Section 1
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necrosis
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Section 1
(50 cards)
necrosis
cell death
Leukemia
When WBC's proliferate...they cause issues and can result in leukemia.
Tumors/Neoplasia
New growths
Mycology
(Fungi, eg. Athletes foot) Organisms that can cause trivial problems and infections but also can cause greater issues in the body. Fungi grow on different media than that of bacteria. You may have to incubate 6 - 8 weeks opposed to overnight for bacteria. Fungi are not likely to produce widespread issues except in people that are predisposed to issues (i.e.: Immune suppressant - AIDS patients or people who have chemotherapy, tissue transplants.....because their immune is purposely suppressed). Immune suppression makes you more susceptible to other organisms. • Another issue with Fungi is that you can be on medications to kill off bacteria which can then allow the Fungi to thrive in the environment because of the conditions. • Penicillin was developed from a Fungi (mold)
Blood Type B
Anti A. Needs Type B. Will attack Type A and AB. Can get O because Anti B would spread out and disperse leaving only Anti A which is what type B is.
Pathology
"ology"= study, "pathos"= disease, suffering, theater, sad or abnormal. The study of disease and injury specifically the study and function of the body as it is affected by disease. Pathology is intimately related to the fields of anatomy and physiology and the structure and function of the human body. When structure and function are no longer "normal" the field of pathology comes into play
Digestive Systems
Ulcers in the stomach or in the intestines
Microbiology
(Microbes) Analyze mostly fluids to see if cause of an illness is contagious/infectious.
Histology
An anatomic pathology lab receives a sample of tissues in formaldehyde to be tested. The water content is removed from the sample and replaced with wax. The tissue is processed and then embedded in the wax to create a block which is then cut into microscopic sections with a Microtome. These sections are thinner than paper and are then floated on a dish of water. The sample is placed on a glass slide and is stained to then be viewed under a microscope. This is done to help add microscopic dictation notes on a lab report that can aid in a final diagnosis of a patient. This process can take 24-36 hours from the removal of the tissue sample.
White Blood Cells
WBC's. Come in 5 types. Some are more prevalent than others. They are slightly larger in size than RBC's and depending on the type of white blood cell determines the size.
Substances Found on RBC's
RH Factor in Blood: A Positive or A Negative, etc. MN: KELL: DUFFY:
Toxicology
(Drugs, Poisons) Subdivision of clinical chemistry. It looks for Poisons or Toxic materials that can be present in the body. Can help to determine drug abuse or poisons present. All Hospitals don't have Toxicology labs because usually topological study will be done in a Medical Examiner's office (to determine if a death was caused due to an overdose). Toxicology can determine a cause of death.
Pathologists
Usually work in hospitals and do not have their own patients. They conduct aid to treating doctors (clinical doctors) in determining illnesses. Pathologists can oversee all subsections in clinical pathology or can be specific to one particular section (i.e.: Hematology Pathologist). This can be determined by the size of the hospital or town, etc.
Clinical Chemistry
(Glucose) Evaluating liquid part of the blood but ignoring the cells. Interested in the molecules present in the blood. Only involves the use of instrumentation. Microscopes are not used to test samples.
Shock
Circulatory Failure (signs of shock include low blood pressure)
Diabetes
: Looks for chemicals such as glucose (sugar) which can be out of balance in Diabetics
Surgical Pathology (Pathological Anatomy)
Examination of tissues removed at surgery. This is also used as a means of "quality control".
Religious Objection to an Autopsy
Can cause issues because of the laws of permission vs. no permission. The coroner has to weigh in the law with each situation. NYS Law from 1983 states that the coroner/medical examiner does not have authority to conduct autopsies over religious beliefs of the deceased and the family can be the "voice" of the deceased. There are exceptions to this law (in case of the family lying, etc) that allow a coroner/medical examiner to perform an autopsy against the wishes of the family if it..... o Will impede on a homicide investigation (i.e.: suicide, drug overdose, etc.) anything that involves homicide detection will require an autopsy. Does not include traffic accidents or deaths that appear to be from natural causes. o If an autopsy will prove a problem with public health and failure to conduct autopsy can cause public health issues (i.e.: rare diseases, etc). ...the family can not object the autopsy if it is deemed necessary. o Compelling public necessity to perform an autopsy by coroner can be granted by a court order if family is dead set against it. The coroner will call the county attorney to file a petition to perform an autopsy and then it will be up to a judge as to whether or not it will be performed.
Blood Type A
Anti B. Needs Type A. Will attack Type B and AB. Can get O because Anti A would spread out and disperse leaving only Anti B which is what Type A is
Inflammation
Cold or Sores in the through or could be an allergy
Blood Bank
(Transfusion compatibility matching) Started at the turn of the century when people realized that blood was needed and could be used for transfusion. Sometimes it worked and sometimes it didn't because there was not a lot known about the blood back then. Since then the science of blood was looked at more closely to determine the ABO Blood groups that we know today.
Physiological Pathology
Refers to studying the functional changes in the body resulting from disease.
Pathology as Practiced
Professed by modern day physicians is based on the ideas of honor and ethical practice of the medical professions as first laid out by Hippocrates (460-359 BC) "the Father of Medicine".
Blood Groups
Within the blood liquid there are items that attach to the blood cells to determine what type they are.
Bacteriology
(Bacteria) Bacteria Microbes. Microscopy done to see bacteria under microscope, Recovering of causative bacteria by growing samples on agar dishes to then further test. Use of Kirby Bauer Disk Susceptibility Test to show zones of inhibition when determining type of microbe in addition to how to best treat it. This information will help a doctor to determine a method of treatment for the patient. Based on where the bacteria is found in the body will also help determine what type of antibiotics to give.
Clinical Pathology
(hospital lab) the study of fluids. Lab pathologists who study fluids (i.e.: spinal fluid that is sent to the lab for analysis). Deals with the laboratory study of, and the performance of standardized tests on body fluids, secretions, such as blood and urine tests, or cultures and smears of various types.
Blood Type AB
Can ONLY get type AB
Anatomic Pathology
the study of tissues to aid in discovery
Abscess
Swelling Infection
Blood Type O
Anti A and Anti B.
Cross Match
Test done to be sure there will be no transfusion reaction to the patient receiving the blood It tests for the other unique substances in the patient's blood to perfectly match that in the donor blood. This way no problems will occur
Hematology
: (Blood Cells, Bone Marrow)The study of fluid (Blood). The study of Blood. Blood cells include Red Blood Cells, White Blood Cells, Platelets and Bone Marrow.
Respiratory System
Emphysema is specific to organ systems
BUN
Blood Urea Nitrogen. Checks for the renal function aka kidney function. Can also check for Liver Function
Bone Marrow
Bone Marrow: Where most cells are manufacturer. RBC's WBC's and platelets. Look at the bone marrow to find abnormalities. Material is drawn out through a syringe (aspirated) to cut out a small core of bone tissue to look at under the microscope. Bone Marrow is the one area of Hematology that does not involve fluid...it involves the tissues of the bone marrow.
Virology
(Viruses) Highly specialized labs not usually in hospitals. Viruses do not grow on media (agar plates). Viruses grow by infecting cells (parasites on cells) so we have to grow cell cultures to put the viruses on to determine what it is. Medical Examiners usually need to hire out a commercial lab to send specimen to because they are not around (expensive and high tech). Nassau County Hospital does have a Virology Lab. Slow Results...by the time results come in the people are either better or dead. Antibiotics do not work on viruses.
Cytology
Part of AP Pathology in dealing with tissues and collecting individual or groups of cells from those tissues. Initiated by Dr. Papanicolaou who developed the technique of cytology pathology and is granted the naming of "Pap Smear" for this technique where it was first used
Forensic Pathology (Medico legal Pathology)
From the Greeks "forum" i.e.: Court. Often this type of pathology involves the court of law. Forensic Pathologists have their own special board certification. Deals with both the medical and legal issues surrounding death.
Tuberculosis
caused by a mycobacterium. You need treatment of antibiotics for over a year to treat tuberculosis and it can take 6 - 8 weeks to diagnose.
Quality Control of Surgical Pathology
For example a doctor removes an appendix from a patient and the pathologist determines that the appendix was not the root of the problems for the patient. Was the doctor over reacting? Has this doctor done this on more than one occasion? Or is this a phantom symptom of another problem? Surgical Pathologists act as a kind of quality control in diagnoses on a few levels. Another example is that of a breast lump that has been removed from a patient. Is it a tumor/growth? Is it benign or malignant? Is it just a structural abnormality from birth (congenital abnormality)?
Medical Technology
Med Techs ; allows people with lower certifications than pathologists to do some routine matters in pathology. They can prep slides and read slides to prepare for the pathologist to review. This frees up the pathologist to be cable to conduct other matters. Med Techs are seen in areas with larger staffs where they are more needed. Also have these in Forensic Pathology...they are trained to conduct autopsy's and display the findings for a pathologist to come in and determine the causes of death.
Parasitology
(malaria, worms, etc) mostly in tropical areas but more important today to us because of world travel...it makes it easier to spread. Causative agents vary from microbes which cause malaria (microscopic parasites that invade blood cells) to worms (round worms, ring worms, etc). microscopy is done to look for eggs under the skin, on the tissues or in the intestines. Parasites have long life cycles...they can go through the human body, come out in feces, contaminate water and continue on again. Signs of parasites present include weight loss, anemia and diarrhea. O&P Evaluation of stool can test for them as well (Ova and Parasites test).
Red Blood Cells
: RBC's Biconvex Cells/Disks. Red Blood cells are approximately 7.5 microns in diameter. They contain hemoglobin (blood protein responsible for carrying oxygen). We need iron (Fe) because hemoglobin has iron in it to bind to oxygen (O2). Diagnosis and tests done through looking through a microscope.
Systematic (special) Pathology
Pathology by organ systems IE Cardiovascular pathology. Goes into the organ systems and is specific to organ systems
Mycobacteriology
: (Tuberculosis, etc.) Combination of mycology and bacteriology. This deals with organisms that have aspects that bacterial like and also fungi like. They look like bacteria but their growth behavior is more that of Fungi or mycotic organisms. They tend to be resistant to normal antibiotics.
General Pathology
: General Topics i.e.: inflammation. Things that are generally applicable to the body in the study of pathology. Deals with general or broad disease processes, such as necrosis or inflammation, which may affect the entire body or widespread tissues and organs.
Autopsy Pathology (Pathological Anatomy)
Examination of the body after death to try to determine the cause of death or to access treatment (experimental chemotherapy) whether it was partially successful or was it detrimental and played a part in the death of a patient. Autopsies follow a specific procedure and are conducted on patients who have died in hospitals due to unknown deaths. The family MUST give permission for an autopsy to be performed in this situation. A sub specialty of autopsy pathology is Forensic Pathology.
Frozen Section
(in surgical pathology) can be done in 5 - 10 minutes. This is adequate for instant diagnosis if you do not have time for Histology. The sample is frozen and cut in to small slivers. It is then stained and placed under a microscope for analysis. Often a surgeon will wait during surgery for this process to be done before completing the surgery.
Infarct
Failure for blood supply to certain vessels
Platelets
Smaller than RBC's and WBC's. They look rounded with little projections coming off of them. The projections help them to stick to each other and to stick to tissues and act as a plug. They are the first line of defense. Then proteins get laid over them to create a clot. They are regulated so they do not plug up areas where they are not needed.
Section 2
(50 cards)
Marks from Lividity
if a person dies and is lying on something like a zipper, sheets, remote, etc...you will be able to see the marks from those items in the Lividity
Algor Mortis
Cooling of the Body. Postmortem cooling due to the fact that there is no more generation of internal body heat once the body is dead. You can also have postmortem heating (Algor Fever). In most instances people are warmer than their environment and so the body will cool down to match the temperature of their environment. Because there are so many variables that affect this rate.....you can not use body temperature to determine a time of death.
Loss of Vascular Tone aka Peripheral Tone
Since the brain sends nerve signals to the blood vessels and tells them how much to squeeze and constrict and relax...brain death results in no signals going to the vessels. These vessels can move on their own but eventually they lose the ability to constrict which results in the loss of vascular tone aka peripheral tone.
Coroner vs. Medical Examiner
o The original death investigation is a Coroners System which dates back to the 1100's. the system started out as the office of the Crowner which was a royal office established for tax collection on estates (when someone died) for the king. The Crowner would put an attachment on the estate to state what was owed to the king once the assets were all accounted for. Pretty soon there was a realization that for examples sons were murdering their father's to inherit the estate. So the Crowner ended up investigating the deaths more and more as time went on. In today's time the Coroner can act as a judge in an inquest. Inquests come out by police, district attorneys, juries. Coroners are used to determine a cause of death.
Cutaneous Pigmentation
increases rate you will see livor mortis (someone who is fair skined). In African Americans, the pigmentation is different so you will not see livor mortis as soon or as much as on someone who is fair skinned.
Pulling the Plug
realizing a person is brain dead and there is no way for them to come back. Pulling the plug results in Cardiopulmonary Arrest
Respiratory Brain Death Syndrome
(due to increased intracranial pressure, facilitated by invention of mechanical ventilator). Another situation which developed because of technology..in this case the ventilator. This was the 2nd situation to alter the "death" definition. A ventilator keeps a person alive when they can not breathe on their own. This is usually due to the fact that they have significant brain damage and the nerve impulses that go to lungs and heart to make a person breathe no longer work.
Coroners in Coroner State
Cleveland, Ohio as an example. Ohio is a coroner state but their coroner is a board forensic pathologist. So system in Cleveland is different than that of a small town.
Lividity can also be Inappropriate
If the person is found lying on his back but his face and front of the body has Livor Mortis then you know the person was moved after the blood had time to fix. If the person was moved before it had time to fix then you would not see this.
2nd definiton of death
has to do with brain death = if there is no life in the brain but the heart is still beating. If there are any signs of clinical activity in the brain the person is not dead.
Cardiovascular System
Disease of the heart. Arthosclerotic heart disease=parital blockage of the arteries, aneurysms in the blood passageways.
Water in the Eart test
If you squirt cold water in the ear you can see if there is Nystagmis in the eyes. If the eye moves quickly and then slowly back. If there is no movement of the eye then the test is negative = brain death.
Rule out hypothermia
repeat after warning. Even if you are in chilling water, the brain cells can be preserved. It is possible to make a comeback from hypothermia. An immediate test of someone who has hypothermia would be a flat line because the brain signals would be so depressed. But once a persons core temperature is warmed, the brain signals may come back.
Cerebral Death
Higher brain functions dead with preserved vegetative functions, probably permanent coma, compatible with prolonged survival. The law can confuse brain death with cerebral death when the two are not one in the same. When someone has cerebral death this means that only the top part of the brain has died. This becomes a legal issue in determining what should be done with people in this condition...will they make a come back...will they not. Should the plug be pulled. The fact of the matter is that you are not dead dead until you are brain dead. These law cases are settled by statute law or by common law (court case in a court such as a supreme court). There are legal requirements to decide an issue of brain death.
Coroner
has evolved from being an office of the king to being an elected office in the government. They run for election which are based on the local laws. They have a length of term and certain qualifications (age, citizen of certain area, etc) dependent on the area they work in. In small rural towns a coroner does not have to be a licensed doctor. They can be an auto mechanic or a funeral director. They become the liaison between the courts and the people who actually conduct and are licensed to conduct autopsies to determine causes of death.
Putrefaction
Breakdown due to microbes. This is a more dramatic type of breakdown of the body. Most dramatic aspect involves gas formation. They metabolize the tissues of the dead body. As they metabolize them they extract the nutrients from the dead matter and produce simpler compounds such as water, carbonmonixide, etc. They create bad smells when they do this.
