teske final

Lesions in which there is a complete necrosis (dead) of the epidermis (skin) over the entire target area. Also referred to as a “scald burn”

The depth of the burn- 2nd is more surfaced and the 3rd burns down deep (muscles, nerves, and tissues) and will not come back so you will either have scar tissue or need a skin graft

The shortest time at any given temp that causes complete destruction of the epidermis

• 111 degrees is the lowest possible temp for subcutaneous burning and requires 6 hrs-that is, burning below the skin
• 115 degrees requires 3 hrs
• 118 degrees requires 15 minutes
• 155 degrees requires 1 sec or less
• Exposure to the sun can someone get a 2nd or 3rd
• degree burn? Yes
• 140 degrees is the temp at which hot water heaters are normally set

Its going to start cooling it and your body will gradually get there unless it’s a very bad case

Excessive heat

Excessive cold

home

• (48% rounded) were scald
• burns,

• followed by flame (30%
• rounded)

• About the same as a glove
• burn

• Immersion-Its an even
• pattern at the bottom, some splashing at the top

that’s the cause of the problem

toilet training

• Killing Someone Is Not Easy
• Tom Curtain, 1966-Kills a man in a hotel roomtook about 5 mins

early training they were told to shot twice but now they are taught to empty the gun

• ○ Societal expectations when someone is shot
• ○ Societal expectations when someone else is shot

the physiological processes of dying from a number of diseases,accidents, homicides, and etc

asphyxia

○ The mouth and nostrils are occluded by water

• The mouth and nostrils are occluded by water
• 

Generally will not resist the inhalation of water

• victim will fight by holding his breath until becoming too exhausted
• and hypercarbic to continue. Hypercarbic-depletion of oxygen in the
• blood

• Obstruction
• ○ The air passages then become obstructed—all the way down to the lungs
• ○ Note: near the surface there is the possibility of foaming from the mouth and a vomiting reflex

Itis one of the body’s natural reflex mechanisms.

About 2-3 minutes. When the water first hits the airways-the larynx reflexively goes into spasm and closes off in an effort to present further intake

Decreasing oxygen in the blood and causes the larynx to relax

The water rushes into the lungs and fills them after about 5 mins

It depends, but you can always try to save them

• The water is absorbed into the circulation through the lungs, the blood is diluted; the chemical imbalance is upset resulting in disequilibrium in the blood; red blood cells are destroyed; large amounts of potassium
• are released into the circulation system and a cardiac poison that causes the heart to fibillate

• The process is reversed—
• water leaves the circulation and enters the aviola of the lungs
• The same process as dying from pneumonia

Salt water drowning b/c of the chlorine

• Yes, adipose tissue releases fat- fat is bouyant
• ○ Think of children—especially babies—and fatty tissue ratio
• ○ 10% of Caucasians and Hispanics are natural “sinkers”
• ○ 90% of Blacks are natural “sinkers”

On their side, feet first

no

For example, injuries to the head (cuts, abrasions, etc. may appear to have been inflicted prior to the drowning

• Yes, about 15% of drowning victims are the result of “dry drowning”
• ○ There may be no water in the lungs
• ○ And, of course, the position of drowning victims may vary depending on circumstances

Head first. The head will looked scratched/cut and beat

Yes, about 15 % of drowning victims are the result of “dry drowning”

is a type of inflicted traumatic brain injury that happens when a baby is violently shaken. (National Institute of Neurological Disorders and Stroke

crying

when a spot hits something in contact but diffuse is through the brain

• Earthquake-slow moving back and forth.
• Peak is rapid movement with abrupt stop

Repeated peak acceleration action

• (1) Bridging veins
• (2) Subdural hematoma and bilateral subdural hemotama
• (3) Concussions
• (4) Shearing of brain tissue
• (5) The eye
• Detached retina
• Retinal hemorrhaging
• (6) Fracture Rib head, first rib, clavicle, and other bones
• (7) Diffuse axonal injury

• a. skin-hair on top
• b. skull-blood vessels on top
• c. Dura Mater-subdural hematomas are right below this
• d. Arachnoid
• e. Pia Mater
• f. the brain

Bruising of the brain tissue

normal flow of oxygen to the part of the brain

doesn’t deplete all of the oxygen flow and, in time, the flow of oxygen returns to normal with no serious damage

additional oxygen deletion with successive concussions resulting in depletion of oxygen (ischemia) to the point that the brain matter cannot recover and necrosis (death) occurs.

Most likely to result form Peak acceleration-deceleration forces

when the brain is moving within the skull cavity

Bending and stretching the brain also slams against the wall of the skull

contusions/concussions but can also result in tearing of arteries

a direct blow to the head can also result in rupturing and shearing of the arteries within the brain and the veins in the dura cavity

the rib that’s going to break first is going to be in the front

• 3 stages
• ????

