This document discusses various types of injuries to the neck, bones, vertebral column, spinal cord, chest, lungs, heart, and abdomen that can occur from blunt force trauma, falls, assaults, or penetrating injuries. It notes injuries like fractures of the hyoid bone or thyroid cartilage in the neck; fractures, dislocations, or chip fractures of bones; fractures or compression of vertebrae that can damage the spinal cord; rib fractures that can lacerate the lungs; ruptures or lacerations of organs in the chest or abdomen; and more. Diagrams are provided to illustrate some example injuries like a contusion of the liver or puncture wound of the lung from a rib fracture.

1. NECK INJURIES
 Fracture of Hyoid bone/Thyroid cartilage
due to falls on neck or blow on the neck
front, which may lead to vagal inhibition or
suffocation from hemorrhage & edema.
 Suicidal / Homicidal cut throat injuries.
 Surgical emphysema of neck area due to
incised injury to trachea.
 Injury to carotid vessels or jugular veins
which leads to rapid death.

2. BONE INJURIES
 Fracture occurs due to RTA or fall from a
height.
 Chip fracture may also occur due to violent
muscular action.
 Simple / Compound fracture.
 Calcaneum fracture occurs if fall over the heel.
 In crush injuries of bone, there might be bone
marrow embolism or fat embolism.

3. VERTEBRAL COLUMN
 Fracture of Spine due to direct or indirect violence.
 Hyperflexion of spine commonly leads to fracture.
 Commonest sites of fracture are upper & lower
cervical or junction of thoracic and lumbar
vertebrae.
 Compression of vertebral bodies leads to wedge
fracture, which occurs due to fall on feet or
buttocks and may lead to paralysis of body below
that level.
 Fracture of vertebrae above C4 level is fatal due to
damage of phrenic nerves.

4. SPINAL CORD INJURIES
 Normally fracture of spine may not lead to cord
injury.
 But when cord is damaged, it is usually associated
with vertebral column damage.
 Whiplash Injury:
 This is the exception to the above case.
 Occurs due to sudden acute hyperflexion
followed by acute hyperextension.
 Usually seen in car accidents injuries to
occupants.
 This results in fatal concussion or laceration of
spinal cord with fracture of apine.

5.  Commonly lower cervical vertebrae are
damaged followed by Thoraco-lumbar
vertebrae.
 Contusion of spinal cord due to direct or
indirect or penetrating injuries.
 ‘Hematorrhachis’ – bleeding into spinal
meninges.
 ‘Hematomyelia’ – bleeding into spinal cord
substance.
 ‘Railway Spine’, where concussion of spinal
cord occurs resulting in temporary paralysis
with recovery within 48 hours.

6. CHEST INJURIES
 ‘Closed Injuries’ where thoracic cavity is
intact.
 ‘Open Injuries’ where thoracic cavity is open
to outside.
 Abrasion / Contusion may be present due to
blunt force with injuries to the lungs /
heart / blood vessels / esophagus, etc.
 Stab injury (penetrating type) may lead to
‘Pneumothorax’.
 ‘Hemothorax’ where collection of blood in
thoracic cavity occurs.

7.  Combination of air and blood leads to
‘Hemopneumothorax’.
 Rib fracture is usually seen from 4 – 8th
ribs
resulting in laceration of lungs.
 ‘Flail Chest’ occurs when there is
unilateral or bilateral multiple rib fractures
leading to paradox respiratory
movements.
 Fracture of sternum results from direct or
indirect violent forces.

8. LUNG INJURIES
 There might be contusion or laceration injuries
due to blunt force impact.
 Lacerated injury occurs due to rib fractures
leading to hemothorax. (Fig)
 Blood in air passage or alveoli may be due to
aspiration of blood from oro-nasal injuries.
 ‘Pneumothorax’ due to accumulation of air in
thoracic cavity which leads to collapse of the
lungs and shifting towards the hilum.
 Sudden death may also be caused due to
cardiac inhibition following lung injuries.

9. HEART INJURIES
 Contusion & laceration of heart may occur
due to direct violence or compression of
chest.
 Contusions are usually seen on anterior
surface.
 There might be sudden death due to
ventricular fibrillation.
 Contused area do not recover and is
damaged permanently.
 .

10.  ‘Cardiac concussion’ occurs due to blunt
cardiac trauma but not sufficient to damage
the tissues and may lead to VF or ‘Asystole’ /
‘Commotio cordis’.
 Rupture of heart may occur due to fall from
height or run-over injury over abdomen.
 Stab wounds of heart are dangerous and fatal
and may lead to ‘Hemopericardium’ and
cardiac tamponade.
 Aorta (thoracic) may rupture due to RTA or fall
from height

11. ABDOMINAL INJURIES
 There may be open or closed injuries.
 Wall injuries may be abrasions, contusions
or laceration depending on the forces.
 Blood may track down into inguinal canal
and then into the scrotum.
 Fatal hemorrhage may occur due to injury
to liver, spleen, or kidney without any
external signs.

12.  Solid viscera are more likely to get damaged.
 Penetrating stab injuries may lead to damage
to diaphragm, liver, spleen, stomach and
intestines.
 In stab injuries, usually small intestine is
damaged and the stomach may escape.
 Rectum injuries may occur in sexual assault
cases or fall over projecting surfaces.

13. ABDOMINAL INJURIES (Cont.)
 In liver injuries, there might be severe
hemorrhage intra-abdominally leading to
rapid death due to hemorrhagic shock.
 In case of disease affected spleen like
malaria, leukemia, typhoid etc, mild trauma
may lead to rupture and bleeding.
 Kidneys can be damaged due to blunt force
applied directly to back or side resulting in
rupture and hemorrhage.

14.  Bladder can be injured due to fall, kick or a
blow.
 Full bladder may rupture with extravasation of
urine into peritoneal cavity and there may be
associated fracture of pelvis.
 Male urethra gets damaged due to kick in
perineum, or fracture of pelvis or fall over
projecting surface.

15. Contusion of Liver
Contusion

16. Puncture wound of Lung from rib fracture

17. Rupture of Liver from RTA