48,470
edits
Difference between revisions of "Forensic pathology"
Jump to navigation
Jump to search
refs
m (mv cats to end) |
(refs) |
||
| Line 1: | Line 1: | ||
'''Forensic pathology''' is figuring out why people died | '''Forensic pathology''' is figuring-out why people died... along with when and how (if possible). | ||
==Manner of death== | ==Manner of death== | ||
| Line 14: | Line 14: | ||
*''Undetermined'' - is a waste basket category. | *''Undetermined'' - is a waste basket category. | ||
*''Homocide'' - not necessarily murder. | *''Homocide'' - not necessarily murder. | ||
*Can be group into three: | |||
*#Intent to kill (homicide, suicide). | |||
*#No intent to kill (natural, accidental). | |||
*#Undetermined. | |||
==Cause of death== | ==Cause of death== | ||
| Line 24: | Line 28: | ||
*Things (mechanisms) that shouldn't be used: [http://www.pallimed.org/2008/03/unacceptable-causes-of-death-other-web.html http://www.pallimed.org/2008/03/unacceptable-causes-of-death-other-web.html] | *Things (mechanisms) that shouldn't be used: [http://www.pallimed.org/2008/03/unacceptable-causes-of-death-other-web.html http://www.pallimed.org/2008/03/unacceptable-causes-of-death-other-web.html] | ||
*A Nice summary: [http://www.eperc.mcw.edu/fastFact/ff_155.htm http://www.eperc.mcw.edu/fastFact/ff_155.htm] | *A Nice summary: [http://www.eperc.mcw.edu/fastFact/ff_155.htm http://www.eperc.mcw.edu/fastFact/ff_155.htm] | ||
===Legal frame work=== | ===Legal frame work=== | ||
| Line 36: | Line 39: | ||
Most general differential diagnosis: | Most general differential diagnosis: | ||
*Natural: | *Natural: | ||
**Infection (e.g. pneumonia) | **Infection (e.g. pneumonia). | ||
**Infarction (e. | **Infarction (i.e. myocardial infarction). | ||
**Haemorrhage (e.g. cerebral, GI). | **Haemorrhage (e.g. cerebral, GI). | ||
*Toxic (memory device: ''PAIRO''): | *Toxic (memory device: ''PAIRO''): | ||
| Line 73: | Line 76: | ||
Its onset & presence is '''highly variable'''. Therefore, it is only marginally useful for determining the time of death. | Its onset & presence is '''highly variable'''. Therefore, it is only marginally useful for determining the time of death. | ||
A crude guess for time of death based on rigor:<ref>KFP | A crude guess for time of death based on rigor:<ref name=Ref_KFP61>{{Ref KFP|61}}</ref> | ||
*Warm & flaccid <3 h. | *Warm & flaccid <3 h. | ||
*Warm & stiff 3-8 h. | *Warm & stiff 3-8 h. | ||
| Line 96: | Line 99: | ||
*Abrasion - "scrape", e.g. motorcyclist slide across the roadway... skin ripped-off | *Abrasion - "scrape", e.g. motorcyclist slide across the roadway... skin ripped-off | ||
*Laceration - "tear", trauma distant from where skin split | *Laceration - "tear", trauma distant from where skin split | ||
* | *Incised - "cut", e.g. caused by a knife.<ref name=Ref_HoFP154>{{Ref_HoFP|154}}</ref> | ||
*#"Cut" or "slash" = length > depth. | |||
*#"Stab" = depth > length. | |||
How to decide what you're looking at: | How to decide what you're looking at: | ||
| Line 242: | Line 247: | ||
*Beer bottles are common... and strong enought to fracture a skull. | *Beer bottles are common... and strong enought to fracture a skull. | ||
**Empty bottles have a higher fracture energy than full ones.<ref name=pmid19239964>{{cite journal |author=Bolliger SA, Ross S, Oesterhelweg L, Thali MJ, Kneubuehl BP |title=Are full or empty beer bottles sturdier and does their fracture-threshold suffice to break the human skull? |journal=J Forensic Leg Med |volume=16 |issue=3 |pages=138–42 |year=2009 |month=April |pmid=19239964 |doi=10.1016/j.jflm.2008.07.013 |url=}}</ref> | **Empty bottles have a higher fracture energy than full ones.<ref name=pmid19239964>{{cite journal |author=Bolliger SA, Ross S, Oesterhelweg L, Thali MJ, Kneubuehl BP |title=Are full or empty beer bottles sturdier and does their fracture-threshold suffice to break the human skull? |journal=J Forensic Leg Med |volume=16 |issue=3 |pages=138–42 |year=2009 |month=April |pmid=19239964 |doi=10.1016/j.jflm.2008.07.013 |url=}}</ref> | ||
==Sharp force trauma== | ==Sharp force trauma== | ||
| Line 295: | Line 299: | ||
Excited delirium - hypothesis: | Excited delirium - hypothesis: | ||
*Thought to arise in the context of severe chronic mental disorders (e.g. schizophrenia) and protracted cocaine binges.<ref> | *Thought to arise in the context of severe chronic mental disorders (e.g. schizophrenia) and protracted cocaine binges.<ref name=pmid9645173>{{Cite journal | last1 = Pollanen | first1 = MS. | last2 = Chiasson | first2 = DA. | last3 = Cairns | first3 = JT. | last4 = Young | first4 = JG. | title = Unexpected death related to restraint for excited delirium: a retrospective study of deaths in police custody and in the community. | journal = CMAJ | volume = 158 | issue = 12 | pages = 1603-7 | month = Jun | year = 1998 | doi = | PMID = 9645173 | url=http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1229410}}</ref> | ||
*Thought to result from alteration of dopamine receptor density. The D2 receptor in particular, which is thought to be important in temperature regulation, is decreased in psychotic cocaine abusers.<ref name=pmid8768172/> | *Thought to result from alteration of dopamine receptor density. The D2 receptor in particular, which is thought to be important in temperature regulation, is decreased in psychotic cocaine abusers.<ref name=pmid8768172/> | ||
| Line 302: | Line 306: | ||
*No agreed upon toxic dose.<ref name=pmid15075681>{{cite journal |author=Stephens BG, Jentzen JM, Karch S, Wetli CV, Mash DC |title=National Association of Medical Examiners position paper on the certification of cocaine-related deaths |journal=Am J Forensic Med Pathol |volume=25 |issue=1 |pages=11–3 |year=2004 |month=March |pmid=15075681 |doi= |url=}}</ref> (due to tolerance) | *No agreed upon toxic dose.<ref name=pmid15075681>{{cite journal |author=Stephens BG, Jentzen JM, Karch S, Wetli CV, Mash DC |title=National Association of Medical Examiners position paper on the certification of cocaine-related deaths |journal=Am J Forensic Med Pathol |volume=25 |issue=1 |pages=11–3 |year=2004 |month=March |pmid=15075681 |doi= |url=}}</ref> (due to tolerance) | ||
*Chronic use may lead to cardiac enlargement. | *Chronic use may lead to cardiac enlargement. | ||
===Ethylene glycol=== | |||
*Not done in routine toxicology screening. | |||
*Birefringent calcium oxalate crystals found in kidney (with polarized light).<ref name=Ref_KFP589>{{Ref KFP|589}}</ref> | |||
==Natural death== | ==Natural death== | ||