Atlas of Forensic Pathology: A Pattern Based Approach

 

Description:

Atlas of Forensic Pathology: A Pattern-Based Approach, by Dr. Walter L. Kemp (Montana State Medical Examiner), Dr. Rhome L. Hughes, and Dr. Jeffrey J. Barnard (Dallas County Chief Medical Examiner) provides a highly illustrated succinct “day-to-day” educational guide to the interpretation of patterns of findings at forensic autopsy to best allow for an accurate determination of cause and manner of death.  The format of the book will also guide a pathologist in how to identify pertinent information (i.e., how to search for the patterns) and assemble a thorough and streamlined autopsy report.

 

 

Table of Contents:

 

1. PATTERN INTERPRETATION IN FORENSIC PATHOLOGY

2. BASICS OF AUTOPSY

Introduction

Hospital vs Forensic Autopsies

Validity of Hospital Autopsy Permit

Organ Removal at Autopsy

Documentation

3. BASICS OF DEATH SCENE INVESTIGATION

Introduction

Basics of Death Investigation

Importance of Scene Investigation

Photography of the Scene and Body

Documentation of Postmortem Changes

Documentation of Discovery History and Terminal Events

Near Misses

4. DEATH CERTIFICATION

Introduction

Description of Cause of Death

Description of Manner of Death

Description of Mechanism of Death

Near Miss

5. IDENTIFICATION

Introduction

Circumstantial, Presumptive, or Tentative Identification

How Formed

Exclusionary Identification

How Formed

Positive Identification

How Formed

Scientific Methods to Identify a Deceased Body

Introduction

Fingerprints

Requirements

Time Frame

DNA Analysis

Requirements

Time Frame

Dental Examination

Requirements

Time Frame

Other Forms of Scientific Identification

Non-Scientific Methods of Identification

Introduction

Visual Identification

Method

Challenges

Physical Findings on the Body

Method

Challenges

Identification Cards

Method

Challenges

Personal Effects

Method

Other Methods

Near Miss

6. POSTMORTEM CHANGES

Introduction

Time of Death and Early Postmortem Changes

Algor Mortis

Postmortem Vitreous Potassium Measurements

Supravitality

Rigor Mortis

Livor Mortis

Additional Findings Associated With Lividity

Tardieu Spots

Decomposition

Important Terms Associated With Decomposition

Green Discoloration of Skin

Adipocere

Postmortem Blisters (or Postmortem Bullae)

Corneal Clouding

Hemolysis

Marbling

Mummification and Postmortem Drying

Skin Slippage

Swelling/Bloating

Tache Noire

Description

Scene Indicators

Postmortem Entomology

How to Collect Appropriate Specimens for Time of Death Determination Using Insect Activity

Animal Activity

Embalming Artifacts

Near Misses

7. NATURAL DISEASE AT AUTOPSY

Introduction

Natural Disease of the Body in General

Autopsy Findings: Obesity

Complications of Obesity

Natural Disease of the Central Nervous System

Introduction

Intracerebral Hemorrhage

Autopsy Findings

Etiologies of an Intracerebral Hemorrhage

Cerebral Infarcts

Autopsy Findings

Lacunar Infarct

Autopsy Findings

Incompetent Diaphragm Sella

Autopsy Findings

Natural Causes of Subarachnoid Hemorrhage

Autopsy Findings

Etiologies of Subarachnoid Hemorrhage at Autopsy

Potential Mimics of Subarachnoid Hemorrhage

Meningitis

Autopsy Findings

Potential Mimics

Osmotic Demyelination Syndrome (Central Pontine and Extrapontine Myelinolysis)