Factor affecting the rate of cooling (or in some cases warming)
clothing, fat, wind chill, body position, and Thermal Conductivity of Surroundings
Marbling
When blood breaks down and is seen in superficial blood vessels. Microbes get in and break down hemoglobin in red blood cells and release the iron in the red blood cells which creates dark colored chemicals that create staining which creates linear patterns that resemble marble. With time the darkening spreads out from these lines which makes you lost the marbling affect and you end up with total Discoloration. Marbling becomes discoloration.
Fat
Also acts as a form of insulation. A person who is naked with more body fat will cool at a similar rate to one who is thinner with clothing on.
Blistering
Further breakdown involving the skin...losening of epidermis from the dermis - Skin Slip - Desquamation. If the area that is blistering is not on a dependent area (ie: Blistering on the front when the person is lying on the back) then the blister will fill up with gas. If the blister is in a dependent area (lying on the back with blisters on the back) these blisters will tend to fill up with fluid. It can look like Fire Blistering (where a person can look like a fire victim). The black blood can also seep out and make it look like a fire when it is really not.
How to tell if Livor Mortis is Fixed
: push on the spot. If the blood moves away and blanches the skin then the livor mortis is not fixed. Someone with fixed Lividity lets you know that they have been dead for at least 12 hours but this is not a definite.
Problems with The Curve
99 Degrees F is the temperature that is used to base this cooling rule. (estimate of temperature at death) Some people die with hypothermia and so their core temperature is lower than 99 Degrees F. Some people can die of Hyperthermia (from heat) and their body can be over 99 Degrees F at death. Although the body follows an exponential curve...there are various curves that are also exponential. So the rates of cooling are different from one to another.
Brain Death
Entire brain dead, not compatible with prolonged "survival". It took a long time for the law to catch up with the medical issues of brain death. Medically it has been determined but even till today it is not determined with the law.
Newtons Law of Cooling
It states that the rate of change of the temperature of an object is proportional to the difference between its own temperature and the ambient temperature (ie the temperature of its surroundings). Can determine approximately how long a person has been dead by its internal body temperature. This law explains how intimate objects cool. Bodies approach cooling by starting out at the temperature they are at...then the plateau and then go into exponential rate where they cool a certain amount over a period of time. The key here is that we do not know the length of the plateau. Because of this it can not be used to completely determine a time of death but can aid in obtaining an approximate time death. The exponential curve of cooling is when the body's temperature is at its greatest and it is also when the cooling rate is greatest. The rate of cooling slows as the temperature of the body reaches its final point.
irreversable Cardipulmonary arrest
(Irreversible part necessary due to invention of CPR). Cardiopulmonary arrest. If you do not have vital signs present then you are dead! Technology has complicated the definition of Death over the years. CPR (Cardiopulmonary Resuscitation) came into effect. Currently it has been found that chest compressions are just as effective as doing mouth to mouth in conjunction with chest compressions and it is more sanitary as well. CPR Complicated the definition of death because now you cant say someone in Cardiopulmonary Arrest is dead because it is possible to revive them. Because of this now people can have 2 - 3 Deaths in a lifetime instead of just 1. So with all of that stated Clinical Death which is apparent death or Cardiopulmonary Arrest is not actual death. DEATH DEFININED IS IRREVERSIBLE CARDIOPULMONARY ARREST. If there is any doubt then do CPR to be sure. This is the 1st situation to alter the death definition. CPR and Time of Death Pronouncement: If a person is pronounced dead at 12:10 am....but the person went into cardiopulmonary arrest at 11:55 pm and there was CPR performed for 15 minutes. Is the time of death at 12:10 really accurate and what will hold up in court. This issue becomes a problem when it comes to life insurance policies and their termination time.....story from class.
Wind Chill
If it is 35 Degrees outside the body would cool as if it is in a 35 Degree temperature, however if the wind is blowing and the wind chill is 20 Degrees F....The body will still cool to 35 Degrees (body will not go below actual temperature...does not cool to wind chill temp). The body will cool much faster due to the wind chill. When the body releases heat to the environment by the air that is in contact with it, the wind moves the warmed air away from the body keeping the air around the body cooler and will drop the temperature of the body at a more rapid rate.
Under Average conditions, 1 ½ Degrees F per hour is the approximate cooling rate
Rule not used if temperature is too close to 90 or 70 Degrees F. Because on a curve it would not apply. If the body is around 80 Degrees F. We could use the rule because of the point it would be on the curve. Is the environment room temperature? Then we can use the 1 ½ Degrees per hour rule. If it is not room temperature we would not want to use this...we may use 3 degrees per hour instead. Is the clothing average clothing or is it unusual. Person clothed would cool slower than someone who is naked. Basically this 1 ½ degree per hour rule is used as a basis and based on the other factors listed above you could determine what rate you should go by.
Rigor Mortis can also be Inappropriate
If a person has rigor mortis..you can tell if the person has been moved or not. Ie: a person is sitting in a chair dead and rigor mortis has set in. Someone decides to move the body before the authorities get there and now the person is on the floor in a sitting position (because of the RM). RM now gave evidence to the authorities that someone was moved. Once Rigor Mortis is broken it does not return so you can only test Rigor Mortis once.
Flat Electroencephalogram (EEG)
This test checks for electrical signals produced by brain activity. You can see if there are any changes in the voltage of the brain waves (if any are present at all). Electrodes are attached to the scalp and hooked up to a machine. If a person is brain dead they will be Flat Lined = no electrical waves. The electrodes are so sensitive that they will pick up even the slightest bit of waves. They can even pick up waves from an ECG or EKG (with the heart). This is something to be aware of when reading an EEG.
Arterogram
: Injection of dye into the carotid arteries to see if the contrast will flow up into the intracranial cavity. You will be able to see if the contrast/dye is moving up and branching out into the brain. If it does not do this then it is a negative result = brain death.
Medical Examiners
Must be pathologists or forensic pathologists. Requirements needed for people who work for the ME. ME is appointed by a board....not elected like a politician or a coroner. ME's work best in limited jurisdiction areas (i.e.: Suffolk County ME, Nassau County ME)
Decomposition
: Marbling, discoloration, bloating, purging, epidermal sloughing and blistering, foul odor, maggots (if flies are present). The body starts to break down. This can take approx 2 days based on average conditions. This process has two parts: Autolysis and Putrefaction
Medical Examiner System
: Developed in Massachusetts about 100 years ago. Due to the need for a better system than a Coroners system. Need for more depth in the department due to the high number of death.
Lactic Acid
: created by metabolism in absence of oxygen which makes things more acidic and results in the onset of rigor mortis.
Rigor Mortis
Stiffening of muscles due to an acidic change in the PH of the dead body. This is not a contraction of muscles....so the position the person dies in is the position the person stays in. This is seen in 3 - 4 hours from death in normal circumstances (ie: normal temperatures). Rigor Mortis chemical reaction which is modified by temperature so people who die in a cold situation (but not below 32 Degrees F) will have rigor mortis retarded. So in this case there could be RM in 5 - 10 hours. Under normal circumstances Rigor Mortis can be seen in 6 - 12 hours. Warm environments (not above 120 Degrees F) will increase the onset of Rigor Mortis. Rigor Mortis can not be used in determining a time of death for a person because it is unpredictable and subjective. Its onset is due to too many factors - temperature activity before death, muscle mass etc. Muscle mass also plays a role in Rigor Mortis. Someone who has large muscle mass (like a body builder) will have a stronger Rigor Mortis than someone who is frailer like a little old lady. It is harder to break Rigor Mortis on someone who has more muscle mass.
Decomposition Rate
If the body is warmer it will decomp faster than if the body is cold (cold retatds decomposition). Decomposition usually can be seen in approx 2 days. As time goes on decomp can rapidly progress from one that is just slightly discolored to one that is bloating and purging etc.
Cherry Lividity
When the Lividity is a cherry red color this lets you know that the person died by some sort of Carbonmonixide poisoning. Example: a person dead in a house appears to have died from natural causes but you see Cherry Lividity: they really died from Carbonmonixide poisoning.
Bleeding Out and Livor Mortis
: If someone is shot or bleeds out, then Livor Mortis will never come into effect because there is no blood left in the body to cause this to happen.
Body Position
You cool through your surface so how much surface is in contact with the surrounding atmosphere. To have maximum surface area you would have to be spread out. If you were curled up in a ball you minimize your body surface area and so it will take longer to cool the body to the environment temperature than if you were spread out.
Purge
Fluid that comes out of the body due to pressure in the body trying to escape. So much blood and fluid can come out of a person from this that it can be mistaken as a stabbing or a murder when it may not be the case. It can just be an artifact of decomposition.
Thermal Conductivity of Surroundings
Some surroundings have higher thermal conductivity than others. Water has a higher thermal conductivity than the air. Water will conduct heat away much quicker than the air. There is a difference lying on a bed (because beds are insulated) as opposed to lying on a metal fire escape. You would cool quicker on a metal fire escape because it is a better Thermal Conductor.
Signs of Death
The signs and symptoms related to disease and death. Signs are things discovered by examination or by an examiner (Ie; Tenderness, Heart Murmur, CT Scan). Symptoms are patient complaints (pain, dizziness, ear ringing, etc.) With symptoms there is no way to tell a person is going through this unless they complain.
Autolysis
Breakdown due to enzymes. More minor aspect of Decomp. Will cause everything to discolor and turn mushy over time. This is a slow process.
Discoloration
First seen without any preexisting marbling in the right lower quadrant of the body by the cecum. Microbes invade from the colon directly into the abdominal wall and cause a discoloration in this area. It is usually a light green color. This also happens with the sigmoid colon in the lower left quadrant of the body because it is also near the surface of the abdominal wall. Further bacterial action progressively makes this discoloration darker and darker. Once it is widespread a dead white person can look like a dead black person.
Bloating
• The gas formation distorts the formation of the body because it can cause the body to swell up. A person in a fluid becomes more bouyant....so when a body swells up they displace the fluid and when the fluid becomes more than the weight of the body, it makes it buyoant (so if you throw a body in water it will sink at first but when it gets to the point of this bouyancy it will pop back up and float on the surface. Even weights may not stop this from happening.) • A person may appear fat but necessarily is not...due to gas production the person can blow up to be twice or more their original size. You can tell this if the eyes are puffing up and bulging and if the tongue is puffed up and swelled out of the mouth.....you will know they have gas build up. Bloating is caused sue to an increase in internal pressure which can drive fluids out of the body. This is when the internal mucous membranes are breaking down. When the mucosa falls off the blood and fluid in the body now has more free reign and can move the blood to parts of the body that it has not been before. The pressure from the bloating will force this fluid out of any oraphus it can get out. • The breasts, penis and scrotum also swell quite a bit due to gas build up.
Rule out drug O.D.
repeat tests later. There can be instances where an EKG or ECG can flat line but an EEG has some action. In this case you need to check and rule out the possibility that a person has had a drug overdose. An over dosage of drugs can depress brain activity but the person is actually not dead. If there is any suspicion of drug use you should wait a few days (to allow the drugs to exit the system) and then repeat the EEG to test for brain waves before pronouncing the person as dead. You do not want to misdiagnose brain death with an overdose and it is possible to do.
Light Reflex
: Involves signals in cranial nerves (cranial nerve reflexes). Reflexes that depend on cranial nerves. To test with light reflexes a light can be shined into the persons eye to see if the pupil constricts when light is on and off the eye. If there is no change in the pupil of the eye then the person has failed the test.
Animals
Bodies that die in an open environment or even in a house with domestic pets, can be found partially or even completely eaten.
Livor Mortis (Lividity)
Dependent on Blood Settling. This is a sign of death. Blood settles due to gravity. It results in a discoloration which is a redish purple color. This is not a defined mark. It, like rigor mortis, is not a definite sign of a time of death. It can onset within 15 minutes of death or later and once it is there it can not be removed if it turns into post mortem stain. If the environment is optimal then in approximately12 hours, livor mortis can fix because the blood coagulates (thickens) similar to that of jello and results in post mortem stain which can not be removed
Clothing
: Form of insulation which sits between the dead body and the environment. Clothing retards the loss of heat to the environment and will change the curve to a more shallow one.
Section 3
(50 cards)
A mechanism is not a disease
. Hemorrhage is not a disease as Tamponade is not a disease. Ions which are critical (sodium, potassium, calcium, etc) to the human body because they are all involved in the heart muscle contracting. If ions in blood get too screwed up they can cause the heart to stop. You can die from Calcium deficiency in the heart. Has to be specified because it is still a mechanism and not a disease
structural abnomalities
Structural abnormalities (ie: bullet hole, broken bones, etc).
Manner of Death
Governed by whether there is an injury on the death certificate. Doesnt matter if listed as a cause or even a contributary cause. If it is unnatural then it is an injury.
Homicide
Murdered
Etiology
Cause of diseases
undetermined
if one of the foregoing can not be decided upon
Disease
Detrimental etiologically specific structural or functional abnormality.
X
X = Proximate" COD = "the" COD
Y
Intermediate COD
Not etiologically specific
ie: hemorrhage. Massive Hemorrhage that filled up in cranial cavity. Is usually Not Etiologically specific. Amount of Hemorrhage to die Acutely....Roughly 56% of blood volume regardless of where the Hemorrhage is. 56$ of blood volume in an adult is roughly 5 Liters of blood. Cardiac Temponade due to gunshot wound of chest. May have ruptured a part of the heart and produce hemorrhage that produced Temponade. This is a mechanism slightly different that hemorrhage.
Nomenclature
Site followed by "itis" eg. Laryngitis, pharyngitis (inflammation of the pharynx), stomatitis, rhinitis (nose inflammation). "itis" indicates that there is an inflammation. o Pollen can result in an inflammation. Pollen usually affects people in that they have Hay fever. It is an overreaction to pollen or an allergy to pollen.
Mechanism of Death
A not etiologically specific derangement leading to death. Ie: hemorrhage. An intermediate or immediate COD may be a mechanism but you will need to add underlying causes to make it valid.
Suicide
Taking of own life
Example of contributory cause of death
Example: We think he died of ASHD (bad coronary arteries) but he also had a bad heart valve so you put valvular heart disease (or aortic valvular stenosis) so you would list both because Aortic Valvular Stenosis can cause ASHD. Example: Someone shot in the arm because of a robber with bad coronaries: How would you write cause of death? Complications of shot gun wound. The problem with this is that if this went to court the jury would expect to hear that the gun shot wound was through the heart but he was really only grazed in the arm. The reason why is because you should have put on the DC that he had a bad heart as a contributory cause of death. Meaning that if he had a healthy heart the gun shot wound probably would not have killed him but because he does have a bad heart it did. So the defense attorney would say so technically it should have been ASHD and a natural death and the gunshot wound had nothing to do with it. So it should be listed as natural and not homicide. You would be ignoring the compelling temporal sequence if the defense attorney tried to use that for his client as a reason to not have him be charged with homicide.
inflammation
A non-specific stereotypic protective reaction to a variety of insults. A reaction to cell death
Depraved Indifference
: to human life. Elevates something up to a murder. It is worse than negligence or recklessness. If you are fleeing the police in a chase and ahead the traffic is all backed up and instead you decide to go up over the sidewalk where people are walking and you don't care and do it anyways to get away from the cops that would be depraved indifference which is murder
Homocide
Murder is not a manner of death...it is a legal term SO homocide is used. Murder really means to kill with malice. One can kill with intent or deliberation or premeditation. You have malice towards the person.
