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ASPECT OF PHYSICAL
INJURIES
Physical injuries . . . .
1. Physical Violence
2. Heat or Cold
3. Electrical Energy
4. Chemical Energy
5. Radiation by radio-active substance
6. Change in the Atmospheric Pressure
Physical injuries brought about by
physical violence
Wound
is the solution of the natural continuity of any
tissue of the living body. In several occasions,
the word physical injury is use interchangeably
with wound. However, the effect of physical
violence may not always result to the production
of wound, but wounds are always the effect of
physical violence.
Vital Reaction:
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(2) Sharp-pointed instrument
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(3) Sharp-edged and pointed instrument
C. Wound brought about by tearing force
D. Wound brought about by change of
atmospheric pressure
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E. Wound brought about by heat and cold
F. Wound brought about by infection
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3. As to the Manners of Infliction:
a. Hit by means of a bolo, blunt instrument, axe.
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b. Thrust or stab-by dagger, knife, saber,
bayonet.
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c. Tearing or stretching.
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d. Gunpowder explosion,- projectile or shrapnels.
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e.. Sliding or rubbing.
4. As regards the Depth of Wound:
a. Superficial - When the wound involved
only the layers of the skin.
b. Deep - When the wound involved the inner
structures of body.
It may be:
(1). Penetrating – When it has
pierced a solid organ or tissue.
(2). Perforating – When there
is a communication between the inner
and outer portions of the hollow
organs.
5. As regards the Relation of the Site of the
Application of Force and the Location of the
Injury:
a. Coup Injury- Physical injury which is found
at the site of the application of force.
b. Contre Coup Injury - Physical injury found
on opposite the site of the application of
force.
c. Coup contre coup injury - Physical injury
which is found at the site and also opposite the
site of application of force.
d. Locus Minoris Resistencia - Physical injury
found not at the site or opposite the site of
the application of force but in some areas
offering the least resistance to the force
applied.
• e. Extensive Injury – Physical injury
involving a greater area beyond the site
of the application of force with manifest
marks of extensions from the location of
the place where the force is applied.
6. As to the Regions or Organs of the
Body Involved:
The wound on different organs and
regions of the body will be
discussed separately under
“Injuries in Various Parts of the
Body”.
7. Legal Classifications:
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2. Incised wound
3. Lacerated wound
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4. Punctured wound
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5. Wound produced by powder explosion
6. Mutilation
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7. Avulsion
TYPES OF WOUNDS
CLOSE WOUNDS:
A. SUPERFICIAL CLOSE WOUNDS:
1. PETECHIAE:
These are circumscribed extravasations of
blood in the subcutaneous tissue or underneath
the mucous membrane. It may or may not be
brought about by trauma. Several petechiae may
coalesce with one another forming bigger
hemorrhagic area.
2. CONTUSION:
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A blow on the head may produce contusion on the eye
lids
The position of the bruise may indicate the manner of assault
Example:
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Contusion produced with a branch of tree will show the markings of the branch.
The determination of the age of the contusion is based on the color changes.
Factors Influencing the Degree and Extend of Contusions;
d. Diseases:
May or may not require force to produce
contusion:
Example:
1. Purpura;
2. Hemophilia;
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3. Aplastic anemia;
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4. Whooping Cough;
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E. Age:
Children and old people tend to bruise
more easily. Children have loose and
delicates skin. Old people have less flesh
and there are vascular changes.
F.Sex:
Women, specially if obese,
easily develop contusion.
Athletes, like boxers do not
develop contusion easily.
3. HEMATOMA:
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c. Hypertrophy
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d. Fibroid thickening
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e. Malignancy
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B. DEEP CLOSE WOUNDS:
1. FRACTURE:
Fracture is the sudden
solution of continuity of a bone,
resulting from violence of from
some existing pathology.
Classifications of fracture:
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b. Open or compound fracture:
Fracture wherein the skin or mucous membrane has direct
or indirect communication between the fracture and the external
air.
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2. Sprain:
A sprain is a subcutaneous separation or tearing of the
articular tendons, ligaments or muscles.
