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Forensics > Notes > Flashcards

Notes Flashcards

1
Q

SIDS: definition

A
  • under 1

- remains unexplained after autopsy, death scene and clinical history

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2
Q

SIDS: characteristics

A
  • Low ses
  • male
  • premature
  • winter months
  • most common in 1-2 months old
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3
Q

SIDS: mother characteristics

A
  • single
  • smoker
  • high parity
  • infection in pregnancy
  • short inter-pregnancy interval
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4
Q

SIDS: mechanisms

A
  • many diff causes, often multifactorial

- Act via a final common pathway of cardioresp failure

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5
Q

SIDS: risk factors

A
  • prone sleeping
  • cigarette smoke exposure
  • covering the head
  • overheating
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6
Q

SIDS: triple risk model

A
  • predisposed infant
  • vulnerable period
  • external stresses
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7
Q

Bruising

A
  • can’t be used for age estimation
  • although, yellow bruise may be more than 18 hours old
  • bruising can occur after death
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8
Q

Incised Wound

A
  • longer than it is deep
  • less likely to effect organs
  • usually bleeding is serious complication
  • if sharp, no bruising or abrasion around wound
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9
Q

Knife Injuries

A
  • single edged blade said to give a V at one end of the wound and a blunt end at the other
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10
Q

Self Inflicted Wounds

A
  • usually multiple
  • No of premil trial or hesitance cuts
  • throat, wrists, front of chest and abdomen, thighs
  • uniform depth
  • superficial or minor
  • similar appearance, style and orientation
  • injuries are grouped on the contralateral side to the patients handedness
  • old healed scars in similar sites
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11
Q

FSSA Departments

A
  1. chem
  2. biology
  3. forensic pathology
  4. toxicology
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12
Q

forensic anthropology

A
  • missing people
  • recently deceased
  • incomplete or partial remains
  • DVI
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13
Q

Haemastix

A
  • detection of blood

- strip used by doctors to test for blood in urine

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14
Q

Polilight

A
  • can locate semen, saliva and blood
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15
Q

Sexual Assault

A
  • 17% of women and 5% of men experience sexual assault

- 19% of adult women report to police

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16
Q

Process

A
  1. assessment
  2. control
  3. preservation
  4. examination
  5. interpretation
  6. recording
  7. collection
  8. case management
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17
Q

Factors that may influence the condition of the body

A
  • fresh vs salt water
  • tidal or non-tidal water
  • presence of predators
  • water temp
  • clothing
  • type of surface at the base of the water
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18
Q

Postmortem findings of drowning

A
  • Washer womans hand
  • Skin degloving
  • Loss of pigment in skin
  • bloating of the body
  • Froth around nose and mouth***
  • haemolytic staining of the aorta (fresh water)
  • water in the stomach
  • Haemorrhage in middle ears
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19
Q

Diatoms

A
  • Microscopic algae

- Found in brain, kidneys and bone marrow

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20
Q

Burns: who is most effected?

A
  • young children
  • males (largely occupational)
  • Older people
  • aboriginal and torres strait island people
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21
Q

Key Chemicals in Drug Manufacturing

A
  • Iodine
  • Hypophosporous acid
  • red phosphorus
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22
Q

Fresh water drowning

A
  • absorbed in circulation (through osmosis): results in dilution of blood -> swelling and rupture of rbcs -> liberation of potassium -> death from hyprekalamemia
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23
Q

Salt water drowning

A
  • water from blood into lungs -> thickening of blood -> failure of circulation
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24
Q

Immediate death due to burn injury

A
  • direct thermal injury: fluid loss, hypovolemia, shock, acute renal failure
  • thermal injury to airways
  • inhalation of toxic gases
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25
Q

Delayed death due to burn injury

A
  • ongoing fluid loss with shock and renal failure
  • resp failure due to damaged resp epithelium
  • sepsis
  • pulmonary embolism
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26
Q

Hyperthermia: Predisposing factors

A
  • extremes of age
  • co existing illnesses
  • drugs
  • obesity
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27
Q

Hyperthermia: autopsy findings

A
  • non-specific
  • vitreous electrolytes can confirm renal failure and dehydration
  • if the deceased is found shortly after death, a core bosy temp (along with environment temp) can assist the diagnosis
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28
Q

