Forensic Medicine chapter
FORENSIC MEDICINE

MECHANICAL INJURIES

141 practice questions · 52 study notes
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Questions

QUESTION 1
During examination of a stab wound, how should tissue dissection be performed to reveal the wound track?
QUESTION 2
Where may a typical knife defence wound occur when the victim grasps the blade?
QUESTION 3
A firearm wound was produced without intervening clothing. Which examination can demonstrate fine powder granules and soot deposits deep within the wound?
QUESTION 4
A person punches an assailant on the head or chin. Which metacarpals may sustain the described knuckle fractures?
QUESTION 5
Which description defines the possible producer of a fabricated wound?
QUESTION 6
In a firearm discharge through clothing touching the muzzle, what causes loose fibres at the centre of the bullet hole to turn outward?
QUESTION 7
A victim grasps a double-edged knife during an assault. Which distribution of cuts is described?
QUESTION 8
A muzzle blast spreads smoke between the skin and several layers of clothing. Which distribution of blackening is described?
QUESTION 9
Which pattern is characteristic of fabricated incised wounds?
QUESTION 10
Why are cuts produced while grasping a knife usually irregular and ragged?
QUESTION 11
With other factors unchanged, which angle of impact usually allows a knife to penetrate the skin more deeply?
QUESTION 12
A victim has a superficial transfixing stab wound of the arm and a chest-wall wound. Which mechanism can account for these wounds being produced by a single stab?
QUESTION 13
Clothing is forcibly grabbed and twisted over a person's skin. Which finding may reproduce the texture of the clothing?
QUESTION 14
A patterned bruise follows impact by an object with alternating ridges and grooves. What explains red lines corresponding to the grooves?
QUESTION 15
An initial medicolegal examination may miss a slowly developing deep bruise. When should a further examination be performed to detect delayed bruising?
QUESTION 16
Which set represents the legal classification of injuries?
QUESTION 17
Which skull defect is characteristic of the exit point of a bullet?
QUESTION 18
A victim lying face up on the ground develops defence wounds on the shins and feet. Which action best explains this distribution?
QUESTION 19
A bullet entrance wound has an abrasion collar that is wider on one side. What does the wider side indicate?
QUESTION 20
Back spatter is more common with which firearm?
QUESTION 21
During an assault, a victim sustains injuries while attempting to grasp the assailant's weapon. How are these injuries classified?
QUESTION 22
Which combination of skin findings is expected around a shotgun wound inflicted at a short range of 1–2 metres?
QUESTION 23
Why may the postmortem depth of an anterior chest stab wound be greater than its depth during life?
QUESTION 24
Which feature of a knife is the most important determinant of initial skin penetration in a stab wound?
QUESTION 25
Excluding bone and calcified cartilage, which tissue offers the greatest resistance to knife penetration?
QUESTION 26
Trench foot belongs to which medical category of injury?
QUESTION 27
Which injury is classified as a mechanical injury due to blunt force?
QUESTION 28
What causes annular or linear abrasions around a short-range shotgun wound during penetration of the shot en masse?
QUESTION 29
Which forearm surface typically sustains bruises and abrasions when a victim raises the arms to protect the head and neck from a blunt weapon?
QUESTION 30
A doctor is asked to estimate the force used solely from the wound produced. How should the opinion generally be expressed?
QUESTION 31
What happens to the force of a blow when the struck body part is immobilized?
QUESTION 32
Which skin layer is usually involved in an abrasion?
QUESTION 33
What forms the protective scab or crust over the raw surface of an abrasion?
QUESTION 34
Which change defines shear strain in a tissue subjected to mechanical force?
QUESTION 35
Which combination tends to produce a deeper abrasion?
QUESTION 36
Which force may damage lung tissue when the lungs are compressed suddenly and violently?
QUESTION 37
A road accident victim has an abrasion with uneven longitudinal parallel grooves and epithelium heaped at their ends. Which type of abrasion is this?
QUESTION 38
Which appearance characterizes a friction burn or scuff abrasion?
QUESTION 39
What determines whether a rigid tissue such as bone fractures under mechanical force?
