Unit 1: role of pathologist, stages of decay, forensic anthropology

Question 1

Early changes of death(minutes/hrs):
-cessation of _____________/_________
-skin _______
-muscle relaxation
-eye changes (cornea, retina)
-blood coagulation & __________

Answer 1

-respiration, circulation
-pallor
-fluidity

Question 2

Determination of Death
Definition of ________ can be problematic, no longer just ‘permanent cessation of cardiac &/or respiratory function’
- concept of ________ & determination of when to pronounce death can be controversial (harvesting organs, moving brain dead individ., etc)

Necessary interdependent organ systems for life-
___________, ____________, ________

Types of death:
__________, _________ & ________ or brain death

Answer 2

-death
-brain death
-respiratory, circulatory, CNS
-cellular, clinical, & legal

Question 3

Late Changes of Death:
______, ______, & _____ mortis.

-___________: ‘_________ of the body’, internal body temp acclimates to ambient temp.

Answer 3

-algor, livor, and rigor
-algor mortis
-cooling

Question 4

-___________: ‘skin___________’: blood pools in vessels due to gravity, causing discoloration of skin on ‘dependent’ parts of the body.
-observable ~20-120 min PM as reddish-purple blotches
-spreads & deepens in color w/ time… ‘fixed’ at ~10-12 hrs PM
-_______ decay & diffuse into surrounding tissues
-helps indicate initial position of body PM…. ‘pressure pallor’

Answer 4

-livor mortis
-discoloration
-RBCs

Question 5

___________: ‘__________ of muscles & joints’
-___________ of muscle fibers (contraction) leads to rigidity
-onset begins ~2-6 hrs PM w/ muscles of eyelids, neck, jaw
-spreads to all muscles within hours
-rigidity persists ~_______ hrs (temp dependent)
-muscle contraction is produced by shortening of __________
-contractile unit consisting of _____ (thin) & ______ (thick) filaments that ‘slide across’ each other

Answer 5

-rigor mortis
-stiffening
-shortening
-24-84
-sarcomeres
-actin
-myosin

Question 6

Rigor Mortis continued:
-______ stored in sarcoplasmic reticulum (SR) of muscle cells leak into cytoplasm
-Bind to _____________ complex, causing ‘active site’ on actin to be exposed
-in the presence of ATP, myosin ‘heads’ bind to actin, causing filaments to ‘slide across’ each other (=contraction)

Answer 6

-calcium ions (Ca2+)
-troponin-tropomyisin

Question 7

Rigor Mortis cont
-Requires _____ to break bond & relax muscle fiber
-remain attached w/ no more ATP synthesis … =rigor
-Rigor reverses itself over time as filaments ______
-thin filaments (actin) ‘detach’ from ends of each sarcomere, allowing contractile unit to lengthen again
-onset & duration determined by ambient temp & metabolic activity @ time of death
-cold temps accelerates onset & prolongs rigor
-warm, hot temps delay it, or potentially never develops
-rigor may accelerate if fever or vigorous activity @ death
1. increase _________ in muscle cells
2. decrease _______
3. ______ released into sarcoplasm

Answer 7

-ATP
-degrade
-lactic acid
-glucose
-Ca2+

Question 8

Postmortem tissue changes:
-decomposition
-_________ & __________
-mummification
-skeletonization
-_________ formation

Answer 8

-autolysis, putrefaction
-adipocere

Question 9

Decomposition:
-cells begin dying ~_____ min PM due to lack of O2
-corpse/carcass appears normally, yet cellular death & microbial activities are occuring internally
-_____________: ‘self digestion’, process by which digestive enzymes w/in cells break down carbs & proteins
-tissue decay initiated by cells w high __________ enzymes
- as _____ increases, pH decreases, & membranes become ‘leaky’
-_______________: major component of decomposition due to bacterial (&fungal, protozoan) activity
-initiated by anaerobic fermentation by intestinal bacteria; releases volatile fatty acids (butyric acid, etc) as by-product
-gas formation & bloating
-greenish discoloration of abdomen
-breakdown of pooled blood produces sulphaemoglobin (green)
-marbling (dark coloring) along blood vessels
-blistering & skin slippage
-loss of hair & nails

