CONTENTSjamespublishing.com/wp-content/uploads/toc/mev-contents.pdf · Chapter 6 Respiratory System §6-1 Thorax and Pleural Cavities §6-2 Pharynx, Larynx, Trachea, and Bronchi §6-2.1

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Part IA clinical atlas

Chapter 1 Anatomical Terminology§1-1 Position, Movement, and Location

§1-1.1 Anatomical Position§1-1.2 Regions of the Body§1-1.3 Directional Terms§1-1.4 Terms Denoting Movements

§1-2 Prefixes, Suffixes, and Abbreviations§1-2.1 Prefixes of Direction§1-2.2 Prefixes of Number§1-2.3 Miscellaneous Suffixes§1-2.4 Abbreviations

Chapter 2 Organization of the BoDY§2-1 Cell

§2-1.1 Nucleus and DNA§2-1.2 Mitochondria and Mitochondrial DNA§2-1.3 Intracellular Membranes§2-1.4 Cell Division

§2-2 Types of Tissue§2-2.1 Epithelium§2-2.2 Connective Tissue

§2-3 Organs and Systems

Chapter 3 Skeletal System§3-1 Skeletal Tissue

§3-1.1 Bone§3-1.1.1 Long Bones§3-1.1.2 Irregular Bones

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§3-1.2 Cartilage§3-1.3 Joints

§3-2 Axial Skeleton§3-2.1 Skull

§3-2.1.1 Skull Cap§3-2.1.2 Facial Skeleton§3-2.1.3 Teeth

§3-2.2 Spine or Vertebral Column§3-2.2.1 Cervical Vertebrae and Ligaments§3-2.2.2 Thoracic Vertebrae, Ribs, and Sternum§3-2.2.3 Lumbar Vertebrae§3-2.2.4 Sacrum and Coccyx

§3-3 Appendicular Skeleton§3-3.1 Upper Limb Skeleton

§3-3.1.1 Clavicle, Scapula, and Shoulder§3-3.1.2 Arm and Elbow Joint§3-3.1.3 Distal Forearm Bones, Hand, and Wrist

§3-3.2 Pelvis and Lower Limb Skeleton§3-3.2.1 Pelvis and Hip Joint§3-3.2.2 Thigh, Leg, and Knee Joint§3-3.2.3 Ankle Joint and Foot

Chapter 4 Muscular System§4-1 Smooth Muscle§4-2 Striated Muscle

§4-2.1 Muscles of the Head and Neck§4-2.1.1 Muscles of Facial Expression§4-2.1.2 Muscles for Chewing (Mastication)§4-2.1.3 Large Superficial Neck Muscles§4-2.1.4 Small Neck Muscles§4-2.1.5 Tongue§4-2.1.6 Eye Muscles

§4-2.2 Selected Muscles That Move the Shoulder§4-2.3 Selected Muscles of the Arm and Forearm

§4-2.3.1 Muscles of the Arm§4-2.3.2 Major Forearm Muscles

§4-2.4 Intrinsic Hand Muscles§4-2.4.1 Muscles of the Little Finger (Digiti Minimi)§4-2.4.2 Muscles of the Thumb (Pollex)§4-2.4.3 Other Intrinsic Hand Muscles

§4-2.5 Muscles of the Trunk§4-2.6 Selected Gluteal and Thigh Muscles

§4-2.6.1 Gluteal (Buttocks) Muscles§4-2.6.2 Thigh Muscles

§4-2.7 Selected Muscles of the Leg and Foot§4-2.7.1 Anterior Leg Muscles§4-2.7.2 Posterior Leg (Calf) Muscles§4-2.7.3 Lateral Leg Muscles

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Chapter 5 Cardiovascular System§5-1 Heart§5-2 Blood Vessels

§5-2.1 Arteries§5-2.2 Veins§5-2.3 Capillaries

§5-3 Blood Cells§5-4 Lymphatics and Lymphoid Tissue

§5-4.1 Lymph§5-4.2 Lymph Nodes§5-4.3 Spleen and Thymus

Chapter 6 Respiratory System§6-1 Thorax and Pleural Cavities§6-2 Pharynx, Larynx, Trachea, and Bronchi

§6-2.1 Pharynx§6-2.2 Larynx§6-2.3 Trachea§6-2.4 Bronchi

§6-3 Lungs

Chapter 7 Gastrointestinal System§7-1 Mouth and Tongue§7-2 Esophagus and Stomach§7-3 Abdominal Cavity§7-4 Small Intestine§7-5 Large Intestine§7-6 Blood Vessels, Lymphatics, and Nerves

§7-6.1 Arteries§7-6.2 Veins§7-6.3 Abdominal Lymphatics§7-6.4 Abdominal Nerves

§7-7 Liver, Gallbladder, and Pancreas§7-7.1 The Liver§7-7.2 Gallbladder and Biliary Duct System§7-7.3 Pancreas

Chapter 8 Female Reproductive System§8-1 Uterus, Uterine Tubes, and Ovaries§8-2 Vagina, External Genitals, and Perineum§8-3 Breasts

Chapter 9 Male Reproductive System§9-1 External Genitals: Penis, Scrotum, and Testicles§9-2 Internal Male Sexual Organs: Prostate and Seminal Vesicles

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Chapter 10 Male and Female Urinary System

Chapter 11 Central Nervous System§11-1 Overview of the Nervous System§11-2 Brain

§11-2.1 Cerebral Hemispheres§11-2.1.1 Major Lobes§11-2.1.2 Interior of the Cerebral Hemispheres

§11-2.2 Diencephalon§11-2.3 Cerebellum§11-2.4 Brain Stem§11-2.5 Blood Vessels and Cerebrospinal Fluid

§11-2.5.1 Arteries§11-2.5.2 Veins§11-2.5.3 Cerebrospinal Fluid

§11-2.6 Meninges of the Brain§11-3 Spinal Cord

§11-3.1 General Structure§11-3.2 Blood Supply and Drainage of the Spinal Cord§11-3.3 Meninges of the Spinal Cord

Chapter 12 Peripheral Nervous System§12-1 Cranial Nerves

§12-1.1 General Features§12-1.2 Applied Anatomy of the Cranial Nerves

§12-1.2.1 Olfactory Nerve (CN I)§12-1.2.2 Optic Nerve (CN II)§12-1.2.3 Oculomotor Nerve (CN III)§12-1.2.4 Trochlear Nerve (CN IV)§12-1.2.5 Trigeminal Nerve (CN V)§12-1.2.6 Abducens Nerve (CN VI)§12-1.2.7 Facial Nerve (CN VII)§12-1.2.8 Vestibulocochlear Nerve (CN VIII)§12-1.2.9 Glossopharyngeal Nerve (CN IX)§12-1.2.10 Vagus Nerve (CN X)§12-1.2.11 Accessory Nerve (CN XI)§12-1.2.12 Hypoglossal Nerve (CN XII)

§12-2 Special Senses:Vision, Hearing, Olfaction, and Taste§12-2.1 Eye

§12-2.1.1 Iris§12-2.1.2 Lens§12-2.1.3 Retina§12-2.1.4 Muscles of the Eye

§12-2.2 Ear§12-2.2.1 Organ of Hearing§12-2.2.2 Balance

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§12-2.3 Tongue and Sensation of Taste§12-2.4 Sense of Smell