Flies and Maggots
: Lay their eggs in dead carcasas so that their eggs have food to feed off of. They lay their eggs by day light (not at night). Because of this and the life cycle of the maggot...you can get an approximation of the time of death. Flies will lay eggs when they find a dead person...in hidden, Dark, moist spots (ie: nose, eyes, ears, mouth, under clothing, etc). You may notice something that looks like sawdust or grated cheese...these are the Fly Eggs that are in clusters. Each cluster is usually 1/8" in length. You can have 100's of these clusters. **This process is temperature dependent and can not be in a dry environment. Cold and drying will retard this whole process. You will see this most if a person is in the woods where it is shady where it is warm and humid. After about a day these clusters will hatch and produce larvae which are pointed at one end which are maggots. Entomologist (study of Entomology): Experts in insects and spiders, etc. Can determine the time of how long this process would take to occur through analysis of genus and species of the fly and also determine the part of the life cycle these maggots are in. ME's often consult Entomologists to help determine a time of death. The pointed end at the front of the larvae has a mouth and hooks which can eat dead tissue when they hatch they are approx 1/8". So this is the feeding stage of the fly: feed on tissue and continue to grow for approximately 5 - 7 days. After 5 - 7 days they grow to full size and so they are approx 3/4" long and now on the posterior end they have a few openings which is where they breathe so they can have their heads in tissue and their rear's up to breathe. They can often look like a honeycomb lined up as tight as they can get just eating. Depending on the number of maggots you can end up with a skeleton of a body in approx 1 week if conditions allow it. If you look closely at the skeleton...there will be some soft tissue left (they do not like ligament tissues). Eventually the flies crawl away which is as far away from the corpse as they can (to a place that is dark and dry such as pockets and pant cuffs or along the walls where they meet the floor), they will contract and meet up (contract into approx 1/2" size) looking like a medicine capsule. They start to look light (maggot color) and over time they darken to red brown, brown and then black. This is the Pupa Phase / Puperia Phase of the fly. This phase is about a week as a well. This is where the maggot undergoes metamorphosis and changes form into the fly. This all occurs inside the capsule. Pretty soon you have a fly which inflates air sacks on its head and pops the capsule open. The fly comes out and flies away...the males and females mate....the female lays eggs....cycle begins again. So the whole life cycle of a fly is approximately a few weeks. The length of the life cycle varies depending on the conditions present. So depending on what you find....you can sort of determine how long the person has been dead for. They cause trouble because if it is a homicide (where there is a bullet hole) the flies can ruin the evidence
Prostate Cancer
Structural problem. You can see it. It will create a physical abnormality called a Lesion. Is it detrimental?: YES It kills people. Is It Cause Specific? No cause we do not know exactly what causes Cancer.
mechanical forces
Hanging (suicide), Hatchet to the head.
injuries
Injured due to Invisible Radiation from a bomb: This is an injury. Thermal Effects that are not mechanical Forces can also be an injury. Hypothermia is considered an injury. Poison's which are toxic are also considered to be an injury. Person dieing in a car not due to carbonmonixide poisoning but due to lack of oxygen. This is an injury. Drowning: Can be water but doesn't have to be. Is an injury. Microbes attacking you (like Tuberculosis) is NOT an Injury...it is a disease but if you were attacked by an animal that would be an injury.
Functional Diseases
Associated with NO lesions. Can lead to structural diseases (ie: Diabetes can result in a person having lesions on their kidneys later on but it is a secondary structural disease) IE: Diabetes mellitus. Have no associated structural changes even microscopically ( can have lesions in the pancreas in the Islets of Langerhans but disease is really purely a functional disease - pancreas is suppose to release insulin so that the nutrients from food are broken down to use. So Diabetes is a Biochemical problem). Ie: Schizophrenia is a functional disease. Brain malfunctions and person can have dilusions where they have no insight that what they are thinking is crazy...it is all reasonable to them. Brain is telling you falsehoods. Is associated with problems with the neurotransmitters.
Anoxia
Lack of oxygen. Injury when produced by the environment
anatomic variants
Not Detrimental. Are not put on DC's because they are structural abnormalities. Not properly classified as Diseases because they tend to not be detrimental or be a cause of death. Most common abnormality you can have/see is with the Aorta and the location of the Circumflex Artery off the Coronary Arteries: Ex: When circumflex arises from the Right Coronary Artery. And goes around the Aorta instead of being a branch from the Left Coronary Artery. It is just a different way of arranging the plumbing of the heart. So it is not detrimental. So you would not put this down as a cause of death because it will not be specific.
Proximate cause
is essentially what gets the ball rolling so to speak. Last line you see in the cause of death section of the death certificate.
Death Certificates
o First half of a death certificate is filled out by a funeral director who has received the personal information about the deceased from the next of kin. o Certifier: Physician who certifies the cause of death. Physician provides his own personal information (license number address, etc) o Part I: Cause of death (lines a, b and c separated by the phrase "Due To") Line A - Immediate Cause: Line B: Due to or consequence of Line C: Due to or Consequence of o Part II: Contributory causes of death. Other significant conditions contributing to death but not directly attributed to cause that is in part I. o Manner of Death: Example of Line 30 How it would read A, B, C, • A: Hemopericardium with cardeact • B: Mild Infarct with Rupture • C: CAD More Informtion....30 A, B, C: • Relevant specific findings • Longtime interval between onset and death: Ex: Christopher Reves o Christopher Reves: Spinal Cord Trauma in cervical area of neck...resulted in Quadriplegia (paralysis of arms and legs), Respriatory Issues. He was immobilized and as a result developed decubitus ulcers (pressure ulcers aka bed sores) which become infected and eventually led to blood poisoning (Septicemia aka Sepsis) which can lead to shock (Septic Shock). He could also have died from respiratory insufficiency but most people from quadriplegia usually die from infection issues. Listing his case on the Death Certificate would look as follows: Infected Decubiti with Septic Shock :A Quadriplegia and Immobilization: B Blunt Cervical Spine Trauma : C (this is the proximate or proximal cause)...occurred 10 years prior but is still a cause. • Proximate Cause tells the attorney who to sue.....if a car accident occurs with ice and snow on the road and the car went off the road and hit a telephone pole. If the road had not been plowed then the town is responsible for the cause so the town is the proximate cause of the accident and death. This is a DEEP POCKET to sue (Town). Or you can sue LIPA because the telephone pole was too close to the street. Item 31C. Describe how Injury occurred: You would put fell off a horse in Christopher Reves case. Gun Shot wound of the head (or brain). Easiest way to put one cause of injury or disease on one line. Most important thing to put onto death certificate is the Proximate Cause (Underlying Cause).
Z
Immediate COD
Justifiable (Excusable) Homicide
death to a criminal maniac and may carry no criminal implications because in the case where an officer has to kill someone who is doing harm to someone else. This is also when you are attacked by someone and are minding your own business (not engaging the person). But you protect yourself and in some way the attacker gets killed.
Septic Shock
on a Death Certificate does not make a good COD...how did they get septic shock? It can be an immediate cause but what was the underlying cause.
Natural
Must be 100% due to disease
Beetles
Also like tissue and their larvae will come and can work for weeks and months on a skeleton to eat away the remaining soft tissue after the flies have had their fill.
Pneumonia
May be immediate cause of death but usually there is another underlying or proximate cause of death. A lot of times people who have terminal cancer die from Pneumonia. There is a form of primary Pneumonia that can cause death in patients and then putting Pneumonia as the COD is ok...but this is very rare.
Diseases
Can be structural or functional
Pending Further Study
Followup on COD is needed and will then be added to the DC once it is figured out the cause of death (usually a pending further study is due to toxicological issues)
SO injuries
include blunt force injuries, suicide causes of death, Neck compressions (strangling, hangings), Radiation, Heat, Cold, Drowning, Drugs, Toxins are all Trauma Injuries and are Not Diseases
Felony Murder
Killing someone during the commission of certain other felony's. Felony murder does not require intent to kill someone. You do not need premeditation. So it can sort of be an accident. If you kill someone as a byproduct of committing a felony or flee the scene of a felony that results in a death includes felony murder. This includes Armed Robbery, burgulary, kidnapping, rape, arson. These are all covered under state laws as murder is usually a state crime. Example of this could be a person burning a building down to collect insurance money and you did not know a homeless person was in the building and they died. This can result in a felony murder. Do not confuse homicide with other legal terms (felony murder, murder, negligence, vehicular homicide,
Functional Injury
Man gets held up by gunpoint and dies of a heart attack and was never shot. He died because he was held up...this is a functional injury. Even though he may have had heart issues it is not a direct structural injury. Stress Cardiomyopathy (death due to a stress functional injury). Stressed can be induced by a serious criminal act (being held up). If it is not due to a serious criminal act then that point would be ignored.
Cause of Death
Disease or injury initiating a sequence, however brief or prolonged, resulting in death. Sequence: X causes Y causes Z causes Death. Aka COD
Temponade
Not allowed on DC because it lack specificity
Structural Disease
Associated with structural changes. Lesions
Manner of death
: Six types (Homicide, Suicide, Accident, Undetermined, Natural or Pending Further Study) that can be put on DC. Sometimes you can have a situation where a person dies because of both an injury and a natural cause. As with the man with the bad heart who also had a gunshot wound that was not fatal. Does it follow the disease or the injury in the manner of death...it follows the INJURY. If it is to be natural it has to be 100% natural due to a disease. There can be NO injury involved at all to deem a manner of death as Natural
How to write out COD
o You have to put down what caused the death of that person. If you do not need to use all 3 lines you do not have to. You can use one. The simplest way to certify a death is by putting its immediate cause (ie: Pancreatic Cancer). **You are not suppose to abbreviate on a death certificate. You may know more about Pancreatic Cancer and know that it is actually Pancreatic Adenocarcinoma (which is more specific than just pancreatic cancer). Sometimes physicians will put Cardiopulmonary Arrest, Due to Pancreatic Adenocarcinoma. Now the physician has told us that the dead guy is dead.....since CPA is part of a definition of death. Sometimes a person dies from a whole bunch of complications. Diabetes, Blood Poisoning, Shock etc. So on the DC you could see "Complications of Diabetes Melanaous". The registrar of the town hall will extract only the key point to list what cause of death was. You would use all three lines if there was relevant information about the COD. If there was truly something that is worth knowing to add to the picture. (Example: Someone in a yard mowing that is 70 years old...person stops mowing comes to house complaining of chest pain and drops dead. The doctor said well he is 70 and had bad artherosclerosis.....we suspect he has bad coronaries...so COD could read just Artherosclerotic Heart Disease. Now if an autopsy is performed and the exact COD is determined it could read....Heart Rupture, as a result of Acute Myocardial Infarct, Artherosclerotic Heart Disease with Coronary Thrombus). If there is a long interval between the onset and death. (since you put down the times) then you would list a bunch of information on all three lines.
Compelling Temporal Sequence
Sequence of events to cause of death. Yes, the above example, the man had heart disease but has not died and once he had the gun shot wound he then dropped dead. So how can you ignore that temporal sequence. You can't and the defense attorney would really not have a case. So now you have a disease and an injury on the death certificate. Does it follow the disease or the injury...it follows the INJURY. If it is to be natural it has to be 100% natural due to a disease. There can be NO injury involved at all.
forensic pathology
sub-specialty of pathology that focuses on the cause of death due to injury
Injury
Is Detrimental because it can kill you. It is etilogically specific (obvious as to why you have an injury), usually a structural abnormality. This can all represent a function of disease but it is not. So injuries and Disease though not related can seem to be related. The only way to really distinguish between Disease and Injuries is by listing them specifically as to what you are going to classify each. Entities which often involve mechanical or other forces, environmental origination and infliction, but which satisfy the definition of disease, therefore the only consistent definition is to say that they consist of an agreed upon list: Ie: Gunshot wounds, stab wounds, blunt force trauma, electrocution, drowning, neck compression (Strangling), etc.
Negligence
If something happens in the back of a car and you stop paying attention to your driving...you should have pulled over to take care of it and didn't and you end up in a car accident. This would be negligence. Negligence can be deemd a Negligent Homocide.
Contributory cause of death
One or more additional causes necessarily acting because the "cause of death" acting alone is inadequate to explain death.
injurues
A list of things that distinguish injuries from diseases because they should not be considered the same even though essentially they are.
Manslaughter
another legal term. To kill people when there is something less than malice towards them. Ie: You might have intended to kill them but there was extreme provocation. You did not have time to think about it or plan it. You were provoked. (You find someone in bed with your spouse and you got so crazed that you killed someone intentionally but it wasn't thought out. Or you kill someone out of recklessness.....you ignored a risk that you knew about.....ie: road rage).
Accident
manner of death that is an accident
Section 4
(50 cards)
Antigen
a protein or other similar thing or moiety acting as a specific identifying feature of that thing and capable of inducing an antibody. Antigen and antibody have a structural complementarity similar to that of a lock and key.
Billiard Ball Effect
if you look from the side, as soon as the pellets hit the skin they will slow up, the second set of pellets crash into the first set, and so on which creates this billiard ball effect so they will take off in a bunch of directions within the body causing more damage. Only happens at close range.
Warmth
Calor
Granulomatous Inflammation
• A special form of chronic inflammation characterized by the granulate, a focal granule-like or nodular collection of macrophages and sometimes other cells. • Autoimmunity can result in a chronic inflammation. • Multiple = granulomata/granulomatous • Mycobacterium Tuberculosis is the classic (but not the only) use of granulomas. It can be ingested and cause granulomas. • A granuloma is NOT a neoplasm even though the word ends in "oma" (it is the only exception) • Results due to inability to destroy antigen • A collection of organized macrophages. Form a little focus that can be so big it is visual to the naked eye. Over time they fuse to form giant cells with multiple nuclei called a "giant cell". • May also have a few lymphocytes. • Fibroblasts and collagen make it up • Silicosis can also cause granulomas (inhaling of rock dust in lungs) • Most important cause is the tuberculosis.
Cellular Phase
o Cellular Phase: when slightly bigger cells (white blood cells) start leaving the blood vessel and collect in the surrounding tissues. Done due to diapedesis = involves ameboid motions...they act like an ameba. Pseudopod = folds or foot process that comes out and allows them to flow through something small to get out. (IE in a blood cell to get out). There are a number of white blood cells that do this but the first one is the poly's:
Swelling
Tumor
Phases of Inflamation
: An inflammation is due to the body trying to protect us against things. However in the course of reacting to the stimulus the inflammation will produce some damage. So inflammation can be a two edged sword (we need it but sometimes the inflammation itself causes some damage). This reaction has two phases. Vascular and Cellular
Redness
Rubor
Choke
Constriction at the end of the barrel of the shotgun that defects the patterning (how the pellets diverge). Not having a choke makes them disperse more. The choke is defined by checking the pattern that is produced by the shot gun. You would go to 40 yards and draw a 30" circle and you would count the number of pellets that are in the circle. If it is: 70 % Pellets in the Circle: Full Choke In between 40 % - 70% pellets in the circle can be deemed Modified Choke 40% Pellets in the Circle: Cylinder Choke (no Choke) - there would be a bigger pattern because the pellets will be disbursing more.
Strippling
- seen at 2 - 3 feet past that you will not see fouling or stippling. Disbursed marks around the bullet hole of a shot gun.
Permanent
Can not undergo mitosis. (IE; the heart, or other muscle and brain tissues and nerve cells)
Range fo 3-4 feet
the wound will look more scalloped
4 Foot Plus Range
you will see satellites in addition to the scalloping.
Scalloping
seen at the 4 - 5 ' range...the pellets start to disburse and the hole will not be a perfect circle
Opsonization
coating a bacterium to facilitate phagocytosis
Lysis
break bacteria and kill them by themselves in the presence of proteins. Compliment proteins are the specific proteins needed to create lysis. Avian: Birds when looked at closely there was Leukocytes that were seen in the bursa and thymus of the birds.
Stable cells
: ones which in the adult have stopped undergoing mitosis but are capable of undergoing mitosis if stressed (skin and gut, liver
Parenchyma
The specific cells for the organ function. Hepatic cells or hepatocytes - the cells that make a liver a liver. Liver makes some of clotting factors to help clot blood, it makes compliment. Some organs may have more than one type of parenchyma (IE: Pancreas that has exocrine functions and endocrine functions (production of insulin) Some parenchyma are labile, stable and permanent. They affect how healing will occur depending on the type of parenchyma you have (determines how healing will proceed).
