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Forensic Pathology PowerPoint Presentation

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Description : Check out this medical presentation on Pathology, which is titled "Forensic Pathology", to know about Forensic Pathology, determining the cause of death by examining a corpse.

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Published on : Aug 03, 2021 | Views : 3718 | Downloads : 14

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Slide 1-

Forensic Pathology “This is the place where death rejoices to teach those who live.”
Slide 2-

Introduction A death that is unexpected or is thought to have been caused by injury or trauma is always investigated. Coroner Medical Examiner
Slide 3-

Coroner vs. Medical Examiner Coroner – a public official, appointed or elected, who makes inquires into deaths and completes death certificates. Determines cause/manner of death Decides if foul play May or may not have medical training
Slide 4-

Coroner vs. Medical Examiner Medical Examiner – a physician, evaluates medical history and physical exam of deceased to determine cause and manner of death. Must receive special training to become a forensic pathologist Forensic Pathology – unnatural or suspicious disease or injury In most large US cities, the medical examiner is required to be a forensic pathologist.
Slide 5-

Forensic Pathologist Education and Training Medical school – 4 years Post – medical training 3 to 5 year residency in general pathology Additional year of training In medical examiners office (forensic pathology) American Board of Pathology Exam Training / Knowledge in other areas of Forensics
Slide 6-

In US 500 Forensic Pathologists About 25 of the 500 also have LAW DEGREES
Slide 7-

Deaths Investigated Two Main Categories 1. Persons who die suddenly when in apparent good health, those who are unexpected to die, or those who are without medical treatment for fatal diseases. Public Health Threat (bacterial meningitus) Death in public places (electrocution in public place) Maternal Death Death outside of medical facility
Slide 8-

Deaths Investigated 2. Deaths caused by unnatural causes Examples: Acts of violence Drug related Trauma / Asphyxiation Weather Vehicular accident
Slide 9-

Deaths Investigated Special Categories: Under 18 Death of an individual under legally dependent care. Death in correctional facility On aircraft or ship MURDERS ARE THE SMALLEST NUMBER OF DEATHS INVESTIGATED!
Slide 10-

Three facets of guilt: Motive Means Opportunity
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Medical Examiner’s Duties: Review eyewitness statements Examine crime scene Autopsy Photography Report Testimony
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Duties and Responsibilities Establish the cause of death Establish the time of death Infer the type of weapon used Determine the manner of death Identify the deceased Determine the effects of trauma or pre-existing conditions.
Slide 13-

Postmortem Lividity(Livor Mortis) The Settling of blood that causes the skin to change color
Slide 14-

30 Minutes: Changes in skin color first appear on fair-skinned persons
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4 to 8 hours: The blood in capillaries settles PERMANENTLY
Slide 16-

Between 1 and 8 hours: (1) Blanching Light-colored marks made by finger pressure
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(2) Where a trained investigator will begin..
Slide 18-

Why livor mortis is important Has the body been moved?
Slide 19-

Rigor Mortis The period of time that a body goes through a state of Rigidity Caused by lactic acid build-up in the body.
Slide 20-

Rigor Mortis Progression Shorter muscles – face, fingers, toes
Slide 21-

Neck
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Then moves down and out the long muscles of the legs and forearms
Slide 23-

Legs stiffen last
Slide 24-

Rigor MortisTime-line 1-4 hours: Jaw and neck rigid, rest of body limp Up to 8 hours: everything down to the legs is rigid For 12 hours: everything remains rigid 24 hours: Jaw is limp, everything else is rigid 30-32 hours: everything but the legs are limp 36 hours: entire body is limp (no rigidity) decomposition has begun
Slide 25-

Circumstances affecting Rigor Mortis Starvation
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Extreme temperatures
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Physical exertion
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Effects of fire
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or water (in the case of drowning)
Slide 30-

Decomposition Bacteria: Co2 is produced, abdominal swelling
Slide 31-

Blood vessels: discoloration of skin in upper abdomen marbling effect Red → darker red → purple → green
Slide 32-

Putracine – foul- smelling, nauseating odors
Slide 33-

Algor Mortis Either Liver temperature (LT) or Rectal Temperature (RT) Drop of about 2 degrees per hour
Slide 34-

Factors affecting temperature loss: Size (mass) of body Body Temperature at death Temperature of crime scene
Slide 35-

The Autopsy Examination “You've got to be the type of person who can emotionally disconnect [from] it. I mean, if you went into a case looking at it as, 'Geez, this is somebody's little girl or somebody's little boy,' you'd never be able to do the case. You can't personalize it in any way... When you walk in, you never forget that this is somebody's loved one. You never forget that, but when you walk in to do the job, you kinda put that information aside. You look at them more as a puzzle, and your job is to sort out this puzzle. I've got to find out what happened. Who, what, why, when, where. I mean, that's what my job is, to sort out and get those answers. And, do it in a respectful way. A lot of people can't do this type of job. A lot of people don't want to do this type of job. There are a lot of jobs I wouldn't want to do either.” Eric Kiesel Atlanta's Fulton County Deputy Chief Medical Examiner
Slide 36-

