Extra if u have time

Question 1

Causes of suspended animation

Answer 1

ABCDE

A. Anesthesia
B. Barbiturates
C. Cold/ Concussion
D. Drowning
E. Electrocution

Question 2

Cause of luicid interval and its MLI (3)

Answer 2

Mechanism= Occurs after Concussion with tearing of Middle Meningeal Artery, There is no Bleeding occurs due to low blood pressure during concussion. but after recovery and normalization of Blood pressure Bleeding starts and increase gradually leading to loss of consciousness and cerebral Compression.

Lucid Interval is the stage of Consciousness between Cerebral Concussion and Cerebral Compression

MLI:-
1) The doctor may neglict the patient and allow him to leave after concussion immediately. Observation should be done within 48 hours after consussion

2) The Assailant may defend himself and say that the cause of death is not due the trauma and it is due to Cerebral compression and the clue is the Stage of Consciousness in between.

3) The Victim may say the name of the Assailant in the Lucid Interval

Question 3

Demonstrate the MLI importance of fractures to base of the skull

Answer 3

1) Ring Fracture= Falling from Height on heals or buttocks or the top of the head

2) Hinge Fracture= Motorcyclist Fracture

3) Raccon’s eye, CSF Rhinorrhea and Epistaxis= Shows Anterior Cranial Fossa Fracture

4) Battle’s sign, CSF Otorrhea and Bleeding from Ear= Middle Cranial Fossa Fracture

5) Blood accumulation in Muscles of the back of Neck= Posterior Cranial Fossa Fracture

Question 4

3 causes of death in criminal abortion

Answer 4

1) Shock (neurogenic)
2) Hemorrhage (1ry and 2ry)
3) Embolism (Air and Amniotic)

Question 5

Compare between epidural and subdural hematoma as regarding to cause and origin

Answer 5

Question 6

Clinical picture of traumatic cerebral compression

Answer 6

History of a recent head trauma:

-Gradual loss of consciousness, irritability and disorientation.
-Headache, projectile vomiting and blurred vision.
-Cushing’s triad; Slow full regular pulse, hypertension, slow breathing which may be irregular.

• Unequal pupil size: ipsilateral constriction followed by dilatation of the pupil.
• Contra-lateral hypertonia & hyperreflexia due to compression of the ipsi-lateral cortico-spinal tracts

Question 7

Enumerate long term complications of head injuries

Answer 7

1. Post traumatic epilepsy: healing and scarring of the meninges and brain surface may be the focus of later epileptic fits
2. Meningitis and brain abscess: particularly common after penetrating head injury and after fractures which disrupt the nasal and frontal air sinuses.
3. Cranial nerve damage (anosmia, ocular palsies).
4. Cognitive disabilities: The most common of these impairments is short-term memory loss.
5. Sensory problems: e.g. persistent ringing ears, bitter taste, bad smell, blind spots or double vision.
6. Language difficulties: (whether spoken and written language) Communication problems are common and also forgery claims because of the change in handwriting.
7. Personality changes: depression, anxiety, aggression, acting out, and social inappropriateness.
8. Alzheimer’s, Parkinson’s disease or Dementia.

Question 8

Cause of death from burns

Answer 8

I) Early causes within 48 hours:
1) Hypovolemic shock (hemoconcentration); resulting from:
a. Evaporation of plasma from burnt area.
b. Accumulation of plasma in vesicles or bullae.
c. Perfusion of plasma into tissues due to capillary damage “increase capillary permeability”.

2) Toxic shock; due to tissue destruction and release of toxins mainly histamine

3) Inhalation injury: due to Inhalation of smoke (irritant gases/hot air) –>pulmonary edema.

4) Acute edema of the glottis; in burns of the neck asphyxia.

5) Fat embolism, in burns of fatty areas as buttocks and breast.

III) Delayed causes.”2.days.onwards”
i j Suprarenal hemorrhaged acute suprarenal insufficiency (5th day).
2) Perforation of acute duodenal ulcer “Curling ulcer”; due to burn toxins excreted with bile in duodenum (12th day).
3) Infection: as local sepsis, septicemia or inflammation of serous membranes as peritonitis, and bronchopneumonia.
4) Degeneration of internal organs (liver necrosis or acute tubular renal necrosis).

Question 9

Cause of death in electrocution

Answer 9

1. Ventricular fibrillation: if the current passes through the heart.
2. Spasm of respiratory muscles: if the current passes through
   the chest.
3. Central asphyxia: if the current passes through the head.
4. Sympathetic shock: in cutaneous bums that may be severe (up to 3rd degree).
5. Extensive cutaneous burns may lead to gangrene and death.

Question 10

MLI of gun powder

Answer 10

1- Diagnosis of firearm injuries,
2- Differentiation between inlet and exit,
3- Identification the type of powder used,
4- Estimation of the distance of firing, and
5- Determination of the direction of firing

Question 11

Give reason there is more loss of substance in inlet than exit wound

Answer 11

Due to High velocity, Spinning movement and heat effects

Question 12

Types of anoxia

Answer 12

1) Anoxic Anoxia (No oxygen) e.g High altitudes

2) Stagnant Anoxia (Stagnation or stoppage of blood circulation) e.g Heart Failure & Cold

3) Anaemic Anoxia Decreased o2 carrying capacity of blood) e.g
- Hemorrhage
-Hemoglobin defects(Carboxy Hb in CO poisoning)

4) Histotoxic Anoxia (Tissue can’t utilize 02): - e.g Cyanide poisoning

Question 13

MLI of umbilical cord:

Answer 13

1. Identification of fetal size and age
2. Signs of live birth
3. Survival period
4. Cause of death

Question 14

internal vs external signs of asphyxiation

Answer 14