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FORB201 > Lecture 12 and 13 - Forensic Pathology > Flashcards

Lecture 12 and 13 - Forensic Pathology Flashcards

1
Q

Definition of pathology?

A

A medical specialty focused on how disease and injuries impact the body

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2
Q

What are the 2 categories of pathology?

A
  • Anatomical
  • Clinical
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3
Q

What are the 5 specialties in anatomical pathology?

A
  • Surgical
  • Cytology
  • Neuro
  • Pediatric
  • Autopsy/Forensics
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4
Q

What are the 3 specialties in clinical pathology?

A
  • Haematopathology
  • Microbiology
  • Biochemistry
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5
Q

Definition of forensic pathology?

A

A medical specialty in which the study of how diseases and injuries impact the body is applied to the law

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6
Q

What do forensic pathologists do?

A
  • Go to scenes
  • Perform autopsies
  • Testify in court

Autopsy facts: unexpected/violent deaths, 150/year, 10-20% suspicous

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7
Q

How do you become a forensic pathlogist in NZ?

A
  • Medical school (6 years)
  • Anatomical pathology + forensics
    or
  • Forensic pathology (6 years)

Total of 12 years

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8
Q

What is the difference between homicide and murder?

A
  • Homicide = death at the hands of someone else (medical term)
  • Murder = can legally charge someone with murder
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9
Q

What is the death investigation system for a medical examiner (M.E)?

A
  • Investigation done by specially trained investigators
  • M.E = forensic pathologist
  • M.E makes autopsy decisions and performs autopsies
  • Death certificate signed by M.E
  • Inquiries initiated by Chief
  • Patnership with other agencies
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10
Q

What is the death investigation system for a coroner?

A
  • Investigations done by police or investigators
  • Coroners = depends on jurisdiction
  • Coroner makes autopsy decisions
  • Pathologist does the autopsy
  • COD/MOD determined by coroner regardless of autopsy results
  • Death certificates signed by coroner
  • Hold coroner’s inquest
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11
Q

What is the death investigation process in NZ?

A
  • Coroner system (coroner are lawyers, no medical training required)
  • Deaths investigated by police (no special training, Criminal Investigation Branch (CIB) involved with suspicious deaths)
  • Autopsies doen by anatomical and forensic pathologists (suspicious deaths and homicides require a forensic pathologist)
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12
Q

What is the New Zealand coroner system?

A
  • Police investigates death, preliminary report supplied to coroner
  • Coroner decides whether an autopsy is required, direction is sent to pathologist
  • Pathologist performs autopsy, preliminary cause of death sent to coroner
  • Pathologist orders and interperates ancillary tests, final autopsy report sent to coroner
  • Coroner reviews all information and determines cause and manner of death
  • If necessary, a coroner’s inquest is conducted into the death
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13
Q

What kinds of deaths become coroner cases?

A
  • Unnatural or violent deaths
  • Unexpected deaths
  • Unattended deaths
  • Death in custody (any time police are present)
  • Deaths in institutions
  • Deaths during or immediately following surgery/anasthesia
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14
Q

Who gets an autopsy?

A

All homicides and suspicious deaths

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15
Q

Who gets an autopsy from a pathologists perspective?

A
  • Unexpected childs deaths
  • Bodies found in water
  • Most apparent suicides
  • Motor vehicle accidents
  • Apparent drug related deaths
  • Workplace related deaths
  • Deaths in custody
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16
Q

What is an autopsy?

A
  • Review of history
  • External exam
  • Internal exam
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17
Q

What other tests do pathologists use to determine what happend to a body?

A
  • Radiology
  • Microscopy
  • Toxicology
  • Microbiology
  • Neuropathology
  • Genetics
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18
Q

During an autopsy, what is looked at during an external exam of the body?

A
  • Hair and eye colour
  • Teeth
  • Tattoos
  • Scars
  • Post-mortem changes (lividity, rigor, decomposition)
  • Injuries
  • Clues to cause of death
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19
Q

What is lividity?

A
  • Setting of blood due to gravity
  • Becomes fixed over a variable amount of time (typically 21 hours)
20
Q

What information does lividity provide?

