Forensic Pathology Flashcards
When should a forensic autopsy be performed?
- when we cannot exclude the possibility of crime
- when there is a possibility of malpractice
- to identify a body
Name the four aims of a forensic autopsy
- to examine unnatural and suspected unnatural death cases
- to detect, confirm or rule out criminal deaths
- to determine the cause of death
- to document and interprete other medical findings relevant to the police investigation
Define “cause of death”
The disease or injury that produces the physiological disruption inside the body resulting in death
Define “mechanism of death”
The physiological derangement that results in death
Define “manner of death”
How the death came about
Name the five types of manners of death
- natural
- accident
- suicide
- homicide
- undetermined
Name some characteristics of sudden death
- deaths from natural causes which can be sudden, unexpected, clinically unexplained or otherwise obscure
- it can be also defined as a death case within 1 hour or the onset of symptoms
- there is no unnatural element in their causation
- approx 50% of cases are caused by sudden, natural death
How can sudden deaths be subdivided?
- according to the mechanism of death
- according to age
- according to organs involved
Name some mechanisms of death
- hemorrhage, hypovolemic shock
- infection/sepsis
- ischaemia/hypoxia
- acidosis
- alkalosis
- arrythmia (asystole, ventricular fibrillation)
- respiratory depression and paralysis
- cardiac tamponade
Which organ system is most often involved in natural sudden death?
cardiovascular (56%)
followed by respiratory (16%), CNS and malignancies (both 8%)
What is coronary atherosclerosis?
The major cause of sudden cardiac death
- basic mechanisms:
- stenosis
- occlusion
- complications
- ulcerated plaques
- haemorrhage in the plaque
- coronary thrombosis
Acute myocardial infarction (AMI)
- mostly caused by atherosclerosis or its complications
- mostly located in the left ventricle
- types
- laminar infarct
- regional or focal infarct
Macroscopic changes after acute myocardial infarction AMi
- under the first day - nothing
- days 1-3 - demarcated and turns yellow; tigroid appearance (red streaks from breakdown of myocytes and hemorrhages)
- few days till few weeks - area becomes fragile and softer (myomalacia)
- from ca 3 weeks - the center becomes gelatinous and grey
- after circa 3 months - widespread fibrosis
Early microscopic changes of AMI
contraction bands
late (18-24 hours) microscopic changes after AMI
- Eosinophilia
- oedema
- variable cellular infiltration
- after 1 weeks - new capillaries and fibroblasts are appearing