§12-3 Spinal Nerves§12-3.1 General Features§12-3.2 Plexuses

§12-3.2.1 Cervical Plexus§12-3.2.2 Brachial Plexus§12-3.2.3 Lumbar Plexus§12-3.2.4 Sacral Plexus

§12-4 Autonomic Nervous System§12-4.1 General Features§12-4.2 Sympathetic Part of the Autonomic System§12-4.3 Parasympathetic Part of the Autonomic System

Chapter 13 Endocrine System§13-1 Pituitary Gland§13-2 Thyroid Gland§13-3 Pancreas§13-4 Adrenal Glands§13-5 Testicles§13-6 Ovaries

Chapter 14 Integument§14-1 Skin Structure§14-2 Hair and Nails§14-3 Burn Injuries

Chapter 15 Embryology—Development and Birth§15-1 Fertilization, Implantation, and the Placenta

§15-1.1 General Structure of the Placenta§15-1.2 Fetal Membranes§15-1.3 Amniotic Fluid§15-1.4 Placental Abnormalities

§15-2 Embryo and Fetus§15-2.1 Embryonic Period§15-2.2 Fetal Period

§15-3 Birth§15-3.1 Maternal Factors§15-3.2 Fetal Factors§15-3.3 Progression of Normal Birth

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Part IIpersonal injury cases

CHAPTER 16 Head and Neck§16-1 Case 1: Epidural Hematoma After Blunt Cranial Trauma

§16-1.1 Fact Summary§16-1.2 Clinical Discussion§16-1.3 Forensic Questions and Answers§16-1.4 Glossary§16-1.5 Additional Reading

§16-2 Case 2: Facial Laceration, Blunt Cervical Trauma, and Jaw Fracture§16-2.1 Fact Summary§16-2.2 Clinical Discussion

§16-2.2.1 Innervation and Muscles Affected§16-2.2.2 Vasculature Affected§16-2.2.3 Mandible§16-2.2.4 Parotid Gland and Duct

§16-2.3 Forensic Questions and Answers§16-2.4 Glossary§16-2.5 Additional Reading

§16-3 Case 3: Cervical Hyperflexion/Hyperextension (Whiplash)§16-3.1 Fact Summary§16-3.2 Clinical Discussion

§16-3.2.1 Neck Muscles§16-3.2.2 Cervical Nerves and Blood Vessels


§16-3A Case 3A: Cervical Hyperextension/Hyperflexion Injury (Whiplash),Low Impact Collision

§16-3A.1 Fact Summary§16-3A.2 Medical Report§16-3A.3 At Issue§16-3A.4 Forensic Discussion§16-3A.5 Additional Reading

§16-4 Case 4: Midface Fracture (Le Fort I) With Orbital and Dental Fractures§16-4.1 Fact Summary§16-4.2 Clinical Discussion

§16-4.2.1 Anatomical Relationships of the Orbits and Maxillary Sinuses§16-4.2.2 Maxilla and Palate§16-4.2.3 Teeth


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§16-5 Case 5: Eye Injury Due to Penetration by Air Gun Pellet§16-5.1 Fact Summary§16-5.2 Clinical Discussion§16-5.3 Forensic Questions and Answers§16-5.4 Glossary§16-5.5 Additional Reading

§16-6 Case 6: Brain Injury Due to Small Caliber Gunshot Wound§16-6.1 Fact Summary§16-6.2 Clinical Discussion§16-6.3 Forensic Questions and Answers§16-6.4 Glossary§16-6.5 Additional Reading

§16-7 Case 7: Burst (Jefferson) Fracture of First Cervical Vertebra§16-7.1 Fact Summary§16-7.2 Diagnosis§16-7.3 Clinical Discussion

§16-7.3.1 The Occipital Condyles§16-7.3.2 The Atlas (C1)§16-7.3.3 The Axis (C2)§16-7.3.4 The Atlanto-Occipital Joint§16-7.3.5 The Atlantoaxial Joint§16-7.3.6 The Jefferson Fracture

§16-7.4 Treatment§16-7.5 Prognosis§16-7.6 Forensic Questions and Answers§16-7.7 Glossary§16-7.8 Additional Reading

§16-8 Case 8: Fracture of Larynx and Hyoid Bone Following An Accident§16-8.1 Fact Summary§16-8.2 Clinical Discussion

§16-8.2.1 Common Injury in Auto Accidents§16-8.2.2 Anatomy of Larynx and Hyoid Bone§16-8.2.3 Emergency Tracheotomy

§16-8.3 Treatment§16-8.3.1 Surgical Repair

§16-8.4 Prognosis§16-8.5 Forensic Questions and Answers§16-8.6 Glossary§16-8.7 Additional Reading

§16-9 Case 9: External Ear Injury§16-9.1 Fact Summary§16-9.2 Diagnosis§16-9.3 Clinical Discussion

§16-9.3.1 Basic Points§16-9.3.2 Nerve Supply of External Ear

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§16-9.3.3 Blood Supply§16-9.3.4 Function


§16-10 Case 10:Tongue Laceration Due to Automobile Collision§16-10.1 Fact Summary§16-10.2 Diagnosis§16-10.3 Clinical Discussion

§16-10.3.1 Function§16-10.3.2 General Anatomy of Tongue

§16-10.3.2.1 Covering and Surface Features§16-10.3.2.2 Nerves

§16-10.3.3 Tongue Muscles and Movements§16-10.3.4 Blood Supply


§16-11 Case 11: Facial Laceration from a Dog Attack§16-11.1 Fact Summary§16-11.2 Diagnosis§16-11.3 Clinical Discussion

§16-11.3.1 The Scalp§16-11.3.1.1 Overview§16-11.3.1.2 Nerve Supply of Scalp

§16-11.3.2 Facial Structures Involved in This Case§16-11.3.2.1 Facial Soft Tissue§16-11.3.2.2 Facial Blood Vessels

§16-11.3.3 Facial Nerves§16-11.3.4 Facial Muscles§16-11.3.5 The Lips§16-11.3.6 Parotid Gland

§16-11.4 General Considerations§16-11.5 Treatment§16-11.6 Prognosis§16-11.7 Forensic Questions and Answers§16-11.8 Glossary§16-11.9 Additional Reading

§16-12 Case 12: Nasal Fracture§16-12.1 Fact Summary§16-12.2 Diagnosis

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§16-12.3 Clinical Discussion§16-12.3.1 Overview§16-12.3.2 Nasal Skeleton§16-12.3.3 Blood Supply of the Nasal Cavity§16-12.3.4 Nerve Supply to the Nose§16-12.3.5 Nasal Fracture


§16-13 Case 13: Fracture of Central Incisors and Lip Laceration§16-13.1 Fact Summary§16-13.2 Diagnosis§16-13.3 Clinical Discussion

§16-13.3.1 Overview§16-13.3.2 Anatomy of Teeth

§16-13.4 Treatment§16-13.4.1 Basic Points§16-13.4.2 Avulsed Tooth Treatment§16-13.4.3 Fractured Tooth Treatment§16-13.4.4 Lip Laceration


§16-14 Case 14: Myofascial Strain§16-14.1 Fact Summary§16-14.2 Medical Report§16-14.3 Clinical Discussion

§16-14.3.1 Anatomy§16-14.3.2 Pathopshysiology§16-14.3.3 Clinical Features§16-14.3.4 Prognosis§16-14.3.5 Chronic Pain After “Whiplash”