A
  • Time of death
  • Position at death
  • Whether the body was moved
  • Possible cause of death (e.g. cherry red lividity = CO, Cyanide, Hypothermia)
21
Q

What is rigor?

A
  • Stiffening of muscles (mucsles need energy to relax, max at 12 hours, gone between 24-48 hours)
22
Q

What information does rigor provide?

A
  • Time since death
  • Whether the body was moved
23
Q

What is the decomposition process (in terms of a pathologist)

A
  • Autolysis (intracellular enzymes)
  • Putrefaction (bacteria)
  • Skeletonization
  • Mummification (dry, warm environment)
  • Saponification (adipocere, cold, wet environment)
24
Q

What is seen during the process of decompositon?

A
  • Green discolouration of abdomen (most bacteria here)
  • Marbling (breaking down of blood cells)
  • Skin blebbing and marbling (blisters and bloating)
  • Insect activity (maggots etc)
  • Skeletonization
  • Mummification
  • Adipocere
25
Q

What is adipocere?

A
  • Tissues turn into fatty acids
  • Grey/white wax substance (“grave wax”)
26
Q

How are post mortem changes speed up?

Environmental factors

A
  • Increased temperature of the body at death
  • Thick clothing
  • Intense activity just prior to death (e.g. seizure, exercise)
  • Obesity
  • Higher ambient temperatures
27
Q

How are post mortem changes slowed down?

A
  • Hypothermia
  • Emaciation
  • Cold environment
28
Q

During an autopsy, what happens during an internal examination?

A
  • All organs removed and examined
  • Samples collected (toxicology, microscopy)
  • Special dissections as needed (neck, spinal cord, injuries)
29
Q

Why is the incision made during an internal autopsy a Y shape?

A

So can be hidden with clothes on for families and funerals

30
Q

What are pathologists looking for during an internal examination?

A
  • Haemorrhage
  • Tumour
  • Infarcts
  • Other signs of natural diseases

Examine all organs

31
Q

What can an autopsy tell us?

A
  • Cause and manner of death
  • ID of victim
  • Types of injuries/weapons used
  • Perpetrator
  • Timeline
  • Time since death
  • Mens rea (intentional)
  • Genetic diseases that may affect familiy members
  • Disease and injury prevalence and patterns
  • New public health concerns
  • Quality assurance and feedback on medical procedures
32
Q

What are some injuries that pathologists look at?

A
  • Blunt force
  • Sharp force
  • Firearms
  • Thermal
  • Environmental
  • Electrocution
  • Asphyxia
33
Q

What are considered as blunt trauma?

A
  • Abrasions
  • Contusions
  • Lacerations
  • Fractures
34
Q

What is an abrasion?

A

Scraping of the skin surface (scratches and scrapes)

35
Q

What is contusions?

A

Breaking of blood vessles with leakage of blood into surrounding tissue (bruising)

36
Q

What is laceration?

A

Tearing of the skin or an organ from a blunt impact

37
Q

What are the properties of a cut/stab?

Sharp force

A
  • Straight edges
  • Clean edges
  • Abrasions less common
38
Q

What are the properties of a laceration?

Blunt force

A
  • Irregular edges
  • Tissue bridging
  • Abrasion common
39
Q

What can gunshot wounds tell pathologists?

A
  • Entrance vs exit (direction of fire)
  • Range of fire
  • Type of firearm
40
Q

What are the properties of an entrance of a gunshot wound?

A
  • Usually round/oval
  • Abrasion margin
  • May have a muzzle imprint (contact)
  • May have soot (close)
  • May have stippling (intermediate)
  • Internal beveling of skull
41
Q

What are the properties of an exit of a gunshot wound?

A
  • Usually star shaped or linear
  • Fully re-opposable
  • No soot
  • No stippling
  • No muzzle imprint
  • External beveling of skull
42
Q

What is stippling?

A
  • Caused by unburnt gunpowder striking the skin
  • “tattooing”
  • Intermediate range
43
Q

What is asphyxia?

A
  • Neck compression
  • Airway obstructed
  • Mechanical asphyxiation
  • Exclusion of oxygen
44
Q

What is mechanical asphyxia?

A

Physical force preventing breathing e.g. car crushing lungs

45
Q

What is Mens Rea?

A

Guilty mind = intention

FORB201 (18 decks)

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