QUESTION 40
Why may a fall against a projection cause more serious injury than a similar fall against a flat surface?
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Study notes

Definitions and classification of injuries
Injuries can be described medically by the tissue damage and causative agent, legally by severity categories, and medicolegally by the circumstances of occurrence. →
Mechanical injury: energy transfer and tissue deformation
Mechanical impact transfers energy to tissues. The resulting injury depends on how tissues move, deform and resist strain. →
Factors determining wound severity: contact area, energy and immobilization
The nature and extent of a wound depend on the striking object, the energy delivered and the conditions under which that energy is discharged. →
Mechanical injury: responses of skin, soft tissues, bone and body fluids
Different tissues respond differently to a blow because of their mechanical properties. Movement and the duration of energy discharge also influence injury. →
Wound severity, forensic interpretation and the definition of abrasion
Injury severity depends on tissue properties and the circumstances of impact. These variations limit precise forensic estimates of the force used. →
Abrasions: mechanism, depth, scab formation and scratches
Abrasions result from pressure and movement at the skin surface. Their depth and pattern reflect the abrading surface and the manner of contact. →
Fingernail mark distortion, grazes and friction burns
Movement across the skin produces characteristic abrasion patterns. Skin recoil can alter nail marks, while grazing and friction injuries have distinct surface appearances. →
Pressure, impact and patterned abrasions
Abrasion morphology reflects how an object contacts the skin and may preserve features of the causative object. →
Patterned abrasions and the sequence of abrasion healing
Surface patterns can indicate the contact object, while gross and microscopic healing changes help assess the approximate age of an abrasion. Exact age cannot be determined. →
Recognition and limitations of postmortem abrasion assessment
The timing of an abrasion relative to death can be difficult to establish, and drying or immersion can alter its visibility and appearance. →
Interpretation of abrasion distribution and recognition of ant erosions
The location and appearance of abrasions can help reconstruct a fall or assault, connect injuries with objects or scenes, and distinguish injury mimics. →
Contusions: mechanism, location and characteristic features
Contusions are blood effusions caused by blunt trauma. The passage also describes skin changes that may resemble abrasions. →
Bruise appearance and factors affecting size and visibility
Bruise size and appearance depend on tissue structure, force, age and other circumstances, so the visible mark does not reflect force alone. →
Sex, body habitus and visibility of bruising
Susceptibility to bruising and its visible appearance vary with tissue characteristics, skin pigmentation and methods of examination. →
Disease-related bruising and migration of extravasated blood
Disease can increase bruising after minimal force, and blood tracking through tissues can produce visible bruises away from the site of injury. →
Patterned contusions and the effect of impact
The shape of a contusion may preserve information about the object that caused it. →
Bruise shape after impact by solid objects and sticks
Bruise shape depends on the object and which part of it strikes the body. →
Patterned contusions and delayed bruising
Bruise patterns can reflect the impacting surface or clothing, while deeper bruises may become visible only after a delay. →
Mechanisms and identifying patterns of weapon-related bruises
Different objects produce characteristic contusion patterns through compression, stretching and displacement of blood. →
Postmortem changes in bruises and consequences of organ contusions
Bruise appearance can change after death, and deep contusions can cause severe functional injury despite limited external evidence. →
Bruise healing and the sequence of colour changes
Bruises heal through destruction and removal of extravasated blood. Their colour reflects blood breakdown, but the rate of change varies. →
Limitations of bruise dating and evidence of antemortem injury
Colour and microscopic findings can help assess bruises, but neither permits confident determination of their exact age. →
Production of small bruises shortly after death
Arrest of circulation limits appreciable bruising after death, although force can still produce small bruises under particular conditions. →
Autopsy demonstration of bruises and effects of decomposition
Bruises may require dissection for detection, while decomposition can obscure the distinction between trauma and postmortem blood pooling. →
Bruise distribution and differentiation from hypostasis
The distribution of bruises may suggest how force was applied. Incision findings and tissue appearance help distinguish bruising from hypostasis. →
Medicolegal limitations, complications and circumstances of bruising