§16-14.4 Forensic Questions and Answers§16-14.5 Additional Reading

§16-15 Case 15: Cervical Spine Injury Playing Football Exacerbated by Removal of Helmet§16-15.1 Fact Summary§16-15.2 Diagnosis§16-15.3 Clinical Discussion

§16-15.3.1 Overview of Injury§16-15.3.2 The Cervical Spine§16-15.3.3 Spinal Discs and Ligaments§16-15.3.4 Blood Supply to Cervical Spinal Cord

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§16-15.3.5 The Architecture of the Spinal Cord§16-15.3.6 Sensory Parts of Spinal Cord§16-15.3.7 Motor Part of Spinal Cord


§16-16 Case 16: Radical Neck Dissection for Cancer Removal§16-16.1 Fact Summary§16-16.2 Diagnosis§16-16.3 Clinical Discussion

§16-16.3.1 Surgical Anatomy of Neck§16-16.3.1.1 Anterior Triangle§16-16.3.1.2 Posterior Triangle (Lateral Neck)

§16-16.3.2 Lymphatics of Neck


§16-17 Case 17: Broca’s Aphasia§16-17.1 Fact Summary§16-17.2 Diagnosis§16-17.3 Clinical Discussion

§16-17.3.1 Broca’s Area§16-17.3.2 Aphasia§16-17.3.3 Broca’s Aphasia


§16-18 Case 18: Coup-Contracoup Injury§16-18.1 Fact Summary§16-18.2 Diagnosis§16-18.3 Clinical Discussion

§16-18.3.1 Contusion§16-18.3.2 Coup Injury§16-18.3.3 Contracoup§16-18.3.4 Subdural Hematoma

§16-18.4 Treatment§16-18.5 Forensic Questions and Answers§16-18.6 Glossary§16-18.7 Additional Reading

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§16-19 Case 19: Death by Exsanguination From Chainsaw Wound to Cervical Region§16-19.1 Fact Summary§16-19.2 Diagnosis §16-19.3 Clinical Discussion

§16-19.3.1 Overview §16-19.3.2 Anatomy of the Injury§16-19.3.3 Layer One: The Platysma and the External Jugular Vein§16-19.3.4 Layer Two: The Sternocleidomastoid Muscle and Associated Structures§16-19.3.5 The Carotid Sheath and Its Contents

§16-19.4 Forensic Questions and Answers§16-19.5 Glossary§16-19.6 Further Reading

§16-20 Case 20: Death Due to a Law Enforcement Officer’s Choke Hold§16-20.1 Fact Summary§16-20.2 Diagnosis§16-20.3 Clinical Discussion

§16-20.3.1 Overview§16-20.3.2 General Anatomy of the Neck§16-20.3.3 The Pertinent Musculature of the Neck §16-20.3.4 The Carotid Arteries§16-20.3.5 The Carotid Sinus§16-20.3.6 The Vertebral and the Basilar Arteries§16-20.3.7 The Internal Jugular Vein§16-20.3.8 Application of a Rear Choke Hold§16-20.3.9 Forensic Issues


§16-21 Case 21: Death Due to Precipitous Drop in Cerebrospinal fluid Pressure Caused by aLumbar Spinal Tap

§16-21.1 Fact Summary§16-21.2 Diagnosis§16-21.3 Clinical Discussion

§16-21.3.1 Overview§16-21.3.2 General Anatomy of the Posterior Cranial Fossa§16-21.3.3 The Cerebellum§16-21.3.4 The Brainstem§16-21.3.5 The Cerebrospinal Fluid and the Ventricles of the Brain and Brainstem§16-21.3.6 Lumbar Puncture §16-21.3.7 Herniation of the Cerebellum §16-21.3.8 Brain Meningioma


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§16-22 Case 22:Tongue Piercing and Myocarditis§16-22.1 Fact Summary§16-22.2 Diagnosis§16-22.3 Clinical Discussion

§16-22.3.1 General Anatomy of the Tongue§16-22.3.2 Bacterial Infection§16-22.3.3 Myocarditis§16-22.3.4 Treatment

§16-22.4 Questions and Answers§16-22.5 Glossary§16-22.6 Additional Reading

CHAPTER 17 Limbs and Lower Spine§17-1 Case 1: Accidental Amputation of Upper Limb at Midforearm


§17-2 Case 2: Brachial Plexus Injury Due to Bicycle Accident§17-2.1 Fact Summary§17-2.2 Clinical Discussion

§17-2.2.1 Surgical Approach§17-2.2.2 Arthrodesis§17-2.2.3 Brachial Plexus Repair§17-2.2.4 Brachial Plexus Deficits Due to C5 and C6 Injury


§17-3 Case 3: Carpal Tunnel Syndrome§17-3.1 Fact Summary§17-3.2 Clinical Discussion

§17-3.2.1 Median Nerve§17-3.2.2 Surgical Procedure


§17-3A Case 3A: Carpal Tunnel Syndrome: Personal Injury or Workers’ Compensation?§17-3A.1 Fact Summary§17-3A.2 Medical Report§17-3A.3 Clinical Discussion

§17-3A.3.1 Anatomy§17-3A.3.2 Pathophysiology§17-3A.3.3 Clinical Effects of Median Nerve Compression in Carpal Tunnel (CTS)

§17-3A.4 Diagnosis

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§17-3A.5 Treatment§17-3A.5.1 Conservative Treatment§17-3A.5.2 Surgical Treatment

§17-3A.5.2.1 Decompression of Carpal Tunnel§17-3A.5.2.2 Post-Operative Care and Treatment§17-3A.5.2.3 Note re: Surgical Neurolysis of Median Nerve

§17-3A.6 Prognosis§17-3A.7 Forensic Questions and Answers§17-3A.8 Additional Reading

§17-4 Case 4: Lumbar Intervertebral Disc Herniation From Lifting§17-4.1 Fact Summary§17-4.2 Clinical Discussion

§17-4.2.1 Peripheral Nerves in Lumbar Spine Injury§17-4.2.2 Lumbar Discectomy


§17-4A Case 4A: Low Back & Radiating Pain After MVA§17-4A.1 Fact Summary§17-4A.2 Medical Report§17-4A.3 At Issue§17-4A.4 Clinical Discussion

§17-4A.4.1 Lumbar Disc Herniation at L5/S1§17-4A.4.2 Significance of MRI Findings§17-4A.4.3 Correlation Between Clinical Finding and MRI Finding

§17-4A.4.3.1 Analysis§17-4A.4.3.2 Application to Ms. Smith

§17-4A.4.4 Symptom Magnification/Malingering§17-4A.4.5 Pain Behavior§17-4A.4.6 Other Diagnoses That Manifest With Sciatica

§17-4A.4.6.1 Sacroiliac Joint Strain/Dysfunction§17-4A.4.6.2 Piriformis Syndrome

§17-4A.5 Additional Reading§17-5 Case 5: Degloving and Crushing Injury of the Lower Limb: A Railroad Accident

§17-5.1 Fact Summary§17-5.2 Clinical Discussion

§17-5.2.1 Muscular Injuries§17-5.2.2 Vascular Injuries§17-5.2.3 Neural Injury§17-5.2.4 Degloving of the Limb


§17-6 Case 6: Hip Fracture§17-6.1 Fact Summary§17-6.2 Clinical Discussion

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§17-6.2.1 Hip Replacement Surgery§17-6.2.2 Muscular and Neurovascular Relationships