Lymphocytes
smaller with a big round nucleus that takes up the majority of the space in the cell. They migrate to site of the problem and one of the types transforms itself and gets a little bigger and moves its nucleus to the side and make proteins. This is known as a Plasma Cell. Plasma cell is a transformed lymphocyte that makes a protein called antibody.
Repeated insults
Neurodermatitis: Inflammation of the skin to do with the nervous system. Is the subconscious activity of the nervous system. Inflammation caused by the patient chronically scratching or damaging an area.
T Cells
from thymus, include T-helper and T-suppressor cells. Accelerate and decelerate antibody production, respectively (regulate production of antibodies). Have suptypes that do various things. They sometimes become killer cells, some become Helpers, some become suppressors. You can think of the T helper as an accelerator. You can think of the T Suppressor Cell as a brake. o NOTE: HIV (Human Immunodeficiency virus), the cause of AIDS (acquired immunodeficiency syndrome), attacks T Helper Cells
Autoimmune disease
(antibodies attack one's own tissues) Body attacking its own tissues (IE: Rheumatoid arthritis - inflammation of the joints which is due to a persons own immune system attacking those tissues) There are a number of autoimmune diseases are oddly more common in women. This is an oddity because usually women are the stronger gender when compared to males except in the case of autoimmune diseases (also lupus is another autoimmune.
Antibody
A protein that is composed of four protein chains (2 heavy and 2 light) that are all hooked together which are called heavy chains and light chains. The connections between chains are simple (consist of two sulfer atoms so sulfer and sulfer binding to the chain). They are called disulfide bridges. Create a constant region (bottom of Y) and two areas called variable regions (two top parts of the Y). It creates something that is structurally compatible to the antigen. So it creates a receptor site that attaches to the antigen. It can create very specific proteins that can attach themselves to the antigen.
Antibody
a protein induced by and specifically reactive with an antigen. Antibody is also called immunoglobulin.
Monocytes
: (which become macrophages, literally "big eaters". The process has been going on for days if the monocytes are present. The poly's start to disappear and the monocytes become more prominent. They are white blood cells with a kidney shaped nucleus. When they arrive at the site they start to undergo phagocytosis but they have a larger capacity than the polys. After they have been working for a while they end up big, their nucleus becomes rounded and they have many small vacules which makes them look foamy (soap bubblyish). When the cell gets to this point (looking foamy) we call it a macrophage: a big eater. Then another set of cells start to migrate called the lymphocytes.
healing by regeneration
- Healing By Regeneration: When damage occurs mitosis kicks in and heals itself. If an animal loses a limb they can regenerate it. Humans cant do that. Usually Stable cells and Labile cells can do this because of mitosis. Form of resolution. o Cirrhosis of the liver..... o Healing: Depends on the nature of the damage and the types of cells involved. o In any tissue there will be Stroma and Parenchyma.
Close Range
you would get a nice smooth hole and all of the pellets will go through the hole. The wad (felt and plastic) would also be found inside the wound. You may also see fouling. The pellets once inside they will disburse due to the billiard ball effect. You will find the pellets all throughout the body.
Pyer's Patches
Oval raised areas. 1 - 2 " in diameter. 20 - 30 of them. Collection of lymphocytes in the submucosa. Are a bursa equivalent. Developed by Peyer in the 17th century...he was a Swiss anatomist
Satellites
shot gun shot seen past 4'. some of the pellets will end up outside the main bullet hole.
Gunshot Wounds
Firearms - Rifles. Rifling (also include handguns, not just long guns) Long guns have all the same components of a short gun bullet but also have a showlder which is between the bullet and the case) spirals (spiral down barrel) Side of bullet will have lands and grooves markings on it. Markings include depressed areas (lands) and between those are the grooves. Also tiny scratches unique to a type of barrel. In crime lab, comparison microscope is used to lode and two bullets simultaneously. Primer: when hit, designed to ignite and a flame goes through a flash hole and ignites powder. Ammunition components Typical Cartridge has a case (metal tube) the bullet, gun powder and the primer (initiator). The bullet is a Component. low velocity...handguns with less than 1500 fps (feet per second). It burns faster high velocity....greater than 2000 fps - 4000 fps. Has more gunpowder and burns slower. Can fracture a bone from force even though it may not actually it it. Wounding: perforating: To burn faster, to make a hole cavitation: is prominent in high velocity. Low velocity: just injures what is passes through. High Velocity: will injure anything reasonably close to the pullet path. Entrance: will have an abrasion (hole) small with scraping around. If the scraping is off to the side then the bullet entered in on an angle. Exit: exit wounds can have any shape...a circle with no scraping, stellate (looking like a star) or a slash mark. angle of fire range of fire: fouling: gun smoke/soot depositing on the surrounding skin (gun would have to be quite close for this to happen) As the distance between the skin and the muzzle increase, particles may not have been fully burned, some not ignited at all. Particles are bigger than soot. They make little marks called Stippling. Stippling aka Tattooing: Particles are driven into the skin through the epidermis causing a little bleeding. Particles will fly 1 - 2 feet gun would be within a few feet if distance is greater, there is nothing at all clothing: May protect the skin, so you have to look for soot or particles on clothing.
IgE
Triggers allergic response IE: pollen. Some people generate a lot of IgE. IgE attaches itself to a mast cell which contains a lot of vacudes that contain histamine which initiates response. ▪ Histamine initiates an inflammatory response. Get the vascular phase of inflammation. Nose runs, runny eyes, etc: = Hay fever ▪ Venom will trigger this response all throughout your body which will cause blood vessels to dilate which drops your blood pressure = anaphylactic shock aka anaphylaxis. ▪ Allergists will do specialized tests and then once they find the antigen they will put you through desensitization (IE: allergic to ragweed pollen you will get the antigen and then administer a bit of the antigen every time the patient comes and keep exposing you to it bit by bit. Your immune system will make a different antibody (IgG). IgG acts as a "blocking antibody" in the blood. The pollen will then get sucked up or blocked by IgG. Note: Inflammation is a "two-edged sword", IE: while designed as a protective reaction it is sometimes harmful, eg: autoimmune disease (such as rheumatoid arthritis) and allergy. Inflammation is a protective reaction but at the same time in addition to destroying antigens, it destroys its own tissue cells or causes shock, etc. Many diseases are based on inflammation. IE: Chrohn's Disease which causes fistulas.
Fouling
Soot
Tension Injuries
can damage tissue by pulling things apart (opposite of compression)
Stroma
Connective tissue the blood vessels, elastic fibers etc. (fibroblasts and cologen). More resistant to damage than the parenchyma.
Shearing Injuries
Injury that occurs because the tissues are distorted in a way that is equivalent of tearing them with scissors. Someone that is hit with elongated objects. Ie: sticks, bats, whips, etc. The skin gets indented by the object hitting into it. The areas where the skin/vessels are at the edges of the site create bleeding and bruising and those are the shearing sites. You will probably see a railroad track of injury instead of a straight line. Double Parallel Line of Injury. You may thing that someone was hit twice but in fact they were not.
Chronic Inflammation
due to persistence of antigen
Vascular Phase
Happens within seconds. The blood vessels are reacting to some stimulus. The reactions are as follows: Vessel Dilation: enlarge, turns the area red due to blood cells building up and dilating. Slowing of blood flow: due to congestion of blood cells in an area, area becomes warm due to slowing of blood flow. Increased vascular permeability: Fluid and protein start leaking out of the blood vessels., produced localized excess fluid (edema) aka swelling. **all of the above ends up sensitizing the nerves and causing pain or aching.
Glutenation
bacteria become immobilized due to sticking in a clump. Makes them vulnerable to being phagocytosed.
5 types of Antibodies
IgG, IgA, IgD, IgE, and IgM
Polys (polymorphonuclear leukocytes, PMN's)
for instance there is a cut in someones arm, the blood vessels nearby send out polys to go towards the stimulus which is the cut which is cell damage, (cells that are damaged put out chemicals to summon the polys). It creates a series of concentration rings of those chemicals around the area where the damage occurred. This is referred to as a gradient- series of various concentrations so the area closest to the site of damage would have the highest gradient (concentration of the chemical). The poly senses the gradient and follows it to the source. The poly then begins phagocytosis which means the cell is eating. Polys have wispy nuclei. It senses things pollen, pieces of cells, etc, that is foreign and needs to be disposed of so the poly's eat it/engulf it. Formation of puss occurs due to suppuration. Puss is white in color and has a creamy consistency. • If this process has to go on for a longer period of time then you need a different classification of white blood cells to take over called monocytes.
labile
tissues continue to undergo mitosis (divide). Example of a labile tissues is epidermis of the skin or the mucosal lining of the small intestine
Signs of Inflammation
Redness, Swelling, Warmth, and Tenderness
Shotgun Wounds
Shotguns - choke. Smooth run barrels ammunition components - pellets and slugs Shotguns have two parts...brass and plastic The bullets have a primer which is on a brass head then a wads which connects the brass head to the plastic tube. The plastic tube is a folded closed crimp area that holds the pellets (shot part). The tip of the bullet has a crimp which is an indentation. The sleeve protects the pellets and keeps them from running and touching along the barrel of the gun. It is composed of petals Larger pellets are called buckshot's Smaller pellets are called bird-shots, Some shotguns have a slug instead of pellets (closer to a bullet) which are used for deer and bucks also. Riffle caliber: .22 rifle (common), .222 (3000 fps), .38 = .357 which is a 9mm Shotguns are sized in terms of a gauge (how many metal balls would it take to weigh a lb) 12 gauge = common 20 gauge = smaller shotgun 28 gauge = very small *.410 = smallest of all, named in terms of caliber, not gauge.
Allergy
• an exaggerated sensitivity (hypersensitivity) to an antigen (often an innocuous one such as pollen) mediated through as special immunoglobulin (IgE in particular) attached to histamine containing mast cells. • The antigen (allergen) causes the release of histamine which produces symptoms such as runny nose, itching, etc, and occasionally cardiovascular collapse (anaphylactic shock). • Allergies can be treated therefore by anti-histamine drugs.
Protein sites
(eg adjacent to a prosthesis): Inflammation that occurs around a prostesis (when someone has a surgical prostesis...joint, heart valve, hip etc.) they have to take extreme care to make sure that operative area does not get any contamination. That artificial joint is a hiding place for bacteria. Indestructibility (IE: mycobacterium tuberculosis) Something you cant destroy (depending on the antigen ..IE: Tuberculosis - microbial infection that the body ingests and tries to ingest and the body can not kill it. Creates a chronic form of inflammation. It can reactivate
coup-countrecoup
Refers stirctly to head injuries. When the head is in motion and strikes someone. You get a contrecoup (which is opposite to the blow in French). If a person is falling or is pushed and their head hits the pavement...you will have one surface injury but then you will see in the brain that the injury is on the opposite side of the head. This happens in a contraversal manner. Can read Dr. Dawson's article on this in the Human Pathology Journal in 1980 volume 11 p. 155-166. This is determined by looking at the surface injury and then looking at the brain injury. If they are opposite it is a result of falling down (can determine homocide or accident). When you have a stationary head you have Coup. You will see a brain injury at the site of the blow from the impact and only there. (ie: Baseball hitting a head). Determines that an assault is to blame because the injury and site of injury are on the same side.
Tenderness
Dolor
B Cells
from bursa "equivalent, become plasma cells, make antibody. Develop in the submucosa and develop into an antibody that is aka "Dock Face"
Compression Injuries
Compression injuries: Can damage tissues by squeezing (compression). This is difficult because tissues area almost the equivalent of liquid and they do not move accordingly (same way as you can not compress water). Compression injuries when you are at an interface (where they meet) between air and water densities. The lungs are an example of this. An explosion (shock wave) can cause a lot of compression injuries to the intestines, lungs, etc.
healting by scaring
: Involves the connective tissue filling in the gaps. Fibroblasts are the cells involved in scaring. They form a protein which secretes into the extracellular space called collagen. It is the basis of scar tissue. Healing of the heart by scar tissue takes about three months. Once you get a scar it is permanent. Deposition of collagen (connective tissue protein) by fibroblasts.
Section 5
(50 cards)
Pattern Recognition
done with computer generated patterns (digitized patterns) and the computer will search for a matching print. This system works the best in small jurisdictions where there are less cards to go through. The FBI has the hardest time determining fingerprints due to the millions and millions of cards they have on file.
Mitochondrial DNA
also used. DNA that is found in mitochondria. They are not part of the nucleus but they are organells that are in the cytoplasm of the cell that are the energy factories in the cell. They also contain their own DNA that is only passed on to you from your MOHTER (Only Mother...not the Father). Do not need to test this if Nuclear DNA is positive or available to you. The advantage of this is that it seems to persist a lot longer than Nuclear DNA (if bones are out in the wilderness for years and years you will not be able to get Nuclear DNA but you could find Mitochondrial DNA) There are very very high probabilities and although nothing is 100% absolute it is more likely a situation of 1 in 25 Billion chance that it is not correct.
IVDA
intravenous drug abuse
Sudden Infant Death Syndrome (SIDS)
age range: Specific age group usually between birth and 2 weeks. No abuse...it just happens. Usually happens during sleep. negative autopsy: Nothing will come up on autopsy...shows no signs of anything. Failure to regulate respiration correctly. Children can show periods of non breathing (apnea)
Visual
Usual day to day identification. Has the problem that people can be honestly mistaken. People can be actively misleading in identification. You never want to rely on this in cases of mass disasters (ie: Plane crash with 100 dead people you will need to use visual to suggest who someone is but then do another form of ID to be definitive).
gastric content- suicide vs accident
It is important to look at stomach contents when trying to determine if a death was an accident or a suicide. You look at the levels of the drug in the person and then you calculate how much drug it would take to reach that level. If 5 grams is the answer then you would see how many pills were taken to reach that 5 grams. If the bottle has 325 mg and it is 3 pills per gram then the person took 15 pills of asprin at one time and that is seen in the blood level. Well was this intentional or accidental? By collecting the stomach contents you can see that there is still 25 grams in the stomach so then there is 75 pills in the stomach and you will know that this was a suicide. Not an accident so the person took about 90 pills in a restively short period of time. So looking at a gastric (Stomach) content will help distinguish this.
asphyxial deaths
main mechanism may not be due to a lack of oxygen. Just a term. Not all due to asphyxiation. There are true asphyxiations IE: suffocating in a refrigerator. These are few and far between. It is possible to chemically asphyxiate IE: CO2 poisoning.
Identification of Remains
Crucial to see who the decedent is
Alcohol
calculating number of drinks (1 drink = 1 shot of spirits = 4 oz wine = 12 oz beer) 1 drink = 0.02% in the blood in a 150 lb person. People metabolize about 0.02% per hour. If you take the blood alcohol amount and it is .18% and that takes about 9 drinks to get to that point and the person has been drinking for about 4 hours this takes the total drink count to 13 drinks. If this was a 75 year old lady then half of 13 drinks is what it would take to get the person up to this point. If the person is 300 lbs then it would take them 26 drinks to get to this point over 4 hours. NYS: 0.08% is the DWI level. If you weigh 150 lbs you would need 4 drinks in 1 hour to reach this point. levels - DWI, lethal
hilt marks
The top part of the knife with the handle that protects the handle from the blade and also protects your hand from the blade. There can be a slit with a total or partial area of abrasion from the hilt itself because it hit the skin hard enough to mark it.
Dicing Pattern
Shows lines and right angles and some three to four sided things on the skin. Characteristic pattern which is due to the behavior of tempered glass - in side windows of a car. It is made to break but not like plate glass. When it breaks it shatters into tiny cubes each of which is about a 1/4" on each side. Can cause surface injury but it will not totally hurt you. ▪ Can indicate position of the person in the vehicle ▪ Cars today have Laminated glass...glass layered with plastic so if your head hits the windshield, instead of going through you would bend the whole thing but it will not perforate. You would have a distorted windshield but your head would not go through. ▪ Cars use to have plate glass where in a head on collision the head would go straight through the glass and if they did not go all the way through they would bob back and cause horrible injuries or even decapitation. So this glass is no longer used.
