Question 1 of 15 5.0 Points
The pain to the victim following a gunshot wound is limited to which of the following.
A. The heart is most likely to cause excruciating pain if penetrated by a bullet.
B. Pain from a bullet is generally limited to the point of entry on the skin.
C. The head is most likely to feel the bullet because of the bone area involved and the vibration of the bone surface.
D. A bullet striking a kidney has been identified as a painful wound.
Answer Key: B
Question 2 of 15 5.0 Points
Gunpower residue is generally distributed circumferentially around a bullet hole. When more residue is apparent on one side more so than another side of a bullet hole, the weapon is likely to have been fired from what direction.
A. From a distance of 25 feet or more.
B. From the opposite direction of the wound; that is, the back of the wound.
C. From the person's own hand.
D. From a shallow angle.
Answer Key: D
Question 3 of 15 5.0 Points
Which is true of a bullet wound entry?
A. It is always the size of the caliber of the bullet.
B. It tends to be smaller than the caliber of the bullet because of the elasticity in the skin.
C. It tends to be larger than the bullet because of the insult to the skin.
D. It is always the same size of the exit wound.
Answer Key: B
Question 4 of 15 5.0 Points
The term "metallic snow" regarding gunshot wounds refers to which of the following?
A. The scattering of metal fragments along the path of a bullet when it hits a hard surface, such as bone.
B. The ricocheting of a bullet when it hits a impermeable path.
C. The explosion of a bullet when shot in extremely cold weather, such as 20 degrees below Fahrenheit.
D. The explosion of the bullet exposes metallic-colored particles that are absorbed into the bloodstream of the body and show up as rainbow colors when X-rayed.
Answer Key: A
Question 5 of 15 5.0 Points
Firearms are involved in approximately what percentage of homicides in the United States?
A. One-fourth
B. One-third
C. One-half
D. Two-thirds
Answer Key: D
Question 6 of 15 10.0 Points
Define "somatic death" and explain specifically what happens to the body.
According to the website About.com, Definition of Somatic Death (2011)http://dying.about.com/od/glossary/g/somatic.htm Somatic death is characterized by the discontinuance of cardiac activity and respiration, and eventually leads to the death of all body cells from lack of oxygen, although for approximately six minutes after somatic death-a period reffered to as clinical death- a person whose vital organs have not been damaged may be revived. However, achievements of modern biomedical technology have enabled the physician to artificially maintain critical functions for indefinite periods. References: About.com, Definition of Somatic Death (2011)http://dying.about.com/od/glossary/g/somatic.htm
Question 7 of 15 15.0 Points
Describe and discuss the differences between the coroner system and medical examiner systems. Include (a) the history of each, (b) the education requirements for both positions, (c) the duties of each and (d) how each are appointed, elected or selected. Organize your response in a logical fashion so that I can read that you have addressed all parts of the question.
According to the National Association of medical examiners, Medical Examiners and Coroners (2011)
http://thename.org/index.php?option=com_content&task=view&id=98&Itemid=41 states every death investigation jurisdiction is run under the jurisdiction of either a coroner or medical examiner; coroners are usually elected lay individuals who serve a county for a specified term while medical examiners are usually physicians (usually pathologists or forensic pathologists) who are appointed for unspecified terms and who serve a county, group of counties, or a state. According to the National Academies Press (2011)
http://www.nap.edu/openbook.php?record_id=10792&page=26 The major differences between coroners and medical examiners are embedded in the manner of their selection by electoral process versus appointment and their professional status. Coroners are elected lay people who often do not have professional training, whereas medical examiners are appointed and have board-certification in a medical specialty. The coroner system has advantages, but they are heavily outweighed by its disadvantages. The major advantages of the coroner system concern autonomy, access to power, and the ability to represent the will of the electorate. As an elected official, a coroner has the power to make decisions and has equal footing with other local elected officials. That places the coroner in a strong position to withstand political pressures imposed by other elected officials and to compete vigorously for the office’s budget allocation. Furthermore, due to their English common law origins, coroners also have subpoena and inquest powers. Finally, being an elected official resonates with American political culture, which views elected officials as the best representatives of a community’s needs and values. Two important disadvantages are that coroner systems are less likely to be medically proficient and that their structure often reflects piecemeal legislative reaction to inadequacies, rather than intelligent design. The coroner system is steeped in the vagaries of history rather than in a forward-looking, planned system that capitalizes on professional depth and knowledge. Coroner statutes are less specific about which types of cases are reported or investigated, and they tend to reflect the lowest common denominator in the qualifications of the office holder and the quality of investigations. The coroner may be deficient in knowledge and may have conflicts of interest; especially when funeral directors, prosecutors or sheriffs act as coroners. As