§17-7 Case 7: Patellar Tendon Disruption§17-7.1 Fact Summary§17-7.2 Clinical Discussion§17-7.3 Forensic Questions and Answers§17-7.4 Glossary§17-7.5 Additional Reading

§17-8 Case 8: Anterior Cruciate Ligament Rupture§17-8.1 Fact Summary§17-8.2 Clinical Discussion§17-8.3 Forensic Questions and Answers§17-8.4 Glossary§17-8.5 Additional Reading

§17-9 Case 9: Multiple Leg Fractures: A Bicycle-Automobile Accident§17-9.1 Fact Summary§17-9.2 Clinical Discussion§17-9.3 Forensic Questions and Answers§17-9.4 Glossary§17-9.5 Additional Reading

§17-10 Case 10: Avascular Necrosis of Femoral Head in Child§17-10.1 Fact Summary§17-10.2 Diagnosis

§17-10.2.1 The Differential Diagnosis§17-10.2.1.1 Femoral Neck Fracture§17-10.2.1.2 Slipped Capital Femoral Epiphysis§17-10.2.1.3 Leg-Calve-Perthes Syndroginous

§17-10.3 Clinical Discussion§17-10.3.1 Development of Hip and Femur§17-10.3.2 Gross and Vascular Anatomy of the Hip

§17-10.3.2.1 Bony Elements§17-10.3.2.2 Blood Supply

§17-10.3.3 Hip Dislocation in Children


§17-11 Case 11: Compound Fracture of Distal Third of Humerus With Subsequent RadialNerve Palsy

§17-11.1 Fact Summary§17-11.2 Diagnosis

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§17-11.3 Clinical Discussion§17-11.3.1 The Humerus§17-11.3.2 The Radial Nerve§17-11.3.3 Impairment Due to Radial Nerve Injury§17-11.3.4 The Deep Brachial Artery and the Brachial Artery§17-11.3.5 Other Structures That May Be Damaged by Fracture of Distal Humerus

§17-11.3.5.1 Median Nerve§17-11.3.5.2 Ulnar Nerve

§17-11.4 Treatment§17-11.4.1 Repair of Fracture§17-11.4.2 Possible Nerve Repairs§17-11.4.3 Tendon Transfer for Radial Nerve Palsy§17-11.4.4 Post-Operative Treatment


§17-12 Case 12: Fracture of Lateral Malleolus§17-12.1 Fact Summary§17-12.2 Diagnosis§17-12.3 Clinical Discussion

§17-12.3.1 The Ankle: A “Mortise and Tenon” Joint§17-12.3.1.1 Ankle Bones§17-12.3.1.2 Ligaments§17-12.3.1.3 Muscles

§17-12.3.2 Ankle Sprain§17-12.3.2.1 Inversion Sprain§17-12.3.2.2 Other Types of Sprains


§17-13 Case 13: Calcaneal Fracture§17-13.1 Fact Summary§17-13.2 Diagnosis§17-13.3 Clinical Discussion

§17-13.3.1 Anatomy of the Calcaneus§17-13.3.1.1 Calcaneus§17-13.3.1.2 Talus§17-13.3.1.3 Talocalcaneal Joint

§17-13.3.2 Blood and Nerve Supply of Calcaneal Region§17-13.3.3 Mechanics of Calcaneal Fracture§17-13.3.4 Classification of Fractures

§17-13.4 Treatment§17-13.5 Prognosis

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§17-14 Case 14: Crushed Foot§17-14.1 Fact Summary§17-14.2 Diagnosis§17-14.3 Clinical Discussion

§17-14.3.1 Common Injury§17-14.3.2 Skeletal Anatomy--Overview§17-14.3.3 Metatarsals§17-14.3.4 Metatarsal Fractures§17-14.3.5 Compartment Syndrome


§17-15 Case 15: Cubital Tunnel Syndrome Following Rear End Collision§17-15.1 Fact Summary§17-15.2 Clinical Discussion

§17-15.2.1 Anatomy§17-15.2.2 Pathophysiology§17-15.2.3 Clinical Manifestations of Ulnar Nerve Injury--By Site of Injury§17-15.2.4 Cubital Tunnel Syndrome

§17-15.2.4.1 Causes of Cubital Tunnel Syndrome§17-15.2.4.2 Clinical Features of Cubital Tunnel Syndrome§17-15.2.4.3 Compare: Carpal Tunnel Syndrome§17-15.2.4.4 Compare: Ulnar Tunnel Syndrome§17-15.2.4.5 Compare: Cervical Disc Herniation

§17-15.3 Treatment§17-15.3.1 Conservative§17-15.3.2 Surgical

§17-15.4 Prognosis§17-15.5 Questions and Answers§17-15.6 Additional Reading

§17-16 Case 16: Flexor Tendon Laceration - Medical Malpractice Case§17-16.1 Fact Summary§17-16.2 Clinical Discussion

§17-16.2.1 Functional Anatomy of Flexor Tendons§17-16.2.2 Tendon Nutrition and Healing

§17-16.3 Treatment§17-16.4 Prognosis§17-16.5 Forensic Questions and Answers§17-16.6 Additional Reading

§17-17 Case 17: Anterior Shoulder Dislocation with Axillary Nerve Damage§17-17.1 Fact Summary

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§17-17.2 Diagnosis§17-17.3 Clinical Discussion

§17-17.3.1 Basic Points§17-17.3.2 General Shoulder Anatomy§17-17.3.3 Nerve Supply to Shoulder§17-17.3.4 Axillary Nerve and Brachial Plexus

§17-17.4 Diagnosis§17-17.5 Treatment§17-17.6 Prognosis§17-17.7 Forensic Questions and Answers§17-17.8 Glossary§17-17.9 Additional Reading

§17-18 Case 18:Torn Rotator Cuff§17-18.1 Fact Summary§17-18.2 Medical Report§17-18.3 Clinical Discussion

§17-18.3.1 Functional Anatomy§17-18.3.2 Pathophysiology§17-18.3.3 Clinical Symptoms and Signs§17-18.3.4 Special Imaging Tests

§17-18.4 Treatment§17-18.4.1 Conservative Treatment§17-18.4.2 Surgical Treatment§17-18.4.3 Massive or Irreparable Tears

§17-18.5 Prognosis§17-18.6 Forensic Questions and Answers§17-18.7 Additional Reading

§17-19 Case 19: Complex Regional Pain Syndrome§17-19.1 Fact Summary§17-19.2 Medical Report§17-19.3 Clinical Discussion

§17-19.3.1 Background§17-19.3.2 Diagnostic Criteria§17-19.3.3 Pathophysiology§17-19.3.4 The Concept of Sympathetically Maintained Pain (SMP)§17-19.3.5 Clinical Findings§17-19.3.6 Pain-Related Terminology§17-19.3.7 Diagnostic Tests

§17-19.4 Treatment§17-19.5 Forensic Questions and Answers§17-19.6 Additional Reading

§17-20 Case 20: Aggravation v. Acceleration§17-20.1 Fact Summary§17-20.2 Medical Report§17-20.3 Clinical Discussion

§17-20.3.1 Basic Points§17-20.3.2 Concepts of Causal Relationship

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§17-20.3.2.1 Direct Causation§17-20.3.2.2 Aggravation§17-20.3.2.3 Acceleration§17-20.3.2.4 Precipitation§17-20.3.2.5 Consequential§17-20.3.2.6 Work-Related v. Occupational Disease


