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70 Cards in this Set
- Front
- Back
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Cause of death
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Specific Disease or Injury or combination of the two - initiates train of events that results in the death
Natural - CAD,Arrythmia, meningitis GSW |
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Mechanism death
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Physical derangement that the cause of death cause which is incompatible with life -
sepsis |
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Manner of death
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Accident, Natural, Suicide, Homicide, undetermined (overdose)
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Postmortem change
Gaseous distention of tissues |
Begins early after death - loose tissues - neck, eyes, scrotum
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Postmortem change
Marbleing |
Hemolytic staining of vasculature in the skin
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Lividity
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Pooling of blood after death dependent areas (NOT PRESSURE AREAS)
1/2-1 hrs - begins 6 hrs - blanches 10-14 hrs - fixed lividity position of body |
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Tardieu spots
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Vessels rupture during early decompisition - always in areas of lividity.
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Rigor Mortis
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Stiffining of muscles
Begins 30mins-2hrs Fixed - 12-14hrs Dissapates after 24hrs |
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Postmortem fly egg deposition
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"parmesian cheese"
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Abrasions (Blunt force)
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Show directionality, injury to upper layers of skin, "brush burns", can be patterned or non patterned
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Laceration (Blunt force)
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skins is torn causing separation, tissue bridges, edges are abraded, undermining (over bones) - skin edges which may help with directionality
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Sharp Force Injuries
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Indent the skin, double countor (tram-track brusing) - 2 parallel linear brusies with a central area of pattern - measure zone of pallor to approximate size of weapon
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Coup and Contra-coup injuries
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Only deals with brain bruises - moving head hitting a stationary object , usually fracture with coup (small), contracoup (is opposite)
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Driver vs Passenger
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Seatbelts
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Dicing Injuries
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Side windows - angled or cubed
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Pedestrian
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Bumper of car - Primary
Pedistrian thrown on the car - Secondary Impact with environment Tertiay |
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Bumper Injuries
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Pt standing
Accelerating - bumper will raise Decelerating - bumper will lower |
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Overstretching injuries
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Yellow superficial skin separates in the groin areas - pedestrian was struck from rear
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Contact GSW
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Muzzle imprint, stellate, soot and gunpowder are imbedded in tissue
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Near contact - within 2-3 inches
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Round entrance wound, soot, gunpowder stippling over a small area, muzzle flame may burn the skin edges
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Close - 6-8 inches
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Round entrance wood, no soot, gunpowder stippling
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Contact GSW - ABD - Chest
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No stellate wound, because gasses dissapate.
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Entrance Wound only
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Greater than 2 feet, or intermediate target (clothing)
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Entrance Wound
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Typically round, abrasion collar, tissue deficit
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Exit Wounds
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Irregular in shape, look like lacerations, edges able to be reapproximated, clean edges
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Skull GSW Wounds
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Directionality - Entrance - Bevel inward
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Shotgun wounds
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Smooth bullet wounds, cartidge (wading), 4 inches together, 26 inches (wad opens "petal shape" - wounding related to wading), 39
inches - cluster of pellets, 6ft or greater - pellets dissapate |
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Handguns
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Imparts rifling marks
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Sharp Force Injuries - Stab wound
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Blunt edge and sharp edge, rare brusing
Deeper than Long |
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Incise Wonder
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Longer than deep
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Serrated Knife
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Can't with a stab wound, if knife dragged along skin, leave a pattern to compare to the knife in question.
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Heat related deaths
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Pugelistic appearance - flexion of arms, wrist, hands, knees come in, feet come out.
Skin splits Heat related fractures |
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Epidural Hemorrhage
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In charred body is artifactual - from bone marrow in skull
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Alive or Dead at time of fire
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Carboxyhemoglobin, smokers -8-10%, >10% alive
Inhaled smoke and soot - Layer of mucous admixed with smoke in bronchi |
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Carboxyhemoglobin
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Cherry red lividity
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Cyanide
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Cherry red lividity
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Cold exposure
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Cherry red lividity
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Electrocution
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Amperage is most important to determine
high voltage > 600 - burns - charring - crater like defects Low voltage <600 - never causes skin injuries Resistance is lowered in wet skin .1 or 100 maps vfib |
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Asphyxiation
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Lack of oxygen -by occluding carotid artery - uncomplicated hanging rarely have fractures of neck
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Strangulation
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May or may not have fractures of neck (usually combination with occlusion of carotid arteries)
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Petechie
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Compression of jugular veins - increased pressure to mucosa (mouth, conjuctivia)
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Drowning
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No diagnostic lab test/autopsy finding
Dx of exclusion (helpful clues - frothy pulmonary edema, voluminous lungs) fish - nose, eyes, mouth |
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Adipocere
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Breakdown of tissues to a gray-white wax like substance - water (moist area) 6 months
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Injuries in childhood
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Fingertip injuries (round/oval), rib fractures (calloused),
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Impact injuries (children)
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Bruises (usually under skin) can be associated with fractures
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Postmortem chemistries (Vitrous)
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Dehydration (inc Na, Cl, N)
Uremia Decomposition (high K) DKA (inc Glc) + toxicology (increase acetone & isopropyl alchohol) |
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heroin
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look for morphine, 6monoactomorphine (urine, occs blood)
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Ant/Roach bites
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Superficial skin lesions with irregular borders - insects feed on epidermis
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Tache noire
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linear black discolorations across sclera, drying artifact
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Contusion (bruise)
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Impact - injury to blood vessels with bleeding into the surrounding tissue
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Red, blue, purple or brown
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within 24 hrs
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Green contusion
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1-2 days (usually 4-7 days)
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Yellow contusion
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greater 1-2 days (usually greater than 1 week)
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Adults - bruises of different ages
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repeated falls - alcoholics, elderly, dementia, arthritis, previous stroke
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intermediate Range
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gunpowder stippling, absence of soot,
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Distant range
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Characteristics of an entrance wound
Circular shotgun - 3 feet Scalloped edges -3-4 feet Separate pellet wounds > 4 feet |
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High velocity rifles
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Severity is because of velocity of bullet
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Chop wound
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clean with thin abraded edges because of the blunt thick body of the blade
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Manual or ligature strangulation
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Fingernail marks, older folks may fracture hyoid/thyroid cartilage
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Traumatic asphyxia
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situation in which breathing is comporomised due to a crush injury
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Positional asphyxia
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breathing is compromised because of the position of the decedent
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CO
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250-300 x greater affinity of binding sites vs oxygen
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CO content
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house fire -10-15%
gas engine (no catalytic converter) -4-6% diesel engine - close to zero manufacturing illuminating gas - 30% Natural gas is zero CO concentration of 1% blood CO level of 75% in 15 mins |
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Rule of nines
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18% chest & abdomen, 18% back & buttocks, 9% each front & back lowe limb, 4.5% each front/back head, 4.5% each front/back upper limb, 1.0 genital area
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Voltage lines
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Residential 110-120
High voltage 7500-8000 transcontiental 100,000 |
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Lichtenberg figures
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transient fern-like injury of the skin - fades over 24 hours - associated with lightening
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Skin Popping
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Coin size, circular scars ulcers - intra-subq injections
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Cocaine
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1/2 life less than 1 hour
benzoylecgonine 1/2 life 4-5 hrs |
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Cocoethylyene
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Cocaine + etoh
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Blood alchohol
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Death - 0.4%
increases 0.025% for each drink and elimination occurs between .013 & .018 g/dl hr |