Answer 9

-3-7
-autolysis
-lysosomal
-CO2

Question 10

Postmorten tissue changes:
________________: drying of body &/or parts, producing leather-like changes
-may occur in environments of high ambient temp and low humidity, hangings, elevated corpses, etc.
________________: physical changes & removal of soft tissue
-enteric and soil bacteria, fungi, scavengers, insects and plants
-once reduced to hard tissues decomp slows
-bone, cartilage, mummified tissue remain
-vertebrate scavengers, weather & bacteria (consume collagen protein in bone matrix)

Answer 10

-mummification
-skeletonization

Question 11

___________: ‘grave wax’ formed due to hydrogenation of body fats; requires anaerobic bacteria and moist environment
-can inhibit further decomp, causing body to remain virtually unchanged for years.

Answer 11

-adipocere

Question 12

___________: elected lay persons who rely upon medical personnel available to assist in investigations & perform autopsies

Answer 12

coroners

Question 13

__________: appointed physicians & pathologists typically w special training in medicolegal death investigations & forensic autopsy performance

Answer 13

medical examiner

Question 14

Medical Examiner performs the following:
-complete external ___________
-x rays
-sampling & toxicological analysis of __________
-blood, urine, bile, vitreous
In violent homicides, deaths of children, etc. -
-ME may visit crime scene
-perform autopsies
-photograph injuries
-submit report

Answer 14

-examination
-body fluids

Question 15

_________________: any injury or disease that is responsible for initiating series of events that result in death

Answer 15

cause of death

Question 16

________________: physiological derangement produced by the cause of death that results in death

Answer 16

mechanism of death

Question 17

_______________: an opinion based on known facts concerning circumstances leading up to & surrounding death, in conjugation w findings @ autopsy & lab tests

Answer 17

manner of death

Question 18

Types of death:
-__________: death resulting from natural causes
-__________: unexpected death resulting from a lawful act performed under a reasonable belief that no harm is possible
-__________: deliberate termination of one’s existence
-___________: killing of one human being by the act or omission of another (doesn’t equal ‘murder’)
-______________: when investigation, autopsy, & other tests fail to identify a commonly accepted cause or manner of death
-____________: when circumstances of death fail to fit into the definition of any other manner of death

Answer 18

-natural
-accidental
-suicide
-homicide
-undetermined
-unclassified

Question 19

____________________: a branch of medicine that applies the principles & knowledge of the medical sciences to problems in the field of law.
-a subspecialty of pathology involved in the investigation of deaths that are sudden, unexpected, unexplained, or violent

Answer 19

forensic pathology

Question 20

5 specific goals of a forensic autopsy~
-Identify victim (____)
-determine cause of death (____)
-time of death (____)
-correlation of body & its environment (____)
-manner of death (____)
-also, collection of evidence for investigative team

Answer 20

-who
-what
-when
-where
-how

Question 21

External Exam:
-Photograph
-retrieval of evidence
-description & removal of clothing &/or medical devices
-cleansing & rephotographing
-general description of body (race, hgt, wgt, sex, birthmarks, scars, etc)
-injuries &/or abnormalities

Question 22

Internal Exam:
-‘Y’-shaped thoracoabdominal & intermastoid incisions
-toxicological samples & organs removed
-evidence recovery (bullets, drugs, etc)
-photographs and diagrams drawn

Question 23

Forensic Examination
Additional studies:
-histology (microscopic tissue exam)
-toxicology
-fixation of heart & brain in formaldehyde
-review medical records, etc.
-assign cause & manner of death, prepare autopsy report

Question 24

5 specific goals forensic autopsy ~
Time of death (when)
-cant pinpoint time of death but may establish an interval
-cant determine at crime scene, complex process
-general investigation & scene investigation important: last seen alive, food, mail, etc.

