BRUISES AND LACERATIONS.pptx forensic medicine

BRUISES AND LACERATIONS.pptx forensic medicine

1. BRUISES AND LACERATIONS PROFESSOR

2. BRUISES A bruise(contusion)is haemorrhage in to the skin, subcutaneous or deeper tissues. The term bruise implies that a lesion is visible through the skin and the term contusion implies that bleeding can be any where in the body.

3. COLOUR CHANGES IN BRUISE Red (haemoglobin) to blue (deoxygenated haemoglobin)=in a day Bluish black to brown ( haemosiderin )=2 to 4 days Green( haematoidin )=5 to 7 days Yellow( bilirubin )=7 to 10 days Normal colour=14 to 15 days. Sub conjuctival haemorrhage (black eye)does not show the similar colour changes owing to haemoglobin being kept oxygenated by air. it is red at first, then becomes yellow and finally disappears.

4. ANTEMORTEM AND POST MORTEM BRUISING Signs indicating antemortem bruising : 1. Swelling of tissues 2.Discoloration of skin with blurred margins 3.Inflitartion of blood

5. BRUISE AND POSTMORTEM LIVIDITY BRUISE POSTMORTEM LIVIDITY cause Rupture of vessels Engorgement of vessels due to pooling of blood histology Signs of inflammation present No signs of inflammation present site Anywhere on the body At dependent parts surface elevated No elevation colour Variable, depending on age Normally purple incision Shows extra vasated blood in the cut tissues which can not be washed out Blood oozes out of cut vessels which can be easily washed

6. MEDICOLEGAL ASPECTS OF BRUISE They are less value than abrasions because A) they may not appear at site of injury due to gravitational shifting of blood. B)a deep bruise may take hours or one or two days to appear or may not appear externally at all. C)its size may not correspond to the severity of violence due to continued extravasation . D)they do not indicate the direction of force.

7. ARTIFICIAL BRUISES Artificial bruises are caused by usually using the marking nut juice , calotropis , roots of plumbago on parts within easy reach These can be differentiated from true bruises by presence of vesicles and inflammation The chemical can be determined on chemical examination in labotatory

8. PETECHIAE : Pin point contusions PERCOLATED CONTUSIONS OR ECTOPIC BRUISE: Appearing at remote site COME OUT BRUISES: Deeply situated bruise manifests after hours or days TRAMLINE CONTUSIONS : Two parallel contusions separated by relatively pale, undamaged section of skin

9. LACERATIONS A Laceration is a wound in which the skin, mucosa or underlying tissues are torn as a result of application of blunt force. Depending upon manner of their production, they are classified in to: Split Laceration: Split laceration are usually found in parts overlying bones without much tissue in between. They are commonly seen at scalp, face, hands and lower legs.They are caused by blunt and almost perpendicular impact.They are also called incised like or incised looking wound

10. Stretch Laceration: This is due to over stretching of skin . Avulsion : it is due to grinding compression of tissues Skin is separated from deeper tissues, it is known as degloving of the skin Tears : it is due to irregular tearing of skin ant tissues Internal Laceratio n: Laceration of internal organs.

11. CHARACTERISTICS OF LACERATIONS : Edges are ragged, irregular and frequently bruised. Margins are commonly abraded. Deeper tissues are unevenly divided with the result that the strands of tissues are seen crossing the deeeper parts of laceration. Hair follicles when present are crushed.

12. INCISED WOUND An incised wound is an injury caused by a weapon with sharp cutting edge when it is drawn across the skin. Characteristics The length of incised wound is greater in length than its depth. No bruising of the wound edges present All tissues are cleanly cut. Blood vessels are cut across and not torn Bleeding is profuse, escapes freely Incision wound tails off to a superficial skin wound. The tailing thus signifies the direction of wound

13. HESITATION CUTS Preliminary cuts by a person committing suicide . before gathering sufficient courage to make a final deeper tissues. They are also known as tentative cuts. They are generally small, multiple, superficial some what parallel and usually skin deep.

14. STAB (PUNCTURE) Stab wounds are piercing wounds produced by sharp pointed weapons. Classification: Penetrating Stab Wounds: If they terminate in tissues, organ or cavity. Perforating Stab wounds: If they transfix them(through and through wounds).There will be entry and exit wounds. The wound of entry is usually larger than the wound of exit. The edges of wound of entry are inverted.

15. MEDICOLEGAL SIGNIFICANCE Wedge shaped entry wound- Caused by single edged sharp weapons. Ellipitical wound- Double edged sharp weapons. Depth of a stab wound is always greater than length of wound

16. DEFENCE WOUNDS Injuries sustained by a person as a result of his spontaneous reaction to protect himself when attacked. Usually found on the grasping surface of hands ulnar borders of forearm and dorsum of the palm Defence injuries on the lower limbs are more common if the victim is a female and they suggest sexual assault

17. FABRICATED INJURIES Also known as fictitious injuries or forged wounds self inflicted and self suffered Purpose- 1.to support a false charge with ulterior motive 2.to avert the suspicion Diagnosis: Recent injuries which are multiple, superfical , half hearted and not on the vital parts of the body. Examination of clothes is very valuable. Corresponding cut is not present on the clothes.

18. CAUSES OF DEATH 1.Primary(immediate or direct) 2.secondary(remote or indirect)

19. PRIMARY CAUSES OF DEATH 1)Haemorrhage 2)Injury to a vital organ 3)Neurogenic shock 4)combination of these

20. HAEMORRHAGE A)External B)Internal Normal blood volume in adult is 8 to 8.5% of body weight. Rapid loss of 2 litres of blood (1/3 of blood of the body)is sufficient to cause death

21. INTERNAL HAEMORRHAGE Site of haemorrhage Cause of death Extra dural or subdural Cerebral compression Medulla Failure of vital functions pericardial sac Cardiac tamponade Pleural cavity Collpase of lungs and displacement of mediastinum Respiratory passages Asphyxia

22. A Necessarily fatal injury: Injury ends in death as adirect result of the injury An injury likely to cause death: When death is merely possible but is likely. In legal language, it is an injury wher form death as a consequence is not surprising An injury sufficient in ordinary course of nature to cause death: Injury fatal by virtue of its own effects.