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Forensic MBBS > Post mortem techniques and mechanical injuries > Flashcards

Post mortem techniques and mechanical injuries Flashcards

1
Q

Types of autopsy

A 
1. Medicolegal autopsy:
 done by forensic pathologist
 whole body PM
2. Pathological autopsy:
 Academic purpose
 Consent of relatives
 Part of body
3. Negative autopsy:
4. Obscure autopsy
5. Virtual autopsy: non invasive methods
6. Psychological autopsy
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2
Q

Causes of negative autopsy

A
  1. Vagal inhibition
  2. Laryngospasm
  3. Thyrotoxicosis
  4. Adrenal insufficiency
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3
Q

Difference between negative and obscure autopsy

A 
Negative autopsy:
 2-5% of whole PM 
 No cause of death even after various types of medical investigations
Obscure autopsy:
 No definite cause of death after PM
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4
Q

Psychological autopsy

A

Done in suicide cases
Questions asked to family members and friends to know mental status of the person at the time of committing suicide or before that

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5
Q

Types of incisions used in PM

A
  1. I shape: most common
  2. Y shape:
    acromian process to
    in females
  3. Modified Y shaped:
    Suprasternal notch
    To preserve neck (hanging,…)
  4. Inverted Y shape:
    Infant
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6
Q

Methods of post mortem

A
  1. Virchow’s method
  2. Rokitansky method
  3. Ghon’s method
  4. Lettule’s method
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8
Q

Virchow’s method

A

Most common method of post mortem

One by one organ removal

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9
Q

Rokitansky method

A

In situ method of PM examination
In infants
If infected with HIV, HBV,…

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10
Q

Ghon’s method

A

A method of PM examination
Separate organ blocks
En block dissection (cervical, thoracic,…)

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11
Q

Stomach PM dissection

A

Opened from greater curvature

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12
Q

Spinal cord PM dissection

A

Best technique is posterior technique

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13
Q

Brain PM examination

A

Started from frontal area
1 cm slice is taken, starting from coronal plane
Then fixed in 40% formalin

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14
Q

Liver PM dissection

A

2 cm slice is made along with long axis

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15
Q

Heart, coronary artery PM examination

A

RA ➡️ RV ➡️ LA ➡️ LV

Coronary artery: 2-3 mm sections are made

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16
Q

Lettule method

A

En masse method of PM examination

All organs taken simultaneously in a mass

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17
Q

Antemortem thrombus

A
  1. Striae of Zahn
    White lines of fibrin
  2. Coralline platelet thrombi
    Platelet + fibrin
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18
Q

Post mortem clot

A

Red current jelly and chicken fat appearance

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19
Q

Skull is opened via the methods

A

Beneke method:
2 halves
Barr method:
4 quarters

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20
Q

First cavity to be opened during post mortem

A

Head
Especially during:
1. poisoning cases (brain gives better smell than other organs)
2. Traumatic head injury
3. Air embolism
4. Asphyxia (neck is last so that we can get a bloodless field)

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21
Q

Cases in which the first cavity to be opened during PM is not the head

A 
1. Infant: abdomen
 To observe the position of the diaphragm
2. Pulmonary air embolism: thorax
 Test used are:-
  1. Water test bubble
  2. Pyrogallol test
22
Q

Undertaker fracture

A

Fracture of the invertebral disc between C6 and C7

Post mortem fracture

23
Q

In an embalmed body the best specimen for toxicology analysis is

A

Skeletal muscle from buttocks

24
Q

Exhumation on the request of magistrate is according to

A

176 CRPC
Done in day light, started early in the morning
No time limit
6 samples of soil (6 parts/sides of body) compared with control soil sample

25
Q

Samples preserved to rule out any poisoning

A

Bone
Nail
Hair

26
Q

Types of mechanical injuries

A
  1. Gravel rash/ abrasion

2. Contusion/ bruise

27
Q

Gravel rash/ abrasion

A 
Epidermis, dermis involved
Types:
1. Grazed abrasion:
  By sliding due to friction- friction burn
2. Scratch abrasion- by nail, thorn, pin
 Linear
3. Patterned abrasion:
• Pressure
• Imprint/ impact
28
Q

Brush burn abrasion

A

Special type of grazed abrasion

When you slide on road, a v-shaped abrasion with burning sensation happens

29
Q

Types of patterned abrasion

A 
1. Pressure:
 crushing
 90°
 Eg., ligature mark in hanging, bite mark 
2. Imprint/Impact abrasion
 Moving objects with a rough surface
 Eg., tyre marks
30
Q

