Forensic Path Flashcards Preview

at site of impact)

– Increased catabolism peripheral fat

– Increased NADH stimulates lipid synthesis

– Decreased fatty acid oxidation

– Decreased transport lipoproteins from liver (acetaldehyde induced microtubule dysfunction)

(opposite site of impact)

• Airway occlusion

• Arrest of arterial supply to brain

• Obstruction of venous return from brain

• Cardiac arrhythmia via stimulation of carotid baroreceptors (carotid sinus reflex)

• Spinal cord/brainstem disruption

– Intoxicated individuals

– Seizure disorders

– Rollover motor vehicle accidents

• Petechiae

• Fingertip bruises

• Fingernail marks

• Chin abrasion

• Tongue injury

• Strap muscle injury

• Laryngeal fractures (70%)

• Defense wounds

• Sphincter incontinence

– Common - Neisseria gonorrhoea, Chlamydia trachomatis, Trichomonas vaginalis, bacterial vaginosis

– Rare - syphilis, HIV

– Others – HSV, HPV, hepatitis

800 microg lead/ft2 hazardous)

– Scraping or stamping of outer layers of skin

• Injuries from intrusion

• Injuries from lateral flexion of neck

• Seatbelts less protective

• Biological father 37%

• Boyfriend 20.5%

• Female sitter 17.3%

• Mother 12.6%

• Male sitter 3.9%

• Stepfather 3.1%

– Fermentation of organic matter (“rotten eggs”) – Sewer gas (with CO2 and methane)

– Oil and chemical industry

• Liver lacerations

• Spleen lacerations

• Mesenteric lacerations

• Pelvic fractures

• Petechiae with tide mark • Horizontal ligature mark

• Chin abrasion

• Tongue injury

• Strap muscle injury

• Laryngeal fractures (12%)

• Defense wounds

• Sphincter incontinence

• Neurologic (0.5 – 12 hrs) – Nausea/vomiting

– Inebriation/euphoria

– CNS depression, seizures

• Cardiopulmonary (12 – 24 hrs)

– Compensatory hyperventilation, heart failure

• Renal (24 - 72 hrs)

– Acute tubular necrosis

Disruption of subcutaneous blood vessels

• Acceleration and deceleration forces

– Intracranial injuries (shearing with SDH)

– Retinal hemorrhages

– Long bone (metaphyseal)

fractures

– Posterior rib fractures

• CNS

– Hyperpyrexia, seizure, cerebral infarct, intracerebral hemorrhage, agitated delirium

• Cardiovascularsystem

– Increased blood pressure and heart rate, arrhythmia, MI,

aortic dissection

• Pulmonarydysfunction • Pregnancy

– Abruption, premature labor, IUGR, teratogenesis • Other

– Rhabdomyolysis, perforated septum, infection

 Fatal dose =100 – 200 mL

• Shaken baby syndrome

• Shaken impact syndrome

• Non-accidental head trauma

• Homicidal craniocerebral trauma

– Tearing or rupture of skin

• Third degree electrical burns

• Second degree contact burns (eg watch)

• Arcing “splash” electrical burns

• Skeletal fractures (tetany or blunt impact)

• Asphyxia (brain stem hyperthermia)

• Vascular thromboses

• Myocardial injury (both UE and LE entrance/exit)

• Violent sneezing or coughing

• Straining (e.g. at stool, childbirth, trumpet playing)

• Compression of the neck with incomplete occlusion of carotid arteries

• Fixation of the chest