Forensic Pathology for Police - Brainshare Public Online Library

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296 11 Drug-Related and Toxin-Related Deaths to fish. It may be ingested or inhaled. The CNS is the primary target of mercury poisoning, causing long-term deficits, including dementia. Other organ systems affected include the kidneys and the GI system. Other Poisons Organophosphates Organophosphates are commonly used as insecticides. They inhibit acetylcholinesterase, which normally functions at nerve endings to break down acetylcholine, which is a neurotransmitter. In the presence of organophosphates, the acetylcholine is not properly metabolized so there is continued nerve transmission, or overstimulation of the target of the nerve ending. This results in a wide variety of symptoms, including sustained muscular contractions for certain muscle groups, depressed muscular function elsewhere, increased secretions, increased sweating, increased GI tract motility, increase urination, respiratory depression, and behavioral and neurologic effects. Organophosphate exposure can be by ingestion, inhalation, or transcutaneously (skin absorption). Cholinesterase levels/activity can be accurately measured in postmortem blood samples. Decreased levels suggest that organophosphate poisoning has occurred. Strychnine Strychnine is a very potent poison. It is produced from the plant Strychnos nuxvomica, which is native to southern Asia and Australia. Its primary use today is as a pesticide (rat poison). Occasionally, the substance is reported as a contaminant in various street drugs, such as LSD, cocaine, and heroin. Numerous routes of exposure may occur, including ingestion and inhalation. The poison is an inhibitor of a neurotransmitter within the CNS. Acute toxicity is characterized by agitation, being easily startled, restlessness, painful muscle spasms, jaw tightness, and possibly difficult breathing. The urine may become dark. High doses can lead to respiratory failure, neurologic deficits, and death. Naturally-Occurring Toxins A variety of other poisons and toxins exist and have been known to cause death. Included here are numerous naturally-occurring toxins, including several that have already been discussed above. Animal venoms represent a type of natural toxin that can cause death. Deaths may be due to the direct toxic effects of these substances, an infection that develops as a result of the corresponding tissue destruction, or as a result of an allergic reaction to the toxin/venom. Animals that produce potentially lethal venoms include certain arthropods (bees, spiders, fire ants, scorpions,
Disc Image Legends 297 wasps), snakes and other reptiles, and numerous aquatic animals. Numerous plants and fungi contain natural toxins. Besides those that have already been presented above, examples include hemlock, holly, jimsonweed, mistletoe, nightshade, poinsettia, and pokeweed. Ricin, from castor beans, is discussed in Chapter 21, along with other potential “terror agents”. Disc Image Legends Disc Image 11.1 In certain drug-related death scenes, there may be little or no indication that drug use played a role in death. Disc Image 11.2 Careful evaluation of the entire death scene, including areas away from the immediate vicinity of the body, may reveal evidence of drug/toxin exposure. Disc Image 11.3 Drug paraphernalia found in the clothing of an overdose victim at autopsy. Disc Image 11.4 Needle tracks and injection sites may be masked by tattoos, as in the example shown. Disc Image 11.5 Another example of needle tracks. Disc Image 11.6 Skin-popping scars. Disc Image 11.7 Recent superficial wrist incisions in a suicidal overdose victim. Disc Image 11.8 Vomit which is discolored yellow from the pills that were intentionally ingested in this suicide victim. Disc Image 11.9 Pill dye (pink-red) on the clothing of an overdose victim. Disc Image 11.10 The belly of an obese individual who had a rather unique hiding/storage place for his crack cocaine (see Disc Image 11.11). Disc Image 11.11 Crack cocaine hidden/stored in the fold of skin/tissue underlying the sizeable anterior abdominal wall of the individual shown in Disc Image 11.10. Disc Image 11.12 A long little fingernail, presumably utilized by the decedent during life for delivering powder forms of various drugs to the nostrils. Disc Image 11.13 Gastric (stomach) mucosa (lining) discolored green by the pills used in an overdose. Disc Image 11.14 Focal green discoloration of the intestines in a case where greencolored pills were used in an overdose. Disc Image 11.15 Brain swelling in an overdose. This finding is “non-specific,” meaning that it can occur in a variety of other situations, not just in overdoses. Disc Image 11.16 Postmortem bleeding in the lateral (side) aspects of the neck region, secondary to attempting to collect blood from the subclavian blood vessels. Such bleeding can cause difficulties in attempting to document the presence or absence of subtle neck injuries. Disc Image 11.17 Urine collection at autopsy. Disc Image 11.18 Cerebral spinal fluid (CSF) collection at autopsy, by internal approach. After the organs of the trunk have been removed, and before brain removal, CSF can be withdrawn by an anterior (front) approach, using a needle inserted into the spinal canal through an intervertebral disc.
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Forensic Pathology for Police, Deat
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Joseph Prahlow Indiana University S
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vi Dedication accepted the free gif
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viii Foreword quality photographs i
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x Acknowledgements Counties, as wel
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Contents Part I Introductory Topics
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Contents xv Hepatobiliary System .
