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Flashcards in Forensic Aspects of Trauma Deck (28)
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1
Q

What is an injury?

A

A disruption in the integrity of the tissues resulting from the application of an external force

2
Q

What might injuries involve?

A

Skin, internal tissues and organs

3
Q

What is injury the consequence of?

A

Transfer of energy - the greater the energy transferred, the greater the disruption of the tissue and so the greater the injury
If enough energy is transferred the injury will be fatal

4
Q

What are the types of energy?

A
Mechanical e.g. from weapon to body 
Thermal 
Electrical 
Radiation
Chemical
5
Q

What does there need to be for an injury to occur?

A

A victim
A weapon
An interaction between them

6
Q

What are the determinants of the nature of any resultant injury?

A

Force - the greater the energy the greater the force
Area - over which the force/energy is delivered
Duration
Direction

7
Q

If a patient is mobile, where will some of the energy causing an injury be dissipated?

A

In their movements and therefore less will be focused on the injury site compared to an immobile patient

8
Q

What parts of the body will people present when an injury is being inflicted on them?

A

Parts that are less vulnerable e.g. arms and legs to protects face, head, internal organs etc.

9
Q

What are the biological factors affecting an injury?

A

Mobility
Anticipation, co-ordination and reaction
Biomechanical properties of the tissues

10
Q

How do the biomechanical properties of the tissues affect an injury?

A

Penetrating weapon hitting bone instead of soft tissue - bone will likely stop a blade whereas it would continue to travel through soft tissue
Energy applied will transfer more in hard external tissues than in soft tissues

11
Q

What is a contusion?

A

Bruise

12
Q

What are the features of bruising?

A

Does not necessarily show point of contact - bruises expand outwards so won’t show direct point of contact
Deep bruising and blood tracking commonly occur
Some bruises may only bruise superficially (dermis) in which case the point of contact and patterns of bruising will be more indicative of the injury

13
Q

What is bruising due to?

A

Breaking of blood vessels

14
Q

When is blood tracking important?

A

In paediatric trauma when considering non-accidental injury e.g. two black eyes are difficult to obtain accidentally, more commonly blood tracking from an injury to the head higher up

15
Q

What are brush abrasions?

A

When wide areas of the body are dragged along a surface e.g. motorcycle accidents

16
Q

What are the features of abrasion?

A

Confined to the skin
May show an imprint of the causative weapon
Will show point of contact

17
Q

What is a laceration?

A

Force spread over an area causing tearing of the skin/tissue

18
Q

What are the features of laceration?

A

Irregular
Presentation depends on energy applied
Tissue will tear in whatever plane is maximally deformed, weakest and least resistant
More extensive debridement and exploration needed than in incisions
Poorer cosmetic outcome
Scarring and infection risk

19
Q

What are lacerations bridged by?

A

Bits of stronger tissues e.g. nerves

20
Q

What is an incision?

A

Cutting using a sharp blade

21
Q

What are the features of incisions?

A

Typically greater length than depth
Wound will have defined margins with no bridging of tissues
Tends to be no surrounding injury unless additional blunt force energy was applied
Minimal debridement and cosmetic surgery needed

22
Q

What are the features of stab wounds?

A

Generally deep wounds (depth variable)
Surface injury may not be indicative of depth and severity of injury, unless a major blood vessel has been damaged and severe bleeding is occurring

23
Q

What are the other types of injury?

A
Blunt penetrating 
Firearm injuries - huge energy and velocity, causes cavitation of the tissues through which the bullet travels and then tissue recoil 
Thermal injuries 
Electrical burns 
Fractures 
Haemorrhage
Asphyxia
24
Q

What are the types of anoxia?

A

Anoxic anoxia - smothering, neck compression
Anaemic anoxia - reduced Hb, CO poisoning
Stagnant anoxia - usually in cardiac failure
Histotoxic anoxia - cells poisoned e.g. cyanide poisoning

25
Q

Why is pain generally not felt at the time of injury?

A

Due to adrenaline

26
Q

What are some factors of acting capacity?

A

Injured person’s ability to run away/remove themselves from the harmful situation etc.

27
Q

What are the modes of death?

A
Natural 
Unnatural - homicide, suicide, accident 
Homicide - assault, culpable homicide, manslaughter 
Suicide - self-inflicted 
Accident - unpredictable
28
Q

How do we attempt to distinguish the mode of injury?

A

By considering;

  • pattern of injury/injuries e.g. position, defensive injuries vs tentative (self-harm)
  • circumstances e.g. evidence of eye-witnesses
  • common sense