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Forensic Pathology Outline Elizabeth J. Miller, M.D.
2005
V Identification of Remains
A. Visual by relatives or friends
B. Location of body (e.g. In home)
C. ID cards distinctive feature (tattoo, ring, necklace)
D. Scientific Identification
1. Ante mortem radiographs/medical records
2. Serology/DNA
3. Dental records
4. Fingerprints
VI Chain of Evidence
A. Item properly identified
B. Item stored so as to prevent tampering
C. Maintain record of what was done with object, by whom, at each
change of hands
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Forensic Pathology Outline Elizabeth J. Miller, M.D.
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D. Decomposition
1. Fresh
2. Bloated
3. Active
4. Dry/skeletal
5. Bloated stage
a. ~ 36 to 48 hrs—marbling (breakdown of blood within veins)
and skin slip/blistering
b. ~48 hrs—bloating (gas production)
c. ~48 to 72 hrs—green to black discoloration
6. Active decay
a. 3 days to several weeks
i. Variables: temperature, insect activity, bacteria
7. Dry/skeletal stage
a. 2 weeks in hot humid temps
b. Months in snow
c. Years if body changed by adipocere
E. Animal Activity
1. Land
2. Sea
F. Preserving Changes
1. Mummification
a. Drying of body—usually in warm/dry climate
b. Skin preserved, internal organs not always
2. Adipocere
a. Waxy change of fat—usually in high humidity/water
b. Conversion of unsaturated fatty acids to saturated fatty acids via
Clostridia enzymes
G. Accelerating Changes
1. Injury sites—allow access to insects
2. Anything that promotes warmth
a. Obesity
b. Heavy clothing
c. Sepsis
IX SIDS
A. Natural Death—SIDS
1. Usually occurs within 6 months, no more than 10 months
2. Exact mechanism unknown
a. Not caused by smothering or choking
3. Not contagious
4. Not hereditary
5. Occurs very quickly and is assumed to happen during sleep—no
suffering or distress
B. Natural Death Presenting As SIDS
1. Pneumonia
2. Pyelonephritis
3. Myocarditis
4. Bacterial meningitis
5. MCAD deficiency
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Forensic Pathology Outline Elizabeth J. Miller, M.D.
2005
i.
Carotid sleeper hold—obstruction of blood flow
(i) Rapid onset of unconsciousness—must release
immediately upon incapacitation
(ii) Release—complete recovery in seconds
ii. Choke hold—airway compression
(i) Serious damage/death within seconds
(ii) Muscular or subcutaneous hemorrhage
D. Chemical asphyxia
1. Cyanide—almond odor
a. Cherry red discoloration of tissues
2. Carbon monoxide
a. 50% carboxyhemoglobin lethal level
b. Cherry red discoloration of tissues
c. Quick (6 to 7 minutes)
d. Children and elderly especially sensitive
XI Burns
A. Categories
1. Flame
2. Contact
3. Radiant heat
4. Scalding
5. Chemical
6. Microwave
B. Rule of nines
1. Head—9%
2. Arms—9% (each)
3. Anterior torso—18%
4. Back—18%
5. Legs—18% each
6. Neck or perineum—1%
C. Degree of injury
1. 1st degree—confined to epidermis
a. Skin red without blistering
2. 2nd degree—destroys epidermis, spares dermis
a. blistering
3. 3rd degree—destruction of dermis
a. Skin surface brown or black
4. 4th degree—destruction of subcutaneous structures (e.g. muscle)
D. Clothing is protective
E. Death
1. Immediate—smoke inhalation
2. Delayed—sepsis from burns
F. Must establish
1. Identification of deceased
2. Whether deceased was alive at the time of fire
3. Cause of death
4. Manner of death
5. Any contributing factors
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Forensic Pathology Outline Elizabeth J. Miller, M.D.
2005
XII Electrocution
A. Ohm’s law—V=IR (volts = current x resistance)
B. Household current 110 volts (alternating)
C. Resistance of skin
1. Dry—100,000 ohms (1.1 mamp)
2. Wet—1,000 ohms (110 mamp)
D. Low voltage
1. Burns usually present at entry/exit sites
a. Caveat—current entering over broad surface, e.g. bathtub
electrocution
2. Death due to ventricular fibrillation
E. High voltage
1. Electrical burns—chalky white with cratering
2. Charring
3. Death due to ventricular standstill or paralysis of respiratory center
F. Lightning
1. Direct strike
2. Side flash
3. conduction
G. Death from high-voltage direct current is usually due to burns and
injury to respiratory center of brain
XIIIGunshot Wounds
A. Mechanics of firing
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Forensic Pathology Outline Elizabeth J. Miller, M.D.
2005
1.
Firing pin ⇒ ignition of primer ⇒ ignition of gunpowder ⇒
creation/expansion of gas ⇒ bullet, unburned powder, soot
propelled down barrel of gun
B. Entrance wounds
1. Characterized based on distance of gun from victim
a. Contact
b. Close range
c. Intermediate
d. Distant
2. Contact
a. Muzzle imprint
b. Stellate lacerations (if adjacent to bony structure)
c. Gunpowder and soot enters wound
3. Close range—within 3 inches
a. Increase in distance = increase in diameter of particle deposition
and tattooing around entrance wound and decrease in particle
density
b. Entrance wound
i. Particles of gunpowder around wound
ii. Soot on skin
iii. Tattooing (stippling) of skin
4. Intermediate range—3 to 36 inches
a. Further increase in diameter of particle deposition and tattooing
around entrance wound and further decrease in particle density
b. No soot
5. Distant range—greater than 36 inches
a. Absence of gunpowder particles, soot, tattooing
b. Difficult to determine exact distance—appearance of GSW
inflicted at 6 feet doesn’t differ from one inflicted at 16 feet.
c. Using the exact same gun and ammunition a ballistic expert can
experiment to determine the distance.
6. Other entrance wound characteristics to look for include:
a. Usually smaller than exit wounds unless:
i. Located adjacent to bony structures (stellate)
ii. Bullet deflected prior to entrance
b. Inward beveling of skull
c. Rim of abrasion
C. Exit Wounds
1. Usually larger than entrance wounds due to deflection of bullet by
tissues
2. Outward beveling of skull
3. No gunpowder particles, soot, tattooing
4. No rim of abrasion
a. Exception: shoring of exit
5. Wound may appear slit like
D. Shotgun Wounds
1. Contact—circular wound with muzzle imprint
2. Close
a. Circular wound < 2 feet
b. Scalloped edges at 3 feet
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