S.U.M.Ph. Nicolae Testemitanu Department of …...Bruise is discoloration of skin surface caused by leakage of blood into skin or underlying tissues from damaged small-calibre blood

Prelection by Vasile Șarpe

MD, MS, PhD, Assoc. Professor

S.U.M.Ph. "Nicolae Testemitanu" Department of Forensic Medicine

2013/2014

Lecture items

• General concepts

• Classification

• Mechanisms of action of the force applied

• Injuries due to blunt objects

Blunt objects are instruments, objects or implements that cause injuries only by their interaction surface

The traumatic capacity of the blunt object depends on kinetic energy.

The kinetic energy of an object is the energy which it possesses due to its motion.

It depends on the mass (m) of the object as well as its speed (v)

General concepts

By their nature

• Hard

• Soft

By the size of their traumatic surface

• Limited surface

• Unlimited surface

or

• Small (< 16cm2)

• Large (> 16cm2)

Classification of blunt objects

Blow (impact) 0,01-0,1 seconds

Compression

Extension

Friction or

oblique force

Mechanisms of action of the force applied

Bruise is discoloration of skin surface caused by leakage of blood into skin or underlying tissues from damaged small-calibre blood vessels

• As a rule is localized on the place of impact

• Can be displaced (if underlying fat tissue is lax)

• Shape and dimensions depend on the traumatic surface of the object

• It changes its color due to hemoglobin process, but in good-vascularized area it does not change the color

Bruise (ecchymosis, contusion)

Bruising discoloration begins from the periphery to the center, due to uneven thickness, which is lower periphery.

• Fresh – red, light-red

• Some hours – blue-red

• 3-4 day – appear green color

• 7-9 day – appear yellow color

• 6-8 may be tricolor (center - purple, middle - green, the periphery - yellow-brown)



A hematoma is a localized collection of blood into soft tissue or cavities from medium or large-calibre blood vessels

This distinguishes it from an ecchymosis

Examples:

• Epidural hematoma

• Subdural hematoma

• Subarachnoid hematoma

Haematoma (hematoma)

An abrasion is a superficial injury of the skin involving epidermis without penetration of the full thickness of teguments

Abrasion (graze)

As the epidermis does not contain blood vessels, superficial abrasions might not bleed

Healing has 4 stages:

Fresh abrasion - initial surface is wet, then – dry

till 12-24 hours

Crust (scall) formation

24 hour - 3-4 days

Crust removing

4-5 days – 7-12 days

Abrasion dent (hyperemia, hyperpigmentation, hypopigmentation)

Abrasion (graze)

A laceration is a blunt-force injury of the skin or mucosa that involves full their thickness.

Laceration

Laceration

• Diversity of the shape

• Irregular & crushed edges

• Abrasions and bruises on the margins

• Rounded (obtuse) ends

• Tissue bridges

• Insignificant bleeding

• Hair follicles are crushed

Morphological appearance

Joint dislocation, or luxation is a bones displacement a joint

Osteoarticular lesions

A bone fracture is a break in the continuity of the bone.

Osteoarticular lesions

Osteoarticular lesions Mechanisms of long bone fractures

dislocation

fix

force


compression

force

force

force force


extension

force

force


bending

fix

force

fix


flexion

fix

force


rotation

force

force

Bending crack, in steps, orificial, depressed

Osteoarticular lesions Mechanisms of flat bone fractures

Cobweb fracture

Osteoarticular lesions Mechanisms of flat bone fractures

S.U.M.Ph. Nicolae Testemitanu Department of …...Bruise is discoloration of skin surface caused by leakage of blood into skin or underlying tissues from damaged small-calibre blood

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