L4: Wounds Flashcards
Def of Wounds
- Breach of the normal continuity of tissue by application of mechanical violence
Classification of Wounds
- Legal (based on the severity of the injury)
- Medicolegal
- Mechanical (Physical) (based on causative instrument)
- Based on time of infliction
what are wounds legally classified according to?
severity of injury
Legal classification of Wounds
- Simple
- Dangerous
- Mortal
Characters of simple wounds
- It is a superficial wound
- which heals rapidly within 20 days
- without leaving a permanent infirmity.
Characters of dangerous wounds
- It is a serious injury
- which takes more than 20 days to heal
- may leave a permanent infirmity
What is a permanent infirmity?
- It is a serious complication which may follow injuries.
- It means loss of a functioning organ or loss of the function of this organ (partially or completely).
Characters of mortal Wounds
- It is a fatal injury.
- which causes death either immediately or after a short time
What is a Disfigurement?
- It means loss of a non-functioning organ
E.g. loss of part from external auricle of the ear.
Medicolegal classification of wounds
Mechanical (physical) classification of wounds
Mechanical (physical) classification of wounds is based on …..
causative instrument
Classification of Wounds based on time of inflection
- Antemortem
- Postmortem
Def Abrasions
- Superficial injury involves only outer layers of the skin.
Characters of Abrasions
It bleeds very slightly and heals rapidly without leaving any scar.
Types of Abrasions
- Scratch Abrasions
- Sliding Abrasion (Graze or Grinding Abrasions)
- Pressure or Contact Abrasions
Description of Scratch abrasions
- It is a linear injury produced by sharp object
Examples of tool causing Scratch abrasions
- sharp object, Such as pins or fingernails running across the skin.
Characters of Scratch abrasions
- The object causing the scratch carries torn epithelium in front of it.
- The direction of injury is indicated from torn epithelium at end of abrasions.
What are another names of sliding abrasion?
(Graze or Grinding Abrasions)
Def of sliding abrasions
It is an injury that occurs due to friction of a broad area of skin against a rough surface
What causes sliding abrasions?
traffic accidents or when body has been dragged.
what are another names for pressure abrasions?
Contact Abrasions
Characters of Sliding abrasions
- They show longitudinal parallel lines, which indicate
- direction of the sliding from torn epithelium at end of abrasions.
Def of Pressure abrasions
- It is an injury that occurs due to pressure with some objects which cause crushing of cuticle and reproduction of its shape on the skin as “Patterned abrasions”.
Examples of Pressure abrasions
- Ligature mark in “hanging and strangulation”
- Fingernails and thumb marks in throttling and smothering”
- Teeth marks in “biting”.
MLI of Abrasions
- They are sure signs of violence and struggle.
- They may be the only external sign of a serious internal injury e.g. ruptured viscera.
- Identification of type of the crime
- Identification of causative instruments from their shape
- Direction of injury
- Time passed since infliction of abrasions
- Difference between antemortem and postmortem abrasions which occur when a body is dragged after death against a hard surface
identification of type of the crime through abrasions
Identification of Causative instrument through abrasions
- In strangulation and hanging where rope leaves its pattern on skin of neck “Ligature mark”.
- In accident where the impact of a motorcar tyre takes place and leaves its pattern on the victim’s skin “Tire mark”.
Identification of Direction of injury through abrasions
- From the torn epithelium at end of abrasions
Why is it important to determine time past since the inflection of abrasions?
to see whether it corresponds with date of a crime.
age of abrasions
- Fresh: Bright red “oozing serum and blood”
- 2 Days: Exudation dries to form a “reddish soft scab”
- 3 days: Scab dries to form “reddish-brown dry scab”
- One week: Scab shrinks and falls leaving a red surface
- Two weeks: Healing usually completed from periphery to center
abrasions after 2 days
Exudation dries to form a “reddish soft scab”
Fresh abrasions
Bright red “oozing serum and blood”
abrasions after 3 days
Scab dries to form “reddish-brown dry scab”
abrasions after 1 week
Scab shrinks and falls leaving a red surface
abrasions after 2 weeks
Healing usually completed from periphery to center
compare between antemortem and postmortem abrasions in terms of:
- Site
- Color
- Exudate
- Healing Process
- Vital Reaction
Def of Bruises (Contusions)
- Extravasation of blood into tissues following rupture of blood vessels
- Due to application of blunt instrument (e.g., a stick, stone)
- Giving bluish purple discoloration and swelling of involved area with intact skin.
what causes Bruises (Contusions)?
- Due to application of blunt instrument (e.g., a stick, stone)
Shape of Bruises (Contusions)
- Giving bluish purple discoloration and swelling of involved area with intact skin.
Classification of Bruises (Contusions)
Bruise is classified into three types depending on its situation:
- Intradermal bruise
- Subcutaneous bruise
- Deep bruise
Characters of Intradermal Bruise
- Site
- Cause
- Shape
- Bruise lies in subepidermal layer.
- It is made by impact with patterned object.
- Hemorrhage is sharply defined.
Characters of Subcutaneous Bruise
- Site
- Cause
- Shape
- It is situated in subcutaneous tissue, often in fatty layer.
- Caused by blunt object.
- Appears soon after injury as dark red swelling.
What is the most common type of bruises?
Subcutaneous bruise
Site of Deep Bruise
Bleeding deeper to subcutaneous tissues.
what demonstrates Deep Bruise?
Infrared photography may demonstrate such bruises, if suspected initially.
time of appearence of Deep Bruise
- May take hours to 1-2 days to appear at surface.
(Delayed bruising). - Therefore, another examination should be carried out 1-2 days after first examination.
MLI of Bruises
- Identification of the causative instrument (patterned bruises)
- Identification of type of crime: From site of bruises on the body (as in abrasions).
- Time passed since inflicted injury
rounded small bruises are caused by …..
Produced by tips of the fingers.
Elongated bruise of the same Thickness of stick Railway Line is caused by …….
blow with a stick
Thin linear parallel bruises run over body curvature are caused by ……
A blow with a whip