Bruises have limitations in reconstructing injury mechanisms and may cause serious complications. Irritant-induced skin injuries can also simulate bruising. →
Lacerations: definition and associated injury observations
Lacerations are blunt-force tears or splits involving skin, mucous membranes, muscle or internal organs. →
Lacerations: formation, wound margins and descriptive terms
Blunt impact displaces local tissue, creating traction that tears it. The resulting appearance reflects crushing, stretching and rubbing by the striking object. →
Split, stretch and avulsion lacerations
Different patterns of tissue compression, stretching and shearing produce distinct forms of laceration. →
Avulsion, tears and concealed blunt-force injury
Lacerations may involve deep tissues or internal organs despite limited external skin injury. →
Laceration edges and swallow tails
Blunt impact can produce different appearances at opposing wound edges, together with characteristic tears at the wound ends. →
Lacerations: directional signs, tissue bridges, bleeding and vitality
Wound structure can help interpret the direction of blunt impact, while healing and vital reactions help assess timing and antemortem occurrence. →
Lacerations: complications, circumstances and associated blunt injuries
Lacerations can cause serious complications, while their pattern and associated injuries may help explain how they were produced. →
Kicking injuries and the mechanism and margins of incised wounds
This passage describes injuries from kicking and stamping, then defines incised wounds and explains their production, margins and width. →
Incised wounds: length, interrupted cuts, shape and gaping
The dimensions and appearance of an incised wound depend on movement of the cutting edge, skin folding and the orientation of underlying muscle fibres. →
Incised wounds: surface effects, bleeding and direction of cutting
Wound shape is influenced by the skin surface and blade orientation, while differences in depth and margin configuration help indicate the direction of cutting. →
Incised wound healing, second intention and wounds caused by glass
The passage gives a sequence for uncomplicated incised wound healing, describes the greater scarring of second-intention healing, and explains why glass wounds can resemble sharp-force injuries. →
Self-inflicted incised wounds and hesitation marks
Patterns, accessible sites and tentative cuts help characterize self-inflicted wounds, although a suicidal fatal incision can be large and gaping. →
Suicidal and homicidal cut-throat wounds
The readable comparison rows describe differences in wound level, hesitation cuts, tailing, weapon recovery and clothing damage. →
Patterns and circumstances of incised wounds
Incised-wound location, direction and associated circumstances help distinguish suicidal, homicidal and accidental injuries. →
Chop wounds and limitations of wound interpretation
Chop wounds result from heavy sharp-edged weapons. Their depth and bone defects can indicate how the blow was delivered. →
Chop-injury circumstances and stab-wound characteristics
The passage completes the discussion of chop injuries and introduces the mechanism, types and margins of stab wounds. →
Stab-wound abrasions and measurement of wound length
The position of a hilt abrasion can reflect the angle of stabbing, while skin stretching and weapon movement affect measured wound length. →
Stab wounds: visceral position, penetration and tissue resistance
Assessment of a stab wound must account for changes in body position after death, the properties of the knife and resistance offered by tissues. →
Stab wounds: penetration, track examination and skin shape
The depth, track and external appearance of a stab wound depend on the weapon, clothing, skin and movements involved. →
Defence wounds and assessment of the circumstances of injury
The circumstances of injury are assessed from wound features, the suspected weapon and the scene. Defence wounds reflect the victim's immediate, instinctive attempts at protection. →
Sharp-weapon defence wounds
The distribution and appearance of defensive cuts vary with the weapon and the victim's attempt to grasp or ward off it. →
Offensive hand injuries and fabricated wounds
Hand injuries may help reconstruct an assault. Fabricated wounds are assessed through their morphology, distribution, clothing findings and the stated history. →
Shotgun wounds at a short range of 1–2 metres
At this range, the shot enters as a single mass and produces a characteristic entrance wound without burning, blackening or tattooing. →
Back spatter in firearm injuries
In contact shots, material drawn back into the firearm barrel is termed back spatter. →
Firearm wounds: clothing, muzzle gases and soot distribution
Muzzle gases and smoke produce characteristic findings in clothing and within firearm wounds. →
Bullet wounds: skull bevelling, shot sequence and direction
Skull defects, fracture-line relationships and the abrasion collar provide evidence about bullet passage and the sequence or direction of firing. →
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