Autopsy Findings

Association

Potential Mimics

Globus Pallidus/Basal Ganglia Necrosis

Autopsy Findings

Association of Globus Pallidus Necrosis

Multiple Sclerosis

Autopsy Findings

Chronic Traumatic Encephalopathy

Autopsy Findings

Seizure Disorder

Autopsy Findings

Association With Sudden Death

Alzheimer Disease

Autopsy Findings

Diffuse Lewy Body Disease

Autopsy Findings

Encephalitis

Autopsy Findings

Colloid Cyst

Autopsy Findings

Natural Disease of the Cardiovascular System

Introduction

Hypertensive Heart Disease

Autopsy Findings

Association With Sudden Death

Coronary Artery Atherosclerosis

Autopsy Findings

Association of Coronary Artery Atherosclerosis With Sudden Death

Gross and Microscopic Aging of an Acute Myocardial Infarct

Complications of Acute Myocardial Infarct

Aortic Dissection

Autopsy Findings

Coronary Artery Dissection

Autopsy Findings

Associations

Abdominal Aortic Aneurysm

Autopsy Findings

Coronary Artery Aneurysm

Autopsy Findings

Associations

Aortic Stenosis

Autopsy Findings

Association With Sudden Death

Bicuspid Aortic Valve

Autopsy Findings

Myxomatous Mitral Valve

Autopsy Findings

Association With Sudden Death

Potential Mimics

Chronic Rheumatic Mitral Valvulitis

Autopsy Findings

Potential Mimic

Endocarditis

Autopsy Findings

Associations of Endocarditis

Pericarditis

Autopsy Findings

Etiologies of Pericarditis

Myocarditis

Autopsy Findings

Mimics of Myocarditis

Cardiomyopathies

Autopsy Findings

Association With Sudden Death

Mimics of Cardiomyopathy

Coronary Artery Anomalies Associated With Sudden Cardiac Death

Autopsy Findings: Anomalous Origin of a Coronary Artery

Association With Sudden Death

Autopsy Findings: Tunneling/Bridging of Coronary Artery

Association With Sudden Death

Lipomatous Hypertrophy of the Interatrial Septum

Autopsy Findings

Association With Sudden Death

Non-Ischemic Left Ventricular Scar

Autopsy Findings

Associated With Sudden Death

Lesions of the Cardiac Conduction System

Introduction

Atrioventricular Nodal Artery Dysplasia

Autopsy Findings

Association With Sudden Death

Incidental and Other Microscopic Findings in the Heart

Clusters of Lymphocytes

Basophilic Degeneration

Contraction Band Necrosis

Natural Disease of the Respiratory System

Introduction

Pneumonia

Autopsy Findings

Potential Mimics of Pneumonia

Aspiration Pneumonia

Autopsy Findings

Mimics

Emphysema

Autopsy Findings

Asthma

Autopsy Findings

Incidental Microscopic Findings in the Lung

Corpora Amylacea

Lentils

Pulmonary Chemodectoma (Mesothelial-Like Rest)

Natural Disease of the Hepatobiliary System

Introduction

Diffuse Fatty Liver

Autopsy Findings

Potential Mimics

Cirrhosis of the Liver

Autopsy Findings

Potential Mimics

Complications of Cirrhosis

Fitz-Hugh-Curtis Syndrome

Autopsy Findings

Acute Cholecystitis

Autopsy Findings

Acute Pancreatitis

Autopsy Findings

Risk Factors for Acute Pancreatitis

Cavernous Hemangioma

Autopsy Findings

Association With Sudden Death

Other Incidental Liver Masses

Autopsy Findings

Natural Disease of the Genitourinary System

Introduction

Nephrosclerosis

Autopsy Findings

Acute Pyelonephritis

Autopsy Findings

Association With Sudden Death

Fournier Gangrene

Autopsy Findings

Incidental Renal Masses

Adenoma

Renal Cell Carcinoma

Adrenal Gland Rest

Renomedullary Interstitial Cell Tumor

Natural Disease of the Endocrine System

Introduction

Features of Diabetes Mellitus

Autopsy Findings

Infarction of the Pituitary Gland

Autopsy Findings

Association

Hashimoto Thyroiditis

Autopsy Findings

Pheochromocytoma

Autopsy Findings

Incidental Findings

Myelolipoma

Black Thyroid

Natural Disease of the Gastrointestinal System

Introduction

Esophageal Inlet Patch (Salmon Patch)

Autopsy Findings

Potential Mimics

Barrett Esophagus

Autopsy Findings

Black Esophagus (Acute Esophageal Necrosis)

Autopsy Findings

Associations

Peptic Ulcer

Autopsy Findings

Ischemic Colitis

Autopsy Findings

Potential Mimic

Intestinal Diverticula

Autopsy Findings

Green Colon

Autopsy Findings

Potential Mimic

Natural Disease of the Hematolymphoid System

Introduction

Disseminated Intravascular Coagulation

Autopsy Findings

Thrombotic Thrombocytopenic Purpura/Hemolytic Uremic Syndrome

Autopsy Findings

Fibrosis of the Splenic Capsule (Sugar Spleen)

