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					Cause of Death/ Pathology
INTRODUCTION
   • ________________ is a medical doctor who studies and diagnoses disease in humans
   • Forensic pathologist also studies trauma that leads to the death of an individual
         – Autopsy involves standardized dissection of a corpse to determine ___________ and
            __________________ of death
CAUSE AND MANNER OF DEATH
   • Cause of death is divided into the ___________ and ____________ causes of death
         – Primary or immediate cause of death is a ___________-link causal chain that explains
            the cessation of life starting with the most recent condition
                • ________ recent condition (is due to, or a consequence of)
                • _____________ oldest condition (is due to, or a consequence of)
                • ____________ (original, initiating) condition
         – Secondary cause of death includes conditions that are not related to the primary cause
            of death but _____________________ to the individual’s demise
         – Medicolegal autopsy is performed pursuant to a medical investigation of death for
            _____________________________
CAUSE AND MANNER OF DEATH
   • Manner of death is the way in which the causes of death came to be
         – Homicide, suicide, accidental and natural
         – Purpose of autopsy is to establish __________________________ of death,
            __________deceased, establish ______________, or collect _______________
            surrounding death
CORONERS AND MEDICAL EXAMINERS
   • The Coroner System
         – The position of coroner has evolved to encompass the investigation of unusual,
            untimely, or suspicious deaths
         – First coroner and medical examiners in U.S. were in Maryland colony
         – Position of coroner today can be ________________________, typically no formal
            education or medical training is required
         – A medical examiner is typically a physician who has gone through four years of
            university, four years of medical school, four years of basic pathology training and an
            additional one to two years of forensic pathology training
                • Medical examiner is an ______________ position
THE POSTMORTEMEXAMINATION (AUTOPSY)
   • External Examination
         – The Visual Examination
                • Begins with ___________________________________________,
                   ____________________________________ and detailed examination of the
                   entire body
                • Trauma is noted on a form that includes
                   _____________________________________________________
VISUAL EXAMINATION
                • ____________________________ are caused by a victim trying to defend
                   himself or herself against an attacker
CLASSIFICATION OF TRAUMA
         – Traumatic deaths may be classified as _____________________________________
         – Mechanical Trauma
                • Mechanical trauma occurs when the __________________________ exceeds
                   the mechanical or tensile strength of that tissue
                       – Sharp force refers to injuries caused by sharp implements
                             » __________________________________ produce incised
                               wounds, or deep wounds
MECHANICAL TRAUMA
  • Blunt force refers to injuries caused by __________________________________ objects
         – Blunt objects produce lacerations, or tears in the tissue
  • Sharp trauma commonly causes death from a ________________________________
  • Blunt trauma commonly causes death from ___________________ or
      _____________________ in the tissues outside the normal blood vessels
         – Extreme contusion, or hematoma, is a blood tumor
MECHANICAL TRAUMA
  • Asphyxia is trauma in which the body is _________________________________
         – Caused by suffocation, strangulation, or chemical asphyxiation
GUNSHOT WOUNDS
  • Projectile discharged from a firearm produces a special type of blunt force trauma
Review Q
  • 1. The speed of decomposition, or the rotting of all tissues and organs in the body, depends on
      the age, size of the body, and the __________________________________________.
  • 2. The specific change in the body that brought about the cessation of life is called the:
  • ____________________________________________________________________
  • What are the four manners of traumatic death?_______________________________
  • _____________________________________________________________________
  • List some types of mechanical trauma._______________________________________
  • ______________________________________________________________________
  • What are the requirements of a medical examiner?_____________________________
  • ____________________________________________________________________
  • Define: pathologist,______________________________________________________
      autopsy________________________________________________________________,
      cause of death_________________________________________________________,
      mechanical trauma_____________________________________________________,
      asphyxia______________________________________________________________