elected officials, they cannot be dismissed for incompetence, except by the electorate after highly visible transgressions. The website also states The major advantages of a statewide medical examiner system are the quality of death investigations and forensic pathology services and their independence from population size, county budget variation, and politics. Certification of death is accomplished by highly trained medical professionals who can integrate autopsy findings with those from the crime scene and the laboratory. The professionals have core competency in assessing immediate and earlier medical history, interviewing witnesses, and physical examination. The recognized excellence of and confidence in a medical examiner system in Virginia have been vital for adjudicating the state’s death penalty cases and for prompt payment of insurance claims. Another major advantage of a statewide system is uniformity. Virginia’s uniformity comes from its statute covering types of cases automatically in the jurisdiction of the medical examiner. One example, set to take effect in 2003, is automatic referral of all deaths in state mental institutions. High-profile investigations had uncovered abusive practices in the handling of patients in those institutions, which resulted in preventable deaths. Automatic referral to medical examiner offices was instituted by the state legislature to promote more humane treatment and avoid abuses. Uniformity also covers credentialing, training, and continuing education of medical examiners and death investigators; coding of deaths; access to case files through archive and retrieval policies; criteria for exhumation and disposition of unclaimed bodies; and appeals processes. Those features benefit not only death investigations but also public health epidemiology and surveillance. Virginia’s office reports to the legislature each year on child fatalities, family violence, and domestic violence. The state office is striving to set up a new information-technology system that will permit greater access to its data; the goal is to develop a system with great utility not only for criminal prosecutions but also for epidemiologic and surveillance purposes. A final set of advantages of a statewide system are related to central administration. References:National Association of medical examiners, Medical Examiners and Coroners (2011)
http://thename.org/index.php?option=com_content&task=view&id=98&Itemid=41 National Academies Press (2011)
http://www.nap.edu/openbook.php?record_id=10792&page=26 Question 8 of 15 5.0 Points
Identify and define three natural causes of death. Then be sure to include examples of each to show your understanding.
According to our text, Sudden and unexpected deaths occur with a variety of acute and chronic pulmonary disorders and as a result of several different lethal mechanisms. Three natural causes of death would be old age, sickle cell disease, and Chronic Renal Failure. According to our text the best postmortem test for chronic renal failure other than a medical history, is the measurement of urea nitrogen and creatinine in vitreous fluid. Anatomical examination of the kidneys permits the labeling of the type of disease, but is a poor way to judge renal function. Most deaths from chronic renal failure are certified by treating physicians. Occasionally, the medical examiner will investigate deaths which occur during outpatient dialysis; most of these are due to cardiovascular disease. Sickle cell disease is characterized clinically by chronic hemolytic anemia, episodes of abdominal and join pain, recurrent infections and thrombotic events. Infection, hypoxia, acidosis and dehydration can precipitate extensive intravascular sickling in these patients, with resultant sudden death. The occurrence of rapidly fatal intravascular sickling following physical exertion at relatively high altitude has been reported in military personnel with sickle trait. In the postmortem diagnosis of sickle cell disease, the history and circumstances are of more importance than the autopsy findings, since erythrocytes will routinely sickle in formalin. Old age is listed in the International Classification of Diseases and is a competent cause of death for certification purposes. We generally reserve diagnosis for persons over the age of 90 with minimal autopsy findings or no significant medical history. In all, natural causes of death could be lung diseases, old age, heart diseases, and some births. References: Spitz and Fisher's Medicolegal Investigation of Death Guidelines for the application of pathology to crime investigation fourth edition (2006)
Question 9 of 15 15.0 Points
Why should all sudden and unexpected deaths outside a hospital setting be investigated? Discuss as many reasons as you can think of and provide support for your answers. Use paragraphs to organize your answer and examples to show your understanding of the various investigations.
Sudden and unexpected deaths outside a hospital setting should be investigated for many reasons. One being witnesses that are in the hospital for example doctors nurses, and the medical technology that is in the hospital. Anything can happen outside the hospital. For example what may look like a natural heart attack may actually be from a poison that triggers a heart attack, who is to say that the person bringing the victim in saying it is a so called heart attack did not actually poison the individual?
Comment: more detail needed here.
Question 10 of 15 5.0 Points
Distinguish between livor mortis, rigor mortis and algor mortis. First explain how they differ; secondly give an example of each; and third discuss how they are used when examining a death. Clearly organize your answer to include all parts of the question.
