Wound Flashcards
What is the definition of a wound?
A wound is the disruption of the continuity of tissues (skin, bone, blood vessels, or organs) produced by external mechanical trauma.
What are the three legal classifications of wounds according to severity?
- Simple wounds: heal in less than 20 days with no permanent infirmity.
- Dangerous wounds: heal in more than 20 days or leave permanent infirmity.
- Fatal mortal wounds: lead to death immediately or shortly after infliction.
What is meant by ‘permanent infirmity’ in the context of wounds?
Permanent infirmity refers to loss of functioning organ or loss of function of this organ, such as permanent loss of vision following trauma.
What are the six medico-legal classifications of wounds according to etiology?
- Abrasions
- Contusions or bruises
- Lacerated or contused wounds
- Incised or cut wounds
- Stab wounds
- Firearm wounds
What is the definition of abrasions?
Destruction of the superficial layers of the skin due to pressure or friction with a rough blunt object.
What is the medico-legal importance of abrasions?
- Indicate signs of violence and resistance.
- Take the shape and pattern of the causal object.
- Occur at the site of impact.
What differentiates antemortem abrasions from postmortem abrasions?
- A.M. abrasions show vital reactions (redness, healing, sepsis).
- P.M. abrasions are due to handling of dead bodies or insect effects.
What are contusions, and how are they formed?
Bruises are extravasations of blood into the tissues following rupture of blood vessels due to blunt trauma.
What is the medico-legal importance of bruises?
- Indicate violence or resistance.
- Take the shape of the causal object (patterned injury).
- The site of bruises usually corresponds to the site of force application.
What are the stages of color change in a bruise?
- Bright red (oxyhemoglobin)
- Blue (reduced hemoglobin)
- Green (biliverdin)
- Yellow (bilirubin)
What are the characteristics of contused/lacerated wounds?
- Irregular and abraded edges.
- Accompanied by abrasions and bruises.
- Minimal bleeding due to crushing of blood vessels.
What defines incised or cut wounds?
Wounds caused by drawing the edge of a sharp object on the skin and underlying tissues.
What are the characteristics of incised wounds?
- Regular edges (unless skin is corrugated).
- No bruising or abrasions.
- Free bleeding and cleanly cut blood vessels.
What is a stab wound?
Stab wounds are caused by forcing a sharp pointed object into the body.
Fill in the blank: A bruise is characterized by the presence of _______.
[extravasations of blood into the tissues]
True or False: Postmortem bruises are characterized by swelling and color changes.
False
What are the types of stab wounds?
- Punctured wounds
- Transfixing wounds
- Perforating wounds
Punctured wounds are caused by pointed objects, transfixing wounds connect organs, and perforating wounds extend into body cavities.
Define defense injuries.
Injuries sustained by the victim while defending themselves.
These include abrasions or bruises on the forearm, back of hands, and thigh.
What are fabricated or self-inflicted wounds?
Simple wounds self-inflicted by a person.
These are superficial, accessible, and not correlated with a specific date or history.
What are common aims for self-inflicted wounds?
- Revenge
- Pretend self-defense
- Avoid prison work
- Obtain illegal compensation
- Escape military service
- Alleged police mistreatment
These motivations often lead individuals to inflict harm on themselves.
List the early causes of death in wounds.
- Hemorrhage
- Shock
- Embolism
Hemorrhage can be external or internal, shock types include neurogenic and hematogenic, and embolism can be air, fat, or thromboembolism.
What is external hemorrhage?
Bleeding that occurs with open wounds reaching large vessels.
It is easily diagnosed, and fatality depends on the amount and rate of bleeding.
What is internal hemorrhage?
Dangerous bleeding not easily diagnosed, with fatality depending on the site of bleeding.
For example, 10-20 c.c. in the cranium can be fatal.
What causes primary neurogenic shock?
Sudden good or bad news, or a blow to trigger areas rich in parasympathetic nerve endings.
Examples include the larynx, precordium, and external ear.
What is sympathetic shock?
Shock occurring after painful wounds or severe fright.
It leads to adrenaline release, increased heart rate, and blood pressure.
What is secondary hematogenic shock?
Occurs a few hours after trauma due to histamine-like substances causing generalized vasodilation.
This leads to decreased venous return and circulatory failure.
List late causes of death in wounds.
- Sepsis
- Disseminated intravascular coagulation (DIC)
- Supra-renal hemorrhage
- Adult respiratory distress syndrome (ARDS)
- Crush syndrome
- Acute renal failure
- Surgical interference
Each of these can lead to delayed fatal outcomes.
What is sepsis?
A serious condition that may cause delayed death due to infection.
It can lead to fatal pneumonia or meningitis.
What is crush syndrome?
Condition resulting from crushing of a limb, leading to renal failure due to myoglobin release.
This occurs in car accidents and can lead to death.
How can you differentiate between homicidal and suicidal cut throat?
Homicidal cut throat often involves severe hemorrhage and neurogenic shock, while suicidal cut throat may have different characteristics.
Signs include the mechanism of death and patterns of injuries.
What are the mechanisms of death in cut throat injuries?
- Neurogenic shock
- Hemorrhage
- Venous air embolism
- Asphyxia
- Transection of spinal cord
- Delayed death due to edema or aspiration pneumonia
Each mechanism can lead to different outcomes in cut throat cases.
