Wounds Flashcards
(23 cards)
What is permanent infirmity
Loss of functioning organ, or loss of function in this organ.
What is Medicolegal classification of wounds
- Abrasions. (Scratches)
- Contusions. (Bruises)
- Incised (cut) wounds.
- Contused (lacerated) wounds.
- Stab wounds.
- Firearm wounds.
What is Abrasions
Destruction of superficial layers of skin (epidermis or upper dermis) due to pressure or friction with blunt object.
-ooze serum dries > form SCAP (crust) and heal with NO SCAR.
MLI of Abrasions
1-Resistance or struggle on victim or assailant e.g. Rape and murder.
2-SITE: •smothering.•throttling. •around (wrist, thighs and mouth) > REAPE.
3-SHAPE. (next card)
4-AGE (next card)
5-Antemortem vs postmortem.
6-Differ between cut and CONTUSED wounds.
Legal classification of wounds
- Simple: heal 20 days without permanent infirmity
- Dangerous: heal >20 days and /or leave permanent infirmity.
- Fatal (mortal) wound: lead to death.
Age of abrasions (from healing)
- 2days > soft scab.
- after 3days > dry scab.
- after 1week > scab falls + red area.
- after 2-3weeks > red area disappear.
What is Contusion and MLI of it
Extravasation of blood in tissues due to rupture of b.v. Caused by BLUNT object.
MLI:
-denote resistant or struggle.
-site of trauma (BUT may gravitate down e.g. Blow in scalp > eyelids and blow in calf > ankle).
-Shape of causal object.
-Types: superficial or DEEP [appear 2 days later].
-Age of bruises from the color.
-Differ Cut from Contused wounds.
Age of Bruising رانية بنت جميلة اوي
From color change caused by disintegration of Hb:
- 1st 2 days: Red (oxy Hb)
- After 2-3 days: Blue (reduced Hb)
- After 2-3 days: Green (biliverdin)
- After 2-3 days: Yellow (bilirubin)
- Then FADES in 2-3 weeks.
** color changes from PERIPHERY to the CENTER.
Shape of bruises
- 2 curved rows in: Human bite.
- 2 parallel rows in: Animal bite.
- Elongated (tramline or railway) in: stick injury.
- Curved around the body by: a Whip.
- Pinch: 2 identical small rounded bruises.
- Hand slaps: multiple parallel linear bruises.
How to differentiate between INCISED and Contused wounds
Cut wounds: 1-drawing SHARP object. 2-REGULAR clean edge EXCEPT: -irregular object (broken glass). -corrugated skin (neck, axilla, wrist and scrotum. 3-gaping and NO bridges. 4-NO abrasions or bruises. 5-hair SHARPLY cut. 6-free ext. BLEEDING. 7-LESS sepsis. (Minimal tissue destruction) 8-RAPID healing with Thin Scar. 9-More LONG than deep.
How to differentiate between incised and CONTUSED wounds
1-Heavy BLUNT object. 2-IRREGULAR lacerated edge EXCEPT in (area of stretched skin over a bone e.g. SCALP and Shin of tibia. 3-Bridges across the edge and NO gaping. 4-Abrasions and Bruises. 5-CRUSHED hair cut. 6-LESS Bleeding. 7-MORE Sepsis. 8-DELAYED healing with THICK scar.
Age of Cut wounds (by 1ry union) رانية ببو وحشة
- 12 hours: Red and Swollen edge.
- 2 days: growth of new vessels.
- 5 days: vessels start to obliterate.
- 10 days: healing (by 1ry intention)
- 3 weeks: formation of Red scar.
- 3 months: scar become BROWN.
- 6 months: pale WHITISH scar.
Definition of Stab wounds
•FORCING a SHARP-POINTED object into the body (knife and dagger).
Characteristics of Stab wounds
- CLEAN cut edge.
- More DEEP than long.
- very dangerous due to internal injuries.
MLI of Stab wounds
Shape of the CAUSAL object: •cross section -1 acute angle as knife > triangular shape. -2 acute angle as dagger > fusiform shape. •length = Breadth but maybe: -Smaller > tissue retraction. -longer > withdrawal of object. -equal > presence of HANDLE abrasion.
Defense injuries
•Injuries sustained by the victim to defense himself.
-In case of HITTING: abrasions or bruises on outer side of forearm, back of hands and fingers may be broken.
-In attack by KNIFE:
Cut wounds across the fingers and palm.
Shapes of abrasions
- Smothering and Throttling > 4semilunar nail abrasions on one side and 5th on the other side.
- Ligature mark > compressed brown Abrasions taking Rope shape.
- Bites marks: • human > 2 CURVED rows. •Animal > 2 PARALLEL rows.
- Car accident > tyre impression ion victim.
What is Fabricated wounds and Aim of it
•Simple wounds SELF-INFLICTED by oneself or others.
•Aim:
-Revenge. -To pretend that crime was self defense. -To obtain legal compensation.
Characters of Fabricated wounds
1-Multiple Superficial Parallel and relatively Harmless.
2-In a Safe area and accessible to victim.
3-Inflicted on a bare skin with no corresponding tears of clothes.
4- Age of wound usually not correlate withe date stated by fabricator.
Hesitating (tentative) marks
Multiple superficial parallel cut wounds at the beginning of incision indicate hesitation in SUICIDAL wounds.
E.g. Carotid (neck) or radial (wrist) arteries.
Causes of death in wounds ?
1- Hemorrhage.
2- Embolism . 3- Disseminated intravascular coagulation (DIC).
What is the amount causing death in External hemorrhage?
1.5 - 2 liters in adult (1/3 blood volume ).
What is the amount of internal hemorrhage which cause death according to its site ?
- 10-20 ccs in the brain.
- 100 ccs in the pleural cavity.
- 200 ccs in the pericardial sac > cardiac tamponade.
- 500 ccs in the peritoneal cavity.