Question 25

5 specific goals
Time of death:
PM changes indicating time of death:
-rigor, livor, & algor mortis & decomp.
__________: PM stiffening of muscles & joints
-timeline for onset & relaxation subject to variables
-graded as : ________ (limp), ________(some stiffness), _________(stiffer but breakable), ____ (complete stiffening)
_____________: discoloration on ‘dependent’ area
-color varies, but normally reddish-purple
-discoloration does not disappear, & timeline subject to variables
-graded as: absent, faint, full, fixed/unfixed
_______________: 1/5-2 degrees/hr PM
-use lab thermometer or electronic meter for core temp (rectum, liver)
-timeline subject to variables: ambient temp, humidity, air currents; location (air, water, ground); body mass, clothing, time elapsed

Answer 25

-rigor mortis
-absent
minimal
moderate
full
lividity (livor mortis)
body cooling (algor mortis)

Question 26

Postmortem changes indicating time of death (when) :
-_______________: observable changes on external surface
-~24 hrs, green discoloration of lower abdomen (caecum)
-~48 hrs, entire abdomen w green discoloration
-~72 hrs, torso green

Answer 26

decomposition

Question 27

5 specific goals cont

Correlation of body & its environment (where)
-may/may not be possible

Identification (who) :
-visual, fingerprints, dental, medical, circumstantial, anthropological, DNA

Question 28

5 specific goals cont

Cause of death (what)
-___________ process that initiates chain of events sufficient to result in death
-___________: heart attack, lung cancer
-___________ causes of death: gunshot/stab wounds, asphyxia by hanging, blunt force trauma

Answer 28

-injury or disease
-natural causes
-medicolegal

Question 29

5 specific goals

Manner of death (how)
-Medical classification of a death according to circumstances surrounding death
-__________= ‘reasonable medical certainty’

Answer 29

-standard of certainty

Question 30

Time of Death indicators
Forensic pathologist;
-rigor mortis, livor mortis, algor mortis, decomp, changes in vitreous humor, & gastric emptying

Forensic entomologist:
-development rates & succession patterns of necrophilous insects

Forensic anthropologist:
taphonomic processes (observable changes in tissues)

Other info:
-last seen alive, scene markers (mail, newspapers, etc.)

Question 31

Taphonomy~
Study of the transition of animal remains PM
Stages of decay are not discrete, described from 2-8 stages, but 5 most comon

5 stages of decay:
_______, _______, _______, ________, & __________

Answer 31

fresh, bloat, active decay, advanced decay, putrid/dry remains

Question 32

5 Stages of decay
-______ (autolysis)
-_______ (putrefaction)
-active decay
-advanced decay (^^ both decay is putrefaction & carnivore/scavenging activities)
-___________ remains (diagenesis)

Recycling of tissues to simplest building blocks (organic molecules of carbs, proteins, lipids, nucleic acids)

Answer 32

-fresh
-bloat
-putrid/dry

Question 33

Rate of decay varies according to:
-___________ & relative humidity
-corpse/carcass ___________: intact, dismembered, burned, etc.
-corpse/carcass ___________
-presence of clothing, ______________, etc.
-____________ of corpse/carcass: terrestrial, aquatic, buried, hung, indoors, shade vs sunlit areas, etc.
-________________ to insects, vertebrate scavengers, bacteria fungi

Answer 33

-temperature
-condition
-size & biomass
-physical barriers
-placement
-availability

Question 34

“fresh” stage of decay
-cell begin dying ~______ min PM due to lack of O2 (brain 1st, epithelium can survive up to 24 hrs PM)
-corpse appears normal ______________, yet cellular death & microbial activities are occurring internally.
-decay initiated by _____________
-CO2 inc, pH dec, cellular biproducts accumulate.
-autolysis externally observable ~few days PM: skin blistering, slippage
-rate of tissue degradation in liver (breakdown of DNA) used as a PM indicator
-Algor, livor and rigor mortis most common methods of PMI during FRESH decay

