Forensic Aspects of Trauma 2 Flashcards
What type of trauma tends to be seen in defensive injuries?
- Blunt
* Sharp force
What 2 kinds of defensive type injuries are there?
- Passive
* Active
Describe a passive defensive injury
- Victim raises arms and legs for protection
* Sliced, shelved often with skin flaps over backs of hands and forearms
Describe an active defensive injury
- Victim tries to grab weapon or attackers hand
- Sliced shelved incised wounds on palmer aspect of hands and web spaces between fingers – particularly between thumb and index finger
What type of trauma tends to be seen in self inflicted injuries?
Commonly sharp force
Where do self inflicted injuries tend to be on the body and what is the nature of their application?
- Usually wrists/forearms, chest and abdomen
* Parallel, multiple and tentative incisions
What 4 factors do the consequences of an injury depend on?
- Type of mechanical insult – blunt, sharp, homicide, suicide, accident etc
- Nature of target tissue - head, chest, abdomen, fat
- Forces involved – high speed RTC, fall from height, kicking, stamping, punch
- Number of impacts – multiple vs single
How may skull fractures appear?
- Linear
* Depressed
What 3 types of brain haemorrhage are there?
- Subarachnoid
- Subdural
- Extradural
At what volume of blood does a brain haemorrhage become symptomatic?
35ml
At what volume of blood does a brain haemorrhage cause clinical deterioration and become life threatening?
40-50ml
At what volume of blood does a brain haemorrhage become commonly fatal and why?
- 80-100ml
* Due to increased intracranial pressure and herniation
At what volume of blood does a brain haemorrhage become completely fatal?
150ml +
How does a subdural haemorrhage appear on a scan?
Crescent-shaped as it can cross suture lines
How does a extradural haemorrhage appear on a scan?
Lens-shaped as it cannot cross suture lines
How does a traumatic subarachnoid haemorrhage occur?
- Due to rapid rotational movement of head, usually as the result of a single punch to jaw/upper part of neck or side of head
- Sudden unexpected twisting movement
Which vessel tend to rupture for a traumatic subarachnoid haemorrhage?
•Traumatic rupture of vessels at base of brain – most frequently distal portion of intracranial vertebral arteries at point where they cross the dura
What is the clinical term for a diffuse brain injury?
•Diffuse axonal injury
What is the clinical definition of a diffuse brain injury?
•Immediate and prolonged coma with no apparent mass lesion or metabolic abnormality
What is the pathological term for a diffuse brain injury?
•Traumatic axonal injury
What is the pathological definition of a diffuse brain injury?
•Damaged axons due to trauma
How is a traumatic axonal injury classified?
•Focal or diffuse - graded 1-3 depending on severity
What are clues that an injury is post-mortem?
- Lack of vital reaction
* Parchmentation
What may cause post-mortem injuries?
- Animal predation
* Insect predation
