The document discusses various types of mechanical injuries including incised wounds, lacerations, and self-inflicted injuries. It provides details on how to distinguish between incised wounds and lacerations. Incised wounds have clean cut edges with minimal tissue damage while lacerations have ragged, irregular edges and tissue bridging. Self-inflicted injuries tend to be superficial, multiple, and located on the non-dominant side of the body. The duties of doctors in examining wounds and factors that influence wound healing are also outlined.

1. Rickshaw ran over a child’s thigh, there is a mark of the
tyre tracks, it is an
⚫ A. Contact bruise
⚫ B. Patterned bruise
⚫ C. Imprint abrasion
⚫ D. Ectopic bruise

2. In which of the following injuries foreign bodies are
not found?
⚫ (A) Grazed abrasion
⚫ (B) Chop wound
⚫ (C) Lacerated wound
⚫ (D) Contusions

3. The following factors do not influence in the formation
of a bruise:
⚫ (A) force used
⚫ (B) sex of a person
⚫ (C) age of a person
⚫ (D) color of a person

4. A 25 year old person sustained injury in right eye. He
developed right corneal opacity following the injury. Left
eye was already having poor vision. Corneoplasty of right
eye was done and vision was restored. Medicolegally such
injury is labelled as :
A. Grievous
B. Simple
C. Dangerous
D. Serious

5. Appearance of a bruise at a site away from the site
of impact is called
(A) Artificial bruise
(B) True bruise
(C) Ectopic bruise
(D) Chemical bruise

6. No color change is seen in sub-conjunctival hemorrhage due
to:
A) Continuous CO2 supply
B) Little amount of blood is present
C) Continuous O2 supply
D) Color change occurs but not visible to naked eye

7. Incised wounds
MECHANICAL INJURIES
Dr. Sunil Duchania
MBBS (MAMC), MD (LHMC)
Certification in Medical Negligence in India
Founder- Forensic Extracts
Founder- SABAL Medico legal Consultancy
Former President RDA LHMC, Delhi
Vice-President FORDA, India

8. Incised wounds
⚫Clean separation or division of skin under the
pressure of a sharp-edged instrument (knives or
broken glass)

9. Incised wounds
� Slash wounds:
� Length > depth. Generally NOT as serious as
stab wounds unless it involves major blood
vessel.
� Tailing

13. Self-inflicted injuries

14. Self-inflicted injuries
� Cuts are usually superficial, multiple and parallel.
� In right handed people most of injuries are on the
left side.

16. ⚫Certain sites : throats, wrists and the front of the
chest are more common.
⚫They are often multiple
Features of SUICIDAL knife wounds

17. Defense Wounds

18. Defense Wounds
⚫Definition:
⚫A wound sustained when a victim places a hand,
arm or other body part to prevent or minimize a
blow or slashing by a sharp weapon.

19. The outer-side of the forearm

20. Back of the hand

21. Fingers

22. Chop wound
Large Gaping wounds

24. Laceration
⚫ Rupture, tear or split in the skin, mucous membrane,
muscle etc.
⚫ Blunt force injury
⚫ Irregular margins
⚫ Tissue bridging

26. Types
⚫ Split
⚫ Tear
⚫ Avulsion
⚫ Internal

27. Split
⚫ Seen over scalp, cheek, chin
⚫ Resembles like incised wounds

30. Tear

31. Avulsion
⚫ By Grinding compression force
⚫ Separation of skin from underlying tissues

34. Internal
⚫ External visible injury may or may not present

35. Incised wounds
Lacerations
Clean
Trace evidence (rust or dirt)
Absent
Tissue bridging present
Clean cut edges
Ragged edge
May be self-inflicted
RARELY self-inflicted
Comparison:

36. Duty of the Doctor
�Make a detailed examination and provide a medical
report that can be used in subsequent criminal or civil
proceeding.
�The purpose of examination is to determine:
� The time of the wound in relation to death.
� How it was caused.
� What is the cause.
� What amount of force was used to produce it.
� The degree of injury that was caused by the wound
(whether the wound influenced death or disability).

37. How to describe a wound
�The nature of the wound (bruise, laceration or
abrasion).
�The wound dimensions (length, width and depth).
�The position of the wound in relation to fixed
anatomical landmarks eg: distance from the mid line,
distance below the clavicle…etc.
�The number of wounds.
�The margins of the wounds (Ragged or Everted)

38. Factors affecting wound HEALING
�Blood supply.
�Infections.
�Age
�Site of wound.
�Nutritional status.
�Inter current diseases.
�Drugs: corticosteroids, immunosuppressive,
radiotherapy, chemotherapy.

39. Complications of wounds
⚫Infection and sepsis.
⚫Bleeding
⚫Hypovolemic shock.
⚫Injury to internal organs.
⚫Formation of scar.

40. Causes of DEATH due to wound
�Injury to a vital organ eg: brain.
�Sever hemorrhage.
�Shock
�Pulmonary embolism.
�Septicemia
�Renal failure due to rhabdomyolysis (crush
syndrome).

41. The greatest dimension of an incised wound is
(A) Breadth
(B) Depth
(C) Length
(D) Breadth and depth are equal

42. Identify the type of wound ?
A. Lacerated wound
B. Incised wound
C. Incised looking lacerated wound
D. Stretch laceration

43. Split laceration resembles:
A) Incised wound
B) Abrasion
C) Gunshot wound
D) Contusion

44. Hesitation cuts are seen in a case of:
A) Homicide
B) Suicide
C) Accident
D) Fall from height

45. In an incised wound, all of the following are true, except:
A) It has clean-cut margins
B) Bleeding is generally less than in lacerations
C) Tailing is often present
D) Length of injury does not correspond with length of blade

46. Bevelling is seen in-
A) Abrasion
B) Incised wounds
C) Firearm wounds
D) Both B &C