§17-21 Case 21:Trigger Finger§17-21.1 Fact Summary§17-21.2 Medical Report§17-21.3 Clinical Discussion

§17-21.3.1 Functional Anatomy§17-21.3.2 Pathophysiology§17-21.3.3 Incidence§17-21.3.4 Causes§17-21.3.5 Clinical Symptoms and Signs

§17-21.4 Treatment§17-21.4.1 Conservative Treatment§17-21.4.2 Injection Treatment§17-21.4.3 Surgical Treatment


§17-22 Case 22: Compartment Syndrome§17-22.1 Fact Summary§17-22.2 Medical Report§17-22.3 Clinical Discussion

§17-22.3.1 Overview§17-22.3.2 Definition and Classification§17-22.3.3 Anatomy§17-22.3.4 Pathophysiology§17-22.3.5 Clinical Signs and Symptoms

§17-22.3.5.1 Differential Diagnosis§17-22.3.5.2 Classical Signs

§17-22.3.6 Invasive Compartment Pressure Measurement§17-22.3.7 Interpretation of Compartment Pressure Measurement

§17-22.4 Treatment§17-22.4.1 Conservative Treatment§17-22.4.2 Surgical Treatment§17-22.4.3 Complications

§17-22.4.3.1 Early Complications§17-22.4.3.2 Long-Term Complications


§17-23 Case 23: De Quervain’s Tenosynovitis§17-23.1 Fact Summary§17-23.2 Medical Report

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§17-23.3 Clinical Discussion§17-23.3.1 Functional Anatomy§17-23.3.2 Pathophysiology§17-23.3.3 Clinical Symptoms and Signs§17-23.3.4 Imaging Studies

§17-23.4 Treatment§17-23.4.1 Conservative Treatment§17-23.4.2 Surgical Treatment


§17-24 Case 24: Shoulder Impingement Syndrome§17-24.1 Fact Summary§17-24.2 Medical Report§17-24.3 Clinical Discussion

§17-24.3.1 Functional Anatomy§17-24.3.2 Pathophysiology§17-24.3.3 Clinical Symptoms and Signs§17-24.3.4 Imaging Studies



§17-25 Case 25: Supracondylar Fracture§17-25.1 Fact Summary§17-25.2 Medical Report§17-25.3 Clinical Discussion

§17-25.3.1 Functional Anatomy§17-25.3.2 Pathophysiology§17-25.3.3 Clinical Signs and Symptoms§17-25.3.4 Imaging Studies

§17-25.4 Treatment§17-25.4.1 Type I Fractures§17-25.4.2 Type II and Type III Fractures

§17-25.4.2.1 Basic Points§17-25.4.2.2 Type II Fractures§17-25.4.2.3 Type III Fractures

§17-25.4.3 Complications§17-25.4.3.1 Vascular§17-25.4.3.2 Neurologic§17-25.4.3.3 Malunion


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§17-26 Case 26:Thoracic Outlet Syndrome Due to Neck Trauma§17-26.1 Fact Summary§17-26.2 Diagnosis§17-26.3 Clinical Discussion

§17-26.3.1 Thoracic Outlet Syndrome: General Attributes§17-26.3.2 Brachial Plexus and Neurological Deficits in TOS§17-26.3.3 Vascular Deficits in TOS


§17-27 Case 27: Synovial Knee Plica§17-27.1 Fact Summary§17-27.2 Medical Report§17-27.3 Clinical Discussion

§17-27.3.1 Functional Anatomy§17-27.3.2 Pathophysiology§17-27.3.3 Clinical Findings

§17-27.3.3.1 History§17-27.3.3.2 Physical Examination§17-27.3.3.3 Imaging Studies



§17-28 Case 28: Posterior Shoulder Dislocation§17-28.1 Fact Summary§17-28.2 Medical Report§17-28.3 Clinical Discussion

§17-28.3.1 Functional Anatomy§17-28.3.2 Pathophysiology§17-28.3.3 Clinical Findings

§17-28.3.3.1 History§17-28.3.3.2 Physical Examination

§17-28.3.4 Imaging Studies



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§17-29 Case 29: Metatarsal Stress Fracture§17-29.1 Fact Summary§17-29.2 Medical Report§17-29.3 Clinical Discussion

§17-29.3.1 Functional Anatomy and Physiology§17-29.3.2 Pathophysiology§17-29.3.3 Epidemiology

§17-29.4 Clinical Findings§17-29.4.1 History§17-29.4.2 Physical Examination§17-29.4.3 Differential Diagnoses§17-29.4.4 Imaging Studies



§17-30 Case 30: Nurse Maid’s Elbow: Dislocation of Radial Head in Child§17-30.1 Fact Summary §17-30.2 Diagnosis §17-30.3 Clinical Discussion

§17-30.3.1 Overview§17-30.3.2 Association of Radius, Ulna and Humerus at Elbow Joint§17-30.3.3 Nerve Supply of Elbow Joint

§17-30.4 Treatment§17-30.5 Prognosis §17-30.6 Forensic Questions and Answers§17-30.7 Glossary§17-30.8 Further Reading

§17-31 Case 31: Osteoporosis of the Spine,With Compression Fractures§17-31.1 Fact Summary§17-31.2 Diagnosis§17-31.3 Clinical Discussion

§17-31.3.1 Overview§17-31.3.2 A Brief Biology of Bones and Osteoporosis §17-31.3.3 Vertebral Compression Fractures§17-31.3.4 Ankylosing Spondylitis§17-31.3.5 Nerve Root Compression

§17-31.4 Treatment of Osteoporosis-Related Vertebral Compression Fractures§17-31.5 Prognosis§17-31.6 Forensic Questions and Answers §17-31.7 Glossary §17-31.8 Further Reading

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Chapter 18 Thorax and Respiratory System§18-1 Case 1: Missed Diagnosis of Breast Cancer With Subsequent Pregnancy


§18-2 Case 2: Death Due to Massive Chest Trauma§18-2.1 Fact Summary§18-2.2 Clinical Discussion

§18-2.2.1 Rib Cage Injury§18-2.2.2 Contusion of the Heart


§18-3 Case 3:Tracheal Laceration Due to Intubation in a Child§18-3.1 Fact Summary§18-3.2 Clinical Discussion

§18-3.2.1 Respiratory System§18-3.2.2 Cardiovascular System§18-3.2.3 Central Nervous System


§18-4 Case 4: Asbestos Exposure With Subsequent Asbestosis and Lung Cancer§18-4.1 Fact Summary§18-4.2 Clinical Discussion§18-4.3 Forensic Questions and Answers§18-4.4 Glossary§18-4.5 Additional Reading

§18-5 Case 5: Pulmonary Embolism§18-5.1 Fact Summary§18-5.2 Diagnosis§18-5.3 Clinical Discussion

§18-5.3.1 Overview

§18-5.3.2 Pulmonary Embolism

§18-5.3.3 Pulmonary Circulation

§18-5.3.4 Veins of Lower Limb


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§18-6 Case 6: Crushing Injury of the Trachea and Bronchus§18-6.1 Fact Summary§18-6.2 Diagnosis§18-6.3 Clinical Discussion

§18-6.3.1 Trachea

§18-6.3.2 Right Bronchus

§18-6.3.3 The Mediastinum

§18-6.3.4 The Anterior Neck

§18-6.3.5 The Sternum, Clavicle and Upper Ribs


§18-7 Case 7: Carbon Monoxide Poisoning§18-7.1 Fact Summary§18-7.2 Diagnosis§18-7.3 Clinical Discussion

§18-7.3.1 Basic Points

§18-7.3.1.1 What Is Carbon Monoxide?