Fire: Postmortem findings

A
  • presence of soot below the level of the vocal cords
  • thermal injury of the epithelial lining of the vocal cords
  • blood samples to detect levels of carboxyhaemaglobin (although can be effecting by other factors eg. smoking)
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29
Q

Mechanism of death during fire

A
  • not usually due to burns
  • usually exposure to products of combustion
  • and/or inhalation of hot air/gases
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30
Q

Hypothermia: Predisposing Factors

A
  • extremes of age
  • sex: males more susceptible
  • thin
  • immersion of water
  • alcohol: vasodilation -> increase heat radiation
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31
Q

Effect of Hypothermia

A
  • ability to shiver lost
  • cerebral function impaired
  • ECG changes
  • Pulse slows
  • Cardiac arrhythmia
  • Death
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32
Q

Hypothermia: autopsy findings

A
  • cherry red lividity
  • Pinkish discolouration over large joints
  • Wischnewsky spots: gastric erosions of the lining of the stomach (not specific to hypothermia)
  • Paradoxical undressing
  • Haemorrhagic pancreatitis
  • Pneumonia
  • Acute tubular necrosis
  • Myofibre degeneration/necrosis
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33
Q

Electrocution: effect depends on

A
  • voltage
  • available current
  • alternating or direct current
  • resistance
  • path through body
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34
Q

Electrical lesion

A
  • collapsed blister surrounded by a pale area then a red rim
  • although if immersed in water, there may by no signs
  • internally there are no characteristics findings in fatal electrocution
  • ‘streaming of nuclei’ was thought to be characteristic but has been seen in other injuries too
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35
Q

causes of death: electrocution

A
  • primary: cardiac (at least 40Amps), resp arrest, CNS effects
  • Secondary: trauma, burns
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36
Q

SIDS autopsy findings

A
  • 70% of cases: intrathoracic petechiae on the pleura, epicardium and thymus
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37
Q

SIDS: conclusions

A
  • not ‘A’ disease with ‘A’ cause
  • end point of a number of diff factors - external and internal
  • these may be different for different babies
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38
Q

Laceration

A
  • bruised and crushed margins

- tissue strands or bridges in depths of wound

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39
Q

Semi-automatic

A
  • single bullet when trigger is pulled
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40
Q

Automatic

A
  • fires bullets as long as its trigger is squeezed eg/ machine guns
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41
Q

Rifle

A
  • long-barrelled with grove to give bullets spin
  • more accurate and powerful than handuns
  • can be single action, semi-automatic or fully automatic
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42
Q

Shotguns

A
  • Smooth bore
  • Similar appearance to rifle but doesn’t have rifling inside the barrel
  • Shell contains one large projectile (slug) and pellets
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43
Q

Gunshot Injuries

A
  • Discharging a firearm will result in formation of smoke, flame and gases of combustion
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44
Q

Forensic Odontology: services summary

A
  • identification
  • oro-facial trauma
  • opinion on dental issues
  • training
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45
Q

Dental Identification

A
  • highly individual
  • resist destruction
  • existence of dental data
  • rapid
  • although, shouldn’t compare to photos of teeth
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46
Q

Coroner

A
  • investigates deaths
  • +/- an inquest
  • determines cause and manner of death
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47
Q

Reportable Deaths

A
  • Unexpected, unnatural, unusual, violent or known
  • Death within 24 hrs of a surgical procedure or having an anaesthetic
  • Death within 24 hours after being discharged from hospital or seeking emergency medical treatment
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48
Q

Causes of Asphyxia

A
  1. reduced oxygen in environment
  2. reduced air/oxygen intake
  3. reduced oxygen transport
  4. reduced oxygen utilisation by tissues
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49
Q

Reduced Oxygen in environment

A
  • Displacement of oxygen: sewers and pits, suicide by inert gas
  • Consumption of oxygen: sealed space and flash fires
  • Altitude
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50
Q

Reduced air/oxygen intake

A

Obstruction/covering of mouth
Blockage of internal airways: choking, disease (acute epiglottis), compression of the neck (about 15kgs to collapse trachea)
Restriction of chest wall movement: crush, disease of muscles/nerves, drugs
Impaired lung function: pneumonia

51
Q

Reduced oxygen transport

A

Cardiac failure
Anaemia
Poisoning of haemoglobin (CO)

