Flashcards in Cell pathology 5 Deck (23):
What are the cases that must be reported to a coroner?
1. Unknown cause of death
2. Deceased has not been seen by doctor after death or 14 days before death
3. Death was violent/unnatural/suspicious
4. Death due to accident
5. Death due to neglect
6. Death due to industrial disease / deceased persons employment.
7. Death due to abortion
8. Death during operation or whilst recovering from anaesthetic
9. Death due to suicide
10. Death during prison sentence or shortly after police custody
11. Death related to poisoning
What does the coroners autopsy aims to do?
Establish the cause of death
What is a hospital autopsy?
Allows thorough examination of disease, extent of disease, treatment and effects
What are some reasons for conducting a hospital autopsy?
1. Allows thorough examination of disease, extent/treatment/effects
2. Useful for audit
3. Monitoring effectiveness of new treatments
Benefit of death certificate?
Used for epidemiology, so mortality and morbidity data can be used to divide funds.
Consent in hospital autopsy vs coroners autopsy.
-consent must be obtained from next of kin
-ANY material can be taken with consent
-no consent needed
-only material pertaining to cause of death can be taken
3 most common causes of death in young people.
1. Congenital disease
3. Drugs and alcohol
What are the 9 natural causes of sudden unexpected death?
1. Coronary Artery Disease
2. Hypertensive heart disease
3. Other cardiac causes
4. Vascular system
6. Respiratory system
Describe coronary artery disease.
75% deaths handled by medical examiners in USA
50% die suddenly, 25% without warning
1. CARDIAC ARRHYTHMIA IS USUAL MODE OF DEATH
2. Severe coronary artery atherosclerosis is most common anatomical finding (usually in 1/2 major vessels)/
-over 75% stenosis to cause death
What are some other findings of coronary artery disease?
Coronary artery thrombosis
Describe hypertensive heart disease.
1. Usually accompanied by coronary artery atherosclerosis.
2. Cardiomegaly with symmetrical left ventricular hypertrophy.
3. Acute cardiac arrhythmia = usual cause of death
List other cardiac causes of sudden unexpected death.
3. Structural anomalies
4. Floppy mitral valve
5. Aortic stenosis
6. Conduction abnormalities
Describe vascular system sudden death.
1. Ruptured aortic aneurism.
Associated with atherosclerosis and hypertension
Describe CNS sudden death.
1. Non-traumatic subarachnoid haemorrhage.
2/3 symptomatic between 40-65 years
90% silent until rupture
2. Intracerebral haemorrhage.
10-30% of all strokes
MOST COMMON CAUSE = hypertension
Describe respiratory system sudden death.
1. Pulmonary embolus
Describe GI tract sudden death.
1. Bleeding oesophageal varices
2. Bleeding ulcers
Describe other causes of sudden unexpected death.
Drugs - 1% reported deaths
Alcohol - 1% reported deaths
- often associated with GI problems
What are the types of trauma
1. Contusion (blunt trauma)
2. Occurs alone/conjunction with other injuries
BRUISE = extravasated collection of blood which has leaked from damaged small arteries, venues and veins, but not capillaries.
3. Vessel fragility and coagulation affect bruising. They occur more easily where skin is lax
4. You can bruise after death
1. Graze or scratch
2. Most superficial blunt trauma injuries
3. STRICTLY CONFINED TO EPIDERMIS
4. May have a distal skin tag due to tangential force
5. May not have distal skin tag if vertical force
1. Split to skin due to blunt force trauma, which overstretched the skin
2. Usually pass through full thickness of the skin - deep and will bleed
3. Margins ragged with crushing and bruising
4. "Bridging fibres" arch across skin defect
5. Common in areas where skin can be compressed between force and underlying bone.
6. RARELY OVER SOFT FLESHY AREAS (e.g. arse/tits)
7. "Flaying" = tangentially applied force which leads to a horizontal laceration
Difference between cut and stab?
Cut = length > depth
Stab = depth > width