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Difference between revisions of "Forensic pathology"
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→Blunt force trauma: re-organizae
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=Blunt force trauma= | =Blunt force trauma= | ||
==General== | |||
*Weapon: fist, foot, baseball bat... pretty much anything. | *Weapon: fist, foot, baseball bat... pretty much anything. | ||
*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> | ||
==Cause of death== | |||
===Commotio cordis=== | ===Commotio cordis=== | ||
Features:<ref name=pmid11334832>{{cite journal |author=Kohl P, Nesbitt AD, Cooper PJ, Lei M |title=Sudden cardiac death by Commotio cordis: role of mechano-electric feedback |journal=Cardiovasc. Res. |volume=50 |issue=2 |pages=280–9 |year=2001 |month=May |pmid=11334832 |doi= |url=}}</ref><ref>{{cite journal |author=Maron BJ, Estes NA |title=Commotio cordis |journal=N. Engl. J. Med. |volume=362 |issue=10 |pages=917–27 |year=2010 |month=March |pmid=20220186 |doi=10.1056/NEJMra0910111 |url=http://www.nejm.org/doi/full/10.1056/NEJMra0910111}}</ref> | Features:<ref name=pmid11334832>{{cite journal |author=Kohl P, Nesbitt AD, Cooper PJ, Lei M |title=Sudden cardiac death by Commotio cordis: role of mechano-electric feedback |journal=Cardiovasc. Res. |volume=50 |issue=2 |pages=280–9 |year=2001 |month=May |pmid=11334832 |doi= |url=}}</ref><ref>{{cite journal |author=Maron BJ, Estes NA |title=Commotio cordis |journal=N. Engl. J. Med. |volume=362 |issue=10 |pages=917–27 |year=2010 |month=March |pmid=20220186 |doi=10.1056/NEJMra0910111 |url=http://www.nejm.org/doi/full/10.1056/NEJMra0910111}}</ref> | ||
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*Analogous to ''[[commotio medullaris]]''. | *Analogous to ''[[commotio medullaris]]''. | ||
==Scenarios== | |||
===Motor vehicle collisions=== | ===Motor vehicle collisions=== | ||
*Pedestrian vs. motor vehicle: heel to injury measurement.<ref>{{Ref OPMfP|18}}</ref> | *Pedestrian vs. motor vehicle: heel to injury measurement.<ref>{{Ref OPMfP|18}}</ref> | ||
===Descent from height=== | ===Descent from height=== | ||
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*+/-Haemoaspiration (due to facial trauma) - presence suggest that decendent was alive shortly after landing/impact and thus likely very alive during the descent. | *+/-Haemoaspiration (due to facial trauma) - presence suggest that decendent was alive shortly after landing/impact and thus likely very alive during the descent. | ||
**Patchy red centrilobular spots on gross examination. | **Patchy red centrilobular spots on gross examination. | ||
==Injury patterns== | |||
===Seromuscular tear=== | |||
* [[AKA]] ''seatbeat syndrome''. | |||
* Intestinal injury associated with motor vehicle collisions and more specifically seatbelts. | |||
Features: | |||
* Def'n: separation of (inner) muscularis propria from submucosa.<ref name=pmid12198344>{{Cite journal | last1 = Slavin | first1 = RE. | last2 = Borzotta | first2 = AP. | title = The seromuscular tear and other intestinal lesions in the seatbelt syndrome: a clinical and pathologic study of 29 cases. | journal = Am J Forensic Med Pathol | volume = 23 | issue = 3 | pages = 214-22 | month = Sep | year = 2002 | doi = 10.1097/01.PAF.0000023001.32202.2D | PMID = 12198344 }}</ref> | |||
===Bite injury=== | ===Bite injury=== | ||
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**In the context of identifying a potential perpetrator, it is essential to swab the bite mark for saliva, which is rich in DNA.<ref>{{Cite journal | last1 = Pretty | first1 = IA. | title = Forensic dentistry: 2. Bitemarks and bite injuries. | journal = Dent Update | volume = 35 | issue = 1 | pages = 48-50, 53-4, 57-8 passim | month = | year = | doi = | PMID = 18277695 }}</ref> | **In the context of identifying a potential perpetrator, it is essential to swab the bite mark for saliva, which is rich in DNA.<ref>{{Cite journal | last1 = Pretty | first1 = IA. | title = Forensic dentistry: 2. Bitemarks and bite injuries. | journal = Dent Update | volume = 35 | issue = 1 | pages = 48-50, 53-4, 57-8 passim | month = | year = | doi = | PMID = 18277695 }}</ref> | ||
==Aortic trauma== | ===Aortic trauma=== | ||
*Classic location of injury is subclavian branch point.<ref name=pmid1934437>{{cite journal |author=Kodali S, Jamieson WR, Leia-Stephens M, Miyagishima RT, Janusz MT, Tyers GF |title=Traumatic rupture of the thoracic aorta. A 20-year review: 1969-1989 |journal=Circulation |volume=84 |issue=5 Suppl |pages=III40–6 |year=1991 |month=November |pmid=1934437 |doi= |url=}}</ref> | *Classic location of injury is subclavian branch point.<ref name=pmid1934437>{{cite journal |author=Kodali S, Jamieson WR, Leia-Stephens M, Miyagishima RT, Janusz MT, Tyers GF |title=Traumatic rupture of the thoracic aorta. A 20-year review: 1969-1989 |journal=Circulation |volume=84 |issue=5 Suppl |pages=III40–6 |year=1991 |month=November |pmid=1934437 |doi= |url=}}</ref> | ||
*[[Aortic dissection]] due to trauma is often catastrophic. | *[[Aortic dissection]] due to trauma is often catastrophic. | ||