§18-7.3.1.2 How Is CO Transported Through the Body?

§18-7.3.2 Sources of Carbon Monoxide

§18-7.3.3 Safe Exposure Limits

§18-7.3.4 Diagnosis of CO Exposure

§18-7.3.5 Statistics


§18-8 Case 8: Strangulation of Child by Automobile Power Window§18-8.1 Fact Summary§18-8.2 Diagnosis§18-8.3 Clinical Discussion

§18-8.3.1 Mechanism of Injury

§18-8.3.1.1 Pertinent Anatomy of the Neck

§18-8.3.1.2 Muscles of the Neck

§18-8.3.1.3 Visceral Portion of the Neck

§18-8.3.2 Mechanism of Strangulation

§18-8.4 Forensic Question and Answers§18-8.5 Glossary§18-8.6 Additional Reading

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§18-9 Case 9: Breast Augmentation With Complications§18-9.1 Fact Summary§18-9.2 Diagnosis§18-9.3 Clinical Discussion

§18-9.3.1 The Breast

§18-9.3.1.1 Basic Anatomy

§18-9.3.1.2 Blood and Nerve Supply

§18-9.3.1.3 Pectoral Muscles and Fascia

§18-9.3.2 Breast Augmentation (Augmentation Mammoplasty)

§18-9.3.2.1 Subglandular Augmentation

§18-9.3.2.2 Submuscular Augmenation


§18-10 Case 10:Winged Scapula After Breast Surgery§18-10.1 Fact Summary§18-10.2 Diagnosis §18-10.3 Clinical Discussion

§18-10.3.1 Overview§18-10.3.2 Serratus Anterior Muscle§18-10.3.3 Long Thoracic Nerve§18-10.3.4 The Axilla §18-10.3.5 Breast Surgery With Extension Into the Axilla§18-10.3.6 Mammary Lymph Drainage

§18-10.4 Treatment§18-10.5 Prognosis§18-10.6 Forensic Questions and Answers§18-10.7 Glossary§18-10.8 Further Reading

§18-11 Case 11: Decompression Sickness & Pneumothorax§18-11.1 Fact Summary§18-11.2 Diagnosis§18-11.3 Clinical Discussion

§18-11.3.1 Decompression Illness§18-11.3.2 Pneumothorax

§18-11.4 Treatment§18-11.5 Prognosis§18-11.6 Forensic Questions and Answers §18-11.7 Glossary§18-11.8 Additional Reading

Chapter 19 Abdomen and Pelvis§19-1 Case 1: Ruptured Spleen and Liver

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§19-1.2.1 Relationships of the Organs Involved

§19-1.2.2 Spleen

§19-1.2.3 Liver

§19-1.2.4 Lung


§19-2 Case 2: Ingestion of a Caustic Substance§19-2.1 Fact Summary§19-2.2 Clinical Discussion§19-2.3 Forensic Questions and Answers§19-2.4 Glossary§19-2.5 Additional Reading

§19-3 Case 3: Abdominal Stab Wound§19-3.1 Fact Summary§19-3.2 Clinical Discussion§19-3.3 Forensic Questions and Answers§19-3.4 Glossary§19-3.5 Additional Reading

§19-4 Case 4: Open Book Fracture of the Pelvis§19-4.1 Fact Summary§19-4.2 Clinical Discussion§19-4.3 Forensic Questions and Answers§19-4.4 Glossary§19-4.5 Additional Reading

§19-5 Case 5: Delayed Laceration of Spleen Due to Slip and Fall Injury§19-5.1 Fact Summary§19-5.2 Diagnosis§19-5.3 Clinical Discussion

§19-5.3.1 General Anatomy

§19-5.3.2 Physiology/Pathology

§19-5.3.3 Surgery


§19-6 Case 6: Pelvic Fracture and Open Bladder Injury Following Motorcycle/Vehicle Collision§19-6.1 Fact Summary§19-6.2 Diagnosis§19-6.3 Clinical Discussion

§19-6.3.1 Skeletal Anatomy of Pelvis

§19-6.3.2 Bladder

§19-6.3.2.1 Blood Supply and Drainage of Bladder

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§19-6.3.2.2 Nerves of Bladder

§19-6.3.3 Rupture of Bladder

§19-6.3.4 Anterior Abdominal Wall


§19-7 Case 7: Failure and Revision of Bariatric (Weight Reduction) Surgery§19-7.1 Fact Summary§19-7.2 Diagnosis§19-7.3 Clinical Discussion

§19-7.3.1 Fat

§19-7.3.2 Obesity and Morbid Obesity

§19-7.3.3 Surgical Anatomy Encountered

§19-7.3.3.1 Lower Esophagus and Upper Portion of Stomach

§19-7.3.3.2 Duodenum

§19-7.3.3.3 The Jejunum

§19-7.3.4 Physiology of Absorption in Gut

§19-7.4 Treatment§19-7.4.1 Bariatric Surgery—Overview

§19-7.4.2 Banded Gastroplasty

§19-7.4.3 Roux-En-Y


§19-8 Case 8: Gallbladder Removal (Cholecystectomy) With Complications§19-8.1 Fact Summary§19-8.2 Diagnosis§19-8.3 Clinical Discussion

§19-8.3.1 Liver, Gallbladder and Bile

§19-8.3.2 Gallstones

§19-8.3.3 Peritoneum and Peritonitis

§19-8.4 Treatment§19-8.4.1 Overview

§19-8.4.2 Laparoscopic Cholecystectomy

§19-8.4.3 Open Cholecystectomy


§19-9 Case 9: Inguinal Hernia Repair Necessitated by Job-Related Lifting Injury§19-9.1 Fact Summary

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§19-9.2 Diagnosis§19-9.3 Clinical Discussion

§19-9.3.1 Introduction to Groin Hernias

§19-9.3.2 Anatomy of Anterior Abdominal Wall as It Relates to Hernia Repair

§19-9.3.2.1 Musculature and Membranous Layers

§19-9.3.2.2 Nerves of Anterior Abdominal Wall

§19-9.3.2.3 Blood Vessels of Anterior Wall

§19-9.3.2.4 Miscellaneous Features of Abdominal Wall

§19-9.3.2.5 Landmarks of Anterior Wall

§19-9.3.2.6 Deep Inguinal Ring

§19-9.4 Overview–Repair of Inguinal Hernias§19-9.4.1 Minimally Invasive Lapaoscopic Herniorrhapphy Using TAPP Approach

§19-9.4.2 Open Hernia Repairs

§19-9.5 Case Specific Treatment§19-9.6 Prognosis§19-9.7 Forensic Questions and Answers§19-9.8 Glossary§19-9.9 Additional Reading

§19-10 Case 10: Radical Prostatectomy With Resulting Urinary Incontinence and Impotence§19-10.1 Fact Summary§19-10.2 Diagnosis§19-10.3 Clinical Discussion

