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Y1 TP2 Pathological Processes (topic 3 Onwards) > 6. Learning From The Dead > Flashcards

6. Learning From The Dead Flashcards

1
Q

Forensic pathology

A

> The study of injuries and or diseases to determine the cause of death

  • A post-mortem investigation of sudden or unexpected death or trauma to the living
  • Speacilisit knowledge of injuries and diseases to determine cause of death
  • Conduct autopsis
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2
Q

Role of forensic pathologist

A
  • Confirm death has occurred
  • Estimate time since death
  • Ensure positive identification
  • Record injuries and natural disease if any
  • Determine the cause of death
  • Form an opinion on possible manner of death through reconstruction of events
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3
Q

5 possible Manner of death

A 
Natural 
• Accidental 
• Homicide 
• Suicide 
• undetermined
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4
Q

What is an autopsy

A

• Inspect body internally or externally

—> Autopsy (necropsy and post-mortem examinations are synonymous) means to ‘see for oneself’.
• It is an opportunity to directly inspect and analyse the organs.

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5
Q

2 types of autopsy

A
  • The clinical or academic autopsy:

* The medico-legal or forensic autopsy:

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6
Q

• The clinical or academic autopsy:

A

○ The medical attendants, with the consent of relatives, seek to learn the extent of the disease for which they were treating the deceased patient.
○ Study disease and treatment given to patient

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7
Q

• The medico-legal or forensic autopsy:

A

○ Performed on the instructions of the legal authority responsible for the investigation of sudden, suspicious, unnatural or criminal deaths.
○ Legal requirement e.g. when attending can’t determine cause of death
○ Consent is not required for this

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8
Q

Physical evidence

A

—> Before an autopsy can occur, a medical examiner will search for any physical evidence on the body

  • Weight
  • Height
  • Fingerprints
  • Physical distinguishing charactersitics
  • Physical evidence e.g. bite marks
  • Biological evidence – insect or qounds
  • Chemical evidence – alcohol or drugs
  • Physioloigcal evidence – bone, hair, blood
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9
Q

Rigor mortis

A

—-> Stiffening of body because of lack of oxygen in muscle cells.
• Begins around 4 hours after death.
• Begins in eyelids and small muscles of jaw, then to neck and rest of body.
• Sits in more quickly when there has been a violent struggle (uses up energy in muscles)
• Completely sits in within 12 hours after death and lasts around 36 hours before body returns to non-rigid state
Impacted by temperature and environment

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10
Q

Rigor mortis - time period

A 
Less than 3 hours – warm 
3 - 6 hours – warm but stiff
6 hours – cool but stiff
36 hours – cold and no stiffness
• Use to determine cause of death
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11
Q

Liver mortis

A

–> Discoloration of skin after death = blue to purple areas
• Caused by gravity-induced stagnation and settling of red blood cells in small blood vessels.
• Commonly referred to as “lividity
• Occurs 6-8 hours after death.
• Occurs in parts of body closest to ground by effect of gravity

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12
Q

Types of wounds

A
  • Lacerations - irregular tearing of tissue that is contaminated wit bacteria
  • Incised wounds – not deep but caused by sharp items
  • Puncture wounds- sharp pointed object
  • Abrasions - rubbing of skin
  • Contusions – rupture of small vessels
  • Gunshot wounds – determine type of firearms distance of shooter
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13
Q

Steps of an autopsy

A 
Rigor mortis and liver mortis 
• Internal and external 
• Opening of trunk: 
• Y incision 
• Open rib cage 
• Remove organs 
• Specimens for testing – fixed with formaldehyde
• Brain stored in 10% formaldehyde for 2 weeks 
• closing
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14
Q

Purpose of an autopsy

A

• find Difference between antimortem and post mortem body

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15
Q

Why examine dead bodies

A

To:
– Understand the anatomy of the body
– Correlate structure to function
– study the effects of disease processes and cause of death
Assess the effect of therapeutic interventions
• Find evidence for criminal proceedings

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16
Q

4 Common affected areas of sudden death

A
  • Head ‘
  • Heart
  • Blood vessels
  • Lungs
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17
Q

Head - sudden causes of death

A

Extradural haemorrhage

Subdural haemorrhage

Sub arachnoid haemorrhage

Intracerebral haemorrhage

Intracranial aneurysm

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18
Q

Meninges - structure and definition

A 
Meninges – membranous covering of connective tissue that support brain and spinal cord 
	• Made of 3 layers
		○ Periosteal dura mater
		○ Meningeal dura mater
		○ Arachnoid mater
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19
Q

Extradural haemorrhage

A

– collection of blood between the skull out outer layer of the dura (periosteal dura).
○ Occurs due to head trauma and can lead to sudden death

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20
Q

Subdural heamorrhage

A

– collection of blood in the subdural space due to bleeding from vein in the area – connection of blood between arachnoid dura layer and meningeal dura mater
○ Occurs due to head trauma and can lead to sudden death
○ This can increase pressure on underlying brain tissue

