INCISED, LACERATED.pptx

Details of sharp and blunt force injuries.

1. Rickshaw ran over a child’s thigh, there is a mark of the tyre tracks, it is an A. Contact bruise B . Patterned bruise C. Imprint abrasion D. Ectopic bruise

2. In which of the following injuries foreign bodies are not found? (A) Grazed abrasion (B) Chop wound (C) Lacerated wound (D) Contusions

3. The following factors do not influence in the formation of a bruise: (A) force used (B) sex of a person (C) age of a person (D) color of a person

4. A 25 year old person sustained injury in right eye. He developed right corneal opacity following the injury. Left eye was already having poor vision. Corneoplasty of right eye was done and vision was restored. Medicolegally such injury is labelled as : Grievous B. Simple C. Dangerous D. Serious

5. Appearance of a bruise at a site away from the site of impact is called (A) Artificial bruise (B) True bruise (C) Ectopic bruise (D) Chemical bruise

6. No color change is seen in sub- conjunctival hemorrhage due to: Continuous CO2 supply B) Little amount of blood is present C) Continuous O2 supply D) Color change occurs but not visible to naked eye

7. Incised wounds MECHANICAL INJURIES Dr. Sunil Duchania MBBS (MAMC), MD (LHMC) Certification in Medical Negligence in India Founder- Forensic Extracts Founder- SABAL Medico legal Consultancy Former President RDA LHMC, Delhi Vice-President FORDA, India

8. Incised wounds Clean separation or division of skin under the pressure of a sharp-edged instrument ( knives or broken glass )

9. Incised wounds Slash wounds: Length > depth. Generally NOT as serious as stab wounds unless it involves major blood vessel . Tailing

10. Self-inflicted injuries

11. Self-inflicted injuries Cuts are usually superficial , multiple and parallel . In right handed people most of injuries are on the left side.

12. Certain sites : throats , wrists and the front of the chest are more common . They are often multiple Features of SUICIDAL knife wounds

13. Defense Wounds

14. Defense Wounds Definition : A wound sustained when a victim places a hand , arm or other body part to prevent or minimize a blow or slashing by a sharp weapon.

15. The outer-side of the forearm

16. Back of the hand

17. Fingers

18. Chop wound Large Gaping wounds

19. Laceration Rupture, tear or split in the skin, mucous membrane, muscle etc. Blunt force injury Irregular margins Tissue bridging

20. Types Split Tear Avulsion Internal

21. Split Seen over scalp, cheek, chin Resembles like incised wounds

22. Tear

23. Avulsion By Grinding compression force Separation of skin from underlying tissues

24. Internal External visible injury may or may not present

25. Incised wounds Lacerations Clean Trace evidence (rust or dirt) Absent Tissue bridging present Clean cut edges Ragged edge May be self-inflicted RARELY self-inflicted Comparison:

26. Duty of the Doctor Make a detailed examination and provide a medical report that can be used in subsequent criminal or civil proceeding . The purpose of examination is to determine: The time of the wound in relation to death. How it was caused. What is the cause . What amount of force was used to produce it. The degree of injury that was caused by the wound (whether the wound influenced death or disability).

27. How to describe a wound The nature of the wound ( bruise , laceration or abrasion ). The wound dimensions ( length , width and depth ). The position of the wound in relation to fixed anatomical landmarks eg: distance from the mid line , distance below the clavicle …etc. The number of wounds. The margins of the wounds (Ragged or Everted)

28. Factors affecting wound HEALING Blood supply. Infections. Age Site of wound. Nutritional status. Inter current diseases. Drugs: corticosteroids, immunosuppressive, radiotherapy, chemotherapy.

29. Complications of wounds Infection and sepsis. Bleeding Hypovolemic shock. Injury to internal organs. Formation of scar.

30. Causes of DEATH due to wound Injury to a vital organ eg: brain. Sever hemorrhage . Shock Pulmonary embolism. Septicemia Renal failure due to rhabdomyolysis (crush syndrome).

31. The greatest dimension of an incised wound is (A) Breadth (B) Depth (C) Length (D) Breadth and depth are equal

32. Identify the type of wound ? A. Lacerated wound B. Incised wound C. Incised looking lacerated wound D. Stretch laceration

33. Split laceration resembles: Incised wound B) Abrasion C) Gunshot wound D) Contusion

34. Hesitation cuts are seen in a case of: Homicide B) Suicide C) Accident D) Fall from height

35. In an incised wound, all of the following are true, except: It has clean-cut margins B) Bleeding is generally less than in lacerations C) Tailing is often present D) Length of injury does not correspond with length of blade

36. Bevelling is seen in- Abrasion B) Incised wounds C) Firearm wounds D) Both B &C