Answer 34

-3-7min
-externally
-autolysis

Question 35

FRESH stage of decay continued
-___________= body temp acclimates to ambient temp
-____________= blood pools in vessels due to gravity, discoloration (reddish-purple coloring); observed ~20-120 min PM as blotches, then spreads and deepens, fixed @ 10-12 hrs PM
-_____________= stiffening of muscles/joints due to binding of actin & myosin filaments & cytoplasm ‘gelling’ with decreased pH (begins ~3-4 hrs PM, peaks ~12 hrs & reverses over next ~36-48 hrs as individual cells decay & myosin heads detach from actin filaments. ; prolonged due to low ambient temps

Answer 35

-algor mortis
-livor mortis
-rigor mortis

Question 36

BLOAT stage of decay
- marked by ____________, decay of soft tissues by bacteria, fungi, protozoa
-_________________ in intestines remain active, breaking down cells (catabolism)
-release by-products including gases, liquids, & simple molecules
-accumulated gases cause abdomen to expand, tongue to protrude, fluids to ooze out of mouth, nostrils, rectum
-_______ of decay now detected
-bloat stage short, though slight distension can be seen during cooler temps of winter
-_________ of gases & fluids marks beginning of “active decay” stage

Answer 36

–putrefaction
-anaerobic bacteria
-odor
-purging

Question 37

Active Decay, 3rd stage of decay
-abdomen no longer distended (or only slightly)
-greenish discoloration becomes yellow-brown-blackish w time
-breakdown of skeletal muscle releases amino acids, bacteria then use to make more fatty acids
-aerobic & anaerobic bacteria flourish, ____________ dominate w fly larvae consuming majority of soft tissue
-‘____________’ refers to darkening of skin due to continued tissue breakdown
-typically appears first in head region as colonization of fly larvae accelerates decay
-escaping gases produce very strong _______, NH3, most noticeable

Answer 37

-insect activity
-black putrefaction
-odor

Question 38

Advanced Decay, 4th stage of decay
-marked by mass _________ of fly larvae away from corpse to pupate
-remains now resemble a __________ corpse/carcass
remaining portions of internal organs, bone, tendons, ligaments & limited amount of muscle, skin
-_________ present but ranges from crumbly (__________) to soft, paste-like (_________) — waxy, fatty substance formed by glycerol & fatty acids, produces cheesy odor associated w the remains
-mold, fungi& other microbes become apparent on drying surfaces
-________ still very important; species change as ‘food’ & ‘habitat’ resources vary

Answer 38

• migration
  -collapsed
  -adipocere
  -rapid decay
  -slower decay
  -insect activity

Question 39

Putrid/Dry remains, 5th stage of decay
-dry or nearly dried remains:
-bone, tendons, ligaments, hair (hide), nails (hooves, horns)
-sinew= shreds of dried tissues attached to bone, hides
-_____________ tend to have a layer of adipocere present on soil, ground surface, bones, clothing etc.
-_____________ typically include sun bleached bone & mummified tissues (if remain) resting on ‘dried soils’ devoid of adipocere
-remains have now become ‘________’

Answer 39

-putrid remains
-dry remains
-skeletonized

Question 40

Decay rates in LA (for small-normal sized adult)
-During ___________ months in LA
–fresh: day 1
—bloat: days 2-3
—-active decay: days 4-7
——advanced decay: days 8-10
———-putrid/dry remains: days 11+

Answer 40

warmer(March-OCtober )

-high heat index of July-SEpt accelerates decay; cold fronts decrease rate.