Height of a Person
particularly if you have long bones left to determine the height of a person. Lower extremities are the best for this to determine the stature of a person. Vertebrae can also help to determine the stature of a person.
Drowning
More complicated than simple asphyxiation. You may also inhale fluid and have the bad effects of the fluid (sea water has salt, fresh water- opposite effect)
Yolking
arm hold. Only evidence may be petechial hemorrhages. May not see marks on neck and throat (internally)
Dental
Similar to fingerprints. Is done based on the unique shapes of teeth and fillings and restorations of the mouth. By the time you get done that one tooth is unique due to the tiny details it has. Not two people will have the same appearance on the x-ray. Will result in a positive identification. It has an advantage over fingerprints because it is more likely to survive trauma (crash, fire, etc) than fingerprints will. You would need to have an idea as to who the person was, go to their dentist and then check the dental records with the ones you have from the deceased person.
Subarachnoid Hemmorrhage
Hemorrhage along the surface of the brain. Most common type of hemorrhage. Can occur in cases of coup or countrecoup. You need to determine between an _____ and a ruptured berry aneurism (congenital rupture or when someone is in their 30's and can be rapidly fatal).
punctures
sites of needle injections that are fresh
Mechanical asphyxia
Enough pressure applied to the chest that you can not breathe. Not a true asphyxial thing because the pressure on your chest also makes it hard for blood to flow back to the heart. Can happen with people who work on cars and the car falls on them and crushes the chest.
Wound angles
The sharp point that goes in on a stab. You will look for angular blunting....what caused the wound has a sharp cutting surface and the opposite surface tends to be blunt and not sharp. The point of the knife can also be moving so on the skin surface you will see slits with two sharp angles to it. It gives you the impression that it was done with a double edged knife (like on a bayonette knife) but this is very rare it would indicate otherwise that there was some sort of cutting action
Single Incident Child Abuse
Person frustrated and flipped out. The caregiver flips out and shakes them. This is not good because the size of the head and their necks are weak. Retnal Hemorrhages would be seen besides subdural bleeding or swelling of the brain
Manual
use of the hands. Most likely to cause fractures. In particular you will see this affect the hyoid bone (fractures of the hyoid bone) or the laryngeal cartilages (thyroid and cricoid). Will show marks.
Chop Wounds
Seen with a chopping instrument (ax or hatchet). These instruments can be sharp and also heavy. Usually you will see a wound that has sharp and blunt aspects. It will create something that may look like an incision but its margins are abbrated (so combination of sharp and blunt force aspects). You may also see on the surface that there can be sharp lacerations going down looking like incisions but you will also see bones with fractures. A knife will slice skin nice and clean but there will be no bone fractures. A chop wound will show fracturing. Varies on how sharp or the force of the implement of the injury is.
Tracks
Series of vena (vein) punctures in the elbow area (antecubital fossa). Over time there will be linear scars (can show puncture marks from recent injections) but the scars themselves are tracks. Eventually veins will be damaged and the site will have to be moved to a new location to inject. You can also look for crystals in the scars of the track marks. When someone dies from this they can be deemed to have died due to an Over Dose. OD. With Heroine there is no normal dose or a safe dose so it really should not be deemed an over dose. Some drugs (when heating to inject) can contain crystals (used to dilute the drug itself). These crystals in the vein will go to the lungs and then they will get trapped as the blood vessels in the lungs get smaller and smaller. The body tends to try to react to the crystals by engulfing them to destroy them but they are insoluable and the body can not dissolve them so a small granuloma (something that can not be engulfed and successfully destroyed) develops. This is a way that you can tell if someone has been chronically injecting drugs....look at the lungs to see if granulomas are present
Delayed deaths- bladder distension, early pneumonia
You can also look at bladder volume. Anything greater than 400 ml is not physiologic (they should wake up and know you have to pee) so if they are dead with 600 - 800 ml of urine it could be suggested that the person died of an overdose even if the level of drugs in their system is low (due to the drug levels vs time theory). Drug level starts out low, peaks and declines over time. So at the point that they are found the drug can be decreased and not indicate an OD but the urine in the bladder can. volume of distribution (Vd) - (Concentration = dose/apparent volume) Apparent volume = volume of distribution x weight
Positional Asphyxia
Closer to true asphyxiation. Position you are in when you start to do a somersault. If you get upside down in that position it can close your airway. You can also fall and end up in this position (being wedged in a space or falling due to drunkenness)
DNA
New technology where now we do not have to rely on fingerprints existing or dental records, etc. You do not have to have an intact body. A little piece of tissue is sufficient to determine who a person is. You need something to compare it to so one approach to DNA testing is that you will have to collect DNA somehow from a potential person. Prisoners usually have DNA taken from them and kept on file to link them to cases. If you have an idea as to who a person is you can get their toothbrush, hair comb, razor (anything that may have a bit of DNA in it to be able to compare it to a person). If you do not have anything from the person you can go to their family (mother and father is the #1 thing..people who are adopted will have a big problem being identified). Even siblings and uncles can provide DNA to show a relation to determine who a person is.
Strangulation
to die by pressure on the neck. Usually have to do with obstruction of blood flow and not asphyxiation. Usually this has to do with venous flow coming down the neck and can also be arterial flow obstruction. Usually causes unconsciousness quicker than asphyxiation.
Pedestrian MVA
◦ Pedestrians: Typically will be identified because witnesses will tell you what happens. Autopsy will show a few things: ▪ Bumper Injury: Where the car first encountered the pedestrian...depends on the vehicle as to where the person is hit. Can cause an internal decapitation (skull coming loose from vertebral column and brain coming loose) but the head would remain in tact. ◦ Hit and Run: May not be witnessed and can be found laying beside the road. Is it a homicide and the person was pushed out of the car? Autopsy will be helpful in this case.
Birefringence
: Ability to rotate polarized light. Found with a microscope that has a light. You put a polarizer (has fine lines and creates polarized light - like sunglasses) on the microscope lense and there is a second polarized line that is at angles to the first one. This creates no light on the slide. If there are crystals present they can change the direction of polarized light and you will be able to see them on the slide. You will see darkness except for where the light goes through the crystals. They will be bright on a dark background.
Petechiae
pin point hemorrhages usually seen in the conjunctiva in the eye. This can be seen also in the lips and the mouth on the mucosal surfaces. Usually though you will see this in the eye
Choking
Obstructing airway by inhaling certain things (food, etc). Babies, elderly who are very weak and may have dementia. Not competent to eat on their own. Can have preexisting neurological problem. You can also be blitzed on alcohol and drugs, have bad teeth, etc that can predispose you to choking to death or just choking in general.
Fingerprints
Gold standard of identification. Only requires one print if it is of good quality (so you do not need all 10 fingers). Criteria is how many points of comparison match up on the fingerprint. It is pretty much fool proof if done properly. The problem comes up if you have one finger print and you do not have a preliminary idea of who someone is because they are classified in groups of 10. Someone with fingerprints on file the first one may have a loop and skin markings, the second one is a whirl, etc. Measurements are made within the print to see how many ridges are crossed by a line. Then you would have 10 characteristics to determine the print. If you have an unknown subject you can classify their prints to determine who they are by coming up with a code for those prints and go to the files. By applying those general characteristics you can narrow the person down to a very small few people and eventually determine who the person is. The problem is if you do not have all 10 prints available (fingers missing can pose a problem for this as this method can not be done).
Volume of Distribution
is in liters per kilogram. You change the dose divided by the volume of distribution times weight. This calculates a dose of a drug that produces a certain level. If the body behaved like water then the Volume of Distribution would be 1. Some drugs have a much bigger volume of distribution and this tells you that when you administer this drug a lot of the drug leaves the blood and enters into the fat of the body. You will then see a less concentration in the blood than expected. Marijuana is an example of this. For a given dose there is a much lower drug concentration in the blood than the drug should produce. Dose = (concentration)(volume of distribution which will be in liters per kilogram)(weight in kilograms changed to liters) So if someone has a concentration of heroine in the blood and you measure that concentration in the blood you would use this equation. Multiply the concentration by the weight of the person and then multiply it by the volume of distribution of heroine (which you look up because it is calculated for you already). If the drug behaved like water then the concentration would be 1 but that does not happen with drugs. Drugs do not all behave the same way on the body. They all act differently.
Asphyxia
to die of lack of oxygen. Can take a minute or so after a few minutes
Epidural
Fracture is usually involved. Takes place above the dura. If the skull crosses one of the lines of the arteries, it can tear the artery and create arterial pressure. So bleeding is in artery at higher pressure. It strips the dura off the skull and lift it and cause hemorrhage to accumulate in the head. Seen in traffic injuries and to people who are more active.
Size
Length of the wound should give you an indication of the size of the knife. If there is cutting and the knife did not go straight in and straight out it can make the wound larger than the knife. So you need to look carefully at the wound.
Stab wounds
When a sharp object is pushed into the skin. It is often triangular in shape. Tends to look deeper than it is long on skin surface when looking at the wound.
Carbon Monoxide
makes you choke and die
Nuclear DNA
DNA from the nucleus of the cell is the best kind of DNA to obtain
xrays
Hospital type x-rays. Various things show up on x-rays that are unique to people. For example in the frontal bone of the skull you will see a marking that is relatively lucent (area of space inside the bone) which is the frontal sinus. This tends to be unique in shape from one person to another and it also tends to be asymetric (not the same on each side). If you can find someone who has had this x-ray before you can match this frontal sinus. This is just a natural characteristic. You can have other things similar to dental restorations such as hip joints, pins and plates in bones, clips placed during heart surgery or wires that are placed in the chest to close the area, etc. They are absolutely unique to each person. No two will be absolutely the same. X-rays are made with silver on a sheet and the images can be recovered but overtime they can go bad. Newer technology of today can make digital pictures so they can last a lot longer. ID methods can fail if the records are not available.
Anthropologic
Take a look at the bones and take a look at what type of person it was during in life. Not a way of making a positive identification precisely however it is a way to get information about the person when all that is left is a skeleton. You will be able to figure out the race of someone (particularly if you have the skull) because you can determnine the main race (caucasian - caucasoid, black - negroid or asian - mongoloid) Asian people have rounded faces that are fairly flat because they have prominent maylar areas (cheek areas) which gives the face a certain appearance. Black people tend to have a broader nasal opening compared to the other two races. This can be seen when comparing the width to the height of the nasal cavity. Race is harder to determine now because of the mix of races in today's times. You can have someone who is interracial and not socially kept to a certain area due to today's travel worldwide. You can get useful information to generate a general description of a person but not get a positive ID.
Incisions (cuts) aka Incised wound
This is NOT a laceration. A laceration is a tear and has to do with blunt force. It can be made in a line and can cause an incision but it is not. So when the media says on the news that a person was being treated for cuts and bruises in a car accident this is wrong because really they are being treated for lacerations due to blunt force trauma. You will see NO Bridging
Depth
If you follow the wound track down into the skin it can give you a prediction as to how big the knife is to the hill (can be longer than indicated on the wound tract). But the knife can also go in it can push the skin downward (compressing the skin downward) so the tip of the knife would reach a deeper level in the tissue than you would normally predict by the length of the knife. It can underestimate or overestimate the length of the blade that made the cut.
identical twins
are an exception to this because they have the same exact DNA.
Battered Child Syndrome
◦ Child abused over and over again and at some point it becomes fatal. Fractures in extremities are usually seen. Lacerations can be seen. This is the classic child abuse syndrome and is usually easy to recognize. Problem is to decide who did it.
Subdural
under the dura of the brain. Common in the elderly, and can be seen shaken babies. Bleeding is due to veins at lower pressure.
Hanging
type of asphyxial deaths
Blood Level
: Concentration of the drug should equal the dose divided by the volume of the drug. Looked at in over dose situations. Say you take a liter (volume) and the dose is 100 ml then you would expect to see a concentration of 100 ml per liter. This would be if the body accepted drugs like a bucket of water. Drugs vary on how they distribute themselves in the body.
Ligature
something put around the neck (wire, rope, etc). Usually produces a line mark. To die from hanging full body weight not necessary. They can be fully suspended but they can also be in a standing position with feet on the floor. Slumping down is enough to cause a hanging. You can hang yourself while in a sitting position.
Sex of a person
Can be determined from a bone through the skull and the pelvis
Section 6
(50 cards)
Febrile Disease
characterized by fever
Age
determined on the skull, pelvis and long bones. Teeth are also good to help determine the age of a person (if molars have not come up yet from the mandible) These statistics combined can help to determine the age, sex and height of a person as well as find other characteristics of a person (ie: person smoked a pipe due to the teeth and how they look and are worn).
Lesions
Structural changes produced in the tissues as a result of disease
Computer Programs
always give a + or - of a person based on the data to show a range of probability. This can help lead you to a positive identification by narrowing down information.
Hereditary Disease
When a person inherited some sort of abnormal genes from his or her parents
Hypoplasia
under development of a body part; phocomelia is a form of hypoplasia, in which the proximal portions of the extremities are absent or poorly formed
Sudden Cardiac Death
can be caused by artherosclerosis, ischemia (reduction of blood flow to an area and makes the cells in the area hypoxic - low in oxygen). Then the ischemia can create an arrhythmia aka disrhythmia which is a disturbance in the rhythm which in worse case scenarios will become vetricular fibrillation (a messed up electrical signal that does not produce effective pumping). A person will collapse and be clinically dead within 10 - 15 seconds of going into ventricular fibrillation. People who have enough ischemia to die from an arrhythmia generally have an obstruction greater than about 75%. You will usually have at least one of the main 3 coronary arteries will have about 75% obstruction or more. Someone can end up dieing by having all three coronary arteries clogged at 90% (they can live past the 75% rate for a while...this is only a marker for hypothetical reasons). Concentric (round) vs Eccentric (odd shaped) to determine the % of obstruction of the coronary arteries by measuring the size of the lumen that is left (not obstructed) and compare that to the space that is obstructed to obtain the percentage. Concentric and Eccentric refer to the shape of the remaining lumen. Statistics on sudden cardiac death is that you have to define it so from a research point of view it is generally stated as someone with no symptoms and all of the sudden something happens and they drop dead and the death occurs within one hour from the onset of symptoms.
Congestive Heart Failure
Long term this can happen from ASHD or from a Myocardial Infarction. Edema can be seen (excess fluid in the interstitial spaces of the body).
Myocardial Infarction
You can see this on an EKG if the person is still alive or you can see it during an autopsy.
Polydactylism
an excess number of fingers or toes
Important benefits to which the autopsy provided to the medical ad funeral professions
o It helps to confirm, or possibly alter the medical diagnosis of death. o It contributes to medical knowledge about various diseases, how to treat them, and hopefully how to prevent their recurrence in the future. o Valuable in medical-legal cases. It assists legal authorities concerning the cause of death in numerous types of situations, such as homicide, suicide and accident cases. o It helps satisfy the minds of survivors about the cause of death and or the existence of disease
Endemic Diseases
Those which are always present to some degree in a given area or community.
Aplasia
Absence of a body part; amelia is a form of aplasia in which one or more limbs is missing.
Congenital
Those diseases which are present at birth
Organic Disease
: readily identifiable, characteristic lesions associated with them, such as the swollen and inflamed mucous membranes of strep throat, or characteristic ulcerations present during syphilis
Functional DIsease
have no such characteristic lesions when they occur, such as migraine headaches, or various mental disturbances called psychoses
Cyst
a sac-like structure, containing fluid or a semi-solid substance. Usually results from the abnormal development of tissues, obstruction of ducts or infections
Infestation
Refers to the presence of macroscopic (visible to the unaided eye) organisms in or on the body, such as animal parasites
Cardiac Hypertrophy and Dilation
Left ventricle in particular due to the distention of it (hypertrophy...increases) due to cell size increasing. Bigger cells. Can be applied in a non cellular sense by just saying that the heart in general the heart hypertrophyed. You would not say the heart is undergoing Hyperplasia. Ejection fraction should be greater than 50 % for the heart. You can eject the same volume if you are a big dilated heart by not having to squeeze as hard. You can measure the ejection fraction which will tell you if it is normal or abnormal (ie: 10% is abnormal).