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21
Q

Sub arachnoid haemmorhage

A

– collection of blood in sub arachnoid space
○ Associated with rupture of aneurysm due to dilation or weakness of blood vessel
○ Pressure and compression on brain tissue
○ Related to trauma, infection, neoplasma

22
Q

Intracerebral haemoorhage

A
  • haemorrhage within brain tissue

○ Space occupying tissue, causes compression and pressure on brain, affecting function

23
Q

Intracranial aneurysm

A

– weakness in the wall

○ Trauma or hypertension leads to rupture and death

24
Q

Stroke

A

—> clinical manifestation of blockage or disruption to brain tissue

25
Q

2 types of stroke

A

Ischaemic

Haemorrhagic

26
Q

Ischaemic stroke

A

• Thrombosis, embolism, narrowing, blocking lumen, reudced blood flow, blood flow infarction and ischaemic defects

27
Q

Haemorrhagic stroke

A

• Aneurysm, blood spreads around brain tissue may damage cell and lead to stroke

28
Q

Neuropathology

A

Cellular pathology to
– Central nervous system
– Peripheral nerves
– Muscle

29
Q

Neuropathology - Relevant autopsies – determine if cause is

A
  • Trauma

* Neurodegenerative disease

30
Q

Alzhheimers disease

A

• Neurodegenerative disease
• Alzheimer patient has atrophy (decrease in structure size)
○ Cortical atrophy – common withg aging

Atrophic brain – gyri of brain are shrunken and suclcus are widened

31
Q

Lewy body dementia

A
  • Microscopic examiantion of tissue
    • Associated with progressive diseases that affect mental abilities and hallucinates e.g. like parksinsons disease

Lewy bodies – basophilic material accumulated in brain tissue

32
Q

2 neurodegenerative diseases

A

Alzhheimers disease

Lewy body dementia

33
Q

Heart

A

Coronary artery thrombosis
Valvular disease
Cardiomyopathies

34
Q

Coronary artery thrombosis

A

• Coronary artery thrombosis – thrombis in artery occluding all artery

35
Q

Valvular disease

A
  • Aortic valve stenosis

* Associate with degernative changes and aging, defects in abnormal valves due to calcification, thickness and fibrosis

36
Q

Cardiomyopathy

A

—> group of disorders that are Non-ischaemic, non-inflammatory disease of heart muscle

37
Q

2 types of cardiomyopathy

A

– Hypertrophic = thickened heart muscle in ventricle and intraventricle septum ,impact lumen size

– Dilated = dilation within ventricular lumen, weakened, increase lumen diameter
Both affect pumping of blood

38
Q

Hypertrophy

A
  • Left ventricular hypertrophy – increase in size of left ventricle affects lumen and pumping mechanism
    • Right ventricular hypertrophy – reduce in lumen size, increase in thickness of muscle in heart wall
39
Q

dilatation

A

• Dilated cardiomyopathy – no change in thickenes but there is dialtion, enlargement of ventricle which affects relaxing and filling mechanism of heart

40
Q

Blood vessels

A

Ruptured abdominal aortic aneurysm

41
Q

Ruptured abdominal aortic aneurysm

A

• Ruptured abdominal aortic aneurysm = weakness in wall due to atherosclerosis (underlying cause)
○ Causes dilation of the vessel and increases pressure = rupture and death

42
Q

Lung

A

Pulmonary embolism

Bronchopneumonia

Viral pneumonia

Lung carcinoma

Metastatic tumour within the lung

Perionitis

43
Q

Pulmonary embolism

A

presence of thrombi emboli (underlying cause can be cancer)

○ Causes obstruction of main vessel , large pulmonary artery = death

44
Q

Bronchopneumonia

A

○ White b=patches around bronchi and bronchioles
○ Can lead to death
○ Grey to yellow dry elevated lesions

45
Q

Viral pneumonia

A

○ Patchy areas of inflammation congestion, necrosis, fibrosis, hemorrhagic areas
○ Within the interstitium (tissue of the lung)

46
Q

Lung carcinoma

A

depends on type of cancer and position of cancer in lung
○ Squamous cell carcinoma – occurs in periphery (A)
○ Adenocarcinoma = occurs in lobe of lung (B)
○ Asbestosis (C)
○ Different cancers change lung different in image

47
Q

Metastatic tumour within the lung

A

○ Multiple nodules affecting lung, associated with metastasis – cancer in different part of body
○ Find out from which organ the metastasis has happened

48
Q

Peritonitis

A

yellowsish disclouration in peritioneum
○ Happens in response to irritation of peritoneum and accumulation of pepinasoxidase ??
○ If extensive it can lead to death

49
Q

Paediatric pathology

A

• Paediatric pathologists are trained in paediatric surgical pathology and autopsy.
• Paediatric autopsies – reasons for it
– Deaths in utero
– Death in infancy eg sudden infant death syndrome
– Suspicious deaths

50
Q

Paediatric autopsies

A 
Macroscopic examination 
• Microscopic examination 
• Toxicology 
• Microbiology 
– In utero infections 
– Sudden infant death 
• Genetic studies 
– Karyotyping

Y1 TP2 Pathological Processes (topic 3 Onwards) (9 decks)

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