Age of abrasion

A 
Using scab- 
dried lymph or blood after 12-24 hours
Brown- 2-3 days
Black - epithelia covers and grows in 4-7 days
Falls after 7 days
31
Q

PM abrasion

A

No vital reaction
Yellow
Common on bony prominences

32
Q

Contusion/ Bruise

A

By blunt trauma causing clotted blood in dermis due to blood vessel rupture
Swelling is seen
Irregular margins
More visible in children and females and also in thin skin
Less visible on thick skin (palm, sole and abdomen)

33
Q

Large bruises are seen in

A

Face
Vulva and scrotum
These organs are soft and vascular

34
Q

Colour changes of bruises or contusions

A

Starts from periphery and goes to the centre

R. Red due to Hb
V. Blue- deoxy Hb for a few hours to 3 days
I. Blue
B. Brown Hemosiderin on day 4
G. Green Hematoidin 5-6 days
Y. Yellow Bilirubin 7-13 days
O. Original and skin colour for >14 days
35
Q

Pattern bruising / contusion

A
  1. Butterfly bruise: Battered baby syndrome (child abuse)
  2. Six penny bruise:
    Coin shaped bruise
    Eg., Throttling and child abuse
  3. Tramline bruise/ Railway line bruise
    Hitting with rod
36
Q

Bruise where no colour change is present

A

Sub conjunctival haemorrhage is the only bruise where no colour change is present

37
Q

Ectopic bruise/ migratory bruise

A

Impact and bruise are seen in different locations
1. Raccoon’s sign/ black eye:
In anterior cranial fossa fracture, bruise is seen in peri orbital
2. Battle sign:
In middle cranial fossa fracture, bruise is seen in mastoid tip

38
Q

Artificial bruise is produced by

A

Plants like:
P. Plumbago
S. Semecarpus anacardium / Marking nut/ Bhilwanol
M. Madar/ Calotropis/ Akar

39
Q

Characteristics of artificial bruise

A 
Produced by plant products and not by injury
No colour changes- just brown 
Only over accessible parts of body
Regular margins
Itching present
Chemical test can be done to confirm
40
Q

Test done for the confirmation of bruise

A

Incision test
Incise the skin and pour water
The clotted blood of bruise is not washed away

41
Q

Laceration

A

Medical terminology for tear
Caused by heavy blunt force ➡️ splitting of epidermis/ dermis / subcutaneous tissue
Irregular margins
Crushed tissue bridges or fibres and crushed hair follicles are seen: confirmation

42
Q

Types of laceration

A
  1. Stretch laceration: tangential force
  2. Shearing laceration: acute angle
    • skin tissue separated: avulsion (eg., degloving)
    • tissue is separated but attached with margin: flaying
  3. Tear: normal laceration with bruised margins
  4. Cut laceration/ chop/ slash wound:
    Spindle shaped gaping wound
  5. Split laceration: force perpendicular to bony prominences
43
Q

Incision

A

Parallel to skin surface by a sharp weapon
Longer than deep
Margins: clean cut
Confirmation: lens examination- cut tissue and hair follicle
Tailing phenomenon

44
Q

Tailing phenomenon

A

At the end of an incision, the depth is less

Tailing decides the direction of weapon

45
Q

Lacerated looking incised wound

A

In sites like scrotum and axilla (soft and relaxed), because of the rugosity the margins look irregular, leading to lacerated looking incised wound.
Confirm with lens.
Note: incised wound on genitalia: homicidal

46
Q

Hesitational/ tentative/ trial cuts

A

Multiple superficial incised wound in wrist

Suicidal in nature

47
Q

Age of incised wound

A 
In hours:
12. Edges are red, swollen
24. Endothelial cells seen 
36. Capillary network 
48. Fibroblasts
3-5 days: collagen fibres 
1-2 weeks: scar formation
48
Q

Delayed bruise

A

Bruise occurs much later after impact
Seen in deep bruise
Infra red photography is used to see them

49
Q

Grievous hurt

A

Emasculation
Permanent privation of sight of either eye
Privation of any member or joint
Permanent destruction of power of any member or joint
Permanent disfigurement of head out face
Fracture or dislocation of a bone or tooth
Any hurt which endanger life or which causes the victim to be in severe bodily pain, or which prevents the person from doing ordinary activities for a minimum period of 20 days

Forensic MBBS (7 decks)

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