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Contents xvii RespiratorySystem....
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Contents xix Mercury ..............
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Contents xxi Strangulation . ......
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Contents xxiii Negligence/Neglect .
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About the Author Joseph A. Prahlow,
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Chapter 1 Introduction to Pathology
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Introduction to Pathology 5 Table 1
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Introduction to Pathology 7 Fig. 1.
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Introduction to Pathology 9 Fig. 1.
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Introduction to Pathology 11 Fig. 1
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Introduction to Pathology 13 Fig. 1
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Selected References 15 Disc Image L
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18 2 Introduction to Forensic Scien
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Chapter 3 Introduction to Forensic
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Duties of the Forensic Pathologist
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Training and Qualifications of Fore
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Training and Qualifications of Fore
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Selected References 47 Selected Ref
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50 4 Death Investigation Death Inve
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52 4 Death Investigation met in ord
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54 4 Death Investigation leading to
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56 4 Death Investigation Fig. 4.2 A
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58 4 Death Investigation Fig. 4.5 P
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60 4 Death Investigation Fig. 4.9 I
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62 4 Death Investigation apartment
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64 5 Death Certification Fig. 5.1 A
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66 5 Death Certification Fig. 5.4 A
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68 5 Death Certification latter, th
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70 5 Death Certification infrequent
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72 5 Death Certification changes in
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74 5 Death Certification suicides.
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76 5 Death Certification death is i
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78 5 Death Certification use involv
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Chapter 6 Overview of Anatomy and P
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Introduction 83 Table 6.1 (continue
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Introduction 89 Term Definition Tab
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Introduction 91 “mucous membranes
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Specific Organ Systems 93 functions
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Specific Organ Systems 95 Fig. 6.2
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Specific Organ Systems 97 Microscop
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Specific Organ Systems 107 respirat
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Specific Organ Systems 111 water co
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Specific Organ Systems 115 Platelet
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Disc Image Legends 125 Disc Image 6
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Part II General Topics in Forensic
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130 7 The Postmortem Forensic Exami
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Chapter 8 Postmortem Changes and Ti
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Early Postmortem Changes 165 Fig. 8
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Early Postmortem Changes 167 can be
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Decomposition 169 exposed to sunlig
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Decomposition 171 Fig. 8.8 As decom
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Decomposition 173 Fig. 8.12 As deco
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Decomposition 175 Fig. 8.16 If flie
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Postmortem Injuries 177 Fig. 8.20 I
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Time of Death Estimation 179 Time o
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Time of Death Estimation 181 Fig. 8
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Chapter 9 Identification of Human R
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Introduction 187 Fig. 9.2 Badly dec
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Common, Non-scientific Methods of I
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Scientific Methods of Identificatio
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Scientific Methods of Identificatio
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Identification Based on Other Uniqu
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Identification Based on Other Uniqu
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Unidentified Remains 199 Fig. 9.16
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Selected References 201 Disc Image
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Chapter 10 Natural Deaths One man d
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Infectious Disease 207 to as “hyp
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Cardiovascular System 209 refers to
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Cardiovascular System 211 related t
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Cardiovascular System 213 heart int
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Cardiovascular System 215 Aortic An
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Cardiovascular System 217 Vasculiti
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Cardiovascular System 219 Valve Dis
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Cardiovascular System 221 Fig. 10.1
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Central Nervous System 223 Neoplast
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Central Nervous System 225 Viral en
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Central Nervous System 227 Spontane
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Respiratory System 229 Fig. 10.18 T
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Respiratory System 231 Pulmonary Th
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Respiratory System 233 identificati
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Respiratory System 235 Chronic Lung
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Gastrointestinal and Hepatobiliary
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Gastrointestinal and Hepatobiliary
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Reticuloendothelial and Immune Syst
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Endocrine System 243 infection, dis
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Page 281: Selected References 255 Fineschi V,
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Page 327 and 328: Chapter 12 Blunt Force Injury Death
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Page 361: Selected References 335 Toro K, Szl
Page 364 and 365: 338 13 Gunshot Wound Deaths shotgun
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346 13 Gunshot Wound Deaths targets
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348 13 Gunshot Wound Deaths (a) (b)
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350 13 Gunshot Wound Deaths Image 1
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352 13 Gunshot Wound Deaths Fig. 13
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354 13 Gunshot Wound Deaths Miscell
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362 13 Gunshot Wound Deaths may be
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368 13 Gunshot Wound Deaths X-Rays
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370 13 Gunshot Wound Deaths left-ha
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372 13 Gunshot Wound Deaths NYCLAD
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374 13 Gunshot Wound Deaths Disc Im
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376 13 Gunshot Wound Deaths Disc Im
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Chapter 14 Sharp Force Injury Death
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Stab Wounds 381 to describe the sha
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Stab Wounds 383 describing “clust
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Incised Wounds 385 Fig. 14.9 A supe
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Incised Wounds 387 Although knives
