Patterns in Injuries

Question 2

What is traumatic change?

Answer 2

Force, chemicals, heat, environmental conditions applied to normal anatomy.

Question 3

What 3 things does traumatic change result in?

Answer 3

Loss/change of tissue
Loss of function
Behavioural change

Question 4

What information can be gleaned from loss\change of tissue interpretation? (3)

Answer 4

Primary, secondary injury
Sequelae of injury
Chain of events -> COD, manner of death

Question 5

What are injuries?

Answer 5

Physical manifestations of trauma on the body

Question 6

What does type of injury depend on?

Answer 6

Type of force and trauma

Question 7

What do injuries convey?

Answer 7

Information

Question 8

List blunt force injuries (5)

Answer 8

Abrasions
Avulsions
Fractures
Contusions
Lacerations

Question 9

What are the 7 ways to describe fractures? OLD ACID

Answer 9

Open or closed
Location
Degree
Articular extension
Comminution and pattern
Intrinsic bone quality
Displacement, angulation, rotation

Question 10

Differentiate between open and closed fractures.

Answer 10

Open - broken end of bone passes through the skin
Closed - skin is not lacerated

Question 11

What information about location of fractures is importnat?

Answer 11

Which bone is fractured?
Which part of the bone is fractured?

Question 12

List the two types of fracture degrees.

Answer 12

Complete and incomplete

Question 13

Describe complete fractures.

Answer 13

Transect the bone
Separation of bone segments

Question 14

Describe incomplete fractures

Answer 14

Bone bends and ‘tears’ but is not transected

Question 15

Give an example of an incomplete fracture.

Answer 15

Greenstick fractures

Question 16

What is a greenstick fracture?

Answer 16

Bone is broken on one side, does not go all the way through.

Question 17

What important information regarding articular extension should be known about a fracture>

Answer 17

Is a joint involved?
Is there joint damage?
Is there a dislocation?

Question 18

What fracture pattern is seen here?

Answer 18

Transverse fracture

Question 19

What fracture pattern is seen here?

Answer 19

Oblqiue

Question 20

What fracture pattern is seen here?

Answer 20

Spiral

Question 21

What fracture pattern is seen here?

Answer 21

Comminuted

Question 22

What pattern of frfacture is seen here?

Answer 22

Avulsion

Question 23

What type of fracture is this?

Answer 23

Impacted

Question 24

What type of fracture is seen here?

Answer 24

Fissure

Question 25

What type of fracture is this?

Answer 25

Greenstick

Question 26

What is a transverse fracture?

Answer 26

Fracture perpendicular to length of bone.

Question 27

What is an oblique fracture?

Answer 27

Bone broken at an angle.

Question 28

What is a spiral fracture?

Answer 28

Bone broken in a twisting motion. Corkscrew appearance

Question 29

What is a comminuted fracture?

Answer 29

Bone broken in at least two places.

Question 30

What is an avulsion fracture?

Answer 30

Small chunk of bone attached to tendon or ligament pulled away from main part of bone.

Question 31

What is an impacted fracture?

Answer 31

Ends driven into each other.

Question 32

What is a fissure fraction?

Answer 32

Crack in bone without alteration to alignment or breaking of periosteum.

Question 33

What is intrinsic bone quality?

Answer 33

Relates to underlying conditions that predispose bones to fracture.

Question 34

Give examples of conditions that can predispose bones to fracture.

Answer 34

Osteoporosis/osteopenia Osteogenesis imperfecta

Question 35

In which cases is it important to test for an rule out conditions affecting one's susceptibility to fractures?

Answer 35

Suspicion of child or elder abuse.

Question 36

What is displacement as it relates to fractures?

Answer 36

Bone moved away from natural position.

Question 37

What is angulation as it relates to fractures?

Answer 37

Bone moved away from natural position and shifted by a discernable angle.

Question 38

What is rotation as it relates to fractures?

Answer 38

Bone rotated along its axis (with or without displacement or angulation)

Question 39

List the types of sharp force injuries (4).

Answer 39

Incision Stab/puncture Chop Fracture (occasionally)

Question 40

What injuries are associated with projectiles? (3)

Answer 40

Direct tissue destruction Cavitation injury Entry/exit wounds

Question 41

Which is usually larger, entrance or exit wounds from projectiles?

Answer 41

Exit

Question 42

What are mixed force injuries?

Answer 42

Injuries resulting from trauma inflicted by more than one type of force or energy.

Question 43

Give examples of mixed force injuries (4)

Answer 43

Chop wounds Crush wounds Pneumo/hemo/chylothorax Blast injuries

Question 44

What forces/energies are involved in chop wounds?

Answer 44

Sharp and blunt force

Question 45

What forces/energies are involved in crush wounds?

Answer 45

Blunt and sharp

Question 46

What forces/energies are involved in pneumo/hemo/chylothorax?

Answer 46

Blunt injury leading to penetration by broken rib.

Question 47

What forces/energies are involved in blast injuries?

Answer 47

blunt, sharp, concussive, heat, etc.

Question 48

Describe the events leading to injuries, from primary to quaternary, in blast injuries.

Answer 48

1. Pressure wave 2/ Flying debris 3. Displacement of victim 4. Crush, burn, asphyxia, toxins

Question 49

What can injury tell us about (4)

Answer 49

Event Circumstances Objects Perpetrators

Question 50

What does the location of an injury tell us?

Answer 50

Direction of attack Position of perp/victim

Question 51

What information does type of injury give us?

Answer 51

Cause of injury Severity of injury Intent of perp?

Question 52

What information does pairing of injuries tell us?

Answer 52

Particular patterns indicate typicality of events

Question 53

What do different stages of healing tell us?

Answer 53

Pattern of behaviour of victim/perp

Question 54

Differentiate between 'patterned injuries' and 'injury patterns'

Answer 54

Patterned injuries = information about the object Injury patterns = informagtion about the circumstances

Question 55

Define patterned injuries.

Answer 55

Imprint of the object or intermediary material (e.g., clothing) is imprinted or stamped onto the skin by the crushing effect of the blunt object.

Question 56

What type of injuries can be patterned injuries?

Answer 56

Abrasions Contusions

Question 57

List some injury patterns.

Answer 57

Location Size Frequency Timing Pairing of injuries

Question 58

What do injury patterns speak to?

Answer 58

Circumstances

Question 59

In what types of trauma may defensive wounds be seen?

Answer 59

Sharp, blunt, ballistic

Question 60

Where are defensive wounds typically seen?

Answer 60

Hands, forearms, feet, inner thighs

Question 61

What are injury patterns common to domestic violence?

Answer 61

Facial fractures with defensive wounds

Question 62

What important information do defensive wounds tell us?

Answer 62

Victim was conscious

Question 63

What type of information should be considered when interpreting injuries (6)?

Answer 63

Age and sex specific patterns of injury Underlying conditions Is medical history plausible? Was presentation to healthcare delayed? Additional injuries? Different stages of healing? Is the individual mobile?