52
Q

Diagnosis of Asphyxia

A
  • Special tests: O2 levels drop and CO2 builds up, poisons: CO, cyanide
  • Post mortem examination: ‘quintet of features’ petechiae, cyanosis, facial congestion, fluid heart blood, right heart congestion - although not specific to asphyxia
  • Diagnosis requires integration of scene, post-mortem findings and other tests (tox)
53
Q

Throttling

A
  • Manual strangulation
  • compression of veins in the neck results in petechiae and congestion
  • External: bruises on neck, fingernail abrasions, petechiae
  • Internal: bruising in muscles and tissues of neck, fractures of hyoid bone (greater wings), thyroid cartilage (superior horns)
54
Q

Hanging Features

A
  • Complete suspension: if sufficient compressive force to compress arteries of neck there is no congestion - petechiae absent
  • Low/partial suspension: if incomplete/less compressive force - petechiae may be present
55
Q

Possible mechanisms of death in hanging

A
  • Compression of veins causing congestion of head stagnating flow
  • Compression of carotid arteries depriving brain of blood
  • Compression of airway - considered less likely
  • Displacement of larynx upwards, causing epiglottis ot be closed over larynx
  • Carotid reflex
56
Q

Carotid Reflex

A
  • at point of bifurcation of carotid artery there is a receptor for BP
  • External pressure may ‘fool’ sensor into thinking BP is high
  • Pressure on the bifurcation can cause the heart to slow and BP to fall
  • Some individuals have a very sensitive receptor area and pressure on both sides can stop heart
57
Q

Crush Asphyxia

A
  • Intense congestion upper chest, into neck and head with petechiae
  • Disruption of superior vena cava
  • Delineation line of crushing object may be seen
  • Weight on body: prevents movement of chest - prevents breathing, compresses chest - impairs blood return to the heart
58
Q

Smothering

A
  • May see blanching of skin under area of object used to perform smothering
  • May have injuries on mouth
  • Typically no findings
59
Q

Asphyxia: Key Points

A
  • There are no specific signs of ‘asphyxia’
  • Petechiae occur due to increased capillary pressure (congestion), not hypoxia
  • ‘Asphyxial death’ covers a range of conditions, in some (eg. hanging) airway obstruction may not be the main factor
  • Diagnostic tests exist for only a small no of specific conditions eg. CO poisoning
  • Diagnosis often requires integration of scene, autopsy, other findings (eg. toxicology)
  • A high degree of suspicion should be maintained in vulnerable groups
60
Q

DVI: Phase 1 - The scene

A
  • scene photographed
  • positioning of bodies recorded
  • human remains are labelled, recovered and transported
61
Q

DVI: Phase 2 - post mortem

A
  • body is photographed
  • jewellery, clothes removed and photographed
  • Examinations: pathology, dental, xray, DNA samples, fingerprints
62
Q

DVI: Phase 3

A
  • Antemortem Info retrieval
63
Q

DVI: Phase 4

A
  • Reconciliation
  • Ante and post mortem info is matched for identification
  • Primary identifiers: dental, fingerprints, DNA
  • Secondary identifiers: physical evidence, property
64
Q

Forensic Toxicology

A
  • Detection: presence or absence of drug or poison
  • Quantification: how much is there?
  • Interpretation: what’s the significance?
65
Q

Drug Metabolism

A
  • ADME
  • Phase I: adds a polar handle or removes a group
  • Phase II: attaches a more water soluble polar group to the handle
66
Q

Somatic Death

A
  • Irreversible loss of sentient personality (unconscious)

- Reflex and other autonomic nervous systems still function

67
Q

Cellular Death

A
  • Tissues and cells are dead - no longer function or have metabolic activity
  • Follow cardio-resp failure
68
Q

Body Cooling after death

A
  • Algor Mortis
  • Loss of metabolic function -> temp drop
  • except when temp is over 37
  • children lose heat more quickly
  • oedema and dehydration can effect cooling
69
Q

Post Mortem Lividity

A
  • Cherry red - CO poisoning
  • Brown lividity- nitrate poisoning
  • Develops 30 mins to 2hrs after death
  • Fully developed 8 to 12 hrs
  • Fixed at 18 - 24 hrs (a finger pressed will not cause blanching)
70
Q

Rigor Mortis

A
  • 20 mins in jaw and eyelids
  • Usually 2 - 4 hours after death and is fully developed 6 - 12 hours
  • Temp and mode of death effect the development
  • high temp may speed up development
  • Cool temp may allow rigor to persist
  • wear off 24-50 hrs post mortem or when decomposition starts
71
Q

