Transportation related Deaths Questions

Death by motor vehicle collision

1. List 5 reasons autopsies are performed in motor vehicle deaths.
   1. to determine the cause of death
   2. to confirm if death was caused by injuries suffered in the accident
   3. to determine extent of injuries
   4. to detect any diseases or other factor which could have precipitated or contributed to the accident or death
   5. to detect any criminal activity associated with the death
   6. to document all findings for subsequent use in criminal or civil actions
   7. to establish positive identification of body, especially if burnt or mutilated
2. What are the four mechanisms of injuries in motor vehicle crashes?
   1. impact on some portion of interior of vehicle
   2. violation of integrity of the passenger compartment by another object
   3. ejection from the motor vehicle, part or entire
   4. fire
3. What is the most common cause of fatal motor vehicle crashes in north America?
   1. impairment of the driver by alcohol, drugs or combination of both >> human error (speed, recklessness, falling asleep)
4. List the 4 categories of motor vehicle crashes.
   1. front impact
   2. side impact
   3. read impact
   4. roll overs
5. List and briefly describe 3 main sites injuries of an unrestrained driver in a front impact motor vehicle crash.
   1. knees hitting dashboard (fractures of femurs, pelvix, tibia)
   2. chest hitting steering column (fractures or ribs, pulmonary and cardiac contusions, impaling, transection of aorta,...)
   3. head hitting windshield, frame or A pillar (lacerations, abrasions, contusions, soft tissue injuries, transection of cervical spine)
6. List 5 fatal internal thoro-abdominal injuries of a driver in a motor vehicle crash resulting from impact with a steering column.
   1. pulmonary and cardiac contusions
   2. laceration of lungs or heart from fractures or objects
   3. splenic or hepatic lacerations or contusions
   4. transection of the aorta
7. List 5 safety features of modern motor vehicles
   1. air bags
   2. three point restraints
   3. tempered glass side windows
   4. laminated windshields
   5. energy absorbing rear and front bumper design
8. A pedestrian is killed by a person driving a sedan, list 5 differences between the injuries of an adult and a child.
   1. adult will tend to be thrown on top of the vehicle while a child will be pushed under and may have tire tread marks
   2. adult will have secondary injuries due other contacts with the vehicle
9. A pedestrian is killed, list five difference between the injuries if they are hit by a sedan moving a 30km/hr vs 100km/hr.
10. A pedestrian is killed what would you expect if he were running vs walking?
    1. walking: the bumper fractures tend to be at the same height on both legs, where as in running they tend not to be
11. A pedestrian is killed, his is struck while walking, his body lands on the roof of the sedan, and he then falls of onto the road on the passenger side. Describe the primary, secondary and tertiary injuries that you might expect.
    1. primary injuries: bumper fractures to the lower legs, laceration of the lower legs
    2. secondary injuries: skull fracture from striking the windshield
    3. tertiary injuries: road rash and other fractures from hitting ground or other objects
12. What is the "Locus minoris resistentiae" if the aorta?
13. What is the most common location of the transsection of the aorta? Immediately distal to the left subclavian artery origin (peri-isthmus, at the ligamentum arteriosum)
14. Describe the cause and features of dicing injuries.
15. You have a scene with multiple unrestrained victims, describe three ways you might be able to determine who the driver of the vehicle was?
16. List 5 scenarios where air bags can cause immediate death in a motor vehicle crash.
17. What four factors determine the pattern and severity of pedestrian injuries when struck by a motor vehicle?
18. What four injuries are correlated with impact velocity?
19. In what circumstances is a child likely be thrown forward when struck by a vehicle?
20. What is a bumper fracture?
21. There are no fractures seen in a pedestrian victim of a motor vehicle collision, what should you now look for in the lower limbs and how?
22. Describe the mechanism by which striae are formed on pedestrian victims of motor vehicle collisons.
23. Describe 4 routes by which the abdominal contents may exit the abdominal cavity during a motor vehicle crash.