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L4, wounds, forensic

 

 Lecture vedio part 1 



 Lecture video Part 2

لحد الدقيقة ٢٣:٥٠ فقط.. الباقي متشرحش في المحاضرة 


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MCQ


Wounds


1- Hesitation marks are characterized by being………………………………


a. single .


b. lacerated .


c. deep .


d. multiple .


2- In healing of abrasion, after lapse of 28 days it appears as………………..


a. hard scab .


b. normal skin .


c. fibrous tissue.


d. pale area .


3- all these types of stab wound except ..………………………………………


a. penetrating


b. puncture


c. torn wound


d. perforating


4- In healing of abrasion, soft scab formation appears within……………….


a. 5 – 8 days.


b. 12 – 15 days.


c. 8 – 13 hours.


d. 12 – 18h


5- Pressure abrasions are due to……………………………………………….


a. tangential impact by blunt object.


b. perpendicular impact by blunt object.


c. scrape off the skin by blunt object.


d. drag a victim over a rough object.


6- Tram – line bruises are due to………………………………………………


a. teeth bite.


b. blow by a board.


c. spontaneous bleeding in the elderly.


d. hemorrhagic tendency.


7- The dark blue color of contusion is due to formation of…………….…...


a. biliverdin.


b. oxyhemoglobin.


c. reduced hemoglobin.


d. bilirubin.


8- The color of bruises due to the presence of bilirubin is…………………..


a. green.


b. yellow.


c. red.


d. black.


9- The color of recent bruise is ……………………………………………….


a. red in color due to reduced hemoglobin.


b. blue in color due to oxyhemoglobin.


c. red in color due to carboxy hemoglobin.


d. red in color due to oxyhemoglobin.


10- The color of contusion is changed to…………………………………days.


a. green after 6 – 8.


b. yellow after 4 – 6.


c. yellow after 6 – 8.


d. green after 8 – 10.




11- The dimensions of the stab wound in relation to the used weapon


indicated that it’s………..............................................................................


a. length equals the thickness of a weapon blade.


b. depth equals the width of a weapon blade.


c. depth equals the length of a weapon blade.


d. length equals the length of a weapon blade


12- The length of a stab wound in relation to depth is………………………..


a. greater than the depth.


b. equal to the depth.


c. less than the depth.


d. double the depth.


13- Chop wounds are induced by………………………………………………


a. blunt object.


b. heavy instrument with a sharp – edged.


c. falling from a height.


d. rifled firearms.


14- all these wounds cause anatomical disruption except…………………….


a. cut


b. stab


c. contusion


d. laceration


15-A cut wound looks like contused wound in………………………………...


a. scalp.


b. over the chin of the tibia.


c. axilla.


d. forehead.



16- Gaping of the wound edges is seen in……………………………wound.


a. cut.


b. contused.


c. lacerated.


d. cut lacerated.


17- Bridging of tissues occurs in……………………………………….wound.


a. contused.


b. stab.


c. incised.


d. puncture.


18- The least amount of air that leads to venous air embolism is………….ml.


a. 40.


b. 100.


c. 140.


d. 60.


19- The most rapid mechanism of death from wounds is……………………...


a. hemorrhage.


b. primary neurogenic shock.


c. fat embolism.


d. Cellulitis.


20-In a healthy adult, death may occur due to sudden loss of………….


amount of blood.


a. 250ml .


b. half a liter.


c. 2 liters .


d. 1-1.5 liter .



21- infection lead to death through………………………….….


a. septicemia


b. pyemia


c. gas gangrene


d. all of above


22- The amount of blood which is enough to induce cardiac tamponade


is……………..cc.


a. 20.


b. 2000.


c. 120.


d. 200.


23- Signs of parasympathetic shock include…………………………………..


a. rapid pulse and hypotension.


b. hypotension and subnormal temperature.


c. hypertension and hyperthermia.


d. rapid respiration and pale moist skin.


24-The autopsy of a case of death from parasympathetic shock may show...


a. pulmonary edema.


b. pallor of the organs.


c. systemic congestion.


d. signs of preexisting cardiac lesion.


25- A slight trauma to a trigger area can lead to death from…………shock.


a. parasympathetic.


b. surgical.


c. sympathetic.


d. histaminic.



26- A delayed mechanism of death from wounds is……...…………………...


a. arterial air embolism.


b. reflex vagal inhibition.


c. neurogenic shock.


d. cellulitis



27-The signs of hematogenic shock include…………………………………...


a. rapid weak pulse and hypertension.


b. rapid shallow respiration and hypertension.


c. hyperthermia and hypotension.


d. hypothermia and rapid weak pulse.


28- Oxygen embolism may occur during irrigation of wounds with……...…


a. hydrogen peroxide.


b. hydrogen oxide.


c. carbon dioxide


d. carbon monoxide.


29- A mechanism of death as a result of parasympathetic shock is……..…...


a. pulmonary edema.


b. atherosclerosis.


c. reflex vagal inhibition.


d. ventricular arrhythmia.


30- Sympathetic shock can cause death from…………………………………


a. ventricular fibrillation


b. coronary obstruction.


c. preexisting cardiac disease.


d. aortic stenosis.



Answers


1-d


2-b


3-c


4-d


5-b


6-b


7-c


8-b


9-d


10-c


11-c


12-c


13-b


14-c


15-c


16-a


17-a


18-d


19-b


20-c


21-d


22-d


23-b


24-b


25-a


26-d


27-d


28-a


29-c


30-a


Venous


At least 60-100 ml, gain access to the venous system filling the right atrium and ventricle and causes circulatory failure (cardiac embolism).


Arterial


Minimum volume of air (few cc), gain access to the left ventricle and causes obstruction of coronaries or cerebral vessels with rapid death.


Soft scab 12-18 hour


Dry scab 3 days


Separation of scab 5-8 days


Regression of epith 12-15 day



Death occurs when the amount of blood lost exceeds 2 liters, but accumulation of 200 cc of blood in the cardiac sac (cardiac tamponade) can cause death by compressing the heart.



Impact (pressure) abrasions: blunt object is directed perpendicular to skin → over a bony prominence


Blow by a board → two parallel linear contusions with normal-appearing tissue in between (tramline bruising).


• Recent bruise appears red, due to oxy-hemoglobin.                                                


• After 2 to 3 days, it is dark blue, due to reduced hemoglobin.                                                                                      


•After 4 to 6 days, it is green, due to biliverdin. •


After 6 to 8 days, it is yellow, due to bilirubin.                                


• length equal width of tool blade, greater → moved during withdrawn from the body) or less than (due to retraction of the skin).


• Depth equal to or less than the length of blade.


• Width equal thickness of the weapon blade.


• Angle : a single-edged weapon one acute angle i.e.


• Broken glass sharp ragged margin.



Sudden, slow pulse, hypotension, ↓R.R , pale moist skin, subnormal temperature


- Autopsy findings: not specific. Exclusion of poisoning.



hypotension, rapid pulse,


rapid respiration pale cold skin.


(oligemic) shock



Death → reflex vagal inhibition of the heart.



Death →ventricular fibrillation






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