Acquired
Any disease which was obtained after birth
Down's Syndrome
genetic defect resulting in various degrees of mental retardation, a dwarfed physique, and certain characteristic abnormalities of the head and extremities.
Sign
objective indication of the presence of a particular disease
Fistula
An abnormal tract or channel through the tissue, connection one body cavity with another, or connecting a cavity with the surface of the body
health
The condition of being sound in body, mind, or soul, especially freedom from disease or pain.
Occupational Disease
A disease resulting from the nature of one's working conditions.
Intoxicating disease
presence of poisons or other toxic substances
Diagnosis
The identification of a disease
Contagious Disease
Those which are easily transmitted from person to person.
Idiopathic Disease
When the cause of the disease is not known.
Hernia
Protrusion of any organ through the wall of the body cavity in which it is contained.
Infectious Disease
Those caused by pathogenic microorganisms.
Cardiac Tamponade
The area of infarct can rupture due to inflammatory cells coming in and digesting the cells and fibroblasts coming in to lay down scar tissue
Malformations or anomalies
Conditions that can be described as any defect in formation, structure, or position of a body part. Malformations can result from many causes, such as inheriting abnormal genes and chromosomes, which may result in defective development, or even absence, of a given body part.
Iatrogenic diseases
One which results from a physician's treatment of a patient
Treatment of Artheroscleorsis
Medical (Nitroglycerine, digoxin, diuretics, antiarrhythmia drugs): Various drugs. Nitroglycerine is the same thing that is in high explosives (dynamite) and can dilate the blood vessels. It is good for people who have Myocardial Ischemia. They slip it under the tongue and help dilate quickly the blood vessels. Digoxin is a drug that increases the strenght of the heart contraction. Diuretics are used to make you pee more and this decreases the blood volume and decrease the blood pressure and therefore decrease the workload of the heart. Antiarrhythmia Drugs: can be given to prevent fibrillation and to quiet the heart down a bit. Lydocaine is the most common of these drugs. Anything that ends in "caine" ie: Xylocaine, Novocaine, means that they are local anasthetics. When it is put into the blood stream it smooths out the heart. Bypass Surgery: Baloong Angioplasty: Streptokinase/urokinase Pacemaker
Recurrent
meaning to come back or recur. Used to describe diseases which show alternating increases and decreases in their symptoms.
Symptom
: used to describe subjective indications of the presence of disease in the body. Examples include: itching, pain, nausea and dizziness.
Diagnosis of Arteriosclerosis
EKG: Show characteristic changes if someone is having a Myocardial Infarct. Stress Test (Treadmill): Not done to diagnose an acute MI but you would do this to try to diagnose ASHD. There are no acute changes so you will not show the pattern of an acute Myocardial Infarction. It will show damage from prior episodes and show that on the test. Can bring out a diagnosis that will not usually show on a regular EKG. Your normal EKG will change to something that looks like a heart attack when you are made to exercise. The person can also have dyes injected into them and placed into a scanner to see where the dye goes. You can also do this while on the treadmill to see where the flow is going when the heart is in physical work. Cardiac Catheterization: Catheters are placed in the heart and inject contrast material into the coronary arteries to see if there are any blockages. It is invasive and expensive and so this is usually not done as a routine exam. It is done if there is high suspicion of coronary artery disease (heredity, etc). Cardiac Enzymes: Looks for myocardial damage through myocardial cells and the certain enzymes that are in them. Some of the enzymes can get into the blood if the enzyme dies but this is not common. If someone has damage to quite a number of the cells (ASHD causing a MI, etc) then you would see in the blood the enzymes because they escaped into the blood from the cells that dies and were effected.
Stages in Artherosclerosis
The body will put up a mild inflammatory reaction against this reaction and try to do something about it. You will eventually end up with some scaring. Some of the fatty material can go away but the scarring will remain and then you will start to see some calcium forming. Between the scarring and calcium deposit in the plaque you will have a hard lesion in the artery that will partially obstruct the lumen of the blood vessel. This hardness leads to the term hardening of the arteries. This is the direction that artherosclerosis will move towards over time.
acute
: A disease with a relatively rapid onset and a short duration. Ie; The Common Cold.
Deficiency Diseases
Characterized by the lack of some essential dietary ingredient
Pandemic
those which affect the majority of the population in a very large area, possibly even worldwide.
Arteriosclerotic Heart Disease (Coronary Artery Disease)
The disease is artherosclerosis. Deposits of fatty material in generally large arteries. This does not happen in small arteries. It is a deposit that occurs just under the endothelium (intima) of the artery. The deposits are said to be sub intimal. The deposits are plaque which is fatty material and contains a lot of cholesterol. As this disease progresses the lumen is compromised.
Fulminating Disease
An acute disease which is particularly severe and sudden in onset, and often proves fatal.
Spina Bifida
A defect in the walls of the lower part of the spinal column, where the bones do not form properly, and may result in a protrusion of the spinal cord and membranes out of the spinal cavity. It is often referred to as a congenital fissure of the spinal column.
Symptoms of artherosclerosis
chest pain (squeezing or compressing), You can also feel pain in the jaw or left arm. This would be symptoms of an Myocardial Infarction or Ischemia but with Ischemia 5 - 10 minutes later the pain is gone then it is Ischemia but if it is persistent then it would be an Infarction. Chest pain that is radiating into the right arm, etc can still indicate ASHD so even if the classic symptoms are not there you would want to do tests to see if that is what it is. Shortness of breath, Diaphoresis (sweating), Nausea and Vomiting are also signs of Myocardial Infarct. SOB (shortness of breath),
Chronic
A disease with a slower onset and a generally longer duration. Ie: Cancer
Autopsy
(aka post-mortem examination from Latin word "after" and "death" or necropsy from Greek word "a state of death") comes from the Greek word "self" and "sight", is used to refer to the examination of the body after death in order to determine the cause of death; and or the existence of various disease conditions. An autopsy allows us to learn about the structure and function of the body as well as learning about pathological conditions. An autopsy involves both the gross examination of the human body and its organs and tissues, plus the microscopic examination of tissue samples and cells which have been removed for further study.
Time of Death
rigor, lividity, body cooling: Things that can be used to estimate something about how long someone has been dead. With rigor mortis you first start to see it around 3 - 4 hours after death (is the onset). 6 - 12 hours it is full rigor, etc. Body cooling is similar.....with outdoor temperature and the body temperature Lividity can also give you an idea if you are able to blanch it or if it is fixed. 12-24 hours it should blanch and after that it will be more fixed. vitreous potassium: Vit K+. Potassium over time....it usually goes up uniformly across the data points. In particular when you look at the cells behind the retna of the eye there tends to be large amounts of potassium and in the surrounding fluid there tends to be more sodium. The potassium will leak out of the cells into the fluid and this can help determine how long a person is dead. Not useful when decomposition has set in. You need a person to remain in good condition for a long period of time for it to really be useful. A person outside in 40 degree temperatures....vitreous potassium will be helpful in determining an approximate time of death. Entomology: Looking at insects. Fly's in particular and their life cycles as we covered before. An expert in insects can collect larvae or pupas, etc from the body to determine an approximate date and time of death. You would need to let the eggs hatch to see what species you are dealing with and then compare the life cycle of that particular species in relation to the particular weather of that area, you can get an idea of how this species would progress and then determine how long they have been around. Usually can get a determined time within one day for a person by looking at Entomology. Other insects can be used to determine and help times of death. After flies beatles and spiders can come into play. association evidence including gastric contents: Refers to something that is not really a part of the body but associated with the body. If you know about digestion and how long certain things take to breakdown and you can figure out when a person consumed certain things you will be able to determine about how long after the meal a person died. In addition any means of common sense can be used as association evidence. The skeleton found in the field. Is the skeleton wearing winter clothing or summer clothing. Are the lights in the house with the dead body on or off (can tell you what time of day it was), One caveat with this is people may become disabled for a period of time before dieing so you need to be careful with interpreting this. Just because the lights are off does not mean they died during the day. They could have had a stroke during the day and did not die for another 3 days. You can also check the mail and see dates and how long it is built up etc. Telephone records can also be used to see when the last call was made from inside the house, etc.
prevalence
The number of cases of a disease within a certain population at a given time
Section 7
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Generalized Passive Hyperemia
Usually the result of a heart issue that affects the efficiency of the hearts pumping action.
Examples of exciting or immediate factors
Living agents, trauma, physical agents, Chemical agents, Deficiencies, Allergens, and Heredity
Allergens
Foreign particles such as dust or pollen
Race
malaria and yellow fever tend to affect Caucasians more than African Americans and sickle cell anemia tends to affect African Americans more than Caucasians
Active hyperemia
ecess blood in a body part which was actively, or purposefully taken there by the arterial system in the body. This increased blood flow to a body part mat be further described as psychological hypermia
Stress and Emotion
working and living under high stress conditions can weaken a person's resistance to disease
Complication
Unfavorable condition which occurs during the course of a disease IE Hemorrhage accompanying stomach uclers
embolus
the object itself in reference to an embolism
Reasons Thrombi are caused
injury to the lining of the heart vessels, diseases of the blood itself, slowing of the blood flow
Chemical agents
acids or alkalids which can result in serious tissue destructions
Trauma
from the Greek word "wound" physical injury to the tissues of the body such as cuts, bruises, scraped or fractures
Predisposing factors
Increase of one's susceptibility to a disease, but do not actually cause it
Economic Status
someone in a high economic status may be under more stress on a job where as someone in a lower economic status may work in a more dangerous less safety conscious job, etc.
Nutrition
poor nutrition can lead to a generally weakened condition which can make the body more susceptible to disease.
Heredity
ones genetic make up due to it's previous ancestors
Examples of predisposing factors
age, race, sex, nutrition, occupation, stress/emotion, environment and economic status
psychological hyperemia
if it results from a normal, everyday, healthful bodily functions. Examples of this would be there presence of extra blood in the muscles during exercise.
Gangrene
classified as either dry gangrene or moist gangrene
Environment
: ie: people living in dark, damp conditions compared to those who are not.
etiology
refers to the the study of the causes of disease. It is closely associated the cause of a disease is the manner in which it develops or the various changes a disease goes through.
Remission or Abatenment
there has been a let-up in the severity of a disease, with diminished signs and symptoms. Ie: cancers are said to be in remission after various therapies have been employed on a patient, and the patients conditions seems to have improved. This however does not mean that the patient is cured.
Pathological Hyperemia
results of some disease process. An example of this is when inflammation occurs to an injured site and the excess blood is sent to that site.
Sex
women tend to be more resistant to diseases than men and also prove to have a longer life span to show for it.
Thrombus
the mass itself, results may be short lived, long term, minor or major depending on many factors Most common locations are in the arteries (coronary arteries most common) Thrombus ca get infected and can result in passive hyperemia and even gangrene. If the thrombus breaks loose it can float and cause other blockages which can result in strokes or heart attacks.
hyperemia
is a condition which refers to excess blood in a body part. "hyper" = excessive "emia" = indicates a blood disorder
physical agents
factors such as heat, cold, electricity or raditation
Cyanosis
Blood that is not properly oxygenated and results in a bluish discoloration of the tissues. Mostly seen in the lips, and nail beds but can be seen more pronounced in some cases.
Prognosis
Prediction of probable outcome of a disease
Passive Hyperemia
Passive Hyperemia is ALWAYS pathological and may be localized or generalized.
Pathogenesis
the term given to this manner of development of a disease. A doctor will take into consideration the pathogenesis of a disease when deciding how to best treat it and to come up with a prognosis
Occupation
ie: Coal miner who is constantly exposed to high levels of coal dust.
Ischemia
Closely associated with the concepts of thrombosis and embolism. From Greek word "to hold back" refers to the decreased blood flow to a body part. Causes: Ischemia may result from other diseases such as atherosclerosis. This causes a thickening of vascular walls resulting in the narrowing of the arterial lumen. Can also result form pressure on an artery from the outside, such as a tumor. Overall effect of Ischemia depends a lot on where it occurs, and whether or not that particular area is able to get an alternate blood supply through collateral circulation.
Living Agents
Includes various microorganisms such as bacteria, viruses and parasites.
Hypostatic Congestion
Faulty circulation can result in blood settling to the dependent parts of the body when gravity overcomes the normal flow of blood trough the circulatory system.
infarctions
The area of tissue which as been deprived of blood supply dies (usually to Ischemia). Infarct: aka Ischemic Necrosis. Area of tissue which dies. Pathologists have often removed hearts during an autopsy to find that the decedent has had one or more infarcts, some which may have occurred years prior to death. Causes: External pressure exerted on the surface of the body over an extended period of time. This compresses the blood vessels which can cause an onset of necrosis. Bedridden patients often experience this due to bed sores or decubitus ulcers.
diabetes melliotus
often associated with moist gangrene as it can cause damage to the vascular walls resulting in poor circulation
Deficiencies
lack of some essential dietary item IE rickets, results from a lack of Vitamin D
Age
age can predispose certain conditions. Heart and arterial diseases are some of these. Chicken pox in children is another because they have not developed an immune system like adults have.
Causes or embolisms
Clumps of bacteria parasites or tumor cells spread to parts of the body. Fat Globules can become loose due to injury and then travel as emboli. Foreign particles: Dirt can become emboli if entered into the blood stream. Air or gas bubbles, this can occur during operations, traumatic injuries to the chest or through hypodermic injection.
hemorrhage
escape of blood from the vascular system. anytime blood leaves a vessel it can be categorized as a hemorrhage. main reason is due to a break in the walls of the vessel.