Autopsy Findings

Natural Disease of the Musculoskeletal System

Introduction

Pregnancy-Related Deaths

Introduction

Amniotic Fluid Embolism

Autopsy Findings

Acute Fatty Liver of Pregnancy

Autopsy Findings

Acute Endometritis-Myometritis

Autopsy Findings

Placenta Accreta, Placenta Increta, Placenta Percreta

Autopsy Findings

Peripartum Cardiomyopathy

Autopsy Findings

Pre-Eclampsia/Eclampsia

Autopsy Findings

Hellp Syndrome

Autopsy Findings

Ectopic Pregnancy

Autopsy Findings

Near Misses

8. ASPHYXIA

Introduction

Specific Forms of Asphyxia Causing Failure of Oxygen to Reach the Lung

Introduction

Smothering

Description

Pattern at Autopsy

Choking

Description

Pattern at Autopsy

Mechanical Asphyxia/Traumatic Asphyxia/Positional Asphyxia

Description

Pattern at Autopsy

Vitiated Atmosphere/Suffocating Gases

Description

Pattern at Autopsy

Entrapment

Description

Pattern at Autopsy

Traumatic Asphyxia Combined With Smothering

Description

Pattern at Autopsy

Specific Forms of Asphyxia Causing External Compression of the Neck

Hanging

Description

Pattern at Autopsy

Strangulation

Description

Pattern at Autopsy

Other Specific Forms Of Asphyxia

Carbon Monoxide Poisoning

Description

Pattern at Autopsy

Drowning

Description

Pattern at Autopsy

Freshwater Versus Salt Water Drowning

Near Misses

9. BLUNT FORCE INJURIES

Introduction

Types of Blunt Force Injuries

Abrasions

Contusions

Lacerations

Fractures

Pattern Interpretation of Blunt Force Injuries

Blunt Force Injuries of the Head

Subgaleal Hemorrhage

Cranial Fractures

Types of Cranial Fractures

Linear Fracture

Stellate (or Complex) Fracture

Depressed Fracture

Ring Fracture

Basilar Fracture

Comminuted Fracture

Diastatic Fracture

Extra-Cerebral Hemorrhage

Epidural Hemorrhage

Subdural Hemorrhage

Subarachnoid Hemorrhage

Traumatic Injuries of the Brain

Type of Contusions

Coup Contusions

Contre-Coup Contusions

Fracture Contusions

Herniation Contusions

Intermediary Contusions

Gliding Contusions

Blunt Force Injuries of the Neck

Blunt Force Injuries of the Trunk

Blunt Force Injuries of the Extremities

Fractures

Specific Fracture Types

Extent: Incomplete vs Complete Fracture

Incomplete Fractures

Bow

Torus/Buckle Fracture

Greenstick Fracture

Complete Fracture: Fracture Type Based Upon Direction

Transverse Fracture

Oblique Fracture

Longitudinal Fracture

Spiral Fracture

Other Fracture Types

Comminuted Fracture

Butterfly Fracture

Segmental Fracture

Avulsion Fracture

Timing of Bone Trauma

Antemortem Fractures

Postmortem Fractures

Perimortem Injuries

Near Misses

10. SHARP FORCE INJURIES

Introduction

Types of Sharp Force Injuries

Stab Wound

Description

Documentation of Stab Wound

Determination of Depth of Stab Wound

Incised Wound

Description

Chop Wound

Description

Sharp Force Injuries of the Bone and Cartilage

Introduction

Basic Features of Bony Defects From Sharp Force Injuries

Identifying Class Characteristics of Sharp Force Injuries in the Bone

Other Features Used to Interpret Sharp Force Wound Characteristics

Near Misses

11. FIREARM INJURY

Introduction

Radiography

Basics of Radiography in Firearm Injuries

Specific Radiographic Findings Associated With Certain Types of Weapons

External Examination

Overall Patterns of Injury to the Body

Interpretation of Gunshot Wound Patterns in the Skin

Entrance Wounds for Handguns/Rifles

Exit Wounds for Handguns/Rifles

Features of Wound That Allow for General Determination of Range of Fire

Special Types of Gunshot Wounds

Graze Wound

Tangential Wound

Superficial Perforating Wound

Re-Entrance Wound/Atypical Wound

Entrance and Exit Wounds for Shotguns and Relative Range of Fire

Features of the Shotgun Wound That Allow for Determination of Relative Range of Fire

