Forensic Pathology, Second Edition

by DiMaio, Dominick; DiMaio, Vincent

• ISBN13: 9780849300721
• ISBN10: 084930072X
• Edition: 2nd
• Format: Hardcover
• Copyright: 2001-06-28
• Publisher: CRC Press

Summary

Medicolegal investigation of death is the most crucial and significant function of the medical examiner within the criminal justice system. The medical examiner is primarily concerned with violent, sudden, unexpected, and suspicious deaths and is responsible for determining the cause and manner of death, identifying the deceased, determining the approximate time of death and injury, collecting evidence from the body, issuing the death certificate, and documenting these events through an official autopsy report. The basis of the medicolegal investigation is forensic pathology.Written for both medical and investigative professionals, Forensic Pathology, Second Edition presents an overview of medicolegal investigative systems. Completely updated, the book examines investigative techniques and procedures that lead to obtaining accurate conclusions of death by homicide, accident, or suicide.

Table of Contents

Medicolegal Investigative Systems
Definition of Death	1	(1)
Delayed Deaths	2	(1)
Cause, Manner, and Mechanism of Death	3	(3)
Sudden, Unexpected Natural Death	6	(3)
The Coroner System	9	(2)
The Medical Examiner System	11	(3)
Operation of a Medical Examiner System	14	(5)
Name Accreditation	19	(1)
References	19	(2)
Time of Death
Livor Mortis	21	(5)
Rigor Mortis	26	(2)
Body Temperature	28	(2)
Decomposition	30	(5)
Chemical Changes in Body Fluids	35	(2)
Flow-Cytometry	37	(1)
Gastric Emptying and Digestion	37	(2)
Insect Activity	39	(1)
Scene Markers	40	(1)
References	41	(2)
Deaths Due to Natural Disease
Cardiovascular Disease	43	(1)
Coronary Atherosclerosis	44	(1)
Bridging	45	(1)
Dissecting Coronary Aneurysm	46	(1)
Coronary Artery Spasm	46	(1)
Mechanism of Sudden Death	47	(1)
Sudden Death: Exercise and Climate	48	(1)
Hypertensive Cardiovascular Disease	48	(1)
Cardiomyopathy	49	(3)
Valvular Disease	52	(3)
Coronary Artery Anomalies	55	(1)
Myocarditis	55	(2)
Aortic Dissection	57	(1)
Sudden Death on a Physiological Basis	58	(1)
Deaths Due to Intracranial Lesions	58	(1)
Epilepsy	58	(3)
Nontraumatic Subarachnoid Hemorrhage	61	(1)
Berry Aneurysms	61	(4)
Intracerebral Hemorrhage	65	(3)
Primary Brain Tumors	68	(1)
Meningitis	69	(2)
Reyes Syndrome	71	(1)
Hydrocephalus	72	(1)
Psychiatric Patients	73	(1)
Respiratory System	74	(1)
Epiglottitis	74	(1)
Pulmonary Thromboemboli	75	(1)
Asthma	76	(1)
Pneumonia	77	(1)
Hemoptysis	78	(1)
Spontaneous Pneumothorax of Newborns	78	(1)
Urogenital and Gastrointestinal Tracts	79	(1)
Spleen	79	(1)
Pancreas	79	(2)
Liver	81	(1)
Adrenals	82	(1)
Miscellaneous	83	(1)
Tumor and Trauma	83	(1)
References	84	(8)
Blunt Trauma Wounds
Abrasions	92	(2)
Dating of Abrasions	94	(4)
Contusions	98	(2)
Dating of Contusions	100	(2)
Postmortem Bruising	102	(1)
The Eyes and Eyelids	103	(1)