Decomposition

A
  • two processes: autolysis and putrefaction
72
Q

Autolysis

A
  • BD of cells and organs through an aspectic process by intracellular enzymes (lysosomes and hydrolases)
  • Accelerated by heat, slowed with cold, stopped with frozen
  • Organs rich in enzymes will autolyse quicker eg. pancreas, intestine and adrenal medulla (within hours)
73
Q

Sequence of Putrefaction

A
  • Due to bacteria and fermentation
  • GI flora travel throughout body
  • Green discolouration in right lower quadrant of abdomen (above caecum)
  • Organisms BD haemaglobin into sulph-haemaglobin (green colour)
  • Green spreads, body becomes distended
  • Bacteria tend to colonise in venous system -> venous marbling
  • Skin blisters and slippage
  • Gas builds up in abdomen
  • Pressure causes eyeball and tongue to protrude
74
Q

Body Changes after Death

A
  • body cooling
  • lividity
  • rigor mortis
  • decomposition
  • mummification
75
Q

Insect Activity

A
  • Maggots secrete proteolytic enzyme that speeds up tissue destruction
  • Diff insects at diff stages of decomposition
  • This can help determine time of death
  • Also can give info as to location of body and if it has been moved at any stage
76
Q

Putrefaction of Internal Organs

A
  • Diff rates
  • Even a body in advances stages of putrefaction can yield info on cause of death
  • Brian is one of the first organs
77
Q

Adipocere

A
  • Waxy substance derived from body fat

- requires water to form

78
Q

Mummification

A
  • Warm dry or frozen environment
  • caused by dehydration of the tissues
  • common in newborn infants (small and sterile)
79
Q

Acceleration of Post Mortem Changes

A
  • hot, moist environment
  • overweight, high fat content
  • infection or sepsis
  • illicit drugs eg. meth
  • insulated by warm clothing or coverings
80
Q

Deceleration of Post Mortem Changes

A
  • Cold environment
  • Scantily dressed/naked
  • Stored in cooling apparatus shortly after death
81
Q

Determining Time of Death

A
  • Three sources:
  • Corporal evidence (present in the body)
  • environment and associated evidence (present in the vicinity of the body)
  • Historical evidence (based on deceased habits, movements and daily activities)
82
Q

Rate Method

A
  • measuring a change produced by a process which take place at a known rate
    Examples:
  • amount and distribution of rigor mortis
  • change in body temp
  • degree of putrefaction
83
Q

Concurrence method

A
  • comparing the occurrence of events which took place at known times with the time of occurrence of the event under investigation
    Example:
  • wrist watch stopped by a blow during an assault
  • the extent of digestion of the last meal
  • reciepts
84
Q

Nomogram Method

A
  • most widely accepted method used to determine time of death based on body temp
85
Q

Circumstances indication child abuse

A
  • explanation not good enough
  • changes the explanation
  • low ses
  • seeks attention late
  • repeating injuries
86
Q

Typical Injuries in Child Abuse

A
  • Subdural haematoma
  • fractures of skull, ribs, arms and legs
  • Patterned skin lesions
  • Injuries to abdominal organs
  • Various ages on injuries
87
Q

Shaken Baby Syndrome

A
  • Subdural haematoma
  • retinal haemorrhage
  • no skull fractures
  • no scalp injuries
  • grip markings
  • rib fractures
  • vein injuries
  • diffuse axonal injuries
88
Q

Why are children vulnerable to being shaken?

A
  • large head compared to body
  • weak neck muscles
  • skull base flat
  • not completely myelinated
  • high water content - less supportive tissue
  • thin and soft skull
89
Q

Child abuse: Burns/Scalds

A
  • characteristic patterns: immersion, splash, contact
  • cigarette burns: multiple, small round lesions
  • contact burns: distinct patterns eg iron, stove, element
90
Q

Child abuse: physical neglect

A
  • Emaciation
  • loss of fat
  • hollow cheeks
  • sunken eyes
  • dry skin
  • ‘little old man’
91
Q

Autopsies in SA

A
  • 1300 per year

- 53% natural causes

92
Q

What can an Autopsy Achieve?