HISTORY OF AUTOPSY EGYPTIONS 1600 BCE HIPPOCRATES – 5TH + 4TH CENTURY BCE
Slide 37-

AUTOPSIES TO DETERMINE THE CAUSE OF DEATH:
Slide 38-

The Autopsy Examination Legality Permission required – family can request an autopsy be performed (usually free) Next of kin must sign autopsy permit. Religious considerations Mandatory when death is suspicious of foul play or if public health concern (in most states)
Slide 39-

The Autopsy Examination Attending Personnel Diener – autopsy assistant Prosector - pathologist Pathologist Assistant Precautions – protective clothing
Slide 40-

The Autopsy Examination The External Exam = done first when body is examined. Looking for: Wounds Contusions (Bruises) Unusual marks on the body Overall impression of the body
Slide 41-

Forensic Autopsy An intensive search for information To locate PHYSICAL EVIDENCE to determine the cause of death
Slide 42-

The Autopsy Examination At this point, a general description of the body is made. All identifying features are noted including: Race Sex Hair color and length Eye color Approximate age Any identifying features (scars,tattoos, etc.)
Slide 43-

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Slide 44-

The Autopsy Examination Opening the Body Y-incision: incision made from left and right shoulders to mid-chest and straight down to pubic region.
Slide 45-

No bleeding (usually) because there is no blood pressure. If head is to be opened, an incision is made across the head from one ear to the other. -----------------------------------------
Slide 46-

The Autopsy Examination Rib cage is cut at the cartilage that joins the ribs to the breastbone with a scalpel, saw or knife to enter the chest cavity. Soft tissue peeled back to look for abnormalities.
Slide 47-

Chest plate (ribs and breastbone) are removed and examined. Often fractured during CPR.
Slide 48-

Skull is cut in front and back for removal.
Slide 49-

The Autopsy Examination Removing and Examination of the Organs Each organ is removed, photographed and weighed. Organs are usually dissected and slides prepared to look for disease or irregularities.
Slide 50-

THE HEART Checked for TRAUMA
Slide 51-

Pulmonary artery
Slide 52-

The pulmonary arteries carry blood from the heart to the lungs. They are the only arteries (other than umbilical arteries in the fetus) that carry deoxygenated blood.
Slide 53-

Looking for a blood clot that has dislodged from a vein traveling through the heart To the pulmonary artery: SUDDEN DEATH
Slide 54-

Blood samples are taken from the AORTA Blood-typing and Blood/Alcohol test
Slide 55-

Larynx and Trachea Checked for food bolus (choking) Food lodged in trachea
Slide 56-

Lungs
Slide 57-

Drowning
Slide 58-

Diatoms lungs stomach Blood stream Bone marrow
Slide 59-

Heroin Use Carbonate crystals Used to mix heroin Will be found in the lungs
Slide 60-

Death in fires If alive During Fire there Will be soot and ash in the Trachea Bronchi And Lungs
Slide 61-

If CO2 levels in blood are greater than 2% The victim was alive at the onset of the fire
Slide 62-

Samples taken CO2 and other gases in lungs Microscopic slides
Slide 63-

Liver
Slide 64-

Liver A healthy liver: Soft, pliable, vulnerable to blunt-force trauma
Slide 65-

Cirrhotic Liver Caused by hepatitus, malnutrition, drug & alcohol use
Slide 66-

Jaundiced Liver
Slide 67-

Kidneys – filter blood
Slide 68-

The “Kidney Punch” A World Boxing Association foul
Slide 69-

Drug use Drug addicts who have a cirrhotic liver cannot metabolize proteins…… Toxins pass out of the liver and Damage kidneys
Slide 70-

Diseased Kidneys Jaundiced kidneys Polycystic liver
Slide 71-

Stomach Important in drug-overdose cases Helps establish activities prior to death
Slide 72-

POISONS CYANIDE -red color of organs -almond-like odor (only 50% of pop can detect the odor) -KCN used for executions
Slide 73-

Estimated time of death If TIME OF MEAL and MENU are known
Slide 74-

Intestines Location of food can help determine time of death
Slide 75-

Pair swallows 850 g cocaine.. “Katriya Connor, 23, a chef from Waterloo in Liverpool, became violently ill on a flight from Cancun in Mexico to Birmingham on February 6, after scores of packets of cocaine that she had swallowed burst in her stomach. She died within hours on an airport runway in the Azores, where the flight had been diverted, while paramedics desperately tried to save her life. A 21-year-old man, apparently travelling with Ms Connor, also fell into a coma on the flight and remains seriously ill on the island.” (from The Guardian)
Slide 76-