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3.DISLOCATION:
It is displacement from each other of the articular surfaces
of bones entering into the formation of a joint.
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Classifications of dislocation:
a. Simple or close dislocation:
A dislocation wherein there is no break in the skin.
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b. Compound or open dislocation:
Dislocation associated with an external wound.
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4. CEREBRAL CONCUSION:
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b. Multi- Linear:
This is a seen when the body surface is rubbed on a rough hard object
thereby producing several linear marks parallel to one another:
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c. Confluent:
Abrasion where he linear marks on the skin surface are almost
indistinguishable on account of the severity of friction and roughness of
the object.
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d. Multiple:
Several abrasions are noted on the body surfaces of a person.
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Types of Abrasions:
1. Scratches – These are caused by a sharp- pointed
objects slide across the skin, like pin, thorn, or finger nail. The injury
is always parallel to the direction of the slide.
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2. Grazes – These are usually caused by forcible contact with
rough, hard objects resulting to irregular removal of the skin
surface.
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3. Impact or imprint abrasion - This is brought about by
sudden impact of hard rough object on the skin there by producing
an impression on the surface.
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4. Pressure of friction abrasion – These are abrasion whereby
pressure is applied accompanied by movement and is commonly
seen in hanging or strangulation.
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Distinctions between erosion and
abrasion:
In abrasion, there is scraping off of
the outer layer of the skin brought
about by friction of sliding, while in
erosion there is superficial loss or
eating away of the tissues by any
cause other than friction or sliding.
Differential diagnosis of abrasion:
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2. Excoriation of the skin by excreta:
It is only found in infants and may be removed when the
cause is removed.
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3. Pressure sore:
Usually found at the back at the region of bony prominence.
History of long standing illness and bedridden differentiate it from
simple abrasion although the sore may start as an area of abrasion.
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Distinctions Between Ante-mortem and Post- mortem
Abrasion:
3. Vital reaction With intravital reaction and Show no vital reaction and
may show remains of is characterized by a
damaged epithelium. separation of the epidermis
from complete loss of the
former.
POST MORTEM ABRASION
ANTE-MORTEM ABRASION
2. INCISED WOUND:
1. Direction- Oblique , from below left ear, 1. Usually horizontal or from below
downwards, across front neck just above upwards through or below Adam’s apple.
Adam’s apple, then slightly upwards on
the right side. May be horizontal or even
from below upwards.
2. Severity varies. One or all large vessels 2. They may be of any depth but seldom
on the side are usually completely show any hacking or cuts in the bones or
severed. All structures down to spinal cartilages of the spine.
column and even the cartilages of the
disc. May be divided or only the wind pipe
may be divided.
3. There may be several cuts at the 3. Practically never seen in homicide, there
commencement of the large wound. may be several superficial cuts but in other
situations, the result of struggling on the
part of the victim.
4. Position of the body- May be found in 4. Features and limbs may be contorted,
front of shaving mirror be spattered with clothes torn and disarranged, cuts on palm
blood. aspect of hands lying on a bed, etc.
6. Distribution of blood- Blood flows down 6. If victim is lying down the blood flows
front of body; hand generally severed with backward there will be little on the front.
blood ; absence of any bloody foot or finger Hands may be clear except from cuts
marks of other person. received in trying to avoid knife. There may
be bloody or finger marks of another
person.
7. History of mental depression of financial 7. Absence of such history
worries or threat of suicide, alcoholism, etc.
SUICIDAL CUT-THROAT
HOMICIDAL CUT-THROAT
“ Chopping or hack wounds” are wounds caused by blow
with a sharp splitting edges of a firmly heavy instrument like
the hatchet, axe or saber.
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CHOPPING OR HACK
WOUNDS
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STAB WOUND:
d. Therapeutic incised wounds:
These are wounds produced by surgical
incision, The absence of infection, they heal by
primary intention.
Dimensions Usually longer Depth varies, but Depth greater than length
than deep, but hand-lens and width.
often gaping. examination reveals
bridges of tissue
joining the edges.