Question 41

Aquatic Environments and Decay
-remains decay _______ slower than terrestrial habitats due to cooler temps, low O2, & inhibition of insect _______

6 stages of decomp in _________ ecosystems:
-_____________= carcass sinks to bottom of pond, etc.
-_________= carcass floats to surface as gases accumulate in abdomen; flies lay eggs on exposed flesh
-_____________= ‘active decay’ w fly larvae feeding on exposed flesh
-________________= carcass still floating though fly larvae have consumed exposed skeletal muscle; limps begin to disarticulate, body fluids leak from orifices.
-____________= disarticulated limbs, skin, internal organs, fatty tissues,etc. “float’ as a mass; exposed remains now have little/no insects associated w it
-____________= bones, bits of skin, etc. sink to bottom of pond.

Answer 41

-~2x
-activity
-freshwater
-submerged fresh
-early floating
-floating decay
-bloated deterioration
-floating remains
-sunken remains

Question 42

Decay in ___________ ecosystems:
- crustaceans, fish, gastropods, & echinoderms main decomposers of carrion
-recovery of human remains rare & limited research on forensic taphonomy in marine env.

Answer 42

-marine

Question 43

Burned bodies
- a ________ burn extremely difficult to achieve
-typically flies will still oviposit on the non-burned tissues (bloating of carcass exposes ‘fresh tissues’)

-Confined/wrapped, buried, hung, dismembered, chemicals (embalmed), etc. all will alter decay table 1.4, text pg 21 case by case, exposure to sunlight

Answer 43

-complete

Question 44

Forensic Anthropology-
-application of knowledge of human biology to criminal and civil investigations (of legal matters)
-obtain info from _________ to answer the following:
-_________ of the deceased
-establish _______ of death
-establish __________ of death

-FA consultants contribute to investigations by:
- determining if remains are human
- recovery of remains
- estimating potential PMI & ID of deceased; providing info on cause and manner of death

Answer 44

-skeleton
-identification
-cause
-manner

Question 45

Questions to ask about remains-
- is it _________?
-typically easy to determine if trained in comparative anatomy
-how ____ is it?
-knowledge of growth & development, maturation & degenerative changes of bones
- is it of interest to ____________?
Most common methods for estimating PMI:
-associative evidence, witness statements, rigor, algor, livor mortis; stomach contents; entomological info; anthropological info

Answer 45

-human
-old
-law enforcement

Question 46

Positive _________ determined typically by:
-CST (investigators), forensic pathologist, odontologist, or anthropologist

Answer 46

-identification

Question 47

Identification
To produce an ID, forensic anthropologists provide:
-______ & _______ determination
-estimations of age, height, weight, physique, handedness, childbirth
-____________________: previous illness, trauma, bone structure, etc.
-facial reconstruction

FA provide a biological profile that can:
1. _________ or __________ individual as suspected victim
2. narrow scope of search of missing persons

Answer 47

-sex and race
-ID of unique features

-confirm or exclude

Question 48

Sex Determination
- Determining sex of ___________ is difficult w any degree of accuracy
-more skeletal material, more accurate
-use both visual and metric techniques
-anthropometric measuring devices: Sliding and hinge _________)
-never use a characteristic in ___________
-bones most commonly used:
-pelvis, skull and long bones
pelvis and skull most useful for adult bones

Answer 48

• infant/child
  -calipers

Question 49

Age Determination
Techniques for estimation vary~
-_________ & ____________ of skeleton
- fetal skeleton
-subadult= infant/child
-__________________ of bones, joints
- adult

Answer 49

-growth & development
-degeneration

Question 50

Subadults Aging
Dental ________:
-can accurately determine age of infants & children by comparing presence/absence of deciduous (baby) & permanent teeth
Cranial ________ closure:
-immovable joints (sutures) between skull bones fuse @ diff times in infancy, early childhood
-w age, sutures ‘fade’ or are ossified (filled in w bone)

