Forensic aspects of trauma

Question 1

What are some significant factors in the mechanism of injury?

Answer 1

Force applied

Area over which force acts

Question 2

What are some possible results of excessive mechanical force?

Answer 2

Compression
Traction
Torsion
Tangential (shearing)

Question 3

What are the main factors determining damage?

Answer 3

Type of mechanical force

Nature of target tissue

Question 4

Which factors are used to classify injury?

Answer 4

Appearance (abrasion, contusion, laceration etc.)
Manner of causation (suicidal, accidental, homicidal etc.)
Nature of injury (blunt/sharp force. explosive)

Question 5

What kind of injuries can result from blunt force?

Answer 5

Contusion
Abrasion
Laceration

Question 6

What is a contusion?

Answer 6

Blood vessels in skin injured

Bruising

Question 7

What are tramline bruises?

Answer 7

Imprinted parallel lines of bruising
Impact with long rod like a broom handle
Stretching at the sides of where the rod impacts
Leaves contusion/tearing at sides and line of pallor in middle

Question 8

What is finger tip bruising?

Answer 8

Small, round, red bruises

Typical of finger tip marks left from gripping

Question 9

What are some factors affecting bruising prominence?

Answer 9

Skin pigmentation
Depth and location
Age
Coagulative disorders

Question 10

Where does bruising more readily occur?

Answer 10

Over loose skin

High fat areas

Question 11

Where do bruises less readily develop?

Answer 11

More easily stretched and compresses
Force more easily spread
Buttocks
Abdomen

Question 12

What can skin tags in abrasion tell us?

Answer 12

May indicate direction of the force of impact

Question 13

What might close, linear, parallel scratch abrasions indicate?

Answer 13

Serrated blade

Question 14

What might we think of with larger semi-circle made of small round abrasions?

Answer 14

Bite

Question 15

What are some signs we look for in strangling?

Answer 15

Broad areas of abrasions

Small linear abrasions which may correspond to finger nails

Question 16

What is a laceration?

Answer 16

Splitting of skin due to blunt force trauma

Question 17

Where are lacerations usually found?

Answer 17

Where skin overlies bone

Question 18

What are some typical features of laceration?

Answer 18

Rough edges
Tissue bridges
Stellate branching

Question 19

What are the 2 main types of sharp force injury?

Answer 19

Incised

Stab wound

Question 20

What is an incised wound?

Answer 20

Longer on skin surface than it is deep

Slash

Question 21

What is a stab wound?

Answer 21

Deeper than length of surface cut

Question 22

What are some things to look for in stab wound?

Answer 22

Is it squared off at one end of cut or both ends sharp?

Shape of wound

Question 23

What does a lighting bolt stab wound indicate?

Answer 23

Scissors

Question 24

What might indicate movement of the blade within the wound?

Answer 24

Additional cuts/notches coming off

Don’t know what was actually moving tho

Question 25

How do we identify self inflicted injuries?

Answer 25

Usually sharp force Wrists/forearms, chest/abdomen Parallel, multiple tentative incisions Position of clothing

Question 26

What are the main factors in consequences of an injury?

Answer 26

Type of mechanical insult Type of target tissue Forces involved Number of impacts

Question 27

What are the main kind of head injury fractures?

Answer 27

Linear Depressed Base of skull e.g. ring around foramen magnum

Question 28

What kind if haemorrhage may result from rapid rotational movement like for a punch?

Answer 28

Traumatic subarachnoid haemorrhage

Question 29

Describe the pathophysiology of traumatic subarachnoid haemorrhage.

Answer 29

Trauma ruptures vessels at base of brain where they cross the dura Usually distal intracranial vertebral arteries Immediately unconscious with cardiac arrest

Question 30

How does diffuse axonal injury present?

Answer 30

Immediate and prolonged coma with no apparent mass lesion or metabolic abnormality

Question 31

How do blunt force injuries usually affect the lungs?

Answer 31

Contusions | Lacerations

Question 32

How do sharp force injuries usually affect the lungs?

Answer 32

Penetration Haemorrhage Collapse

Question 33

How do sharp force injuries usually affect the heart?

Answer 33

Penetration Tamponade Haemothorax

Question 34

How do blunt force injuries usually affect the heart?

Answer 34

Bruising Laceration Commotion cordis

Question 35

How do blunt force injuries usually affect the abdomen?

Answer 35

Bowel tears Mesenteric haemorrhage/laceration Liver and spleen lacerations

Question 36

What kind of injuries may be expected for resuscitation?

Answer 36

``` Bruising neck and chest Gingers marks Bruising/lacerations of lips gums, lungs Teeth damage Sternal and rub fractures Venepuncture and cannulation Pleural cavity haemorrhage Heart rupture ```