Hemorrhage Usually longer Not pronounced. Varies-profuse if vessels are
from wound than deep, but cut in depth of wound.
often gaping.
Condition of Bruising may or Bruising usually Bruising rarely present.
skin may not be present.
surrounding present.
wound edges.
Distinctions between an Incised Wound and
Lacerated Wound:
1. Edges clean-cut, regular and well- 1. Edges, roughly cut, irregular and ill-
defined. defined.
2. No swelling or contusion around the 2. There is swelling and contusion around
incised wound. the lacerated wound.
4. Shock:
Shock may occur with or without violence. A slight blow on
the genitalia, slight burns in children or old age, or slight violence
on the head or neck may cause severe shock. However, violent
trauma to healthy, strong person may not produce shock.
c. Shock:
This is the disturbance of the balance of fluid in
the body capable of producing delayed or immediate
death.
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b. Specific infliction:
Pathogenic micro-organisms may develop and
multiply in the wound causing septicemia, bacteremia, or
toxemia. Tetanus, gas gangrene infection are common in
open wounds.
c. Scaring effect:
Chronic gonorrheal infection may cause
stricture of the urethra. Stricture of the
esophagus may follow ingestion of irritant
poison. Keloid formation in burns may not only
cause deformity but disturbance of the normal
respiration or locomotion.
d. Secondary shock.
Complications of trauma or Injury:
1. Shock:
Shock is the disturbance of fluid balance resulting to
peripheral deficiency which is manifested by the decreased
volume of blood, reduced volume of flow, hemoconcentration and
renal deficiency. It is clinically characterized by severe depression
of the nervous system. Three major factors operate in the
production of shock and all are likely to be associated together as
the condition develops:
a. Injury to the receptive nervous system.
b. Anoxemia – Reduction of effective volume or oxygen carrying
capacity of the blood.
c. Endothelial damage, thus increasing capillary perme ability.
Kinds of shock:
a.Primary shock:
This is caused by immediate nerve impulse
set up at the injured area which are
conveyed to the central nervous system. The
impulse may also whelm the vital center in
the medulla thereby it develop within a short
time due to vasomotor collapse. If the
reaction is not intense, the patient may live
longer or may recover complete from the
effects of shock.
b. Delayed or secondary shock:
b. Secondary hemorrhage:
This occurs not immediately after the infliction
of the injury but sometime thereafter on or
near the injured area.
3. Infection:
Infection is the appearance, growth and development of
micro- organisms at the site of injury.
1. Hemorrhage:
As a general rule, hemorrhage is more profuse
when the wound was inflicted during the lifetime of
the victim. In wounds inflicted after death, the
amount of bleeding is comparatively less if at all
bleeding occurred. This is due to the loss of tone of
the blood vessels, absence of heart action and post
mortem clothing of blood inside the blood vessels.
Violence inflicted on a living body may not show the
formation of a bruise until after death.
2. Signs of Inflammation:
There may be swelling of the area
surrounding the wound, effusion of lymph or
adhesion f the edges. Other vital reactions are
present whenever the wound was inflicted during
life, although it may be less pronounced when
the resistance of the victim is markedly
weakened. Post mortem wounds do not show any
manifest signs of vital reaction.
3. Sign of repair:
a. Signs of struggle:
Absence of signs of struggle is more in suicide,
accident or murder.
Contusion or abrasion may indicate fist, finger
or feet of the assailant.
Presence of hair or portion of the
skin(epidermis) on the nails of the assailant or
deceased may be a clue in the determination whether
death is suicidal, homicidal or accidental.
b. Number and direction of wounds:
Multitude wounds in concealed portions of the
body generally are indicative of homicide.
Single wound located in a position that the
deceased could have conveniently inflicted is usually
suicidal.
1. Degree of healing;
2. Changes in the body in relation to the time of
death;
3. Age of blood stain;
4. Testimony of witness when the wound was
inflicted;
Possible instruments used by the assailant in inflicting
the injuries: