Forensic Clinical Anatomy—Definitions, Methods and Fields

  • Andrea Porzionato
  • Veronica Macchi
  • Marios Loukas
  • Raffaele De Caro
Chapter

Abstract

Forensic Clinical Anatomy may be defined as the practical application of Clinical Anatomy to the ascertainment and evaluation of medico-legal problems. Individual Anatomy (normal anatomy, anatomical variations, age-, disease- or surgery-related modifications) may acquire relevant significance in various fields of Legal Medicine, such as Child Abuse, Sudden Death, Medical Responsibility and/or Liability, Personal Injury and Damage. Anatomical data of forensic interest may arise from the correct application of methods of ascertainment and anatomical methodologies may then be required for further comprehensive analysis. The rigorous interpretation of the anatomical data, derived from ascertainment phase and analysed on the basis of pertinent literature, may be pivotal for the correct application of evaluation criteria in various forensic contexts. Awareness of the relevance of Individual Anatomy should be one of the principles guiding the Clinician to Personalized Medicine; conversely, in Personalized Justice, medico-legal analyses cannot ignore the implications of individual anatomy in terms of ascertainment and evaluation.

References

  1. 1.
    Porzionato A, Macchi V, Massaro L, Morra A, Sarasin G, Rambaldo A, De Caro R (2016) Double origin of the superior cerebellar artery associated with homolateral haemorrhagic infarction of cerebellum. Folia Neuropathol 54:410–417Google Scholar
  2. 2.
    Adachi B (1928) Das Arterien system der Japaner. In: Kyoto (ed) Verlag der Kaiserlich-Japanischen Universitat, Kenyusha Press, KyotoGoogle Scholar
  3. 3.
    Shivaleela C, Suresh BS, Kumar GV, Lakshmiprabha S (2014) Morphological study of the supracondylar process of the humerus and its clinical implications. J Clin Diagn Res 8:1–3CrossRefGoogle Scholar
  4. 4.
    Opanova MI, Atkinson RE (2014) Supracondylar process syndrome: case report and literature review. J Hand Surg Am 39:1130–1135CrossRefPubMedGoogle Scholar
  5. 5.
    Petkar N, Georgalas C, Bhattacharyya A (2007) High-rising epiglottis in children: should it cause concern? J Am Board Fam Med 20:495–496CrossRefPubMedGoogle Scholar
  6. 6.
    Alamri Y, Stringer MD (2014) A high-rising epiglottis: a benign anatomical variant. Clin Anat 24:652–654CrossRefGoogle Scholar
  7. 7.
    Ahmed FJ, Shinohara AL, da Silva SMB, Andreo JC, de Castro Rodrigues A (2014) Visible epiglottis in children. Int J Clin Pediatr Dent 7:223–224CrossRefGoogle Scholar
  8. 8.
    Ross SG, Bolliger SA, Ampanozi G, Oesterhelweg L, Thali MJ, Flach PM (2014) Postmortem CT angiography: capabilities and limitations in traumatic and natural causes of death. Radiographics 34:830–846CrossRefPubMedGoogle Scholar
  9. 9.
    Flach PM, Gascho D, Schweitzer W, Ruder TD, Berger N, Ross SG, Thali MJ, Ampanozi G (2014) Imaging in forensic radiology: an illustrated guide for postmortem computed tomography technique and protocols. Forensic Sci Med Pathol 10:583–606CrossRefPubMedGoogle Scholar
  10. 10.
    Flach PM, Thali MJ, Germerott T (2014) Times have changed! Forensic radiology—a new challenge for radiology and forensic pathology. AJR Am J Roentgenol 202:W325–W334Google Scholar
  11. 11.
    Ruder TD, Thali MJ, Hatch GM (2014) Essentials of forensic post-mortem MR imaging in adults. Br J Radiol 87:20130567CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Grabherr S, Grimm J, Dominguez A, Vanhaebost J, Mangin P (2014) Advances in post-mortem CT-angiography. Br J Radiol 87:20130488CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Grabherr S, Grimm J, Baumann P, Mangin P (2015) Application of contrast media in post-mortem imaging (CT and MRI). Radiol Med 120:824–834CrossRefPubMedGoogle Scholar
  14. 14.
    Bolliger SA, Thali MJ (2015) Imaging and virtual autopsy: looking back and forward. Philos Trans R Soc Lond B Biol Sci 370(1674)Google Scholar
  15. 15.
    Brinkmann B (1999) Harmonization of medico-legal autopsy rules. Committee of Ministers. Council of Europe. Int J Legal Med 113:1–14CrossRefPubMedGoogle Scholar
  16. 16.
    Porzionato A, Macchi V, Da Broi U, Giraudo C, Miotto D, Rodriguez D, Moreschi C, De Caro R (2015) Diffuse pulmonary ossification in permanent vegetative state. Pathol Int 65:27–32CrossRefPubMedGoogle Scholar
  17. 17.
    Hammer U, Boy D, Rothaupt D, Büttner A (2015) Distinction between forensic evidence and dermatological findings. J Forensic Leg Med 33:1–4CrossRefPubMedGoogle Scholar
  18. 18.
    Wiedijk JE, Soerdjbalie-Maikoe V, Maat GJ, Maes A, van Rijn RR, de Boer HH (2016) An accessory skull suture mimicking a skull fracture. Forensic Sci Int 260:e11–e13Google Scholar
  19. 19.
    Porzionato A, Macchi V, Guidolin D, Parenti A, Ferrara SD, De Caro R (2005) Histopathology of carotid body in heroin addiction. Possible chemosensitive impairment. Histopathology 46:296–306CrossRefPubMedGoogle Scholar
  20. 20.
    Guidolin D, Porzionato A, Tortorella C, Macchi V, De Caro R (2014) Fractal analysis of the structural complexity of the connective tissue in human carotid bodies. Front Physiol 5:432CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Macchi V, Snenghi R, De Caro R, Parenti A (2002) Monolateral hypoplasia of the motor vagal nuclei in a case of sudden infant death syndrome. J Anat 200:195–198CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Porzionato A, Macchi V, De Caro R (2009) Sudden infant death syndrome. N Engl J Med 361:2580CrossRefPubMedGoogle Scholar
  23. 23.
    Macchi V, Porzionato A, Guidolin D, Parenti A, De Caro R (2005) Morphogenesis of the posterior inferior cerebellar artery with three-dimensional reconstruction of the late embryonic vertebrobasilar system. Surg Radiol Anat 27:56–60CrossRefPubMedGoogle Scholar
  24. 24.
    Longatti P, Porzionato A, Basaldella L, Fiorindi A, De Caro P, Feletti A (2015) The human area postrema: clear-cut silhouette and variations shown in vivo. J Neurosurg 122:989–995CrossRefPubMedGoogle Scholar
  25. 25.
    Benetazzo L, Bizzego A, De Caro R, Frigo G, Guidolin D, Stecco C (2011) 3D reconstruction of the crural and thoracolumbar fasciae. Surg Radiol Anat 33:855–862CrossRefPubMedGoogle Scholar
  26. 26.
    De Caro R, Parenti A, Montisci M, Guidolin D, Macchi V (2000) Solitary tract nuclei in acute heart failure. Stroke 31:1187–1193CrossRefPubMedGoogle Scholar
  27. 27.
    Porzionato A, Guidolin D, Macchi V, Mazzarolo C Sarasin G, Rambaldo A, De Caro R (2016) High-quality digital 3D reconstruction of microscopic findings in forensic pathology: the terminal pathway of a heart stab wound. IALM Intersocietal Symposium. Oral Communication OP-75, Abstract Book, p 140Google Scholar
  28. 28.
    Weber W (1984) Experimental studies of skull fractures in infants. Z Rechtsmed 92:87–94CrossRefPubMedGoogle Scholar
  29. 29.
    Weber W (1985) Biomechanical fragility of the infant skull. Z Rechtsmed 94:93–101CrossRefPubMedGoogle Scholar
  30. 30.
    Li Z, Liu W, Zhang J, Hu J (2015) Prediction of skull fracture risk for children 0-9 months old through validated parametric finite element model and cadaver test reconstruction. Int J Legal Med 129:1055–1066CrossRefPubMedGoogle Scholar
  31. 31.
    Daniels JK, Lamke JP, Gaebler M, Walter H, Scheel M (2013) White matter integrity and its relationship to PTSD and childhood trauma—a systematic review and meta-analysis. Depress Anxiety 30:207–216CrossRefPubMedGoogle Scholar
  32. 32.
    Guntheroth WG, Spiers PS (2002) The triple risk hypotheses in sudden infant death syndrome. Pediatrics 110:e64CrossRefPubMedGoogle Scholar
  33. 33.
    Porzionato A, Macchi V, Parenti A, Matturri L, De Caro R (2008) Peripheral chemoreceptors: postnatal development and cytochemical findings in sudden infant death syndrome. Histol Histopathol 23:351–365PubMedGoogle Scholar
  34. 34.
    Porzionato A, Macchi V, Parenti A, De Caro R (2009) Morphometric analysis of infant and adult medullary nuclei through optical disector method. Anat Rec 292:1619–1629CrossRefGoogle Scholar
  35. 35.
    Porzionato A, Macchi V, Stecco C, De Caro R (2013) The carotid body in sudden infant death syndrome. Respir Physiol Neurobiol 185:194–201CrossRefPubMedGoogle Scholar
  36. 36.
    Ferrara SD (2013) Medical malpractice and legal medicine. Int J Legal Med 127:541–543CrossRefPubMedGoogle Scholar
  37. 37.
    Ferrara SD, Baccino E, Bajanowski T, Boscolo-Berto R, Castellano M, De Angel R, Pauliukevičius A, Ricci P, Vanezis P, Vieira DN, Viel G, Villanueva E (2013) EALM Working Group on Medical Malpractice. Malpractice and medical liability. European guidelines on methods of ascertainment and criteria of evaluation. Int J Legal Med 127:545–557CrossRefPubMedGoogle Scholar