Internal Examination

Mechanism of Death in Gunshot Wounds

Composition of Projectiles

Manner of Death Determination With Gunshot Wounds

Near Misses

12. FIRE DEATHS

Introduction

Features of Thermal Injury

Description of Flash Fire

Autopsy Features of Fire Deaths

Heat-Related Fractures

Explosion-Related Deaths

Near Misses

13. CHILD ABUSE

Introduction

Features of Subdural Hemorrhage

Features of Retinal Hemorrhages

Other Features in the Eye: Retinoschisis

Differential Diagnosis of Subdural and Retinal Hemorrhages

Differential Diagnoses: Glutaric Aciduria Type I and Galactosemia

Differential Diagnosis: Congenital Heart Disease, Meningitis, and Leukemia

Differential Diagnosis: Menkes Disease

Differential Diagnosis: Neurosurgical Complications and Traumatic Labor

Differential Diagnosis: Aneurysms

Differential Diagnosis: Hypernatremia

Differential Diagnosis: Coagulation Disorders

Differential Diagnosis: Accidental Injury

Other Important Topics With Regard to Inflicted Head Trauma in Infants

Rib Fractures

Falls

Apparent Life-Threatening Event

Alternative Theories as to the Causation of Findings Associated With Abusive Head Trauma

Other Features of Child Abuse

Fractures

Bruising and Lacerations

Burns

Malnourishment and Dehydration

Near Misses

14. ENVIRONMENTAL DEATHS

Introduction

Hyperthermia

Introduction

Clinical Features of Heat Stroke

Pattern at Autopsy

Hypothermia

Introduction

Pattern at Autopsy

Autopsy Findings Associated With Hypothermia

Wischnewski Spots

Gross Appearance

Microscopic Appearance

Other Associations

Important Points

Frost Erythema

Gross Appearance

Microscopic Appearance

Subnuclear Vacuolization of the Proximal Convoluted Tubular Epithelial Cells

Gross Appearance

Microscopic Appearance

Vacuolation of Pancreatic Adenoid Cells

Microscopic Appearance

Other Associations

Description of Snow Immersion

Bodies Found in the Water

Introduction

Did the Decedent Drown?

How to Determine

What Environmental and Human Factors Were Involved?

