Module 6: Forensic: blunt impact to firearms Flashcards Preview

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Flashcards in Module 6: Forensic: blunt impact to firearms Deck (35):
1

What are blunt impact injuries?

Rough edges and bridging strands of tissue
--abrasions: scraping of outer layers of skin
---contusion: disruption of subcutaneous blood vessels
--laceration: tearing or rupture of skin by blunt force
--skeletal fractures

2

What is a scalp laceration?

Scalp lacerations: important to identify site and number of impacts
--single impact (assault or fall) and many impacts

3

What is seen in a basal skull fracture?

Raccoon eyes (periorbital contusions), battle sign (Hemorrhage in mastoid process) and blood/CSF rhinorrhea or otorrhea

4

What are the two different types of intracranial hemorrhage?

Epidural hemorrhage (b/w skull and dura)
--caused by blow to side of head with temporal bone skull fracture and laceration of middle meningeal artery
Subdural hemorrhage (b/w dura and arachnoid )
--due to torn bridging veins with or without fracture
--caused by rapid acceleration or rotational force

5

What is a focal traumatic brain injury?

Cortical contusions: bruise of the brain (often seen with subarachnoid bruising)
--contrecoup contusion
Cerebral laceration

6

What is a diffuse traumatic brain injury?

Concussion: transient and highly variable disturbance of neurological function following trauma
--blow to head is not required; pre disposition= APO-E

7

What is a diffuse traumatic brain injury?

Diffuse axonal injury: rotational acceleration (Shearing of axons as they are stretched beyond elastic point with rotational force)

8

What are the various types of chest injuries?

Fracture
Cardiac contusions and lacerations
Aortic Lacerations (deceleration injury and crush injury)
Pulmonary contusions and lacerations
Diaphragmatic lacerations

9

What is the sequelae in chest injuries?

Flail chest
Hemopericardium
Hemothorax
SQ emphysema
Pneumothorax

10

In regards to chest injuries what is a deceleration injury?

Heavy heart keeps moving while tethered to vertebrae at distal arch

11

In regards to chest injuries what is a crush injury?

Osseous pinch (Crushed between chest and spine)

12

What are examples of abdominal and pelvic injuries?

Liver lacerations
spleen lacerations
mesenteric lacerations
Pelvic fractures

13

What are examples of extremity injuries?

Soft tissue injury
Long bone fracture
Traumatic amputations

14

What are pedestrian transportation injuries?

Primary impact with bumper
Secondary impact with windshield (spiderweb pattern of broken glass)
Tertiary impact with roadway

15

What are the type of occupants in a transportation injury?

Child vs adults
Restrained/Unrestrained
Type of vehicle (airbag and size)
Type of crash (frontal, side, rear, roll over and ejected)
Speed

16

What types of injuries do you see in a head on collision?

Face and head injury, cervical spine injury, braced leg fracture and pelvic fracture

17

What types of injuries do you see in a rear impact collision?

More neck injury at lower speed
--hyperflexion/extension of neck with cervical spine fractures

18

What type of injuries do you see in a side impact collision?

Injuries from intrusion and lateral flexion of neck

19

What type of injuries do you see in a rollover accident?

Unrestrained passengers commonly ejected -- amputations and patterned injuries

20

How would you tell the difference on exam in a fall vs an assault?

Fall: level of hat line, protuberant areas, one plane and contrecup contusions
Assault: above hat line, recessed areas, more than one plane, fracture contusions

21

What is shaken baby syndrome?

Acceleration and deceleration forces lead to:
--intracranial injuries
--retinal hemorrhages
--long bone fractures
--posterior rib fractures

22

What are the clinical feature of shaken baby syndrome?

Mental status changes
Increased ICP
Resp changes
Suggestive bruising
Retinal hemorrhage

23

What is found on clinical and autopsy findings?

Scalp hematomas, subdural, subarachnoid, perioptic nerve and retinal hemorrhages

24

Who are the perpetrators in shaken baby syndrome?

Biological father
BF
Female sitter
Mother
Male Sitter
Stepfather

25

What are common explanations in regards to shaken baby syndrome?

Accidental Injury
SODDI
No impact/assault
Re-bleed of an old subdural hemorrhage
Second impact syndrome due to two minor injuries

26

What are sharp injuries?

Incised (Cuts, slashes) or stab wounds

27

Sharp injuries are variable in size and shape, what are the various sizes and shapes?

Type of weapon
Depth of penetration: wound depth doesnt always match blade length b.c tissue is very compressible
Movement of victim.perpetrator
Movement of instrument
Orientation of body

28

What are hilt marks?

part of handle of the blade that leaves a mark

29

What are Langer's lines?

Lines of elasticity (orientation of collagen fibers in dermis) that determine scarring
--wound perpendicular to the line: gashing wound
--used by surgeons for suturing

30

How can you tell the difference b/t self inflicted an homicide?

Self: history, hesitation marks, not through clothing and rarely head and neck
Homicide: multiple, deep/chops, defense wounds and neck

31

What are considered small firearms and ammunition?

Handguns
Rifles
Shotguns
Ammunition: bullets, shotgun pellets and shotgun slugs

32

What are wound ballistics?

Kinetic energy of bullet = weight x velocity2/2g
Temporal and Permanent Cavity:
--tem: shearing, compression and stretching of adjacent tissues as energy is lost from bullet
--perm: actual tract of crush injury by bullet
Density and strength of tissue
Angle of yaw or tumbling at impact
Configuration of bullet

33

What are the various wound paths?

Perpendicular to skin = concentric abrasion
Angled entry = eccentric abrasion

34

What is the appearance of an entrance wound?

Ovoid
Muzzle abrasion
Gunshot residue
Marginal abrasion
Tissue loss

35

What is the appearance of an exit wound?

Irregular
No muzzle abrasion
No gunshot residue
No abrasion ring
No tissue loss

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