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Forensic Significance Pt. 2 > Environmental Trauma > Flashcards

Environmental Trauma Flashcards

1
Q

What is environmental trauma?

A

Morbidity and mortality due to tissue damage caused by environmental conditions

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2
Q

Give examples of environmental trauma (4)

A

Hypothermia
Hyperthermia
Drowning
Lightning

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3
Q

What is the average core body temperature for hypothermia?

A

<35 C

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4
Q

What causes hypothermia?

A

Exposure to cold environment for prolonged periods of time + susceptibility

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5
Q

What factors affect the survivability of hypothermia?

A

Age (infants and elderly)
Sex
Body habitus
Water exposure

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6
Q

What age groups are more susceptible to hypothermia?

A

Infants (don’t regulate thermally)
Elderly

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7
Q

Which sex is more susceptible to hypothermia?

A

Female

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8
Q

How does water impact hypothermia?

A

Water has a high heat capacity, will lose body heat more quickly than you will in air.

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9
Q

What was the lowest survived temperature?

A

13.7 C

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10
Q

What causes morbidity and mortality with hypothermia? 6

A

Depressed respiration
Muscle stiffness + loss of coordination
Pneumonia
Kidney damage
Myocardial degeneration and/or necrosis
Ulcers and focal GI bleeding

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11
Q

What is present in this image? Cause?

A

Wischnewsky spots
Hypothermia

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12
Q

What is the average core body temp for hyperthermia?

A

> 40.5 C

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13
Q

What are sensitivity and severity of hyperthermia dependent on?

A

Age
Social determinants of health
Pre-existing conditions

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14
Q

What pre-existing conditions can make someone more susceptible to hyperthermia?

A

Alcoholism
Cerebral or cardiac atherosclerosis
Rx drugs
Obesity

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15
Q

What is the number one factor contributing to the susceptibility of hyperthermia?

A

Obesity

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16
Q

What prescription medications can make an individual more susceptible to hyperthermia?

A

Tranquilizers
Tricyclic antidepressants
MOIs

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17
Q

What are symptoms of mild hyperthermia?

A

Heat cramps
Heat exhaustion

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18
Q

What are symptoms of heat exhaustion?

A

Mild nausea
Altered understanding
Fatigue

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19
Q

What are symptoms of severe/life-threatening hyperthermia?

A

Brain damage
Resp failure
Heart failure
Liver failure
Pancreas damage
Kidney failure
Intestine damage

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20
Q

What is the mortality rate of hyperthermia at temps >41.1 C?

A

76%

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21
Q

What are the two types of heat stroke?

A

Exertional and non exertional

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22
Q

What are the two factors causing the most damage in heat stroke?

A

CNS dysfunction
Systemic inflammatory response

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23
Q

What are 6 symptoms of heat stroke?

A

Disseminated intravascular coagulation
Rhabdomyolysis
Heart dysfunctions
Pulmonary edema
Liver failure
Renal failure

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24
Q

What are the two possible causes of asphyxia?

A

Oxygen cannot enter bloodstream
Oxygen cannot exit bloodstream to tissues

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25
Q

What can prevent oxygen from entering the blood stream?

A

Low environmental oxygen
Blockage of inhalation (e.g., suffocation)

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26
Q

What can prevent oxygen from leaving the bloodstream?

A

Strangulation (blocked blood vessels)
Metabolic disorders

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27
Q

Hypo- or hypertonic? Freshwater; saltwater

A

Fresh = hypo
Salt = hyper

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28
Q

What is drowning?

A

When water enters airway

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29
Q

What happens when drowning in a hypotonic solution?

A

Passes more quickly through alveoli
Blood volume increases
Denatures surfactant

30
Q

What happens when drowning in a hypertonic environment?

A

Draws water into alveoli from blood
Decrease blood volume
Washes away surfactant

31
Q

Regardless of what type of water enters the airway, what does it eventually lead to?

A

Hypoxia

32
Q

What is hypoxia?

