14 Forensic Aspect Of NAI and Child Abuse Flashcards
Definition of child abuse
When infant/child suffers repetitive physical injuries inflicted by parent/guardian
Victims: young, under 3 years of age
Most common mode of death
Head injury, rupture of abdominal viscus
Location of six penny bruises occur
Chest abdomen neck (finger pressure)
Common site of skull fracture and most common haemorrhage occur
Occipito parietal area
Common: subdural haemorrhage
Different between skeletal damage dt NAI and accidental falls
NAI: multiple #, depressed on skull, wide cranial suture and ‘growing’
Accidental falls: narrow, linear, single usually in parietal area
Findings of chest injury
Callus formation (string of beads) on xray in paravertebral gutters dt squeezing of chest from side to side
Rib # in axillary line dt AP pressure of chest
Infantile cortical hyperostosis
Extensive new periosteal bone around diaphysis of long bones; rib, ulnar, clavicle, mandible
Cong syphilis
- symmetrical periosteal thickening
- # of metaphysis
- porotic shafts of long bones
Menke’s syndrome
- abnormal metaphyses
- males only
- abnormal hair
- wormian bones in skull
- mental retardation
Ix for bite marks
- cast for individual teeth
- swab for saliva identification
What is epilation
Hair pulled in clumps
Autopsy in child abuse
- visit crime scene
- examine original clothing for blood
- Full radiologic skeletal survey
- full physical measurements
- examine body orifice
- full photography for record
- dissect subcutaneous tissue for bruises
- sampling of blood, urine, stomach contents, liver, ocular fluid, csf for toxicologic analysis
- microbiologic test for blood c&s
- blood for grouping and DNA analysis
- bite marks for swab for saliva and cast for teeth indentation
- whole brain fixed in formalin (TRO intracranial haemorrhage)
- eye globes for retinal bleeding and detachment, lens dislocation and vitreous haemorrhage
