Pathology-Forensic Pathology

Question 1

Disease or injury that initiates the lethal chain of events that brought about a person’s death

Answer 1

Cause of death: immediate = just before death, intermediate = intervening steps, proximate = what started the whole process. This is usually determined by the post-mortem examination.

Question 2

Things that are NOT causes of death

Answer 2

Cardiac & respiratory arrest, renal failure, asystole

Question 3

The nonspecific, final common pathway by which the cause of death exerts its lethal effect

Answer 3

Mechanism of death

Question 4

How the cause of death came about or the circumstances under which the person died

Answer 4

Manner of death: classified as natural, accident (unforeseeable event that lead to death), suicide, homicide (killed by another person regardless of intent) and undetermined (doesn’t fall in other categories because you don’t know all the circumstances).

Question 5

What is it called when people die and blood pools at the lowest point in the body because the heart stops pumping?

Answer 5

Labidity.

Question 6

What is responsible for the green discoloration and marbling seen in deceased patients?

Answer 6

Bacteria from the GI tract begin the putrefaction process, when they get out of the GI tract and into the blood vessels they give the marbled appearance.

Question 7

4 classifications of blunt force injury

Answer 7

Abrasions (scrape of superficial skin layer at point of contact), contusions (hemorrhage into soft tissue from ruptured blood vessels, may be away from site of contact), lacerations (tissue tearing due to stretching, crushing, shearing of avulsing) and fractures

Question 8

5 different types of blunt force abrasions

Answer 8

Scrapes, road rash, patterned, impact and binding abrasions

Question 9

What do you know about a yellow bruise?

Answer 9

It is at least 18 hours old because the heme has broken down to hemiverdin, biliverdin and is now bilirubin.

Question 10

What is this bruise?

Answer 10

It’s not a bruise it’s a Mongolian spot.

Question 11

Key distinguishing point in blunt force laceration

Answer 11

Tissue bridging: blood vessels and nerves stretch across the lacerations.

Question 12

3 types of sharp force injuries

Answer 12

Stabs, incisions and chop wounds

Question 13

Stab wound that can mimic a bullet wound

Answer 13

Wounds from ice picks or screwdrivers

Question 14

Stab wounds into what tissue leave the best evidence for the weapon used?

Answer 14

Bone

Question 15

Where are you likely to see defense stab wounds?

Answer 15

*

Question 16

What should you do if you are working in the ED and a patient expires after you tried to save him from multiple stab wounds?

Answer 16

Leave all chest tubes and procedures in place so the examiner knows what you did and what the offender did

Question 17

Characteristics of suicide incisions?

Answer 17

Multiple superficial wounds: hesitation wounds.

Question 18

Common causes of death from sharp wound injuries?

Answer 18

Hemorrhage, air embolism, airway obstruction from blood aspiration, pneumothorax, infection, arrhythmia, brain infarct.

Question 19

What will tell you if a wound was inflicted before vs. after death?

Answer 19

Contusions only form when the person is still alive.

Question 20

How do you tell the range of fire in a person killed by a gunshot wound?

Answer 20

Contact (muzzle touches body, everything that leaves gun enters body), Intermediate range (gunpowder stippling) and distant range.

Question 21

How can you tell where a bullet entry vs. exit wound is?

Answer 21

The hole will be smooth and circular at the entry wound.

Question 22

3 Types of asphyxia

Answer 22

Suffocation (environmental lack or displacement of O2, smothering of mouth and nose, choking from internal away obstruction, and external mechanical pressure the obstructs airway) strangulation (hanging blocks blood flow, ligature and manual) and chemical (CO, hydrogen cyanide and hydrogen sulfide).

Question 23

Why do petechia appear when people are strangulated?

Answer 23

It only takes 4.4 pounds of pressure to occlude the jugular vein. This leaves the vertebral artery supplying blood with no return and capillaries burst.

Question 24

How do you determine that someone died of asphyxia from drowning?

Answer 24

Their circumstances. The findings are the same in someone who died from drowning and someone who died from other forms of asphyxia and then was thrown into the water.