According to our text Livor Mortis also known as Postmortem Lividity is a purplish-blue discoloration due to the settling of blood by gravitational forces within dilated, toneless capillaries of the deceased's skin. Livor Mortis is seen in the dependent areas on the back if the body was in a supine position, and on the face and front if the body remained prone. Livor Mortis may be evident as early as twenty minutes after death or may become apparent after several hours. Lividity is caused by the cessation of the hearts pumping action, which allows the red and white blood cells to separate. The red cells then settle into the lowest parts. A dead man found lying on his back will exhibit lividity on his back. If it appears elsewhere, that means the body was moved since death. Discolored skin that blanches when touched indicates that lividity has not yet set in permanently and the death was more than two hours earlier but probably not as long as ten. Some deaths will have different appearances because substances such as carbon monoxide keep the blood a bright red color, and bodies that have lost a lot of blood will not discolor. Reference: Spitz and Fisher's Medicolegal Investigation of Death Guidelines for the application of pathology to crime investigation fourth edition (2006) Rigor Mortis is when the joints of the body stiffen and become locked in place. Depending on temperature and other conditions, rigor mortis becomes apparent within half an hour to an hour, increases progressively to a maximum within twelve hours, remains for about ten or twelve hours and then progressively disappears within the following twelve hours. The phenomenon is caused by the skeletal muscles partially contracting. The muscles are unable to relax, so the joints become fixed in place. More specifically, what happens is that the membranes of muscle cells become more permeable to calcium ions. Living muscle cells expend energy to transport calcium ions to the outside of the cells. The calcium ions that flow into the muscle cells promote the cross bridge attachment between actin and myosin, two types of fibers that work together in muscle contraction. The muscle fibers ratchet shorter and shorter until they are fully contracted or as long as the neurotransmitter acetylcholine and the energy molecule adenosine triphosphate (ATP) are present. However, muscles need ATP in order to release from a contracted state. ATP reserves are quickly exhausted from the muscle contraction and other cellular processes. This means that the actin and myosin fibers will remain linked until the muscles themselves start to decompose. Rigor mortis can be used to help estimate time of death. The onset of rigor mortis may range from 10 minutes to several hours, depending on factors including temperature. Maximum stiffness is reached around 12-24 hours post mortem. Facial muscles are affected first, with the rigor then spreading to other parts of the body. The joints are stiff for 1-3 days, but after this time general tissue decay and leaking lysosomal intracellular digestive enzymes will cause the muscles to relax. Reference: Spitz and Fisher's Medicolegal Investigation of Death Guidelines for the application of pathology to crime investigation fourth edition (2006) According to our text Algor Mortis is when postmortem body temperature declines progressively until it reaches the ambient temperature. Under average conditions, the body cools at a rate of 2.0F to 2.5F per hour during the first hours and slower thereafter, with an average loss of 1.5F to 2F during the first twelve hours and 1F for the next twelve to eighteen hours. The final slowing of the rate of cooling is attributed to the reduced gradient between body temperature and ambient temperature. Careful studies under controlled conditions have shown that the decrease in the postmortem temperature is not rectilinear but sigmoid in shape with a plateau at the beginning and at the end of the cooling process. References:Spitz and Fisher's Medicolegal Investigation of Death Guidelines for the application of pathology to crime investigation fourth edition (2006)
Question 11 of 15 5.0 Points
SFI found on the forearms and hands; or on the legs and feet, indicate which of the following?
A. The attacker was aiming for the victim's feet.
B. The attacker was not a good aim.
C. The victim was defending himself or herself.
D. The victim was likely unconscious.
Answer Key: C
Question 12 of 15 5.0 Points
Weapons of attack in SFI are often identified by which of the following?
A. The handle, tip of the weapon, type of blade, length of blade and width of instrument.
B. b. Brand name on the blade
C. Types of weapons found in the victims home.
D. Location of the wounds on the victim's body.
Answer Key: A
Question 13 of 15 5.0 Points
A shot in the back of the head indicates what.
A. The victim's spouse was likely the perpetrator.
B. Suspicion of homicide.
C. The person had long arms and was able to shoot himself in the back of the head.
D. The victim was defending himself in a house invasion.
Answer Key: B
Question 14 of 15 5.0 Points
The spread of the soot and gunpowder around a bullet hole and the density of the material contribute to determining which of the following?
A. Age of the weapon
B. Range of fire
C. Emotional condition of the perpetrator
D. The toughness of the victim's skin
Answer Key: B
Question 15 of 15 5.0 Points
Beveling bullet wounds are most likely found in what part of the body?
A. Skull
B. Hip bone
C. Hands
D. Femur Bone
Answer Key: A
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