5. BRUISES(CONTUSIONS)
DEFINITION;-
“A bruise signifies haemorrhage into the skin,
the subcutaneous tissues, or deeper tissues.It is
due to an infiltration or extravasation of blood into
the tissues, following rupture of small vessels, as a
result of blunt force.”
7. BRUISES(CONTUSIONS)
INTRADERMAL BRUISE:-
When a bruise is made by impact with a
patterned object, the haemmorhage may lie in the
immediate subepidermal layer & its pattern may
correspond to the form of the object or the weapon
causing it, e.g, whips, canes, bicycle chain etc.
9. BRUISES(CONTUSIONS)
SUBCUTANEOUS BRUISE:-
The usual bruise from a blunt impact is
situated in subcutaneous tissues. It is somewhat
blurred at the edges & raised above the skin surface
due to infiltration of blood in subcutaneous tissues.
11. BRUISES(CONTUSIONS)
• DEEP BRUISE:-
This signifies bleeding deeper to the
subcutaneous tissues & some swelling may be
apparent when the opposite limb or part of the body
is compared with the injured area. It may take hours
or one or two days to appear at the surface.
13. BRUISES(CONTUSIONS)
• CHARACTERISTICS:-
1. May not always be present at the site of impact.
2. The greater the force or violence used, the more
extensive is the bruise.
3. Spreads due to continued extravasation &
consequently occupies a wider area, it is not
possible to assess the area of impact & severity of
violence in such cases.
14. BRUISES(CONTUSIONS)
• FACTORS MODIFYING APPEARANCE OF A BRUISE:-
1. Site of injury
2. Vascularity of the part
3. Age
4. Sex
5. Colour of skin
6. Natural disease
7. Gravitational shifting of blood
15. BRUISES(CONTUSIONS)
• COLOUR CHANGES & AGE OF A BRUISE:-
After a bruise has appeared, it tends to get smaller from
periphery to center & passes through a series of colour changes:-
1. Red Immediately after infliction
2. Dusky purple/ Black Fairly fresh(1/2-8hrs)
3. Blue 8hrs-4days to 2 weeks
4. Green 4days-1 or 3 weeks
5. Yellow 7days to 3 weeks
6. Disappears 1-4weeks
16.
17. BRUISES(CONTUSIONS)
• MEDICOLEGAL SIGNIFICANCE:-
Bruises provide information in regard to:-
1. Identification of the object causing the injury.
2. Degree of violence.
3. Cause of injury.
4. Time of injury.
5. Possibility of infection.
19. LACERATIONS
DEFINITION:-
“ A laceration is a wound in which the skin,
mucosa or underlaying tissues are torn as a result of
application of blunt force”
21. LACERATIONS
1. SPLIT LACERATIONS:-
The injury is due to crushing of the skin
between two hard objects, viz, underlaying bone &
the object responsible for injury.The result is linear
split in the skin & injury may simulate an incised
wound.They are commnly found in parts overlaying
bones without much tissue in between i.e on scalp,
face, hands & lower legs.
23. LACERATIONS
2. STRETCH LACERATIONS:-
This is due to over-stretching of the skin till it
splits & produces a flap.Such an injury is produced
by a blunt tangential impact, e.g, laceration of the
scalp when the head strikes a motor car wind
screen.It is also produced when sudden deformaity
of a bone occurs after a fracture.
25. LACERATIONS
3. AVULSION:-
This is due to grinding compression of tissues
to such an extend as to separate the skin from
deeper structurs(degloving of skin) & crush the
muscles underneath.It results from horizontal
crushing impact such as by lorry wheel or by
machinery.
27. LACERATIONS
4. TEARS:-
The injury results from irregular tearing of skin &
tissues. These are due to impact against irregular or
sharp objects, e.g motor car door handles, blows
from broken bottles.
29. LACERATIONS
5. INTERNAL LACERATIONS:-
When the blunt force exceeds the tensile
strength & elasticity of an internal organ or tissue,
laceration may result in such organ without any
surface tear.
31. LACERATIONS
• CHARACTARISTICS:-
1. The edges are ragged, irregular, & bruised.
2. The margins are abraded.
3. Hair follicles & blood vessles are seen to have been
crushed.
4. External haemorrhage not pronounced.
5. Foreign material found in the wound.
6. Surface appears depressed.
32. LACERATIONS
MEDICOLEGAL FACTORS:-
In examination of a victim the following essentials
should be kept in mind:-
1. External evidence of Injury may be minimal or absent even
massive internal injuries may be present.
2. Tissues will bleed less.
3. Foreign material or trace evidence indicate agent
responsible.
4. Pattern of injury.
5. Suicidal lacerations.
6. Homocidal lacerations.
7. Accidental lacerations.
34. BRUISES Vs LACERATIONS
BRUISES LACERATIONS
Skin, mucosa, or underlaying
tissues remain intact.
Haemorrhage into skin,
subcutaneous tissues, or deeper
tissues.
Closed wound
May not always be present at the
site of impact.
Foregin bodies not present.
Skin, mucosa, or underlaying
tissues are torn.
Haemorrhage not pronounced.
Open wound
Always present at the site of
impact.
Foregin bodies frequently present.