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Special Issues 389 Fig. 14.16 A sta
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Special Issues 391 Defensive Wounds
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Special Issues 393 disorders; howev
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Special Issues 395 area of “radio
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Special Issues 397 Artifacts A fina
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Selected References 399 Disc Image
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Chapter 15 Asphyxial Deaths So Juda
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Suffocation 403 Fig. 15.1 Petechiae
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Suffocation 405 Certification of th
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Suffocation 407 usual occluding sub
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Suffocation 409 being able to expan
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Neck Compression (Strangulation) 41
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Chemical Asphyxia 419 the object ha
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Chemical Asphyxia 421 Fig. 15.21 A
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Other Issues 423 to function proper
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Other Issues 425 (a) (b) Fig. 15.24
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Other Issues 427 the arms/hands bou
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Selected References 431 Prahlow JA,
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434 16 Drowning Physiology and Mech
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436 16 Drowning Fig. 16.2 Thedriver
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438 16 Drowning Fig. 16.4 “Cadave
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440 16 Drowning Finding water withi
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442 16 Drowning Fig. 16.10 Marked d
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444 16 Drowning Fig. 16.14 True ant
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446 16 Drowning Manner of Death A l
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448 16 Drowning Pachar JV, Cameron
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450 17 Electrical Deaths Fig. 17.1
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452 17 Electrical Deaths required f
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454 17 Electrical Deaths death (Fig
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466 17 Electrical Deaths Disc Image
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Chapter 18 Temperature-Related Deat
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Hypothermia 471 constrict, thus con
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Hypothermia 473 Fig. 18.3 Prominent
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Hyperthermia 475 Toxicology testing
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Hyperthermia 477 Fig. 18.8 A 24-yea
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Selected References 479 disease. In
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Chapter 19 Burns and Fire-Related D
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Introduction 483 Fig. 19.3 Example
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Burn Types 485 Fig. 19.5 A postmort
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Burn Types 487 Chemical Burns As me
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Fire Deaths 489 Fire burns represen
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Fire Deaths 491 Fig. 19.11 Dense so
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Fire Deaths 493 Fig. 19.13 Multiple
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Fire Deaths 495 a CO test or an ins
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Fire Deaths 497 Fig. 19.20 Atrue an
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Disc Image Legends 499 Disc Image L
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Chapter 20 Deaths in Infancy and Ch
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Discarded Fetuses/Infants and Fetal
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Discarded Fetuses/Infants and Fetal
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Birth-Related Infant Deaths 507 abr
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Infant Deaths 509 Fig. 20.3 A diaph
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Infant Deaths 511 Fig. 20.6 The pre
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Natural Death in Childhood 513 path
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Accidental Childhood Deaths 515 pon
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Homicidal Childhood Deaths 517 occu
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Homicidal Childhood Deaths 519 Fig.
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Homicidal Childhood Deaths 521 in a
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Classification of Childhood Homicid
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Pediatric Autopsy Considerations 53
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Disc Image Legends 535 Disc Image L
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Selected References 537 Selected Re
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540 21 Miscellaneous Topics Aircraf
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542 21 Miscellaneous Topics CAMI to
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544 21 Miscellaneous Topics To summ
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546 21 Miscellaneous Topics typical
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548 21 Miscellaneous Topics quite o
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550 21 Miscellaneous Topics Fig. 21
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552 21 Miscellaneous Topics The emb
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554 21 Miscellaneous Topics various
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556 21 Miscellaneous Topics stress
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560 21 Miscellaneous Topics ampheta
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562 21 Miscellaneous Topics victim
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564 21 Miscellaneous Topics more se
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568 21 Miscellaneous Topics Organ a
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572 21 Miscellaneous Topics region
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574 21 Miscellaneous Topics Regardi
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576 21 Miscellaneous Topics and lar
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578 21 Miscellaneous Topics some wo
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580 21 Miscellaneous Topics Non-ion
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582 21 Miscellaneous Topics Yersini
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584 21 Miscellaneous Topics water (
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586 21 Miscellaneous Topics to gene
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588 21 Miscellaneous Topics Disc Im
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590 21 Miscellaneous Topics Leclair
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Appendix: Additional Resources and
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Index Note: The letters ‘f’ and
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Index 597 Arnold-Chiari malformatio
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Index 599 closed head injuries, 311
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Index 601 immediate, 68 intermediar
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Index 603 liver demonstrating cirrh
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Index 605 Death investigation syste
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Index 607 pressure related processe
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Index 609 bridging veins, 316 dura
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Index 611 brain, serially-sectioned
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Index 613 Gestational DM, 247 Gesta
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Index 615 Homicide(s), 444 by heart
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Index 617 Infant death, 501-502, 50
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Index 619 Material Safety Data Shee
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Index 621 CNS, 223-229 cerebral pal
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Index 623 Over-the-counter (OTC), 2
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Index 625 Pregnancy-related materna
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Index 627 industrial settings, 486
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Index 629 Smoke and soot inhalation
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Index 631 Thrombophlebitis, inflamm
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