Exciting or immediate factors
thing which actually cause a disease
dry gangrene
not a prefered term. it is just another name for ischemic necrosis or an infarct. Usually dry gangrene is used when it it located in the extremitites of the body. The affected part is dry, shruken, progressively turns black If an area of dry gangrene is invaded by saprophytic bacteria, it may turn into moist gangrene
Exacerbation
a sudden increase in the severity of a disease. IE sudden increase in fever during a disease
Localized Passive Hyperemia
Thrombosis: formation of a blood clot in a vein. The clot does not allow the blood to pass and therefore it builds up in that body site. Thickening of vessel walls due to disease which make the lumen of the blood vessels smaller and restrict blood flow. External Lesions (outside pressure) such as a tumor may press on an area restricting blood flow. Signs/Symptoms of Localized Passive Hyperemia: bluish-red in color in the area and the area is swollen and colder than usual.
hemorrhage per rhexis
from the greek word "rupture' is when the blood escapes into the surrounding tissues or onto a body surface, usually this is due to blunt force trauma
Moist gangrene (true gangrene
nectotic tissue which has been invaded by bacteria. this is responsible for the putrefaction that occurs. affected are is swollen, high liquid content of the tissues, bad odors and tendency to spread, most often associated with disturbances in the venous return of blood from an area. Can result in blood stagnation and improper drainage may make someone predisposed to gangrene, crushing injured of the toes and feet or freezing of the tissues can lead to moist gangrene. severe cases often result in a need for an amputation in that area
Embolism
refers to the condition of an object having floated through the bloodstream and causing an obstruction of a vessel. Usually a thrombosis is what causes an embolism. Can result in a stroke or heart attack if not found and stopped before it travels to certain part of he body. An embolism in the leg can travel to the heart and cause a heart attack.
petechia
pin-point hemorrhages
Thrombosis
a term which refers to the formation of a solid mass, or blood clot within the heart or vessels of the body
Congestion
Used to indicate that blood is congested in a given body part. It does not mean that there is an excess of total blood volume in the body. results from the fact that there has been extra blood delivered to a body part or that drainage of blood from an area has been impaired
Section 8
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cardiogenic shock
where the heart fails to pump blood through the circulatory system
causes of inflammation
• Living Agents: microorganisms such as bacteria, fungi, protozoa and viruses. When inflammation is referred to by living agents it is generally referred to as Infection. • Chemical Irritants: Chemicals such as strong acids of alkalis are capable of causing significant damage to body tissues. • Physical Irritants: this general category of tissue injury includes various agents such as heat, cold, electricity, radiation injuries, and trauma. Trauma involves physical injuries such as fractures, bruises, cuts and gunshots. • Immunological Reactions: Inflammation may be caused by the action of antibodies which a person has produced acting upon their own tissues. These conditions are often referred to as autoimmune diseases.
fatty degeneration
fatty molecules are accumulating within the cell and having an adverse affect on oral cellular function. The liver is an organ that is sometimes affected by fatty degeneration
stone dust
silicosis
Passive hyperemia and edema
Type and quantity of embalming solution must be determined. Edema can dilute solutions. Edamous bodies can also increase the rate of decomposition.
hemorrhagic shock
loss of blood supply in the body
amyloid disease: amyloidosis
Where a starch like substance called amyloid is deposited in the tissues. It is thought to be a metabolic disorder involving proteins, and may accompany carious chronic, pathological conditions.
edema
an excess accumulation of fluid in the tissues of the body It is an extravascular condition. tissues can take on a "doughy" consistency or retain finger prints called pitting edema. caused by heart failute, venous or lymphatic obstruction, increased capillary permeability, such as that which occurs during inflammation and decreased osmotic pressure of plasma protiens
epistaxis
Bleeding from the nose
diminished cirrculation
: Prime concern for embalmers. The diseases and issues that were listed above can result in the flow of embalming fluids to the various body parts being significantly reduced. Proper fluids and techniques are needed to improve distribution to the body areas.
inflammation process
initiated when injured and dying cells release chemical substances into the surrounding tissues which in turn stimulate other events to occur.
hemopericardium
bleeding into the pericardial cavity
ascites
edema o the peritoneal cavity. "ascites" come from the Greek word for "sack or bag"
cloudy Swelling (Cellular swelling)
Is the term given to the appearance cells take on when they are somewhat swollen and contain an abnormal amount of water.
coal dust - anthracosis
black lung disease
Circulatory Shock
A condition which results from a serious reduction of blood flow in the body, resulting in reduced oxygen supply to the tissues, it is often described as a state of collapse, with depressed vital signs. weak, rapid pulse, low blood pressure, shallow breathing and cold and clammy skin especially in the extremities
Melanin (melanosis)
abnormal amounts of melanin accumulates in the tissues. This is a brownish coloring. Common freckles and moles are examples of excess melanin being present in certain areas of the skin.
abscesses
: Often associated with the destruction and degeneration of tissues as a result of circulatory interruption
vascular response
Tiny blood vessels in the area dilate, and increased blood flow is allowed into the vicinity. This can be interpreted as active pathological hyperemia occuring as a result of the innflammation process.
melena
from greek word for black. refers to very dark tarry feces or vomitus which results from the action of gastrointestinal secretions upon blood in the digestive tract.
bilirubin (jaundice) (icterus)
Orange to yellowish pigment present in bile. Inflammations of the bile ducts in the liver, liver, cancer, inflammations and blockages of the bile ducts can result in bile pigment spilling over into the bloodstream. Yellowish discoloration of the skin, whites of eyes
degeneration
referring to the deterioration of cells within the body due to changes which occur within the cytoplasm of the cells, and which affects their normal function.
Inflammation
the body's response to tissue injury. Inflammation is not a disease but a process the body goes through in responding to the fact that injury has occurred. It is thought of as a defense mechanism, whose purpose is threefold: • To destroy and remove injurious agent from the body • to limit the extension of injurious agent in the body • To serve as the mechanism for allowing the body to repair itself and return the injured tissues to normal use.
physiological atrophy
indicates that the decrease in size is a normal, regular occurrence in the human body, can be seen in atriophy of the mammary glands after milk production ceases, the uterus after pregnancy or general atrophy with old age (senile atrophy).
atrophy
decrease in size of a once normal body part. This is not hypoplasia, which indicates the underdevelopment of a body part. Atrophy may be either physiological or pathological in nature
hemoptysis
blood in the sputum (or from the lungs)
exudate
edema which collect around an inflammation site
ecchymosis
larger irredular patched of hemorrhage in the tissues and sometimes is referred to a bruise under the skin
Hemorrhage
can also occur as a result of circulatory disorders, effectively short circuiting the flow of embalming fluids.
fainting (syncope)
often referred to as a mild form of shock due to a temporary decrease in blood flow to the brain
Hemoglobin (blood discoloration)
: Normally functioning as oxygen carrying substance within a red blood cell., Post mortem stain is an example of hemoglobin which can create post mortem stain when goes through hemolysis
exudates
fluids which collect around an inflammation site may be thought as of a type of edema. These are subcategorized based o the substances they contain. Cellular response is also involved in the inflammation process in addition to vascular response.
exogenous pigmentation
pigment which enters the body from the outside
Hemoperitoneum
bleeding into the peritoneal cavity
pneumoconiosis
Pigmentations caused by prolonged inhalation of dust
Hematemesis
Blood in the vomit (or from the stomach)
pupura
from latin word "purple" widespread ares of hemorrhage into the skin or mucous membrane
cotton dust - hyssinosis
mill fever or brown lung
dehydration
aka Desiccation can be defined as a decrease in total body fluids and can be a serious and even fatal condition if it progresses beyond certain levels. Replenishment of water without a corresponding replenishment of salts can upset the normal osmotic concentration of the fluid in the tissues of the body. Cramping of muscles is an example of this loss of salt. Increase of fluids plus salts can prevent or alleviate these "heat cramps" Causes: Loss of large amounts of salts. High body temperature during febrile diseases, which leads to moisture loos via sweating through the skin. High environmental temperatures, which also cause excessive sweating Gastro-Intestinal diseases, which result in either considerable vomiting or diarrhea Glandular diseases which exhibit hormonal disturbances.
regressive tissue changes
changes may be described as the various pathological processes indicating some disturbance in cell metabolism
endogenous pigmentation
coloting matter is from a normal pigment present in the body.
hydropericardium
edema of the pericardial avity
pathological atrpohy
Can occur as a result of various functional and structural problems which occur in the different organs of the body. Some reasons include: Inadequate Nutrition: without proper nutrients in the blood stream. Inadequate Nervous Stimulation: muscles require nervous stimulation in order to contract and create movement. Paralysis of body parts can decrease in size of the area due to the loss of function. Disuse: Broken bones that are in casts for extended periods of time can show decrease in size of the body part because of disuse.
hematoma
tumor like swelling filled with bloods
infiltration
Suggests that some sort of substance has infiltrated the tissues of the body and accumulated in abnormal amounts. Common form occurs when coloring matters pass into the tissues and accumulate causing discolorations. This refers to pigmentation. Pigmentation's are further categorized based on some factors:
tissue fluid
When blood plasma seeps out of capillary walls it is called this. When tissue fluid moves into tiny lymph vessels, eventually to be returned to the bloods steam is is referred to as lymph. Various disease conditions can alter the balance of these things
calcification
calcium is deposited within the tissues of the body with no attempt at bone formation. Seen in arteriosclerosois, lesions of tuberculosis.
hemothorax
bleeding into the pleural cavity
hydrothorax
edema of the pleural cavity
causes of shock
infection, poisoning, and dehydration
Section 9
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leukocytosis
refers to an increase in the number of circulating white blood cells, and is an important defense mechanism of the body when it occurs in a temporary or transient fashion.
heredity
genetics in causing cancer. breast cancer is one example of a tumor which is more likely to occur in women whose family members have also has the disease
furnucle
boil an abcess located in the deeper layers of the skin
Benig Tumors
from latin word for "mild" ones that are less serious ◦ Grow by expansion. They expand as they grow and push aside surrounding tissues ◦ Usually are encapsulated ◦ Usually do not spread from their growth site. ◦ Generally do not cause extensive destruction of tissues surrounding it ◦ Tissue cells of benign tumors usually resemble the tissues surrounding the tumor ◦ Generally they do not reoccur once removed ◦ Not likely to be fatal but can be serious depending on what anatomic location they are in. They can interfere with the vital function of organs.
sickle cell anemia
hemolytic anemia which results from a genetic defect in the manufacturer of hemoglobin. It is characterized by the abnormal, crescent shaped red blood cell which is less functional as an oxygen carrier. The abnormal cells are called "sickle cells" and are also more likely to cause thrombosis.
inflammation and repair process
• Causative Agent (ie: Bacteria) • Cellular Damage Occurs • Chemicals are released from Dying Cells • Bodily Responses Occur ◦ Active Pathological Hyperemia ◦ Leukocytosis/Phagocytosis ◦ Exudates form ◦ Fever and antibody production increased ◦ Suppuration may occur • Containment and Neutralization of Causative Agent Occur and the following two things can happen ◦ 1. Regeneration of damaged cells which lead to Resolution ◦ 2. Repair/Fibrosis/Cicatrix Formaion occurs which leads to Resolution.
emanciation
post mortem condition that results in the loss of body mass in a person due to the disease they have endured. Must select fluids that will fill out and rehydrate the tissues.
ulcer
a localized area of necrosis on the skin or mucous membrane
acute lymphocytic leukemia
most common form of cancer in children
tissue deformation
another problem which accompanies tumors
carcinoma
is usually given to any agent capable of causing cancer
histological basis tumors
type of tissue from which the tumors arise. ◦ Benign Tumors usually end in "oma" such as lypoma ◦ Malignant tumors usually have the suffix "sarcoma" which is used to identify malignancies of non-epithelial tissues especially various connective and muscle tissue tumors. ◦ Ending "Carcinoma" designates malignancies of Epithelial Tissues
pernicious anemia
one of decreased production usually associated with old age. May be thought of as a deficiency disease, as it results from a lack of Vitamin B12 being asborbed from the digestive tract.
vesicle
an elevation on the skin containing fluid, as in a blister
environmental factors
asbestos is an example of one that is a factor in our daily environment. Foods we eat are also frequently implicated. Excessive radiation is another
tumor
means swelling and although they are not necessarily neoplasms, the terms tumor and neoplasm have come to be used somewhat interchangeably.
hypertrophy
describes an increase in the size of a body part due to an increase in size of the individual cell. This is not neoplastic in nature.
occupational exposure to chemicals
Petroleum distillates, vinyl chloride in manfacturing of PVC plastics, arsenic compounds and benzenene in those working with paints, varnishes glues etc.
aplastic anemia
characterized by a virtual stoppage of blood cell production in the bone marrow. The exact cause is not known but is thought that some cases are related to certain drugs and chemical agents such as radiation.
repair
replacement of damaged tissues with connective tissue. Little or no scarring will occur
abscess
an ares of pus surrounded by a wall of inflammatory tissue
viruses
Epstein-Barr virus which causes mononucleosis in humans ans been associated with a particular form of lymphoma in Africa. Animals mostly have this where viruses lead to tumors and cancer
pustule
an elevation on the skin containing pus, as in a pimple
Maligant Tumors
From the latin word for bad kind which are more serious and the term cancer is used. ◦ Grow by Infiltration in that they grow from the edges and send out proceses or strands like the claws of a crab that dig into surrounding tissues. Cancer comes from the Latin word "Crab" ◦ Usually are not encapsulated and the body has greater trouble surrounding, walling off and controlling the invasive nature of these tumors. ◦ Do usually spread from their growth site aka Metastasis: the ability of a malignant tumor to spread. ◦ When surgery is done to remove malignant tumors, it is often necessary to also remove surrounding lymph nodes where cancer cells are likely to be located. ◦ Create extensive damage of tissues surrounding it. ◦ Cancerous cells are often greatly different microscopically from their tissue of origin. ◦ Often these can reoccur after surgery due to the difficult chore of removing the main part of the tumor, plus its extensions in the surrounding tissue. ◦ Very likely to become fatal if not removed or properly treated.
regeneration
replacement of damaged tissue with identical tissue. As general rule, connective tissue and epithelial tissues regenerate fairly well. Muscles regenerate poorly. Nervous tissues regenerate worse of all (if they are destroyed they will never regenerate
oncology
the study of neoplasms or tumors
leukemia
a malignancy of the hemopoietic tissues in the body and is sometimes referred to as "cancer of the blood". It is characterized by a relatively permanent and massive leukocytosis, unlike the transient increase in white cells which serves a protective function in the body
anemia
• is a term whose literal meaning would be "no blood". • Refers to a decrease in the number of red blood cells and or hemoglobin. • Any significant decrease in the number of red blood cells or hemoglobin will in turn result in diminished supply of oxygen to the tissues of the bodies. • Characterized by weakness, fatigue, shortness of breath upon exertion and lightheadedness
pus
bacteria cause this formation which results from the liquefication of dead tissue cells. It can be presumed to contain both fluid and a mixture of living and dead tissue, plus bacterial and white blood cells.
erythroblastosis fetalis
a hemolytic disease of a newborn. Secondary anemia. Blood incompatibility between the mother and her unborn fetus. The problem occurs when the mother who is Rh- carries a child who is Rh+. If the fetal red cells manage to enter the mothers blood stream which is most likely to happen in delivery, the mother body forms antibodies against the Rh factor in the fetal blood. These antibodies can then cross the placenta barrier and destroy the blood of an unborn fetus of the subsequent pregnancy
neoplasm
from the Greek words "neo" meaning new and "plasm" formed substance. It is a new abnormal growth of tissue in the body which serves no useful purpose. They seem to grow as a result in cellular proliferation completely seperate from other ormal body tissues.
Suppuration
process of pus formation
hormones
the activity of certain hormones is also thought to be involved in the development of some tumors in the body.
extravascular obstruction
tumors result in this due to the flow of embalming fluids not making it through the vessels. Even if a tumor is not malignant, it may well have the effect of putting pressure on surrounding vessels, thus resulting in partial or total occlusion of these vessels.
myeloid (myelocytic) leukemia
shows an increase in myeloid cells, or the precursor cells in bone marrow from which other granulocytic white cells are normally formed
cachexia
closely related to emaciation and refers to a state of general ill health, malnutrition and wasting away.
discoloration
often preset in tissues affected by tumors. Cosmetic agents may be needed to cover preexisting discolorations after other embalming techniques have been employed.
primary anemias
those diseases involving a decreased production of red blood cells
Cicatrix
scar tissues, contain no blood vessels, hair follicles, oil or sweat glands or nerve endings
prolonged irritation
chronic irritation of localized areas of tissue is thought by many scientists to be involved in the formation of certain types of cancer. Ie; cancer of the lip in pipe smokers
Leukopenia
: indicates a decrease in white blood cells. Various drugs and conditions which suppress he bone marrow activity may result in this
diapedesis
process where white blood cells are migrating out of the capillary walls and into the surrounding tissues. These cells, particularly neutrophils are involved in phagocytosis and help to ingest invading bacteria and other cellular debris.
clinical basis tumors
how they behave and their general characteristics
polycythemia
a condition which is characterized by an increase in the number of blood cells in the body.
embalming implications of inflammation
Careful attention and often additional care is needed to treat the situation with inflammation present. Cosmetic Coverage may be necessary More extensive treatment of badly damaged tissues. Adequate disinfection of lesions and deep wounds Waxing of deep leisons and treatment.
Pyogenic bacteria
bacteria which cause suppuration. Examples include Staphlyococcus aureus, Streptococcus pyogenes, Pseudomonas aeruginosa and Neisseria gonorrhea.
hyperplasia
Increase in the size of a body part due to an increase in the number of cells in that organ. This type of growth is not neoplastic in nature. It is a growth that is of a limited controlled nature.
carbuncle
two or more communicating furnucles and often accomplanied by additional symptoms such as fever, leukocytosis, weakness and fatigue
metaplasia
replacement of one type of tissue in a major category (ie: epithelial) by another type of tissue in that same category. In other words one type of epithelial tissue such as squamous cells, may replace another type of epithelium such as columnar cells.
secondary anemias
aka hemolytic anemias. Those that involve an increased loss of destruction of red blood cells.
