Presentation on examination of bruise.pptx

examination of injury bruises and contusion in forensic medicine

1. Forensic Examination of Bruise/Contusion Submitted To: Submitted By: Department of Zoology, Shivani Kurukshetra University, M.Sc. Forensic Sci. Kurukshetra Roll No: 4 Session: 2021-23

2. Introduction Injury and their types Blunt force injury and its classification Contusion Salient features of contusion Factors affecting appearances of contusion Types of contusion Patterned contusion Delayed contusion Natural contusion Contents

3. Deep bruises Artificial bruises Ante-mortem finding Post-mortem finding Medico-legal aspects Case-study Conclusion References Contents contd.

4. A wound or injury is defined as termination of the natural continuity of any of the tissues of the living body. Any physical damage to the body caused by violence or accident or fracture can be called injury. Legally, as per sec.44 IPC; injury is defined as any harm caused illegally to a person i.e. to his body, mind, reputation or reputation or property. Injury

5. In general, the body absorbs the natural forces like gravity, movement, routine movements like sitting and walking by the flexibility and elasticity of its soft tissues and rigid skeletal framework. Injury is formed due to the result forces which cross the limits of the elasticity or resistance. Mechanism of injury

6. Injuries an be further divided into two types such as: Abrasions due to heat- burns and scalds Contusions due to cold- frostbite Lacerations chemical burns Incised radiation burns- due to X-rays Stab electric burns Fire arms lightening burns Fractures /dislocations explosive burns Types of Injuries Mechanical injury Thermal injury

7. The mechanical injury is defined as “damage to any part of the body due to application of mechanical force”, like blunt force, sharp force and firearms. This damage may cause loss of tissue. The injury which is associated with loss of tissue is usually mentioned to as wound. Mechanical Injury

8. “ A bruise signifies haemorrhage into the skin , the subcutaneous tissues, or deeper tissues” It is due to an infiltration or extravasation of blood into the tissues, following rupture of small vessels, as a result of blunt force. It is a haemorrhage into tissues produced by the escape of blood from vessels. Bruises may be found in the skin, muscles, and internal organs. Contusion Fig no:1Bruises

9. Contusion may not always be present at the site of impact. The greater the force or violence used, the more extensive is the bruise. It spreads due to continued extravasation &consequently occupies a wider area, it is not possible to assess the area of impact & severity of violence in such area. Salient features of Contusion

10. Types of Contusion

11. When a bruise is made by impact with a patterned object, the haemorrhage may lie in the immediate sub epidermal layer and its pattern may correspond to the form of the object or the weapon causing it that is whips, canes, bicycle chain etc. Intra-dermal Contusion Fig no. 2 :Intradermal bruise

12. The usual contusion form a blunt impact is situated in sub cutaneous tissues. It is somewhat blurred at the edges and raised above the skin surface due to infiltration of blood in subcutaneous tissues. Sub cutaneous Contusion Fig no. 3:Sub cutaneous bruise

13. This signifies bleeding deeper to the sub cutaneous tissues and some swelling may be apparent when the opposite limb or part of the body is compared with the injured area. It may takes hours or one to two days to appear at the surface. Deep Bruise Fig no. 4: Deep bruises

14. Age Sex Colour of skin Site of injury Vascularity of part Natural disease Gravitational shifting of blood Factors affecting appearances of Bruises

15. Colour changes a bruise goes through can give a rough estimate of time of injury. Colour result from breakdown of haemoglobin from tissues. Red (initially due to oxyhaemoglobin) Blue/purple(~1 to 3 days due to ) Bluish black ( 4 th day due to lack of oxygen,) Green (~2 to 3 days due to haematodin ) Yellow (~3 to 7 days due to bilirubin) Dark blue/purple (1-18 hours) Aging of Bruises Fig no. 5: Stages of bruise healing

16. Age of Bruise - Fig no 6: Age of bruise

17. Bruises may occur in a variety of natural diseases in which there is an abnormality of the clotting mechanism of the blood, e.g. Scurvy (vitamin C deficiency), leukemia, alcoholic liver disease. This bruise is spontaneous because the injury which produces it is so insignificant as to typically pass unnoticed. The process of such natural disease will exaggerate the bruising effects of any trauma Natural Bruise

18. It is type of bruise which reflects the size and shape of the weapon of offence over the point of impact. Medico-legal importance of such bruise is more as they reflects an idea of the possible weapon of offence. Patterned Bruise Fig no. 7: Patterned bruise

19. Reproduced over the body mainly for the purpose of malingering. They are produced by rubbing irritants, chemicals like marking nuts, Calotropis gigantea They are produced to bring false charge of assault against an enemy or for malingering to take medical leave. Artificial Bruise

20. Finger pad bruises: battered babies, manual strangulation Different ages: repeated assaults Shoulders and arms: forceful restraint Wrists and ankles: dragging Inner thighs: forceful intercourse Chest: resuscitation Bruising is uncommon in suicides Classic causes of Bruises

21. Post-mortem and Ante-mortem Bruise

22. The bruises may be accidental, suicidal, or homicidal in nature self-inflicted bruises are rare as they are painful. The shape and size of bruise generally correspond to object. So, the weapon or object can be identified. With examination of bruises age of injury can be determined. The manner of injury may be known from its distribution. Bruises may be artificially produced to make false charges against some one. these false bruises are produced by irritants like juices from marking nut, root of chitrak, etc. Medicolegal aspects

23. Case—‘Tramline’ Bruising by Beating with a Cane The victim , a married woman of about 28 years, had been running fever for few days prior to her admission to hospital. Before admission, as usually prevalent amongst the village folk, she was taken to some tantrik to effect withdrawal of the ‘evil spirit’ responsible for causing fever as her husband had lost all his patience and hopes due to her chronic illness. He developed a belief that it was due to some ‘evil spirit’ hiding within his wife and thereby thought of treatment (withdrawal of spirit) from some tantrik. The tantrik, as we usually observe and see in the cinema and otherwise, commenced his operation by beating her with some specific cane and also slapping her on the face. This was based on the theory that he was beating the spirit within the lady rather than the lady herself. ‘tramline/railway line’ type of multiple contusions on the back, distributed in an irregular fashion, some superimposing others; typically consistent with production by some stick or a like instrument. Left side of the face exhibits characteristic linear intra-dermal haemorrhages with some haemorrhages lying scattered within these linear haemorrhage. Case- Study

24. A contusion or bruise might reflect object of offence. A contusion at a sight does not necessarily indicate the point of trauma, since soft tissue bleeding will follow the path of least resistance. A patterned bruise is the type of contusion, which reflects the size and shape of the weapon of offence over the point of impact. Occasionally, the injuries may be produced before death, but bruise may manifest after death due to further escape of the extravasated blood from the ruptured blood vessels due to gravitation. These bruises are termed as Come-Out Bruise. Artificial bruises or false bruises or Fake bruises are reproduced over the body mainly for the purpose of malingering. Conclusion

25. Dimaio D., Dimario V.J. forensic pathology 2 nd edition, CRC Press Tyalor and francis, ( 76 - 79 ). Umadethan B. 2011. Forensic medicine. First edition. CBC Publishers and distribution, PP-570 Vij k. 2011. Forensic medicine and toxicology fifth edition, Elsevier (213-224). https://www.healthline.com/health/bruise https://www.legalserviceindia.com/mwdicolegal/bruise.htm https://forensicmed.webnode.page/wounds/blunt-force-trauma/bruises/ References