CLASSIFICATION OF TRAUMA
  • Chemical Trauma
        – Interactions of chemicals with the human body
  • Thermal Trauma
        – Hypothermia is too much exposure to _____________
        – Hyperthermia is too much exposure to excessive ____________
        – __________________________________________ most often succumb to hypo- or
           hyper-thermia
        – Thermal burns are localized
               • Persons who die in a fire do so generally because of ______________, or lack of
                  oxygen, and inhalation of combustion products
               • True thermal deaths occur due to
                  ______________________________________ and/or
                  _________________________________________________________
CLASSIFICATION OF TRAUMA
  • Electrical Trauma
        – Electricity can cause death by a number of means
               • _________________________ is a random quivering of the heart that does not
                  pump the blood through the body properly
                      – Heart is pushed into _______________, a sustained contraction that is
                         broken only when the circuit is broken
   •  Classification of Trauma
          – Care is taken to preserve any trace evidence that may be later submitted to a forensic
              science laboratory
          – Age, sex, ancestry, height, weight, state of nourishment and any birth-related
              abnormalities are noted during exam
          – Body is examined for death-related phenomena that may provide information to the
              investigation
Time of Death—Livor Mortis
The Leaden-Color of Death
   • When red blood cells break down, they turn a ______________________________
   • With decomposition, blood seeps down and settles in the lower parts of a body.
   • The discoloration that accompanies this becomes permanent after __________________.
   • __________________ accelerates the process.
THE POSTMORTEM EXAMINATION
          – Livor mortis, or ________________________________________, is the settling of
              blood due to _______________________ after the heart no longer circulates it through
              the body
                  • Results in purplish discoloration of the skin
                  • Sets in an hour after death and peaks in ______________________
                  • Can indicate if ____________________________________________________
Time of Death—Rigor Mortis
The Rigidity of Death
   • At death, skeletal muscles _______________________ relax.
   • Without oxygen, ___________________ accumulates in these muscles.
   • The muscles become ______________.
   • This starts in the ____________ and works its way down to the __________.
   • After about ____ hours, the muscle fibers begin to dissolve, and softening begins.
Time of Death—Rigor Mortis
   • At _______________ after death, the body is at its most rigid state.
   • If a body has _____________ signs of rigor, it probably has been dead
      l=_________________________________________
   • If the body exhibits rigor only in the ___________, the time of death is just over
      ____________.
   • This stiffness will have disappeared for the most part _________________
Time of Death—Rigor Mortis
      Many factors affect when rigor mortis sets in and how long it lasts:
          – Ambient temperature
          – The weight of the body
          – The body’s clothing or lack of it
          – Any illness the person had at the time of death
          – The level of physical activity at the time of death
          – Sun exposure
THE POSTMORTEM EXAMINATION
                  • _________________________ is the stiffening of the body after death due to the
                     membranes of muscle cells becoming more permeable to calcium ions
                         – Begins _____________ hours after death, remains for two to three days
                         – Muscles begin to relax when decomposition begins
                         – Rate depends on activity before death and ambient temperature
Time of Death—Algor Mortis
The Chill of Death
   • In death a body no longer generates warmth and begins to ____________________.
   • To find the standard temperature of a corpse, a thermometer is inserted into the liver.
   • Body heat is lost at about ______________________________________.
   • Time of death determined by temperature calculations is expressed as a range of time.
Time of Death—Stomach and Intestinal Contents
       Based on these specifics, give an estimate for each of these on how much time has passed
since the meal was eaten:
          1. Food is still present in the stomach.
          2. The stomach is empty but food is found in the ______________________.
          3. The small intestine is empty but waste is present in the ____________________.
THE POSTMORTEM EXAMINATION
          – Eye examinations also provide clues to pathologist
                • ____________________ are pinpoint hemorrhages found around the eyes, the
                   lining of the mouth and throat, as well as other areas
                        – Also called Tardieu spots
Review Q
   • Pooling of blood in the body, known as lividity, provides a clue as to how long the person has
       been dead. Lividity first begins about: ___________________________________________
   • Liver mortis means roughly, the: ________________________________________________.
   • Death stiffness is roughly defined as:______________________________________________
   • If a body shows no visible rigor, it has probably been dead: __________________________.
   • Factors affecting rigor include: __________________________________________________.
   • Algor mortis means roughly: ____________________________________________________

OTHER EVIDENCE COLLECTED
       – Swabs (vaginal, oral and rectal) are taken for submission to forensic or toxicological
          laboratory
              • One set is taken for ______________, whereby the collected fluid on each swab
                 is wiped across a separate clean glass microscope slide
                     – Examined for spermatozoa
              • Second and third sets of swabs are for serological examinations
       – Known head and pubic hairs are collected during autopsy
OTHER EVIDENCE COLLECTED
       – ________________, or victim’s bindings, are extensively photographed, sketched and
          collected
       – Full set of ____________________ is taken to be referenced against any databases
       – For badly decomposed remains, the jaw may be used for forensic
          ____________________ and identification
NTERNAL EXAMINATION AND DISSECTION
       – After external examination, ____________________________________________
              • Stomach contents are examined thoroughly
       – Each organ is sectioned and viewed internally and externally
              • Samples for microscopic analysis of the cellular structure, or histology, and for
                 toxicology screening are taken
DETERMINING TIME SINCE DEATH (POSTMORTEM INTERVAL)
       – Based on principle of sequential changes that occur following death called the
          postmortem clock
              • Body temperature, livor, rigor, and decomposition
                     – Decrease in body temperature is called algor mortis
              • Chemical changes in body fluids or tissues
              • Physiological changes with progression rates
              • Survival injuries
       – The rate at which algor mortis occurs is not precise
       – Eyes are indicator of postmortem changes
       – Stomach contents may be used to determine PMI because the
           _______________________________________________________
       – Decomposition of the body begins almost immediately
              • _________________________ the disintegration of the body by enzymes
                  released by dying cells
              • _____________________ is the disintegration of the body by the action of
                  bacteria and microorganisms
              • Four main steps of decomposition are _______________________________
                      – Dependant upon environmental factors
LABORATORY ANALYSIS
  • Histology
       – Examination for evidence of cellular pathologies resulting from
           _________________________________________________________________
              • Tissue samples taken with a ___________________, a machine that makes very
                  thin, very precise slices
  • Toxicology
       – __________________________ are broad-based screen tests that help to determine
           the absence or presence of drugs and their metabolites in human fluids and tissues
LABORATORY ANALYSIS
  • Autopsy Report
       – No standard reporting form exists, though all reports should include:
              • _________________________
              • ___________________________________ report
              • ________________ reports
              • __________________ of the decedent
LABORATORY ANALYSIS
  • Exhumations
       – __________________ is the digging up or removing of a deceased individual from a
           mausoleum
              • ____________________ may obliterate or obscure details that might otherwise
                  be easily examined
                      – Embalming is a process of chemically treating the dead human body to
                          reduce the presence and growth of microorganisms, to retard organic
                          decomposition and to restore an acceptable physical appearance
  • Consultations
       – Forensic anthropologists, entomologists and odontologists may play a role in a death
           investigation
CHAPTER SUMMARY
  • Medical examiners study disease and trauma that lead to the death of an individual
  • Determine cause and manner of death

				
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