Difference between revisions of "Forensic pathology"

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'''Forensic pathology''' is figuring out why people died.  If possible... you figure-out when and how.
'''Forensic pathology''' is figuring-out why people died... along with when and how (if possible).


==Manner of death==
==Manner of death==
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*''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==
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*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===
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Most general differential diagnosis:
Most general differential diagnosis:
*Natural:
*Natural:
**Infection (e.g. pneumonia),
**Infection (e.g. pneumonia).
**Infarction (e.g. MI),
**Infarction (i.e. myocardial infarction).
**Haemorrhage (e.g. cerebral, GI).
**Haemorrhage (e.g. cerebral, GI).
*Toxic (memory device: ''PAIRO''):
*Toxic (memory device: ''PAIRO''):
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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 3rd Ed., P.61.</ref>
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.  
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*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
*Incision - "cut", e.g. caused by a knife
*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:
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*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==
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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>[http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1229410 http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1229410]</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/>


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*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==
48,830

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