Importance to Consider

Postmortem Artifacts Associated With Bodies Found in the Water

Scuba Diving-Related Deaths

Causes of Death Associated With Scuba Diving

How to Test for Gas Embolism and Barotrauma in a Scuba-Related Death

Electrocution

Introduction

Gross Appearance

Microscopic Appearance

Dog Attacks

Introduction

Autopsy Findings Associated With Fatal Dog Attack

Snake Bite

Introduction

Pathologic Features of Pit Viper Injury

Clinical Features of Pit Viper Injury

Pathologic Features of Coral Snake Injury

Clinical Features of Coral Snake Injury

Spider Bite

Introduction

Pathologic Features of Black Widow Bite

Clinical Features of Black Widow Bite

Pathologic Features of Recluse Bite

Clinical Features of Recluse Bite

Other Forms of Animal Attack Encountered by Forensic Pathologists

High-Altitude Pulmonary Edema/High-Altitude Cerebral Edema

Features of High-Altitude Cerebral Edema

Features of High-Altitude Pulmonary Edema

Autopsy Findings in High-Altitude Pulmonary Edema

Near Misses

15. POSTMORTEM TOXICOLOGY

Introduction

Autopsy findings of a drug overdose

Obtaining specimens for toxicologic analysis

Interpretation of toxicologic results

Description of postmortem redistribution and its importance

Specific drugs encountered by forensic pathologists

Metabolites of Common Drugs

Ethanol

16. SUICIDE

Introduction

Basic Considerations When Determining That the Manner of Death Is Suicide

Gunshot Wound Homicide vs Gunshot Wound Suicide

Comparison of Features in Homicide vs Suicide Gunshot Wounds

Sharp Force Injuries Homicide vs Sharp Force Injuries Suicide

Comparison of Features in Homicide vs Suicide Sharp Force Injury

Asphyxial Homicide vs Asphyxial Suicide

Comparison of Features in Homicide vs Suicide Asphyxia

Near Misses

17. HISTOLOGY AT AUTOPSY

Introduction

Frequency of Histologic Examination at Autopsy

Histologic Examination of the Brain at Autopsy

Near Misses

18. EMBOLISM

Introduction

Pulmonary Thromboemboli

Circumstances Under Which Pulmonary Thromboemboli Occur

How to Identify

Complications of a Pulmonary Thromboembolus

Aging of Pulmonary Thromboemboli

Air Embolism

Circumstance Under Which Air Emboli Occur

How to Identify

Fat Embolism

Circumstances Under Which Fat Emboli Occur

Clinical Signs of Fatty Emboli

How to Identify

Amniotic Fluid Embolism

Circumstance Under Which Amniotic Fluid Emboli Occur

Clinical Signs of Amniotic Fluid Emboli

How to Identify

Bullet Embolism

Circumstances Under Which a Bullet Embolism Occurs

How to Identify at Autopsy

Septic Embolism

Description of Septic Embolism

Circumstances Under Which Septic Emboli Occur

How to Identify at Autopsy

Location of Emboli

Cholesterol Crystal Embolism

Circumstances Under Which Cholesterol Crystal Emboli Occur

How to Identify at Autopsy

Other Forms of Embolism

Near Misses

19. MICROBIOLOGIC ANALYSES

Introduction

20. VITREOUS ELECTROLYTE ANALYSIS

Introduction

Vitreous Electrolyte Patterns

Hyponatremia

Causes of Fatal Hyponatremia

Clinical Features of Hyponatremia

How to Determine at Autopsy

Hyperglycemia

How to Determine at Autopsy

Ketoacidosis

How to Determine at Autopsy

21. SUDDEN UNEXPECTED INFANT DEATH

Introduction

Checklist for Investigation of a Sudden Unexpected Infant Death

Description of SUID (sudden unexplained infant death) and SIDS (sudden infant death syndrome)