Decomposed Bodies	104	(1)
Lacerations	104	(4)
Defense Wounds Due to Blunt Force	108	(1)
Determination of Whether a Wound is Ante- or Postmortem	108	(1)
Fractures of the Face	109	(1)
Fractures of the the Extremities	110	(1)
Fractures from Direct Application of Force	111	(1)
Fractures Caused by Indirect Application of Force	112	(2)
Pelvic Fractures	114	(1)
Healing of Fractures	115	(1)
References	116	(1)
Blunt Trauma Injuries of the Trunk and Extremities
Blunt Force Injuries of the Chest	117	(1)
Injury to the Ribs	117	(1)
The Sternum	118	(1)
The Heart	119	(3)
The Aorta	122	(4)
Diaphragm	126	(1)
Lungs	126	(4)
Blunt Force Injuries of the Abdominal Viscera	130	(2)
Liver	132	(2)
Pancreas	134	(1)
Spleen	135	(1)
Gastrointestinal Tract	136	(3)
Kidneys	139	(1)
Urinary Bladder	139	(1)
Internal Genitalia	140	(1)
Blunt Force Injuries of the Estremities	140	(3)
References	143	(4)
Trauma to the Skull and Brain: Craniocerebral Injuries
Impact Injuries	147	(1)
Soft Tissue Injuries	147	(1)
Fractures of the Skull	148	(7)
Contusions of the Brain	155	(5)
Lacerating, Penetrating, and Perforating Wounds of the Brain	160	(2)
Epidural Hemorrhages	162	(3)
Acceleration/Deceleration Injuries	165	(1)
Subdural Hematomas	166	(3)
Diffuse Axonal Injury	169	(3)
Death Due to Cerebral Concussion	172	(1)
Subarachnoid Hemorrhage	173	(2)
Vertebral Artery Injury (Laceration)	175	(1)
Traumatic Injury of the Carotid Artery	176	(1)
Traumatic Dissection of Intracranial Arteries	176	(1)
Traumatic Brain Swelling and Edema	177	(2)
Boxing Injuries	179	(1)
Occipito-Cervical Injuries	180	(1)
Lacerations of the Brainstem	181	(1)
Traumatic Intracranial Aneurysms	181	(1)
Cerebral Palsy	182	(1)
References	183	(4)
Wounds Caused by Pointed and Sharp-Edged Weapons
Stab Wounds	187	(1)
Depth of Stab Wounds	188	(1)
Appearance of Stab Wounds in Skin	189	(5)
Stab Wounds from Weapons Other than Knives	194	(7)
Identifying the Weapon	201	(3)
Manner of Death	204	(2)
Stab Wounds by Anatomical Location	206	(2)
Incised-Stab Wounds	208	(1)
Physical Activity Following a Fatal Stab Wound	209	(2)
Force Necessary to Inflict Fatal Stab Wounds	211	(1)
Postmortem Bleeding	212	(1)
Incised Wounds	212	(4)
Incised Wounds of the Neck	216	(5)
Miscellaneous	221	(2)
Chop Wounds	223	(4)
Therapeutic or Diagnostic Wounds	227	(1)
References	228	(2)
Asphyxia
Suffocation	230	(1)
Entrapment / Environmental Suffocation	230	(1)
Smothering	231	(4)
Choking	235	(5)
Mechanical Asphyxia	240	(4)
Suffocating Gases	244	(1)
Strangulation	245	(12)
Ligature Strangulation	257	(5)
Manual Strangulation	262	(8)
Chemical Asphyxiants	270	(2)
Sexual Asphyxia (Autoerotic Asphyxia, Autoerotic Deaths)	272	(3)
References	275	(4)
Deaths Caused by Motor Vehicle Accidents
Causes of Motor Vehicle Accidents	279	(1)
Natural Disease as a Cause of Motor Vehicle Accidents	280	(1)
Categories of Motor Vehicle Accidents	281	(1)
Front Impact Crashes	281	(9)
Side Impact Crashes	290	(3)
Rollovers	293	(3)
