Flashcards in Forensic Aspects of Trauma Deck (43)
-Physical harm or damage to someone's body caused by an accident or an attack
-Damage to any part of the body due to the application of mechanical force
What forces does the intensity of injury obey?
Laws of physics
-Force varies directly with mass of the ‘weapon’ and directly with square of velocity of impact
-Kinetic energy = ½ mass x velocity^2
How does area over which force acts affect injury severity?
-Force (same mass and velocity) over a smaller area will deliver a greater impact to any given unit of tissue
How do seatbelts work?
Stretching of seatbelt fabric extends time of energy exchange and considerable area of seatbelt surface is preferable to alternative of transferring all kinetic energy via a few cm^2 of the forehead against the windscreen
What can excessive mechanical force cause?
What does resultant damage depend on?
Type of mechanical insult and nature of the target tissue
How can injury be classified?
Appearance or method of causation:
-Abrasion, contusion, laceration, incised wounds, gunshot wounds, burns
Manner of causation:
-Suicidal, accidental, homicidal
Nature of injury:
-Blunt force, sharp force, explosive
How are blunt force injuries caused?
Caused by impact with blunt object (ground, fist, foot, weapon)
Give examples of blunt force injuries.
-Burst blood vessels in skin
Abrasions (graze, scratch)
-Scraping of skin surface
Lacerations (cut, tear)
-Tear/split of skin due to crushing
Give examples of patterned bruises.
-Finger trip bruises
-Patterns from objects
What factors affect prominence of bruising?
-Depth and location
-Increased subcutaneous fat
-Young and old
-Resilient area such as buttocks and abdomen bruise less easily
-Areas with underlying bone bruise more easily
-Coagulative disorders (including alcoholics)
What is a sharp force injury?
-Injury caused by any weapon with sharp cutting edge.
-Can be superficial or penetrating
Give examples of sharp force injuries.
How do incised wounds occur?
Superficial sharp force injury caused by a slashing motion
How do incised appear?
Longer on the skin surface than it is deep
How do stab wounds occur?
Penetrating injury resulting from thrusting motion
How do stab wounds appear?
Wound depth greater than length on the surface
What types of defensive injuries do you get?
Blunt and sharp force
How do passive defensive injuries occur?
Victim raises arms and legs for protection
What types of passive defensive injuries can occur?
Sliced, shelved often with skin flaps over backs of hands and forearms
How do active defensive injuries occur?
Victim tries to grab weapon or attacker hand
What types of active defensive injuries can occur?
Sliced shelved incised wounds on palmer aspect of hands and web spaces between fingers – particularly between thumb and index finger
What sites are usually used for self inflicted injuries?
-Chest and abdomen
How do self-inflicted injuries usually appear?
-Commonly sharp force
-Parallel, multiple and tentative injuries
-Positioned under clothing
What does consequence of injury depend on?
Type of mechanical insult
-Blunt, sharp, homicide, suicide, accident
Nature of target tissue
-Head, chest, abdomen, fat
-High speed RTC, fall from a height, kicking, stamping, punch
Number of impacts
-Single vs multiple
What can head injuries result in?
-Skull fractures (linear or depressed)
-Subarachnoid, subdural, extradural haemorrhage
When will patients start to show symptoms of brain haemorrhage?
35ml blood loss
How will a patient present with 40-50ml of brain haemorrhage?
How will a patient present with 80-100ml of brain haemorrhage?
Commonly fatal due to increased ICP and herniation