  38. 38.
    Porzionato A, Macchi V, Fenato F, Parenti A, De Caro R (2008) Femoral nerve injury after gynecologic laparoscopy. J Minim Invasive Gynecol 15:105–107CrossRefPubMedGoogle Scholar
  39. 39.
    Ferrara SD, Baccino E, Boscolo-Berto R, Comandè G, Domenici R, Hernandez-Cueto C, Gulmen MK, Mendelson G, Montisci M, Norelli GA, Pinchi V, Ranavaya M, Shokry DA, Sterzik V, Vermylen Y, Vieira DN, Viel G, Zoja R, Members of the IALM Working Group on Personal Injury and Damage (2016) Padova Charter on personal injury and damage under civil-tort law: medico-legal guidelines on methods of ascertainment and criteria of evaluation. Int J Legal Med 130:1–12CrossRefGoogle Scholar
  40. 40.
    De Caro R, Macchi V, Porzionato A (2009) Promotion of body donation and use of cadavers in anatomical education at the University of Padova. Anat Sci Educ 2:91–92CrossRefPubMedGoogle Scholar
  41. 41.
    Macchi V, Porzionato A, Stecco C, Tiengo C, Parenti A, Cestrone A, De Caro R (2011) Body parts removed during surgery: a useful training source. Anat Sci Educ 4:151–156CrossRefPubMedGoogle Scholar
  42. 42.
    Porzionato A, Macchi V, Stecco C, Mazzi A, Rambaldo A, Sarasin G, Parenti A, Scipioni A, De Caro R (2012) Quality management of body donation program at the University of Padova. Anat Sci Educ 5:264–272CrossRefPubMedGoogle Scholar
  43. 43.
    Riederer BM, Bolt S, Brenner E, Bueno-Lopez JL, Circulescu ARM, Davies DC, De Caro R, Gerrits PO, McHanwell S, Pais D, Paulsen F, Plaisant O, Sendemir E, Stabile I, Moxham BJ (2012) The legal and ethical framework governing body donation in Europe—1st update on current practice. Eur J Anat 16:1–21Google Scholar
  44. 44.
    Lloyd GM, Maxwell-Armstrong C, Acheson AG (2011) Fresh frozen cadavers: an under-utilized resource in laparoscopic colorectal training in the United Kingdom. Colorectal Dis 13:e303–e304Google Scholar
  45. 45.
    Zevin B, Aggarwal R, Grantcharov TP (2012) Simulation-based training and learning curves in laparoscopic Roux-en-Y gastric bypass. Br J Surg 99:887–895CrossRefPubMedGoogle Scholar
  46. 46.
    Polese L, Lezoche E, Porzionato A, Lezoche G, Da Dalt G, Macchi V, Stecco C, De Caro R, Norberto L, Merigliano S (2014) Transanal ileoproctostomy is feasible in human cadavers. Colorectal Dis 16:O367–O369Google Scholar
  47. 47.
    Polese L, Porzionato A, Luisetto R, Mastrogiacomo D, Macchi V, De Caro R, Norberto L, Merigliano S (2016) Roux-en-Y gastrojejunal bypass using a hybrid NOTES-12 mm trocar technique in a porcine model. Minim Invasive Ther Allied Technol 25:86–90CrossRefPubMedGoogle Scholar
  48. 48.
    Porzionato A, Polese L, Lezoche E, Macchi V, Lezoche G, Da Dalt G, Stecco C, Norberto L, Merigliano S, De Caro R (2015) On the suitability of Thiel cadavers for natural orifice transluminal endoscopic surgery (NOTES): surgical training, feasibility studies, and anatomical education. Surg Endosc 29:737–746CrossRefPubMedGoogle Scholar
  49. 49.
    Santos BF, Hungness ES, Boller AM (2011) Development of a feasible transrectal natural orifice transluminal endoscopic surgery (NOTES®) approach in a cadaveric appendectomy model: anterior is better. Surg Endosc 25:3773–3783CrossRefPubMedGoogle Scholar
  50. 50.
    Telem DA, Han KS, Kim MC, Ajari I, Sohn DK, Woods K, Kapur V, Sbeih MA, Perretta S, Rattner DW, Sylla P (2013) Transanal rectosigmoid resection via natural orifice translumenal endoscopic surgery (NOTES) with total mesorectal excision in a large human cadaver series. Surg Endosc 27:74–80CrossRefPubMedGoogle Scholar
  51. 51.
    Bevilacqua M, Fanti G, D’Arienzo M, Porzionato A, Macchi V, De Caro R (2014) How was the Turin Shroud Man crucified? Injury 45 Suppl 6:S142–S148Google Scholar
  52. 52.
    Bevilacqua M, Fanti G, D’Arienzo M, De Caro R (2014) Do we really need new medical information about the Turin Shroud? 45:460–464Google Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2017

Authors and Affiliations

  • Andrea Porzionato
    • 1
  • Veronica Macchi
    • 1
  • Marios Loukas
    • 2
  • Raffaele De Caro
    • 1
  1. 1.Section of Anatomy, Department of NeuroscienceUniversity of PadovaPadovaItaly
  2. 2.Department of Anatomical SciencesSt. George’s UniversityGreat River, West IndiesGrenada

Personalised recommendations