A

Insufficient oxygen supply to tissues to maintain homeostasis

33
Q

What does hypoxia lead to? What can this cause?

A

Cerebral anoxia
Death

34
Q

What is cerebral anoxia?

A

Brain not receiving enough oxygen/

35
Q

What sex is more susceptible to drowning?

A

Males

36
Q

Why are males more likely to drown?

A

Higher access to aquatic sites
More likely to participate in high risk behaviours
More alcohol consumption at sites.

37
Q

What happens when drowning in cold water?

A

Diving reflex

38
Q

Describe the diving reflex

A

HR slows down
Increase in parasympathetic stimulation
Less need for metabolites and oxygen

39
Q

What happens when drowning in warm water?

A

Irreversible cerebral anoxia within 3-10 mins

40
Q

What happens when drowning in heated water?

A

Often accompanied by intoxication
Cerebral anoxia more rapid
Hypotension can lead to slipping
Often unaccompanied

41
Q

What is near-drowning?

A

Surviving for at least 24 hours post rescue

42
Q

What are possible symptoms of near drowning?

A

Sequelae of anoxia
Pulmonary edema
Blood in urine
Swollen lung tissue
Cardiac arrhythmia
Fever
Sepsis
Cerebral edema

43
Q

What is Ohm’s law?

A

I = V/R

44
Q

What path does current follow?

A

Shortest path

45
Q

What are typically fatal paths of elecgtricity?

A

Across brain or heart

46
Q

What current powers a lightbulb?

A

100 mA

47
Q

What current is sufficient for cardiac arrest?

A

2A

48
Q

What voltage range is considered low voltage?

A

<1000 V

49
Q

What is residential voltage in North America? Europe?

A

NA: 120 V
Europe: 240 V

50
Q

How are injuries caused at low voltage?

A

Must be direct contact

51
Q

What voltage range is considered high voltage?

A

> 1000 V

52
Q

What is the voltage of power lines?

A

2,300 - 100,000 V+

53
Q

How are injuries caused by high voltage?

A

Do not need direct contact

54
Q

Give examples of environmental sources of high voltage

A

Electrical arc
Lightning strike

55
Q

What type of injuries can be caused at low voltages?

A

Burns at contact sight
Ventricular fibrillation/cardiac arrhythmia
Asphyxia

56
Q

Describe asphyxia as it relates to low voltage.

A

Secondary to muscle paralysis. Caused by low voltage for a long time

57
Q

List possible injuries caused by high voltage. (8)

A

Respiratory arrest
Electrothermal injury (frying)
Lichtenberg figure
Other cutaneous injuries
Ruptured tympanic membranes
Organ rupture
Craniocerebral injuries
Cardiac contusion

58
Q

What are Lichtenberg figures?

A

Tree-like red mark on skin

59
Q

What is the prevalence of Lichtenberg figures?

A

1/3 cases

60
Q

When do Lichtenberg figures appear? How long do they last?

A

~1 hr post strike, disappears ~24 hr

61
Q

What other cutaneous injuries can be caused by exposure to high voltage? (4)

A

Burns
Blisters
Bursting
Epithelial nuclear streaming

62
Q

What is cardiac contusion? What can this lead to?

A

Bleeding on heart muscle.
If enters pericardial space, risk of cardiac tympana

63
Q

What type of things can act as resistance to voltage? (5)

A

hand skin
body
foot skin
footwear
floor cover
water

64
Q

Describe hand skin resistance

A

high

65
Q

describe body resistance

A

very low

66
Q

describe foot skin resistance

A

high

67
Q

describe footwear resistance

A

may be very high

68
Q

describe floor cover resistance

A

may be very high

69
Q

describe water resisfance

A

low

70
Q

What factors affect the severity of electrocution? (7)

A

Nature of current
Amount of current
Voltage
Path through body
Time of exposure
Condition of the circuit
Resistance

71
Q
A

Forensic Significance Pt. 2 (7 decks)

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