Forensic Pathology

PMCT scan is good for?

• trauma

• some natural disease

• foreign bodies

• burnt and decomposed bodies

• disaster victim identification (dvi)

• later demonstration in court

• audit/review

PMCT is not good for?

• most natural diseases

• determining post mortem blood clotting or thrombus

• vascular stenosis

coronary artery causes

• atheroschlerosis

• dissection

• vasculitis

• aneurysms/congenital abnormalities

• bridging/spasm

coronary artery atherosclerosis

• most common cause of sudden death, usually arrhythmia

• mostly in men ages 20-65

• risk factors: smoking, high cholesterol, hypertension, diabetes, gentics or drugs

non-coronary causes

• myodarditis often heals with scarring, often viral

cardiomyopathies

• hypertrophic cardiomyopathy has a high incidence rate 1/500

• most common cause of sudden death in younger individuals often in athletes

• massive expansion of the muscle and a diastolic dysfunction

what are injuries forensically important

• can assisst in the identification of the assailant — traces evidence from assailant or used weapon

• identification of weapon(s) used — pattern or shape that may depict outline, shape etc

• reconstruction of events

• find or preserve evidence

Locard’s principle

every contact leaves a trace

injuries

• the most trivial injuries medically may be the most forensically important

• injuries that have no potential to cause death may have evidentiary value at some later date

types of injuries

• blunt force injury

• sharp force injury

• hybrid injuries

• firearm injury

blunt force injury

wound produced by blunt impact causing shearing, tearing, or crushing of tissues

abrasions (BFI)

• superficial injury to skin with subtypes like ‘brush’ or ‘impact’

• pattern abrasions are most forensically significant

bruises (BFI)

• leakage of blood from vessels that have been damged by mechnical trauma

• cutaneous, subcutaneous or involving internal organs

• bruises can ‘move’ rfom site of injurt and therefore may not be useful in localising precise site of injury

lacerations (BFI)

• BFI causing tearing or splitting, rathan than cutting

• bruised and crushed margins

• tissue strands or bridges in depths of wounds

• most common overlying bone

• not usually patterned

Sharp force injuries

• cutting, dividing or penetration of tissues by an object with a sharp edge

• beware of over-interpretation

incised wound (SFI)

• longer than it is deep and less like to affect vital organs than stab wound

• bleeding is more serious complication

penetrating wounds (SFI)

• deeper than it is long

• can cause death via haemorrhage and/or damage to internal organs

• length on skin surface approx. minimum blade width

• depth of wound may approx length of weapon

Hybrid injuries

• blunt and sharp “hybrid injury” from chopping weapon i.e axe or blunt penetrating injuries like spike

self-infliceted wounds

• typically multiple with a number of preliminary ‘trial’ or ‘hesitancy’

• incised wounds usually deeper at site of origin → become shallower

gunshot wounds

• rifled weapon vs shotgun

• appearances of the wound can give some idea of range of fire

• exit and entry wounds typically have different appearances