§19-10.3.1 Overview

§19-10.3.2 Male Pelvis

§19-10.3.3 Bladder and Sphincter Muscles

§19-10.3.4 Prostate

§19-10.3.5 Benign Prostate Hypertrophy and Transurethral Surgery


§19-11 Case 11: Alcoholism and Resulting Illnesses (Hemorrhoids, Liver Disease, Diabetes) as Incapacitating Condition

§19-11.1 Fact Summary§19-11.2 Diagnosis§19-11.3 Clinical Discussion

§19-11.3.1 Normal Rectal and Anal Anatomy

§19-11.3.2 The Hepatic Portal Vein

§19-11.3.2.1 Cirrhosis of the Liver and Related Maladies

§19-11.3.2.2 Results of Portal Hypertension

§19-11.3.3 Diabetes

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§19-11.4 Treatment§19-11.4.1 Treatment of Hemorrhoids

§19-11.4.2 Treatment of Liver Disease

§19-11.4.3 Treatment of Diabetes


§19-12 Case 12: Pancreaticoduodenectomy (Whipple Procedure) With Complications§19-12.1 Fact Summary§19-12.2 Diagnosis§19-12.3 Clinical Discussion

§19-12.3.1 The Pertinent Surgical Anatomy of the Whipple Procedure§19-12.3.2 Pancreatic Cancer§19-12.3.3 The Whipple Procedure (pancreaticoduodenectomy)

§19-12.4 Forensic Questions and Answers§19-12.5 Glossary §19-12.6 Additional Reading

§19-13 Case 13: Failure of a Fundoplication§19-13.1 Fact Summary§19-13.2 Diagnosis§19-13.3 Clinical Discussion

§19-13.3.1 Anatomy of the esophageal-gastric junction§19-13.3.2 Pre-operative evaluation of candidates for the Nissen procedure§19-13.3.3 The Laparoscopic Nissen Fundoplication §19-13.3.4 Re-operation for Hiatal Hernia

§19-13.4 Forensic Questions and Answers§19-13.5 Glossary §19-13.6 Additional Reading

Chapter 20 Integument§20-1 Case 1: Second- and Third-Degree Burns


§20-1.2.1 Integument

§20-1.2.2 Replacement of Skin

§20-1.2.3 Circulatory System

§20-1.2.4 Respiratory System


Chapter 21 Reproductive System§21-1 Case 1: Brachial Plexus Injury During Delivery


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§21-2 Case 2: Failure of a Penile Prosthesis§21-2.1 Fact Summary§21-2.2 Clinical Discussion§21-2.3 Forensic Questions and Answers§21-2.4 Glossary§21-2.5 Additional Reading

§21-3 Case 3:Vasectomy,With Complications§21-3.1 Fact Summary§21-3.2 Diagnosis§21-3.3 Clinical Discussion

§21-3.3.1 Overview

§21-3.3.2 Scrotum

§21-3.3.3 Epididymis

§21-3.3.4 Spermatic Cord

§21-3.3.5 Ductus (vas) Deferens

§21-3.3.6 Nerve Supply to the Testicles, Epididymis, and Scrotum

§21-3.3.6.1 Nerves

§21-3.3.6.2 Blood Vessels

§21-3.4 Treatment§21-3.4.1 Vasectomy

§21-3.4.2 Epididymectomy

§21-3.4.3 Orchiectomy


§21-4 Case 4: Perineal Tear With Rectovaginal Fistula§21-4.1 Fact Summary§21-4.2 Diagnosis§21-4.3 Clinical Discussion

§21-4.3.1 Perineal Anatomy

§21-4.3.2 The Levator Ani Muscles

§21-4.3.3 Episiotomy


§21-5 Case 5: Breast Milk Contamination in a Drug-Using Mother§21-5.1 Fact Summary§21-5.2 Diagnosis

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§21-5.3 Clinical Discussion§21-5.3.1 Drug Transmission & Detection§21-5.3.2 The Breasts and Milk Formation/Secretion

§21-5.4 Treatment§21-5.5 Prognosis§21-5.6 Forensic Questions and Answers§21-5.7 Additional Reading

Part IIILITIGATION TOOLS

CHAPTER 22 Governing Principles: Effective Use of Medical EvidenceI. Attorney’s Guide to Understanding Medical Records

A. Introduction B. Access to Medical Records

§22-1 HIPAA §22-2 Mental Health Records [§§22-3 – 22-4 Reserved]

C. Components of a Typical Medical Chart §22-5 Overview§22-6 Types of Records

Form 22-6.1 Letter to Provider Requesting Patient RecordsForm 22-6.2 Letter to Provider Requesting Patient Records (Alternate)Form 22-6.3 Follow-Up Letter to Provider Requesting Missing Records

§22-7 Admission Records §22-8 Discharge Summary §22-9 Physician and Nursing Notes§22-10 Consultations§22-11 Orders§22-12 Lab Reports and Results§22-13 Daily Progress Notes §22-14 Operative Procedure Reports and Notes§22-15 Glossary of Common Medical Abbreviations

CHAPTER 23 Medical Evidence in Traumatic Brain Injury CasesI. What Is TBI?

§23-1 Overview of Closed Head TBI Cases§23-2 Three Major Classes of Traumatic Brain Injury§23-3 Degrees of Impairment [§23-4 Reserved]

II. Gathering Evidence to Establish TBI Before TrialA. Overview

§23-5 Common Injury; Common Misconceptions§23-6 Use Discovery to Expose Misconceptions

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B. Interview Client §23-7 Basic Principles §23-8 Checklist

C. Gather Records and Interview Witnesses §23-9 Obtain Medical, Employment and Education Records

Form 23-9.1 Medical Records Authorization/ReleaseForm 23-9.2 Authorization for Release of Employment RecordsForm 23-9.3 Authorization for Release of Education RecordsForm 23-9.4 Authorization for Release of Military Records

§23-10 Interview Lay Witnesses, Including Family, Friends and Coworkers§23-11 Screen Plaintiff’s Treating Doctor

D. Consult With Experts §23-12 Arrange for Neuropsychological Testing §23-13 Obtain Vocational Assessment§23-14 Obtain a Vocational Economist

E. Take Depositions 1. Depose Treating Doctor §23-15 Governing Principles §23-16 Elicit All Opinions 2. Depose Defense Neurologist/Neuropsychologist §23-17 Goals§23-18 Sample Deposition Questions of Defense Medical Witnesses

Form 23-18.1 Subpoena Duces Tecum for Defense Neurologist/Neuropsychologist[§§23-19 – 23-29 Reserved]

III. Presenting Evidence of TBI at TrialA. Overview

§23-30 Proving an Invisible Injury§23-31 In Practice: Order of Witnesses

B. Direct Examination of Neurologist §23-32 Background and Qualifications§23-33 Experience§23-34 Examination and Treatment of Plaintiff §23-35 Opinions on Causation§23-36 Permanency/Prognosis§23-37 Amount of Present and Future Medical Services

C. Direct Examination of Neuropsychologist§23-38 Opinions on Causation§23-39 Permanency/Prognosis

D. Direct Examination of Vocational Expert§23-40 Witness’ Background and Qualifications§23-41 Opinions and Basis for Opinions

E. Lay Witness Testimony§23-42 Direct Examination of Coworker §23-43 Direct Examination of Family Member

F. Plaintiff ’s TestimonyG. Demonstrative Evidence

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CHAPTER 24 MAXIMIZING your RECOVERY IN MOTOR VEHICLE CASESI. Introduction: Common Sense Advice for Proving Liability and Damages