Rear Impact Crashes	296	(1)
Seat Belts and Air Bags	296	(2)
Air Bags	298	(3)
Motor Vehicle Fires	301	(1)
Motorcycle Accidents	302	(3)
Suicide by Motor Vehicles	305	(1)
Determination of Who Was Driving	305	(1)
Motor Vehicle-Train Accidents	306	(1)
Toxicology in Motor Vehicle Accidents	306	(2)
Pedestrian Deaths	308	(1)
Relationship Between Speed at Impact and Injuries	308	(1)
Child Pedestrians	309	(1)
Adult Pedestrians	309	(8)
References	317	(2)
Airplane Crashes
Crashes Involving Light Planes	319	(1)
Crashes of Commercial Aircraft	320	(1)
Causes of Crashes	320	(1)
Crash Scene	321	(1)
Crash Patterns	321	(2)
In-Flight Fire	323	(1)
Helicopter Crashes	323	(1)
Hot-Air Balloons	323	(1)
Lightning Strikes	323	(1)
References	324	(2)
Sudden Infant Death Syndrome
Incidence of SIDS	326	(1)
Presentation of Cases	326	(1)
Non-Hereditary Nature of SIDS	327	(1)
Diagnosis of SIDS	328	(1)
Etiology of SIDS	328	(1)
Investigation of the Death	329	(2)
Communication with the Parents	331	(1)
References	332	(4)
Neonaticide, Infanticide, and Child Homicide
Neonaticide	336	(1)
Infanticide and Child Murder	337	(2)
Battered Baby Syndrome	339	(7)
The ``Impulse'' or ``Angry'' Homicide	346	(3)
``Gentle'' Homicides and the Lethal Variant of Munchausen's Syndrome by Proxy	349	(6)
Miscellaneous Causes of Child Deaths	355	(1)
Radiological Evidence of Child Abuse	356	(2)
The Shaken Baby Syndrome	358	(4)
Unintentional Causes of Intracranial Hemorrhage	362	(1)
References	363	(4)
Fire Deaths
Burns	367	(1)
Severity of Burn Injuries	368	(4)
Deaths Caused by Fire	372	(1)
The Burned Body	372	(2)
Smoke Inhalation	374	(3)
Inhalation Injuries	377	(1)
Identification of the Deceased	378	(2)
Causes of Fires	380	(1)
Homicide by Fire	380	(1)
Self Immolation	381	(1)
Scalding Burns	382	(1)
Chemical Burns	383	(1)
Microwave Burns	384	(2)
Miscellaneous	386	(1)
Flash Fires: Fires Involving Flammable Hydrocarbon Liquids	386	(1)
Flashover	386	(1)
References	387	(2)
Carbon Monoxide Poisoning
Mechanism of Action	389	(1)
Deaths from Motor Vehicle Exhaust	390	(1)
Survival Time	391	(1)
Outdoor Deaths Caused by Carbon Monoxide	392	(1)
Carbon Monoxide Deaths from Sources Other than Exhaust	392	(1)
Decomposition and Carbon Monoxide	393	(1)
Signs and Symptoms of Carbon Monoxide Poisoning	393	(1)
Fatal Levels of Carbon Monoxide	394	(1)
Suicide or Accident	394	(1)
Autopsy Findings	395	(2)
References	397	(3)
Death by Drowning
Physiology of Drowning	400	(2)
Autopsy Findings	402	(3)
Tests for Drowning	405	(1)
Drownings in Bathtubs	406	(1)
Scuba Divers	406	(1)
References	407	(3)
Electrocution
Mechanism of Death	410	(1)
Fractures Caused by Electrocution	411	(1)
Involuntary Movements Caused by Electricity-Induced Contraction of Muscle	411	(1)
Autopsy Findings	412	(2)
Manner of Death	414	(1)
Lightning	415	(3)
References	418	(4)
Hyperthermia and Hypothermia: the Effects of Heat and Cold
Heat Stroke	422	(4)
Malignant Hyperthermia	426	(1)
Miscellaneous Causes of Hyperthermia	426	(1)
