Forensic Medicine chapter
FORENSIC MEDICINE

MECHANICAL INJURIES

141 practice questions · 52 study notes
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Questions

QUESTION 41
A moving object's velocity doubles while its mass remains unchanged. How does its kinetic energy change?
QUESTION 42
A patient has severe underlying injury after a blunt blow, but the overlying skin remains intact. Which skin properties explain this finding?
QUESTION 43
Which combination usually protects muscles from damage due to blows?
QUESTION 44
Sudden chest compression causes rupture of distal venules and capillaries in traumatic asphyxia. Which mechanism explains the distant vascular injury?
QUESTION 45
Why does a forceful impact affect different body tissues non-uniformly?
QUESTION 46
Why may the curve of a fingernail abrasion reverse after the nail is removed?
QUESTION 47
A linear scratch has a clean area at one end and epidermal tags at the other. Which end represents the termination of the scratch?
QUESTION 48
What feature defines a patterned abrasion?
QUESTION 49
At 12 hours, what forms the deepest histological layer of an abrasion?
QUESTION 50
Where is a bruise usually situated?
QUESTION 51
An abrasion has a reddish-brown scab. Which approximate age corresponds to this appearance?
QUESTION 52
Which postmortem change in abraded epidermis may lead to its being mistaken for a burn?
QUESTION 53
During abrasion healing, when are collagen fibres seen?
QUESTION 54
Crescentic fingernail abrasions on the neck are associated with which mechanism of injury?
QUESTION 55
A person who collapsed has abrasions over the eyebrow, nose and cheek, with no upper-limb injuries. Which circumstance best matches this distribution?
QUESTION 56
Brown superficial skin erosions show multiple crescent-shaped, sand-like bite marks under a hand lens, each separated by normal skin. What is the most likely cause?
QUESTION 57
Which type of abrasion is exemplified by a ligature mark in hanging?
QUESTION 58
Why can slight violence produce a large bruise in the face, vulva or scrotum?
QUESTION 59
What is the basic mechanism of a contusion?
QUESTION 60
What is the value of microscopic examination in distinguishing abrasions produced slightly before death from those produced slightly after death?
QUESTION 61
What is the usual surface contour of an impact abrasion when there is no underlying contusion or local oedema?
QUESTION 62
A body recovered from water shows no obvious abrasions on initial inspection. What subsequent change may make existing abrasions easier to see?
QUESTION 63
Why is the centre of a bruise lighter in colour?
QUESTION 64
Which tissue characteristic explains why children bruise more easily?
QUESTION 65
After blunt trauma, injury to a large blood vessel produces a tumour-like mass of blood. What is this mass called?
QUESTION 66
What potentially fatal consequence can follow even a small contusion of the heart?
QUESTION 67
Which local finding characterizes purpuric areas?
QUESTION 68
Following suction during sexual activity, a person develops a bruise on the side of the neck. Which appearance is characteristic?
QUESTION 69
Which tissue characteristics explain why women bruise more easily than men?
QUESTION 70
What mechanism explains the appearance of a bruise at a site distant from the original impact?
QUESTION 71
Which photographic method more truly reproduces the appearance of contusions?
QUESTION 72
How does skin colour affect the detection of bruising?
QUESTION 73
Why does the intervening skin remain apparently unchanged between the two contused lines produced by a rod?
QUESTION 74
Which feature distinguishes bruises caused by pliable canes from those caused by whips?
QUESTION 75
Why can a heavier impact produce a solid contusion pattern rather than an outlined pattern?
QUESTION 76
A person is struck by the length of a thick stick rather than its end. What shape of bruise is expected?
QUESTION 77
What defines a patterned contusion?
QUESTION 78
Following head trauma, a patient develops bruising behind the ear without a direct blow at that site. Which fracture should this finding suggest?
QUESTION 79
At autopsy, eyelid haemorrhage is found after the corneas were surgically removed for transplantation. Which procedure-related change can explain this finding?
QUESTION 80
Why should the postmortem interval be considered when assessing the extent of bruising?
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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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