Forensic Pathology - Exam 1

Branch of medicine that applies the principles and knowledge of the medical sciences to problems in the field of law.

ID, time of death, cause and manner of death, collect evidence, document injuries, how injuries occured, natural disease, expert testimony for trial

Violent deaths (accidents, homicides, suicides), suspicious deaths, suddena nd unexpected deaths, deaths w/o physcian in attendace, deaths in institution

Now: Brain dead, dpoesn't respond to stimulus and is kept alive artificially.Historically: cessation of cardiac and respiratory function.

Medical examiner jurisdiction is retained even if there is a long delay between injury and death, as long as the dath was a result of injuries.

Injury or disease that produces a physiological derangement in the body that results in the death of the individual. ex: gunshot wound or coronary atherosclerosis

Physiological deranement produced by the cause of death. ex: hemorrhage or cardiac arrhythmia

How the cause of death came about. Types: natural, homicide, suicide, accident, undetermined (not enough information to determine), unclassified (manner of death is known but it doesn't fall into any of the categories)

Occur instantaneously or within 1 hour of the onset of symptoms.

Older, started in feudal England. Often not a physician. Elected position. Can order an autopsy or consult a physician. Rules on cause and manner of death. Historically there has been a lot of conflict of interest. Sometimes is also a sheriff or a funeral director. More costly in the long run due to mistakes and need to hire experts. Also not as acurate.

Started in MA in 1877. The first true medical examiner system was established in NYC in 1918. Had to be a physician experienced in pathology. Could perform autopsies and had a toxicology lab. Now often have to be a forensic pathologist. Start with an external exam, then internal, and full autopsiy if needed. Also collect at least blood, urine, and vitreous fluid (and often bile). Also often run full toxicology report on blood. If drug/alcohol concentrations are higher in blood than in vitreous fluids, then it indicates that the person used large quantites quickly, and vice versa.

A physician who has completed a graduate meidcal education program in wither anatomical or anatomical and clinical pathology that has been reviewed and accreditted. And pass a written and practical examination.

National association of medical examiners started in 1997, voluntary inspection and accreditation program.

Reddish purple coloration in dependent areas of the body due to accumulation of blood in the small vessels of the dependent areas secondary to gravity. Dependent (bottom) areas against a firm surface will appear pale in contrast due to the compression of the vessels in this area which is supporting the weight of the body. Usually evident 30 minutes to 2 hours after death. reaches maximum coloration at 8 - 12 hours and becomes fixed. Is quicker in hot environments and sloweer in cold environments.

Stiffening of the body after death due to the disappearence of ATP from the muslces. ATP is the source of energy for muscle contraction. ATP consumtions continues afer death, although production does not. Violent or heavy exercise, severe convulsions, and high body temperature my speed up onset of rigor mortis. In some cases it can be insstantaneous, called a cadaveric spasm. Disapears with decomposition. Onset is usually 2-4 hours and fully develops in 6-12 hours. Slowed by cold, sped up by heat. Often appears first in the jaw, then upper extremities, then lower extremities.