Saunas	427	(1)
Exercise, Body Temperature, Humidity and Exhaustion	427	(1)
Hypothermia	428	(1)
Hypothermia in Water	429	(2)
Hypothermia on Land	431	(1)
References	432	(3)
Rape
The Living Rape Victim	435	(3)
Rape-Homicides	438	(1)
Transport of the Body	438	(2)
Examination of the Body	440	(1)
Trace Evidence Recovery from the Hands	440	(1)
Examination of the Clothing	441	(1)
The Body	441	(1)
Hair	441	(1)
Evidence of Sexual Intercourse	442	(2)
Bite Marks	444	(1)
Homosexual Rape	444	(1)
DNA Analysis	444	(5)
Short Tandem Repeats	449	(1)
Combined DNA Index System	450	(1)
Mitochondrial DNA Analysis	450	(1)
References	451	(2)
Emboli
Gas Embolism	453	(5)
Fat Embolism Syndrome	458	(1)
Amniotic Fluid Emboli	459	(3)
References	462	(3)
Topics in Forensic Pathology
Primary Cardiac Arrest During Exercise	465	(1)
Starvation	466	(2)
Anaphylactic Deaths	468	(1)
Injury of the Eye Caused by Acids and Alkalis	469	(1)
Death in the Dental Chair	470	(3)
Maternal Mortality: Criminal Abortion	473	(1)
Abortifacient Drugs	473	(1)
Local Abortifacient	473	(1)
Instrumentation	474	(4)
Stillborn Infants	478	(1)
Traumatic Lesions of Birth	479	(1)
Water Intoxication	480	(1)
Vitreous	481	(2)
Electrolyte Disorders	483	(1)
Blast Injuries	484	(1)
Intra-Operative Deaths	484	(2)
References	486	(3)
Nursing Home Deaths
Drug Overdoses	489	(1)
Accidents Not Involving Medications	489	(1)
Homicides	489	(1)
Suicides	490	(1)
Gross Neglect of Patients	490	(1)
Signs of Neglect	490	(1)
Contractures	491	(1)
Malnutrition	491	(2)
Dehydration	493	(1)
Decubitus Ulcers	493	(3)
Homicide by Decubitus Ulcers	496	(1)
Deaths Caused by Hospital Bed Side-Rails	496	(1)
Deaths Caused by Medical Restraints	497	(1)
References	497	(3)
Sudden Death During or Immediately after a Violent Struggle
Excited Delirium	500	(1)
Catecholamine Release	500	(1)
Potassium	500	(1)
Effects of Catecholamines on the Heart	501	(1)
Actions of Drugs	501	(1)
Alcohol	502	(1)
Endogenous Mental Disease: Acute Psychotic Episodes	502	(1)
Natural Disease Without Anatomical Manifestations	502	(1)
Deaths Ascribed to Positional Asphyxia	503	(1)
Certification of Death	504	(1)
Pepper Spray	505	(1)
References	505	(2)
Interpretive Toxicology: Drug Abuse and Drug Deaths
Collections of Tissue for Analysis	507	(3)
Tissue Analyses	510	(2)
Analysis	512	(1)
Toxicology Screens	513	(2)
Deaths	515	(1)
Ethyl Alcohol	516	(4)
Methyl Alcohol	520	(1)
Isopropanol	520	(1)
Ethylene Glycol	521	(1)
Phencyclidine (PCP)	521	(1)
Heroin	521	(3)
Propoxyphene	524	(1)
Fentanyl	524	(1)
Cocaine	524	(1)
Methamphetamine and Amphetamine	525	(1)
Miscellaneous Narcotics	526	(1)
Inhalants	527	(1)
Lead	527	(1)
Iron	528	(1)
Lye (NaOH)	528	(2)
Arsenic	530	(1)
Cyanide	531	(1)
Strychnine	531	(1)
Digoxin, Succinylcholine, and Insulin	532	(3)
Antidepressants	535	(8)
Mixed Drug Overdose	543	(1)
Barbiturates	544	(1)
References	544	(3)
Appendix
The Forensic Autopsy	547	(2)
The Autopsy Report	549	(4)
Index	553