• is a medical term-- “The act or fantasy or engaging in sexual activity with pre-pubertal children as a repeatedly
• preferred or exclusive method of achieving sexual excitement.”

The same definition as pedophilia, except the child has reached puberty.

“A significantly older individual who engages in any type of sexual activity with individuals legally defined as children"

A form of child abuse in which a parent or guardian fabricates or induces illness in a child.

the mother

The caretakers of the children are adept at deceiving medical and mental health professionals

Apnea

• 1. The evidence is usually circumstantial.
• 2. Physicians are not trained to identify.
• 3. Physicians are uncomfortable with the concept of MSBP.
• 4.Judges are reluctant to believe that the condition exists.
• 5. Juries do not want to believe that mothers
• would do such a thing

• 1. Perpetrators who engage in MSBP are often connected, or have been connected to, the medical profession or child care agencies
• 2. The perpetrators research medical symptoms and conditions. They know what they are talking about
• 3. Shopping--perpetrators move around from doctor to doctor, hospital to hospital.
• 4. The children are often coached and become very good at faking and are convincing
• 5. Mortality rates are estimated at about 10 %.

video and voice

• 1.Multidisciplinary team worked together at a hospital
• 2. Emphasis on protecting the child
• 3. When a child was admitted the family member signed a form. Included was permission to use video and sound monitoring
• 4. Security officers monitored the surveillance cameras 24 hours a day.
• 5. If something observed, the floor nurse was notified and immediately went to the room and intervened.
• 6. Most of the cases were referred to this hospital because of the video surveillance and because a physician suspected MSBP.
• 7. A team at the hospital decided that there was a high probability this was a case of MSBP before monitoring.

yes

• 1. Inducers induce the disease or medical condition
• directly.{(Note example given: smothering 1injection of bodily fluid (urine)}

2. Fabricators No inducement of disease or medical condition.--Either creates symptoms by lying or stages the disease. (Note example given: mother vomits and then presents the vomit as coming from the child)

• 1.Apnea/cyanosis
• 2.Undiagnosed persistent symptoms
• 3.Vomiting
• 4.Sepsis
• 5. Behavior problems
• 6. Other

Some of the mothers were overheard coaching their child to display the symptoms.

• 23 confirmed
• 10 fabricators
• 2 inducers
• 11 both
• § 2 of these confirmed by lab drug tests
• § 2 by direct observation
• § 1 confessed when questioned

• ○23 cases confirmed
• ○13 required video monitoring to prove
• ○5 the video monitoring was supportive
• ○5 video monitoring was not necessary

the mother of the child

4

epicac

gaining social attention and social acceptance

yes

Eminem

• A concussion reduces the normal flow of oxygen to that part of the brain. Normally, a single concussion does not deplete all of the oxygen flow and, in time, the flow of oxygen returns to normal with no serious
• damage. Repeated concussions in short intervals results in additional oxygen depletion with eachsuccessive concussion resulting in depletion of oxygen (ischemia) to the point that the brain matter
• cannot recover and necrosis occurs.

• During a concussion, arteries constrict, slowing blood flow to the brain. At the same time, calcium floods the energy-producing portions of brain cells. That calcium
• plays a mean defense, blocking oxygen- and glucose-rich blood from replenishing neurons' energy supply.

• The constriction of arteries increases and additional calcium floods the energy-producing portions of brain
• cells. The flow of oxygen is further depleted and may be reduced completely or sufficiently to the point that cells in this part of the brain die. Remember, necrotic brain cells are not replaced by new brain cells.

During a concussion, arteries constrict, slowing blood flow to the brain. At the same time, calcium floods the energy-producing portions of brain cells. That calcium plays a mean defense, blocking oxygen- and glucose-rich blood from replenishing neurons' energy supply. Brain cells get sluggish, and a concussed athlete who can't focus or suffers from slower reaction times is left more susceptible to a slew of other injuries, including another concussion. A second blow to the head could lead to more arterial constriction and more calcium infusions.

in place of the parents

they intentionally…causes serious bodily injury

• With the intent is to arouse or gratify the sexual desire of any person
• Affirmative defense:
• -Opposite sex, didn’t use duress, force, or threat, was more that 3 yrs older than the victim
• -The child can not give consent

yes

must provide the burden of proof that the child is 17 or younger

• A designated emergency infant care provider shall, with ought a court order, take possession of a child who appears to be 60 days or younger if the child is voluntarily delivered to the provider by the child’s parent and the parent didn’t express an intent to return
• for the child

the report number and/or the police officers name and contact information

immediately

Anyone age 18 or older and it must be reported if you know about it