A
  • Establish or confirm identity of the deceased
  • Determine cause of death
  • Determine the mechanism of death
  • Determine manner of death
  • Establish time/place of death
93
Q

Prevalence SIDS

A

0.4-1/1000 live births

94
Q

Tram track marking

A

Bruising along the edge of the weapon

95
Q

Burns 1st - 3rd degree

A

1st: superficial blistering
2nd: full thickness
3rd: destruction of skin and underlying muscle, fat and bone

96
Q

Forensic Assessment of Bites

A
  • Swabbing for DNA is the most important
97
Q

Suicide Stabbing

A
  • Will usually take top off first

- If wearing clothes, could be a homicide

98
Q

Contact Discharge of Gun

A
  • Circular hole with abrasion collar +/- muzzle impression, no soot or burn
99
Q

Close Discharge on Gun

A
  • Burns of the skin and hairs, soot soiling, propellant tattooing and unburnt propellant flakes
100
Q

Distant Discharge

A
  • No soot or powder
101
Q

Death from external causes

A
  • accidents, homicides, suicides

- 6.1% of deaths in Aus

102
Q

Males Death from external causes

A
  1. suicide - hanging

2. transport accidents

103
Q

Female Death from external causes

A
  1. falls

2. suicide - self poisoning

104
Q

Manslaughter

A
  • Voluntary: diminished responsibility, loss of control, suicide pact
  • Involuntary: gross neglect, unlawful or dangerous act
105
Q

Role of Pathologist at Blast Scene

A
  • Not really identification
  • Description and prep of bodies
  • Assessment of victimes
106
Q

Identification in DVI

A
  1. Dental
  2. Fingerprint
  3. DNA (problem; ‘comingling’/contamination)
  4. Pathological
  5. Circumstantial
107
Q

CSI Examination

A

Aim is to identify potential physical evidence

108
Q

Dead before entered water

A
  • Natural disease IHD
  • Homicide
  • Accident: water skiing
  • Suicide: planned complex suicide
109
Q

Hypothermia in Water

A
  • Survival time at 6 degrees is estimated at .4-8.8hrs

- Water at 5 degrees will reduce body temp to 35 degrees (hypothermia) in around an hour

110
Q

Drowning Mechanism

A
  • When immersed in water breath holding
  • Then gasp and hyperventilation - results in inhalation of water -> drowning
  • Water disrupts surfactant -> collapse of alveoli -> hypoxia
111
Q

Haemolytic Staining of Aorta

A
  • Fresh water
  • Attributed to haemolysis of RBCs
  • Not always seen as when bodies not rapidly recovered postmortem changes lead to dark red colouration of the aorta
112
Q

Drowning Tests

A
  • Blood biochemistry: changes in potassium, sodium or chloride (unclear in literature)
  • Vitreous biochem: increased sodium in vitreous in salt water drowning has been reported
  • Diatoms
113
Q

Poison Schedules

A
  • Prescription: S4
  • Dependence: S8- meth, morphine, cocaine
  • Prohibited: S9 - heroin, LSD, MDMA, cannabinoids
114
Q

Fantasy

A
  • GHB, GBL, NaGHB
115
Q

Indoles

A
  • LSD, magic mushrooms
116
Q

NPS

A
  • range of drugs generally not explicitly listed in the regulations
  • ‘Designer drugs’
  • Chemical structure are similar to many controlled drugs
  • Limited data on dosage levels and the effect of abuse (both short and long term)
  • Users unaware of what they are consuming
  • Difficulty in treating overdoses
117
Q

Types of Hyperthermia

A
  1. Classic: prolonged or extreme environmental exposure eg. heat waves, saunas, children in cars
  2. Exertional: extreme exertion eg. marathon runners, labourers, military
118
Q

Hypothermia Definiton

A

Below 35 degrees

119
Q

Hyperthermia Definition

A

Above 40.5 degrees

120
Q

Investigation of Sudden Death

A
  • History
  • Scene
  • Postmortem examination: internal, external, other eg. histology, tox
121
Q

Haemopericardium

A
  • Pericardial sac filled with blood -> heart can’t beat

- Causes: ruptured MI or ruptured dissection of the aorta

122
Q

Cardiomegaly

A
  • Cardiac enlargement

- Hypertension

123
Q

Myocarditis

A
  • ‘flu like illness’
  • Inflammation of the heart
  • Mainly viral

Forensics (3 decks)

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