Answer 50

-eruption
-suture

Question 51

Subadults Aging cont.
-timing of fusion of _________ & ________ in early childhood
- @ birth, ‘forehead’ & ‘jaw’ are separate left & right bones
-long bone growth:
-long bones of arms & legs grow throughout childhood/adolescence @ the _________________ (growth zone) -region of transition from hyaline cartilage to bone
-growth occurs @ both ends of the bone (epiphysis)
-2 regions: shaft (diaphysis) & end (epiphysis)
-when growth ceases (adult height), epiphyseal plate disappears & shaft & bones ends ossify
-x-rays will show an ____________ after 2 regions of bone have ossified

Answer 51

-frontal bone
-mandible
-epiphyseal plate
-epiphyseal line

Question 52

Age Estimation
Adults
-Typically observe ___________ changes:
-pubic symphysis
-fusion of sutures
-microstructure changes & ‘smoothness’ of certain bones
-surface of the _________ symphysis changes w time~
-young adults: symphyseal face has a rounded appearance
-surface flattens (remodels) w age, by 50+ years it exhibits arthritic changes (erosion & possibly osteophytic growth)
-___________ changes of humerus & femur throughout life (75+ yrs) have been well documented
-ulna, radius (forearm), & tibia, fibula (lower leg) less accurate
-____________ of costal cartilage of ribs
-__________ of teeth ( molar wear)

Answer 52

-degenerative
-pubic
-structural
-mineralization
-condition

Question 53

Determining Race ~
-3 main classifications of race:
-_______________
-_______________
-________________
-Facial bones of __________ best for identifying race:
-eye orbits
-shape of nasal cavity, nasal bones, & nasal spine
-prognathanism of lower face
-chin shape
-variations in shape of teeth (shovelling) & dental margin
-simple or complex sutures; shape of sutures
-max width of face vs cranium

Answer 53

-american caucasoid
-southwestern mongoloid
-american black

-cranium

Question 54

Body Profile
Estimating height, weight, & physique~
-__________: use long bones of limbs (femur then tibia)
-__________: cannot estimate using skeleton, must rely on clothing & height of individual
-__________: muscular bodies tend to have thicker bones
-inc bone density supports inc tension exerted onto skeleton
-compare size & prominence of areas of muscle attachment to height & weight of individual

Answer 54

-height
-weight
-physique

Question 55

Additional Info FA’s provide:
Identification of unique features ~
-_________________ help narrow &/or provide specific identity (healed fractures, surgical pins, post-surgical evidence, abnormalities in bone, etc)
-______________: based on craniofacial morphology, along w age, sex, & race determinations
-create 3d facial reconstruction based on known tissue thickness @ specific landmarks of face
-photograph to make a 2d image to publicize/circulate info
-__________: ligament attachment @ dorsal surface of pubic symphysis & sacroiliac joints may rupture& hemorrhage during childbirth (results in pits on bone surface)

Answer 55

-dental & medical records
-facial reconstruction
-childbirth

Question 56

Additional info FA’s provide
-____________- may be able to suggest if indiv. was left/right handed (side-specific bone changes, shoulder joint of dominant arm, diff arthritic changes in wrist/fingers, little practicality in estab identity directly
-___________- rough indication can be suggested by amt of soft tissue remaining on skeleton, PMI’s est by FA’s are typically assoc w how long it would take to skeletonize &/or skeletal changes long after it became dry bone

PMI can be EXTREMELY vague (years, decades, etc)

Answer 56

-handedness
-time of death

Question 57

Additional info & recovery of remains

Indications of cause/manner of death ~
-primary responsibility of ____________, not FA
-__________: entrance & exit wounds, path of bullet(s)
-____________ injuries
-_____________ trauma
-fractures: antemortem vs postmortem

Forensic anthropologists cooperate w investigative teams during ____________~
-___________: airplane crashes, bombing, etc.
-__________ of badly decomposed or skeletonized remains (complete skeleton or surface scatter of body parts)
-locating & recovering _______ remains
-______ death scene investigation & recovery

Answer 57

-medical examiner
-gunshot wounds
-stabbing/cutting
-blunt force
-recovery of human remains
-mass disasters
-surface recovery
-buried
-fire