Last Pathology Test
Terms
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- Used for artifical respiration
- Endotracheal tubes
- endotracheal tubes are placed through the ____ or ___
- nose or mouth
- With Endotracheal Tubes, a ____is inflated to hold in place
- balloon
- Endotracheal tubes are ____above carina
- 5-7 inches
- _____for endotracheal tubes need repositioning after insertion
- 10-20%
- if the endotracheal tube goes into right main bronchus, leads to
- atelectasis of left lung
- if the tube is positioned too high or in the esophagus causes air to enter the stomach what happens?
- severe gastric dilatation or vomiting or aspiration of gastric contents
- why is a CXR done?
-
ensure proper positioning
make certain that the tube has not been displaced by the weight of teh respirator apparatus, patient coughing, or by movement
ensure prompt detection of complications - CVL is used for
- administration of medications of fluids
- CVL are inserted in ____
- subclavian vein or more peripheral vein in the upper extremity
- The optimal locaiton for the Central venous catheter is the
- superior vena cava
- CVL/catheter should be confirmed by CXR and looking for ____
- Px
- PEG tubes are also called ___
- feeding tubes
- how are PEG tubes different from dobjoff tubes?
- PEG tubes go from outside of abdomen into stomach. A Dobhoff goes through the nose into the stomach, so it is very similar to NG.
- PEG tubes are made of
- polyurethane or silicone
- PEG tubes are measured in
- French units
- WHat is sometimes used to determine placement with a KUB with a PEG tube?
- gastrograffin
- used in infant BEs and VCUG's and IVPs and for standard purposes
- foley catheter
- foley catheter is inserted where
- into urinary bladder to drain
- an equivalent of forum
- forens-
- of or belonging to
- ens
- "forensics"
- of or belonging to the forum, public
- Early records of forensic medicine date back _____
- thousands of years ago
- ______is credited with being the first to link the two
- Egyptian pharaoh Imhotep
- _____is a formal medical laws put into practice in ancient Babylon- now Iraq
- Hammurabi Code
- Hammurabi Code was written in ___
- 2200 BC
- Forensic Medicine was used by ___ __ ___
- Greeks, Romans, and ancient Indians
- Forensic Medicine deals with _____
- medical facts and knowledge as it pertains to the law and court systems
- 9 primary disciplines in forensics
-
criminallistics
engineering sciences
jurisprudence
odontology
pathology
physical anthropology
psychiatry
questioned documents
toxicology - what is radiology
- a branch of medicine that uses ionizing radiation to diagnose and treat disease
- Forensic radiology combines the use, interpretation, and reporting of the findings for ___
- admission in legal proceedings in court
- _____discovered x-rays on November 8 1895.
- Wilhelm Roentegen
- Where it all began, was a ____purchased at a market revealed shotgun pellets. The cause of death was not previously known, therefore cause of death was a shooting
- rabbit
- First case using radiograpy
- George Holder v. Tolson Cunning
- When was the first case in radiograpy and what was it?
- christmas eve 1895; (3 days before roentegen submitted his findings) ; gunshot wound to leg.
- WHat happened in the George Holder v. Tolson Cunning case?
- Dr. R.C. Kirkpatrick made a 45 min exposure to reveal a bullet; Cunning recovered; Holder sentenced to 14 years
- The quote to The battle of admissibility is what?
- It's like offering the photograph a ghost
- ____settled the battle of admissibility
- Judge LeFevre
- First Comparison Views
- Sept. 1895: Miss Folliot; a burlesque actress, fell and injured her foot. One month later, she was sent for radiographs of both feet, which revealed a displaced cuboid bone. A charge of contributory negligence was ruled agains Miss Folliot
- First Murder:
- April 23, 1896; Hargreaves Hartley shot his wife, 4 times in his head. then jumped in canal; drowning; Radiographs were made and all four bullets were located; Elizabeth died
- Civil Suits- Cause of Injury
- September 2 1895: Frank Bowling fell from a buggy, fracturing his right ankle. 8 days later, 3 radiographs were made. DDamages were severe enough to warrant amputation of the foot and ankle. Bowling was awarded 10,000.
- Civil Suits_ Used as evidence_ April 1896-
- James Smith v. Dr. W.W. Grant Smith claimed limb shortening and disability due to misdiagnosis of an impacted fracture of his left femoral neck
- Theodore Roosevelt?
- while campaigning for a third term, Mr. Roosevelt was shot in chest. He refused treatment and continued with his campaign speech and greeting. Radiograph revealed a bullet lodged in his rib.
