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Samenvatting gerechtelijke geneeskunde
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By: lisahoeman63 • 3 year ago
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Gerechtelijke geneeskundeInhoud
Deel I: Basisbegrippen ......................................................................................................................... 5
Definities ............................................................................................................................................ 5
Geschiedenis gerechtelijke geneeskunde .................................................................................... 7
Arts en gerechtelijke geneeskunde .............................................................................................. 10
Elke arts ....................................................................................................................................... 10
Specifieke opdrachten ............................................................................................................... 12
Arts en vaststellen overlijden ........................................................................................................ 15
Dood? ........................................................................................................................................... 15
Geschiedenis :definitie van dood ............................................................................................. 16
Dood registreren ......................................................................................................................... 18
Dood vaststellen: 3 stappen ...................................................................................................... 19
Kritische blik .................................................................................................................................... 23
Toestand anno 2020? .................................................................................................................... 26
Deel II: Plotse dood ............................................................................................................................ 29
Terminologie .................................................................................................................................... 29
Doodsdiagnose ............................................................................................................................... 33
Diagnose ...................................................................................................................................... 33
Identificatie van een lijk .............................................................................................................. 33
Tijdstip overlijden ........................................................................................................................ 36
Schouwing en autopsie (= inwendige schouwing)................................................................. 36
Sudden adult death syndrome (plotse dood) ............................................................................. 41
1.1. Oorzaken .......................................................................................................................... 41
Bijzondere omstandigheden ......................................................................................................... 47
Chronische alcoholieker ............................................................................................................ 47
Alleenwonende ............................................................................................................................ 48
Fysieke inspanning (sport) ........................................................................................................ 48
Agressie of agitatie ..................................................................................................................... 48
Wiegendood of sudden infant death ............................................................................................ 49
Deel III: Postmortale veranderingen ................................................................................................ 52
, Inleiding ............................................................................................................................................ 52
Supravitale verschijnselen......................................................................................................... 52
Postmorale verschijnselen ........................................................................................................ 53
Deel IV: Verstikking ............................................................................................................................ 70
Definiëring ........................................................................................................................................ 70
Fysiopathologie van asfyxie .......................................................................................................... 70
Oorzaken:..................................................................................................................................... 71
Methoden die aanleiding geven tot verstikking .......................................................................... 72
Methoden bij mechanische verstikking.................................................................................... 72
Methoden bij inwendige verstikking ......................................................................................... 82
Symptomen / kenmerken van een verstikking ....................................................................... 84
Deel V: Water en vuur ........................................................................................................................ 86
Verdrinking ....................................................................................................................................... 86
Definitie......................................................................................................................................... 86
Oorzaken primaire verdrinking.................................................................................................. 86
Badetod – oneigenlijke verdrinking .......................................................................................... 87
Karakteristieke postmorale veranderingen van het waterlijk ............................................... 89
Oorzaken van verdrinking ......................................................................................................... 92
Tekens van verdrinking (typisch maar niet specifiek) ........................................................... 95
Onderzoeken van verdrinkingsdood ........................................................................................ 97
Bacterieel onderzoek ................................................................................................................. 99
Deel II: Letsels............................................................................................................................... 100
Thermische letsels .................................................................................................................... 100
Deel VI: Mechanische verwondingen ............................................................................................ 112
Verwonding .................................................................................................................................... 112
Mechanisme van verwondingen ............................................................................................. 112
Ernst van verwonding............................................................................................................... 113
Soorten verwondingen ............................................................................................................. 115
Deel VII: Verkeerstraumatologie .................................................................................................... 131
Inleiding .......................................................................................................................................... 131
Het verkeer en middelengebruik ................................................................................................ 131
Middelen ..................................................................................................................................... 131
De reactietijd.............................................................................................................................. 132
Aard van het letsel ........................................................................................................................ 133
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, De botsing ...................................................................................................................................... 135
Letselbilan: bestuurder en inzittenden Frontale botsing ................................................ 135
Letselbilan: bestuurder en inzittende Zijwaartse botsing ............................................... 136
Letselbilan: bestuurder en inzittenden Staartbotsing ...................................................... 136
Letselbilan: bestuurder en inzittenden Koprol ................................................................. 137
Bescherming.................................................................................................................................. 137
Gordeldracht .............................................................................................................................. 137
Airbag ......................................................................................................................................... 138
Medico-legale aspecten bij auto-ongevallen ............................................................................ 138
Soorten ongevallen....................................................................................................................... 138
Voetgangers .............................................................................................................................. 138
Tweewielers ............................................................................................................................... 141
Treinongevallen......................................................................................................................... 142
Bootongevallen ......................................................................................................................... 142
Vliegtuigongevallen .................................................................................................................. 142
Deel VIII: Ballistiek en traumatologie ............................................................................................. 143
Definities ........................................................................................................................................ 143
De ernst van de verwonding is afhankelijk van het type projectiel: ...................................... 143
Kaliber van patroon .................................................................................................................. 143
Kaliber hagelpatroon ................................................................................................................ 145
Vuurwapens ............................................................................................................................... 145
Factoren die de ernst van de graad van het letsel bepalen ................................................... 146
Letsels door hagelpatronen..................................................................................................... 155
Het schottraject ............................................................................................................................. 157
Zelfmoord vs Moord ..................................................................................................................... 158
Deel IX: Forensische toxicologie .................................................................................................... 160
Inleiding .......................................................................................................................................... 160
Farmacoklinetiek ........................................................................................................................... 160
Opname of absorptie ................................................................................................................ 161
Distributie ................................................................................................................................... 162
Metabolisme / eliminatie .......................................................................................................... 162
Vergiftigingen ................................................................................................................................ 164
Opzettelijke vergiftiging ............................................................................................................ 164
Accidentele vergiftiging ............................................................................................................ 165
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, Medicinale vergiftigingen ......................................................................................................... 166
Psychotrope stoffen...................................................................................................................... 166
Bewustzijnsonderdrukkende ................................................................................................... 167
Bewustzijnsstimulerende (stimulantia) .................................................................................. 168
Bewustzijnsverstorende (Psychedelica / Hallucinogenen) ................................................. 170
Inebriantia (veroorzaken dronkenschap) .............................................................................. 170
Deel XI: Forensische kliniek ............................................................................................................ 176
Inleiding .......................................................................................................................................... 176
Auto-agressie ................................................................................................................................ 176
Kindermishandeling ...................................................................................................................... 177
Lichamelijke mishandeling niet accidenteel trauma ....................................................... 178
Huishoudelijk geweld ................................................................................................................... 182
Oudermishandeling .................................................................................................................. 182
Partnergeweld ........................................................................................................................... 182
Bejaardenmishandeing ............................................................................................................ 182
Seksuele agressie ........................................................................................................................ 182
Verkrachting............................................................................................................................... 183
Documentatie van seksuele agressie .................................................................................... 185
Set seksuele agressie .............................................................................................................. 186
Gevolgen van seksuele agressie ........................................................................................... 187
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