§24-1 Plan Your Case With Sensitivity to the Public’s Perception of Lawyers§24-2 Expect Fallout From “The McDonald’s Case”§24-3 Know the Demographics of Your Venue§24-4 In This Chapter[§24-5 Reserved]

II. Gathering Evidence Before TrialA. The Initial Client Interview

§24-6 Overview §24-7 Insurance§24-8 Police Report

B. The Lawyer’s Informal Investigation §24-9 Examine Local and State Vehicle Codes§24-10 Contact Witnesses and Consider Obtaining Statements

§24-10.1 Sample Field Questions to Potential Parties or Witnesses to Elicit Facts Necessary toProve the Case

§24-10.2 Sample Statement Prepared for Independent Witness After Interview§24-11 Documenting the Scene and Site Conditions at the Time of the Occurrence§24-12 Consider Retaining Expert Witnesses Early[§§24-13 – 24-14 Reserved]

C. Formal Written Discovery§24-15 Scope of Discovery in General§24-16 Initial Written Discovery and How It Can Be Used to Your Advantage

Form 24-16.1 Sample Written Interrogatories – Auto Case§24-17 Preparing Answers to Written Interrogatories§24-18 Production Requests

Form 24-18.1 Sample Written Document Request [§24-19 Reserved]

D. Depositions: A Critical Tool Which Can Make or Break a Case §24-20 Deposing the Opposing Party or Witnesses§24-21 Uses of the Deposition§24-22 Using Time, Speed, and Distance Formulas to Establish Liability§24-23 Checklist to Prepare for Taking Auto Collision Depositions§24-24 Checklist: Opposing Party Deposition§24-25 Presenting the Client for Deposition

Form 24-25.1 Letter to Client re Deposition §24-26 Sample Client Deposition Questions §24-27 Checklist: Deposition of a Treating Physician[§§24-28 – 24-33 Reserved]

III. Medical Evidence at TrialA. Streamlining the Evidence at Trial

1. Stipulate to Foundations of Evidence §24-34 Sample Exhibit List§24-35 Video Evidence§24-36 Diagrams§24-37 Blackboards§24-38 Models§24-39 Demonstrative Devices Used With Medical Testimony

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2. Motions in Limine §24-40 Description and Purposes of Motion

Form 24-41 Sample Motion in Limine – Motor Vehicle Case[§§24-42 – 24-44 Reserved]

B. Jury Selection§24-45 Governing Principles §24-46 Two Types of Jurors to Choose§24-47 Challenges for Cause§24-48 Use of Open-Ended Questions§24-49 Sample Voir Dire Questions[§§24-50 – 24-54 Reserved]

C. Examination Outlines §24-55 Checklist: Direct Examination of Treating Physician[§§24-56 – 24-64 Reserved]

IV. Issues Unique to Low Impact, Soft Tissue Injury (“LIST”) CasesA. Mechanism of Injury

§24-65 Generally[§24-66 – 24-69 Reserved]

B. Effective Use of Medical Evidence in a LIST Case 1. Medical Records§24-70 What You Need to Know§24-71 Common Anatomical Terms in Soft Tissue Cases§24-72 Components of a Typical Medical Chart§24-73 Admission Records2. Proving Pain Through Range of Motion (R.O.M.) Tests §24-74 Governing Principles §24-75 Sample Questions to Physician re R.O.M. Deviations to Demonstrate Injury3. Medications§24-76 Use Evidence of Prescriptions to Help Establish Pain and Suffering [§§24-77 – 24-79 Reserved] 4. Refuting Negative Diagnostic Findings§24-80 Use Medical Testimony and Literature to Refute Necessity of Positive Test to Explain

Plaintiff’s Complaints

Chapter 25 Establishing Liability and Proving Injury in PremisesLiability Cases

I. Governing LawA. Who Are Owners, Occupiers and Possessors of Land?B. Duties Owed by Owners, Occupiers and Possessors of Land

§25-1 Duty of Reasonable Care §25-2 Other “Duties of Care” That May Apply §25-3 Restatement (Second) of Torts, §343§25-4 Duty to Warn

C. Breach of Duty and Proximate CauseD. Immunities

§25-5 Common Law Immunity§25-6 Statutory Immunity§25-7 School Immunity[§§25-8 – 25-9 Reserved]

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E. Other Defenses§25-10 Notice §25-11 Foreseeability§25-12 Open and Obvious[§§25-13 – 25-14 Reserved]

II. Damages: Common Injuries in Premises Liability Cases A. Traumatic Injuries to the Foot and Ankle

§25-15 Fractures of the Foot§25-15.1 Types of Fractures

§25-16 Fractures of the Ankle§25-16.1 Ankle Anatomy§25-16.2 Types of Fractures

B. Traumatic Injuries to the Knees §25-17 Anatomy of the Knee§25-18 Types and Causes of Knee Injuries§25-19 Symptoms and Signs of Injury§25-20 Mechanisms of Specific Knee Injuries

C. Traumatic Injuries to the Wrist and Hand§25-21 Types of Wrist Injuries§25-22 Finger Injuries[§§25-23 – 25-24 Reserved]

D. Traumatic Injuries to the Shoulder§25-25 Shoulder Anatomy§25-26 Fractures§25-27 Joint Injuries §25-28 Rotator Cuff Tear

E. Traumatic Brain Injuries§25-29 In General

F. Tests and Treatments§25-30 Diagnostic Tests §25-31 Common Hardware Used to Treat Fractures[§§25-32 – 25-34 Reserved]

III. Common Slip and Fall Fact PatternsA. Snow and Ice Cases

§25-35 The Natural Accumulation Rule §25-36 Contractual Relationship Exception§25-37 Immunity for Snow Removal on Residential Property

B. Defects in Sidewalks and Walkways§25-38 The De Minimis Rule

C. Failure to Provide Safe Ingress and EgressD. Pleadings in Slip and Fall Cases

§25-39 Initial PleadingsForm 25-39 Sample Complaint – Premises Liability

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IV. Proving a Premises Liability CaseA. Gathering Liability and Medical Evidence Before Trial

§25-40 Client Information§25-40.1 Checklist: Initial Client Interview

§25-41 First Responder Reports and Preliminary Medical Reports§25-42 Incident Reports

§25-42.1 Sample Business Owner’s Incident Report §25-43 Third-Party Witnesses

§25-43.1 Checklist: Sample Field Questions to Potential Parties or Fact Witnesses§25-44 Mechanism of Injury

§25-44.1 Checklist: Deposition of Treating Orthopedic Physician§25-45 Your Client’s Deposition§25-46 Written Discovery

Form 25-46.1 Sample Fact Witness InterrogatoriesForm 25-46.2 Sample Request for Production of Documents to Defendants

[§§25-47 – 25-49 Reserved]

B. Proving Liability and Medical Issues at Trial§25-50 Jury Instructions

§25-50.1 Sample Form Jury Instructions§25-51 Motions in Limine

Form 25-51.1 Sample Motion in Limine – Premises Liability Case§25-52 Witness Testimony

§25-52.1 Treating Orthopedic Physician §25-52.2 Plaintiff’s Testimony

§25-53 Demonstrative Evidence

Appendix: Glossary

Index

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MEDICAL EVIDENCE

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