- Hitler?
- badly burned remains were identified by Russians using skull radiographs produced on Sept. 19, 1944. Apparently dental work was distinctive and postive ID. Russians held this secret for 20 years
- JFK
- x rays added to controversy about # of shots, direction of travel, trajectory, and # and location of shooters.
- Later on, Radiographs were made of
-
packages
finerprints
knuckle folds
palmar lines
documents
art
- x-ray fluorescence(bathing the object in radiation, causing it to emit raditation)
- can reveal if the metals in a metal sculpture or if the compostion of pigments is too pure or newer than the supposed age
- Postmortem radiography is usually performed when?
- usually after external examination adn before dissection of the body
- Disadvantages to not using radiographers:
- lack of consistency between antermortem and postmortem images
- Advantages in postmortem radiography
-
patients dont breathe and dont move
exposure times arent a problem
repeats dont harm pt. - Forensic Radiology is used for what?
-
idenification of victim
determining injury
evidence in criminal
evidence in administrative(workmans comp) - what is the difference in radiology vs. anthropology
- radiology uses ionizing radiation to visualize remains and anthropology examines remains or bones by defleshing them and removing any tissues or debris
- using _____would be great in suspected abuse cases because of the detail provided on bones
- cardboard bones
-
Idenification of skeletal features
Animal vs. human - some animal remains may be misidenified as human because of similarities in size and structure.
-
Age
The bony skeleton can begin to be visualized about the _____in utero. Growth continues into early adulthood - 20th week
-
Age
After teh ___or ____year females begin to develop faster than males - 3rd or 4th
-
Age
the last plate to fuse is the _____during the 30's - medial end of the clavicle
-
Age
____-____= the skull sutures and pubic symphysis provide the most info about age - 25 to 50
- ___+= degenerative changes begine to develop in major joints and vertebrae; these changes are in males
- 40
- Age determination is based on ____
- growth plates
-
Sex
___is larger and heavier with more prominent attachments for muscles
The ____femoral head is larger in all directions - male
-
Sex
The ____is the most definitive portion to determine sex - pelvis
-
Sex
Features of the pelvis provide info on the -
gender
age - Sex determination based on ___is less reliable than other methods
- skull
-
Sex
___have a more rounded forehead - females
-
sex
____have larger browns and larger jaws - males
- Using radiography in idenification:
-
fingerprints
dental work
healed fx
surgical scarring
implanted medical devices
frontal sinus patterns
-
Determining cause of death
___vs_____vs____ - accidental, natural, intentional
- Radiography can detect cause of death by detecting ___, ____, ___,___
- PX, pneumoperitoneum, air embolus, fxs
- ___and____people who overthrew the Roman Empire forbid personal vendettas and employed the Wergeld or blood pric , paid to the vicim or the victims family. Fee was greater for higher class and dependent on level of blood shed.
- Germanic and Slavic People
- ___described how to destinguish between drowning and strangulation and how to determine if a person was dead or alive before being burned
- chinese textbook
- Advantages to using radiography with a gunshot are :
-
location of projectile
visulation of multiple bullets of different calibre
angle and direction of fire, trajectory or yaw
may be the first indicator of a crime
- ____accounts for more deaths than murders.
- suicides
- 2/3 of all suicides result from
- firearms
- Disadvantages to using radiography
-
caliber determination is not exact
tandem bullets
not all projectiles fired from a weapon are bullets
typical radiologist lacks experience determining caliber - Using the _____is a good rule of thumb. If the entrance wounds plus the exit wounds plus hte bullet equal an even number then there should not be any projectiles. (One entrance, no exit, should be one bullet in victim) Tandem bullets are an exception. Som
- dkfsljf
- Child abuse can consist of :
-
skeletal
intracranial
visceral
sequential
prenatal
religious - Advantages of radiography with abuse
- detection of metaphyseal injuries, diaphyseal fxs, dislocations, rib fxs., fx of hands and feets, scapulae, vertebrae, facial bones, and skull, and injuries to internal organs ( most commonly the duodenum)
- Disadvantages of radiography with abuse
- misdiagnosis of congenital diseases (osteogenesis imperfecta)
- Disadvantages of using radiography with child abuse
-
multiple films results in more radiation
false allegations against caregiver
misdiagnosis - Non Medical uses of Radiography:
-
Bombs
explosives
drugs
illegal smuggling - virtopsy
- using ct or mri to do the autopsy