Identifying an overlay or other asphyxial death at autopsy

Microbiology Studies

Near Miss

22. IN-CUSTODY DEATHS

Introduction

Excited Delirium Syndrome

Restraint Asphyxia

Prone Restraint Cardiac Arrest

Conducted Electrical Weapons/Electronic Control Devices

23. ELDER ABUSE

Introduction

Risk Factors for Elder Abuse

Senile Ecchymoses

Description

Causes

Decubitus Ulcers

Description

Causes

Risk Factors for Decubitus Ulcers

Classification of Decubitus Ulcers

Complications of Decubitus Ulcers

Important Point

Near Misses

24. ANTHROPOLOGY

Introduction

Non-Human Versus Human

Introduction

Identification of Non-Human Bones

Biological Profile

Introduction

Sex

How Determined

Pelvic Features of Sex

Cranial Features of Sex

Age

How Determined

Pubic Symphysis

Auricular Surface

Rib Ends

Cranial Suture Closure

Ancestry

How Determined

Morphologic Analysis for Ancestry

Stature

How Performed

Variants and Natural Disease

Introduction

Near Misses

25. ODONTOLOGY

Introduction

26. MASS DISASTERS

Introduction

27. STILLBIRTHS

Introduction

Basic Information Regarding Handling of a Stillborn Infant

Basic Features of a Stillborn Fetus

Examination of the Placenta

Chorioamnionitis

Autopsy Findings

Potential Mimics

Placental Abruption

Autopsy Findings

Meconium Aspiration

Autopsy Findings

Near Miss

28. COMMON MECHANISMS AT AUTOPSY

Introduction

Hypovolemic Shock

Mechanism

Causes of Hypovolemic Shock

Estimation of Effect of Blood Loss

Autopsy Findings of Blood Loss

Cardiogenic Shock

Mechanism

Causes of Cardiogenic Shock

Septic Shock

Mechanism

Causes of Septic Shock

Anaphylactic Shock

Mechanism

Neurogenic Shock

Mechanism

Autopsy Findings Associated With Shock

Autopsy Findings of Cerebral Edema

Complications of Cerebral Edema

Autopsy Findings of Global Hypoxic Ischemic Encephalopathy

Near Misses

29. TREATMENT-RELATED AUTOPSY FINDINGS

Introduction

Types of Medical Devices Used

External Injuries Caused by Resuscitation Attempts

Internal Injuries Caused by Resuscitation Attempts

Near Misses

30. AUTOMOBILE ACCIDENTS

Introduction

Characteristic Injuries in a Motor Vehicle Accident

Transection of the Aorta

Gross Features

Important Points

Basilar Skull Fracture

Gross Features

Flail Chest

Gross Features

Atlanto-Occipital Fracture/Dislocation (See Blunt Force Injuries Chapter)

Dicing

Gross Description

Importance

Stretch Abrasions/Lacerations

Gross Description

Near Misses

31. SPECIAL DISSECTIONS

Introduction

Dissection of Middle Ears

When Performed

How Performed

Dissection of Optic Nerves and Eyes

When Performed

How Performed

Dissection of Vertebral Arteries

When Performed

How Performed

Dissection of the Anterior and Posterior Neck

When Performed

How Performed

Dissection of the Cervical Vertebral Column

When Performed

How Performed

Examination for Pneumothorax

When Performed

How Performed

Examination for Air Embolus

When Performed

How Performed

Dissection of the Back

When Performed

How Performed

Dissection of the Lower Extremities

When Performed

How Performed

Dissection of the Sinoatrial and Atrioventricular Nodes

When Performed

How Performed

Dissection of the Parathyroid Glands

When Performed

How Performed

Examination of Esophagus for Varices

When Performed

How Performed

Quick Removal of the Entire Spinal Cord

When Performed

How Performed

Underwater Removal of Macerated Infant Brain

When Performed

How Performed

Maceration of the Thyroid Cartilage

When Performed

How Performed

En Bloc Removal of Female Genitalia and/or Anus (Including the Male Anus)

When Performed

How Performed

Static Presentation

APPENDIX A: SELF-ASSESSMENT QUESTIONS

Questions

APPENDIX B: SELF-ASSESSMENT ANSWERS

Answers

Interactive Presentation

APPENDIX A: SELF-ASSESSMENT QUESTIONS

APPENDIX C: WRITING THE AUTOPSY REPORT

Introduction

Near Miss

APPENDIX D: BIAS

Introduction

Specific Forms of Bias

Alliterative Bias

Ambiguity Effect

Anchoring Bias

Availability Bias

Belief Bias

Confirmation Bias

Contrast Effect

Diagnosis Momentum

Expectation Bias

False Consensus Bias

Framing Effect

Gambler’s Fallacy

Gender Bias/Ascertainment Bias

Hawthorne Effect

Hindsight Bias

Illusory Correlation

Information Bias

Need for Closure Bias

Outcome Bias

Overconfidence Bias

Premature Closure

Reactance Bias

Search Satisficing Bias

Semmelweis Reflex

Sutton’s Slip

Vertical Line Failure

Zebra Retreat

APPENDIX E: RARE BUT IMPORTANT TO CONSIDER

Introduction

Nervous System Conditions

Sudden Death Associated With Schizophrenia

Myasthenia Gravis

Wernicke-Korsakoff Syndrome

Endocrine System Conditions

Lymphocytic Hypophysitis

Thyroglossal Duct Cyst

Parathyroid Gland Hyperplasia/Adenoma

Cardiovascular System Conditions

Mesothelioma of the Atrioventricular Node

Wolff-Parkinson-White Syndrome

Long QT Syndrome and Torsade De Pointes

Infectious Conditions

West Nile Virus Myelitis

Naegleria Fowleri Meningitis

Rabies

Hantavirus

Rocky Mountain Spotted Fever

Miscellaneous Conditions

Snake Bite

Serotonin Syndrome

Allergic Reaction-Anaphylactic Shock

Acute Stress

Toxins and Poisons

APPENDIX F: SUMMARY

INDEX

 

An aparitie	13 ian 2024
Autor	Walter L. Kemp
Dimensiuni	213 x 276 mm
Editura	LWW
Format	Hardcover
ISBN	9781975222505
Limba	Engleza
Nr pag	690
Versiune digitala	DA