26
Q

What is decomposition?

A

final soft tissue breakdown

27
Q

what is the effect of bacterial enzymes post-mortem

A

disintegration of soft tissues

28
Q

what causes discolouration of the body post-morten

A

hemolysis

29
Q

what causes distension and bad smell

A

gases

30
Q

Where do you examine on a dead body

A
  • whole body, including the back
  • especially: scalp, inner mouth, neck, palm, wrists
31
Q

What do you look for on a dead body

A
  • unusual skin discolouration: cyanosis, hypostasis, bruises, pallor
  • petechial HGEs: conjunctiva, face, lips, behind ears, and upper chest
  • inconsitency between PM changes and PM interval
  • external signs of disease
  • injection marks (recent/old)
32
Q

What do you see in this image

A

deep cyanosis

33
Q

What do you see in this image

A

petechial hemorrhages

34
Q

What do you see in this image

A

scalp lacerated wound

35
Q

What do you see in this image

A

inner-lip lacerated wound

36
Q

What do you see in this image

A

Defensive cut wounds

37
Q

What do you see in this image

A

CO Poisoning (pink)

38
Q

Determine the cause of death in this image

A

Asphyxia

39
Q

Determine the cause of death

A

while sleeping, nosebleed due to gases (bloody froth)

40
Q

Determine the cause of death

A

hanging with breif suspension

41
Q

Determine the cause of death

A

Hanging with prolongued suspension

42
Q

*A 5 5-y r-old male was brought dead to ER following an episode of severe chest pain.
*He had history of HTN and DM.
*External examination revealed a couple of skin abrasions on his left eye brow and tip of nose

A

ischemic heart disease/myocardial infarction
superficial injury to prominent parts from falling

43
Q
  • A 19-yr-old man was brought dead to ER by his father.
  • There was excessive white froth around mouth and nostrils
  • Examination showed a recent injection mark on his left arm and gangrenous areas on both feet
A

drug overdose
thrombophlebitis (injection mark)
heroin overdose (frothing due to pulmonary edema vagal stimulation by morphine)

44
Q

A young man was brought dead to hospital after he was found collapsed in his room by his flat mate. Apparently the deceased was trying to fix the A/C unit in his room.
Examination did not show remarkable findings apart from 2 pale dry lesions of 1-2 mm diameter in palm of the right hand

A

electric injury/burn from electrocution

45
Q
  • A young woman was brought to ER by her relatives who gave account of finding her unconscious in her bed
  • They mentioned that she had history of cardiac illness
  • Examination did not show any injuries around the
    extremely pale body, but it was noticed that her underpants were soiled with fresh blood stains and small blood clots
A

abortion (could be criminal)

46
Q

What are the 4 basic/general ethical principles

A
  1. no maleficence (no harm)
  2. beneficence (do good)
  3. justice (be fair)
  4. respect of autonomy (free decision)

CVS - Forensic Science (1 decks)

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