Stomach of drug “mule” Drug packets in rectum area
Slide 77-

Bladder URINE SAMPLE
Slide 78-

Reproductive Organs Inspected for pregnancy (Teenage suicide)
Slide 79-

The Brain
Slide 80-

Removal of Brain
Slide 81-

A blood clot caused by a blow to the head – can be fatal
Slide 82-

Formaldehyde “fixes” the brain for better dissection
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Slide 84-

Autopsy Conclusion
Slide 85-

Samples are obtained of bodily fluids and sent to toxicology for examination. Blood Urine Bile
Slide 86-

Manner and Cause of Death Mechanism – biochemical or physiological abnormality produced by the cause of death that is incompatible with life. Manner of Death – homicide, suicide, natural causes, accidental or undetermined. Cause – disease or injury that initiated the lethal chain of events that lead to death
Slide 87-

Manner of Death homicide Suicide accidental – trauma occurring from acts NO REASONABLE person would have felt have a high probability of injury or death natural cause undetermined
Slide 88-

Determination of Cause of Death One can die of a massive hemorrhage (the mechanism of death) due to a gunshot wound through the head (the cause of death) as a result of being shot (homicide), shooting yourself (suicide), dropping the gun and it discharging (accidental), or not being able to tell how it occurred (undetermined). All of which are manners of death.
Slide 89-

Causes of Death Brain Damage: Subdural hematoma
Slide 90-

Brain Damage: Subarachnoid hematoma
Slide 91-

Brain Damage: Intracerebral hematoma:
Slide 92-

Suffocation
Slide 93-

Positional Asphyxiation
Slide 94-

Positional Asphyxiation
Slide 95-

SADS
Slide 96-

Choking
Slide 97-

Drowning Vomitos amigos: Drug/alcohol Intoxication
Slide 98-

Neck Injuries Strangulation accidental suicide homicide
Slide 99-

Petechial hemorrhage Ruptures in the tiny capillaries
Slide 100-

Hyoid Bone
Slide 101-

Hanging Nature of rope and knots
Slide 102-

Suicide by hanging Male suicide Female suicide
Slide 103-

Jugular vein On average, blood accounts for 8% of total body weight 5 to 6 liters of blood for males 4 to 5 liters of blood for females A 40 percent blood loss results in death. The loss of 1.5 L can cause incapacitation. Jugular vein
Slide 104-

Stab Wounds: Sharp Force Trauma Type of knife used (width, length, single or double-edged) Stabbing wounds Slicing wounds
Slide 105-

Blunt Force Trauma Caused by being struck by a flat surface
Slide 106-

Gunshot Wounds
Slide 107-

International Gun Statistics
Slide 108-

Classification of Traumatic Death Four Categories: Thermal Chemical Electrical Mechanical Asphyxiation – interference of oxygen to brain Can be caused by all mechanisms
Slide 109-

Mechanical Trauma Blunt or Sharp Penetrating or Non-penetrating Mechanical Trauma occurs when the applied physical force exceeds tensile strength of the tissue, causing lacerations (blunt force) or incised wounds (sharp)
Slide 110-

Mechanical Trauma Sharp Force Trauma Most common cause of death = exsanguination Major arteries or the heart are damaged Blunt Force Trauma Cause contusions or lacerations Most common cause of death = significant damage to brain or internal bleeding
Slide 111-

Mechanical Trauma Firearm Injury Contact wound – blackening of skin around wound (gas “burns” skin), small in size Distant wound – circular skin defect and rim of abraded skin around the edges Exit wound is larger and more irregular than entry wound.
Slide 112-

Chemical Trauma Death that results from drugs or poisons Alcohol = most common drug that causes death Rarely kills directly, but contributes to about 50% of traumatic deaths. Other chemicals: Drugs Carbon Monoxide Cyanide / Arsenic (poisons)
Slide 113-

Thermal Trauma Exposure to excessive heat or cold Hypothermia – excessive cold Hyperthermia – excessive heat Causes death via a breakdown in the normal mechanisms that maintain body temperature. Thermal Burns – death usually occurs as a result of complications (shock; mechanism = multiple organ failure) Cause of death in fires – inhalation of CO, not burns
Slide 114-

Electrical Trauma Passage of electricity through a person Low Voltage – heart experiences ventricular fibrillation (quivering of the heart; beats faster than the body can handle) High Voltage – forces heart into tetany, a contraction that is broken when the circuit is broken. Heart generally starts again with a normal rhythm Loss of limbs or electrical burns are possible within seconds of shock.