Section 10
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prolapse
affects the atrioventricular valves in particular the mitral valve. One or more of the cusps of the heart valve turns backwards into the atrium upon ventricular systole.
Predisposing Factors in Cardiovascular Disease
◦ Heredity: occurance of heart disease in a family (parents, grandparents, siblings, etc). ◦ Obesity: Carrying extra weight puts extra work on the heart. Weight loss is a common part of heart patients healing process. ◦ Diet: low in fats and cholesterol is recommended to help avoid cardiovascular disease. Artherosclerosis and hypertension are closely related with dietary intake. ◦ Diabetes: diabetes mellitus or sugar diabetes is a disease which can have serious adverse effects upon the cardiovascular system. The disease is often characterized by vascular damage and occlusion, artheroslcerosis and possibly even gangrene, especially in the extremities. ◦ Other Social Factors: stress smoking, alcohol and drug use are known to predispose to cardiovascular disease.
Treponema Pallidum
: the causative agent of syphilis which can also lead to inflammatory lesions in the mouth referred to as mucous patches during the secondary stage of the disease.
Glossitis
inflammation of the tongue. Associated with somatitis
Aschoff's Bodies
connective tissue within the heart and it's lining endocardium are damaged and cause the formation of these small nodules.
arteriosclerosis
formation of intimal plaques in the vessels
Gastritis
inflammation of the stomach. Most commonly caused by bacterial and viral infections and chemical irritations such as coffee, alcohol, aspirin and tobacco
Aphthous (greek meaning ulcer) stomatitis (canker sores)
Common condition characterized by the formation of tiny white ulcers which form at the base of the gums, lips and cheeks.
Hematemesis
vomiting of blood from the stomach often associated with gastritis
patent ductus arteriosus
the opening between the pulmonary artery and the aorta fails to close. The ductus arteriosus allows blood being pumped from the right ventricle to enter the aortic arch as it does not need to enter the lungs for oxygenation in an unborn child.
dissecting
a weakening and separation between the walls of an artery which may allow blood to make its way between the layers of the vessel wall.
purpura
Thrombocytopenic Purpura due to the color of the spontaneous hemorrhages into the skin and mucus membranes. It is purple in nature
Gingivitis
Inflammation of the gums. Associated with somatitis
Cyanosis
bluish discoloration of the skin due to blood mixing and is often referred to as "blue babies" when seen in infants at birth.
thrombocytopenia
characterized by a decreased number of platelets, or thrombocytes in the blood.
varicose veins or varices
are those veins which become dilated and tortuous. They often form when the return of blood flow toward the heart is impeded. Heredity factors, and other conditions predispose someone to them (on your feet for long periods of time, pregnancy, tumors and heart failure).
Bacterial Infections of the heart
do damage to the valves of the heart and can cause inflammation (it is).
hemorrhoids
varices (vericoses veins) of the rectum and anal canal.
hypertension
high blood pressure. Can be monitored by taking blood pressure readings. Normal is 120/80. Anything over 140/90 is said to be high blood pressure.
Stenosis
Narrowing of an opening or passageway. Particularly affects the atrioventricular valves
Rheumatic Heart Disease
Heart damage which results from rheumatic fever
Polycythemia vera
serious form of polycythemia characterized by overactive bone marrow which leads to an increase in all cellular elements
Tonsillitis
Inflammation of the tonsils which are masses of lymphoid tissue located in the walls of the oral pharynx.
rheumatic fever
: a febrile systemic disease which normally follows an attack of tonsillitis or strep throat caused by hemolytic streptococci. Usually referred to as an immunological disease because it is interpreted as an allergic reaction to the previous strep infection.
arteritis
inflammation involving an artery which may be a primary disease or associated with other conditions such as rheumatic fever and various bacterial infections.
Esophagitis
inflammation of the esophagus. Can be due to a regurgitation of stomach acids
Congenital Heart Disease
Many heart conditions are congenital as opposed to acquired diseases. Some of the more common conditions involve septal defects or defects in the walls separating the two atria. Results in the mixing of blood between the left and right side of the heart. Blood pressure is usually greater on the left side of the heart and these defects often result in oxygenated blood being shunted through the opening into the right side of the heart, resulting in excess blood being present in these chambers. Septal Defects: may be the result of improper development of the walls of the heart or failure of the closure of the foramen ovale.
Factors that implicate diseases of the the vessels
Stress, Age, Smoking, Lack of exercises, Diet
Stomatitis
the inflammation of the mouth. Can take many forms. Can be from an infection from pathogens, trauma, chemical irritation, burns, tobacco, etc
pericarditis
inflammation of the outer sac of the heart
phlebitis
when the veins of the body become inflamed
fusiform
an aneurysm which results in a "tubular" swelling around the entire circumference of an artery
myocarditis
inflammation of the heart muscle itself
Syphilis
caused by treponema pallidum and affects the heart. Does damage to the aorta and the aortic valve often resulting in aneurisms and aortic insufficiency
pharyngitis
inflammation of the pharynx or throat and may be a primary infection such as strep throat or diphtheria or a complication of another infections such as rhinitis, sinusitis, or influenza
Candida Albicans
fungus which causes inflammation in the oral cavity. It is a fungus which causes thrush, Herpes simplex I (a viral infection commonly seen as cold sores or fever blisters.
Aneurysm
localized weakening and dilation on the wall of an artery.
mitral insufficiency
could result in the left atrium undergoing dilation as a result of the overflow of blood.
hemophilia
hereditary bleeding disorder characterized by a greatly prolonged clotting time for blood. Some can experience a prolonged bleeding time for even small cuts or scrapes. It is referred to as a sex linked inherited disorder because the defective gene is transmitted on the X chromosome. It generally only affects males but is transmitted by females.
endocarditis
an acute fulminating disease where the heart valves and endocardium are rapidly destroyed and death occurs within a few days or weeks. Most commonly occurs as a focal infection which spreads from another body area. Commonly caused by Streptococcus Pyogenes and Staphlococcus Aureus.
Embalming Considerations in Cardiovascular Disease
have a direct impact upon the ultimate success of the embalming operation, pre-injection and co-injection chemicals are often required for their anti-coagulating abilities. Single point injection will not work on people with widespread arteriosclerosis. Must be careful in handling these vessels when they have disorders.
bacterial endocarditis
inflammation of the inner lining of the heart
sub-acute bacterial endocarditis (SBE)
chronic thrombi called vegetations which occur on the valves. The thrombi break loose and become infected emboli which lodge in the vital organs.
blood pressure
refers to the actual pressure exerted upon the walls of the arteries in the body, and it is reflected in a two digit reading. The first number is the systolic pressure which is the arterial pressure which exists at the time the heart muscle is contracting and exerting its maximum pressure upon the vascular walls. The second number is the diastolic pressure, which reflects that pressure within the arteries when the ventricles of the heart are relaxing and filling back up with blood.
Congestive heart failure
general term given to the condition in which the heart is diseased and not able to adequately pump blood to meet the needs of the body. Results in high blood pressure, arteriosclerosis, myocardial and infarction's.
peptic ulcers
ulcers which occur in the stomach and duodenum. derive their name from pepsin
Cardiomyopathy
Disease of the heart muscle and is related to congestive heart failure. It can also accompany infectious diseases, hypertrophy of heart chambers or chronic alcoholism.
erythrocytosis
increase in red blood cells such as in Polycythemia Vera. Results in an increase in blood viscosity, high blood pressure and extra work on the heart
hypertensive heart disease
refers to the various changes which occur in the heart as a result of prolonged pumping against unusual resistance. Usually the resistance is from disease and narrowed peripheral blood vessels and the heart (particularly the left ventricle) is required to pump harder in order to meet the demand which is being placed upon it.
insufficiency and incompetence
term related to diseased valves of the heart. Refer to the inability of the valve to close properly. This allows back flow (regurgitation) of blood.
Section 11
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peritonitis
An infection of the lining membrane of the abdominal cavity. This is a very serious and even fatal issue due to the fact that ulcers may perforate through the walls of the stomach or intestines allowing fecal matter and bacteria to reach the abdominal cavity.
pyloric stenosis
: as the pyloric area of the stomach, and the initial part of the duedenum, are the most common sites for these ulcers to occur, the formation of scar tissue in these areas may result in this.
pleuritis
aka pleurisy, results in severe pain upon breathing due to the fact that the inflamed membranes are rubbing against each other when the chest expands and contracts.
hepatitis
inflammation of the liver and the most common cause of hepatitis are several strains of viruses
Embalming consideration with digestive tract disorders
• infections of the digestive tract can lead to dehydration, rapid blood coagulation and rapid decomposition. • Edema and ascites, also accompanies many digestive diseases as was mentioned under the discussion of cirrhosis. • Closely evaluate the amount of strength. • Jaundice is a condition which needs to be treated carefully with special purpose fluids for jaundice. • Distention can cause swelling in the abdominal area. • You may need to puncture the abdomen to release the pressure and gas buildup in someone who has distension.
polyps
benign tumors which develop on the mucous membranes
tuberculosis
mycobacterium tuberculosis
toxic hepatitis
results from the liver attempting to perform its normal function of detoxifying the bloodstream. Excess quantities of drugs or poisons which enter the blood stream and collect in the liver may result in inflammation and damage to the liver tissue.
asthma
a form of allergy characterized by hypersecretion of mucous and spasm of the bronchial muscles. Some people are overly sensitive to various antigens, such as animal hair or feathers, dusts, certain food products and various other chemicals. These antigenic substances cause abnormal, spasmodic contractions of the musculature in the bronchial passageways. Asthma attacks are characterized by a "wheezing" sound from air passing through these obstructed airways. No Cure for asthma but there are medications available to lessen the symptoms.
Amoebic dysentery
etamobea histolytica
cholecystitis
when the gallbladder becomes inflamed. Often associated with the formation of gallstones
hay fever
common upper respiratory problem ad is described as a form of an allergy. The pollen (antigen) causes the release of a histamine from certain cells in the body. The histamine in turn causes the dilation of the surrounding capillaries which then become "leaky" and secrete excess plasma into the tissues.
Hepatitis B
aka serum Hepatitis: transmitted through contaminated body fluids such as blood or semen. It is more serious than hepatitis A. Can do permanent liver damage.
pneumonia or pneumonitis
inflammation of the lungs, generally with the collection of inflammatory exudates in the alveoli. Can be caused by many organisms including viruses and various types of bacteria.
sinusitis
paranasl sinuses that are involved in infection and inflammation
Edma
the liver fails to produce some of its normal proteins such as albumin, which affects the permeability of the vascular walls, allowing fluid to leak out into the tissues.
colitis
inflammation of the colon (which is the main part of the large intestines)
typhoid fever
salmonella typhi
hemothorax
collection of blood may acompany some infections, wounds, tumors, etc.
common conditions which may lead to intestinal obstructions
◦ Tumors, either from within or from outside causing external pressure ◦ Paralysis: lack of blood or nerve supply to a part of the intestine can paralyze it, resulting from decreased peristalsis, which serves to move the contents along. ◦ Volvulus: a twisting of a loop of the intestines ◦ Intussusception: a slipping, or telescoping, of one segment of intestine into the succeeding one. ◦ Adhesion's: intestine may be distorted and partially obstructed when scar tissue forms and loops of the bowel adhere together where they normally would not do so.
pharyngitis
inflammation of the voice box
Proctitis
inflammation of the rectum
Pancreatitis
: inflammation of the pancreas, and may be either acute or chronic. Sometimes it is associated with gallstone blockages, where bile cannot enter the duodenum and is forced into the pancreatic duct, causing irritation and pancreatic tissues. It is also associated with chronic alcoholism. Many causes are idiopathic (unknown). Can cause necrosis and hemorrhage and in severe cases, death.
pleural effusion or hydrothorax
when fluid is collecting in the pleural cavity and is more watery or edamous in nature.
bronchitis
inflammation of the bronchi. often occurs after another upper respitory tract infection. It is most serious in infants. Symotoms include fever, chest pain and difficulty breathing. Can be caused from smoking, long term exposure to dusts and pollitants.
bacillary dysentery
shigella species
punemothorax
air in the pleural cavity. may result from penetrating wounds from the outside or from ruptured alveoli
influenza
Common viral infection affecting the upper respiratory tract and is characterized by fever, chills, sore throat, runny nose, cough and often muscle pain. It is highly contagious and often occurs in epidemic form. Some cases can be mild or some can be severe or even fatal
tracheitis
inflammation of the trachea
Empyema or Pyothorax
when inflammatory exudates which collect in the pleural cavity are purulent (containing pus) in nature
cirrhosis
: long term degeneration of the functioning cells of the liver, with a proliferation of fibrous connective tissue and scaring
Rhinitis
inflammation of the nasal passages
emphysema
: respiratory disease which can be described as a long term chronic deterioration and destruction of lung tissue. It is not infectious but associated with long term irritation of the respiratory passageways. Often a complication of chronic bronchitis and other respiratory infections, such as smoking and environmental pollutants. Lungs stay filled with carbon monoxide and patients can show a characteristic "barrel chest" due to prolonged labored breathing and constant abnormal expansion of the chest. Patients have a suffocating feeling. It is a debilitating disease and it causes great pain and distress for those suffering from it with each breath they take over the years.
Chronic Obstructive Pulmonary Disease (COPD)
umbrella term encompassing the various conditions which cause long-term interference with the normal respiratory exchange of gases. Emphysema, chronic bronchitis and bronchial asthma are included in this.
food poisoning
staphlyococcus aureus, clostridium perfringens and clostridium botulinum
hepatitis A
aka infectious hepatitis. Form of infection usually transmitted via contaminated food and water supplies
eteritis
escherichia coli and others
enteritis
inflammation of the small intestines
tumors in the digestive system
affect nearly all parts of the digestive system. • Carcinomas affecting the epithelial lining of the alimentary canal are the most common form of cancer in the digestive system. • Carcinomas occur frequently in the lips, mouth area, pharynx, esophagus and stomach. • Carcinomas are less frequent in the small intestines when compared to the colon and rectum. • Colon cancer and rectal cancer are the most common cancers in the digestive system.
cholangitis
: if the bile ducts themselves become inflamed in the gallbladder.
common cold (coryza)
Acute viral infection of the upper respiratory tract. Characterized by congestion, runny nose and eyes, and mild sore throat and fever. There is no cure for the common cold and it does not confer immunity against future colds.
Ascites
edema of the abdominal cavity
atelectasis
collapsed lung. Due to pressure or obstructions of a bronchus. Can be a congenital conditions in which the lungs fail to expand after birth.
lobar pneumonia
one of the more common forms of the disease, and is so named because the infection tends to be localized in one or two lobes of the lung. It is most often a primary one, with the organism streptococcus pneumoniae.
diverticula
small pouch-like structures which protrude into the walls of the intestines. They are somewhat akin of a saccular aneurysm on an artery
Jaundice
: due to the build up of bile pigments in the blood stream which is due to damage of the liver cells
appendicitis
inflammation of the vermiform appendix. an acute infection of the appendix where if it ruptures can be difficult to control and can become fatal
Hepatitis C
Non A Non B Hepatitis
Bronchial Pneumonia or Bronchopneumonia
second main category of pneumonia and is so named because it is primarily an inflammation of the bronchi and bronchioles, which can spread into the lungs. Unlike lobar pneumonia it tends to be more scattered through both lungs and the bronchi occurring in spotty patches and not consolidating in the one or two lobes of the lungs. Caused by pneumococcus and also staphylococcus and other strep's. Often a secondary disease and can complicate other diseases. It is a common nosocomial (hospital) acquired infection. It is a predisposition to chronic recurrences. It does not resolve as well as lobar pneumonia.
diverticulosis
having one or more diverticula
Section 12
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