Wound Classification and Types

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Questions and Answers

What constitutes a medically defined wound?

Any superficial cut or scrape on the body

Any injury to the skin caused by environmental factors (correct)

Disruption of tissue continuity due to an internal force

Disruption of the continuity of tissues caused by external mechanical force (correct)

Which type of wound results from exposure to environmental elements like heat or chemicals?

Laceration wound

Abrasion wound

2-wound (correct)

Blunt force wound

What factors primarily influence the severity and appearance of wounds?

Size of the wound and type of medical treatment provided

Location of the wound and age of the person

Type of mechanism causing the injury and the person's health status

The amount of force delivered and the duration of force application (correct)

How is a defense wound typically characterized?

Wounds that result from an attempt to protect oneself Signup and view all the answers

Which of the following classifications was specifically created for wounds caused by mechanical forces?

1-wounds Signup and view all the answers

What type of abrasion would likely result from a car accident?

Friction (sliding) abrasion Signup and view all the answers

Which type of abrasion is most indicative of struggle caused by fingernails?

Pressure (imprint) abrasion Signup and view all the answers

In a medico-legal context, what might semilunar abrasions suggest?

Signs of a struggle or resistance Signup and view all the answers

Which instrument is associated with rope marks found on the skin?

Rope Signup and view all the answers

What characteristic of abrasions helps to establish the circumstances of how they were inflicted?

Their shape and pattern Signup and view all the answers

What is a key characteristic of simple wounds?

They leave no permanent infirmity. Signup and view all the answers

Which of the following defines a dangerous wound?

An injury that requires more than 20 days to heal. Signup and view all the answers

What is considered a permanent infirmity?

Complete loss of the functioning of an organ. Signup and view all the answers

What is not classified as a permanent infirmity?

Loss of a non-functioning eye-globe. Signup and view all the answers

What differentiates dangerous wounds from simple wounds?

Severity and potential for permanent infirmity. Signup and view all the answers

What is the first stage in the healing process of abrasions?

Scab formation Signup and view all the answers

What distinguishes an animal bite abrasion from a human bite abrasion in the classification table?

Two parallel lines of teeth Signup and view all the answers

Which characteristic is true for abrasions immediately after an injury?

They ooze a serous fluid. Signup and view all the answers

During which time frame does the scab start to darken in color after an abrasion?

Day 2-3 Signup and view all the answers

What appears to be the last stage in the healing process of abrasions?

Regression of epithelium and granulation tissue Signup and view all the answers

Which feature is indicative of antemortem abrasions?

Presence of vital tissue reactions Signup and view all the answers

What describes the microscopical findings in postmortem abrasions?

Absence of characteristic features found in antemortem abrasions Signup and view all the answers

What characteristic finding is unique to antemortem abrasions compared to postmortem abrasions?

Hyperemia is present Signup and view all the answers

Which statement is true regarding hyperemia in postmortem abrasions?

Hyperemia is absent, indicating no fresh wounds Signup and view all the answers

Which situation would most likely lead to the development of postmortem abrasions?

Dragging a body across a rough surface Signup and view all the answers

What primarily determines the extent and severity of a contusion?

The force applied and the tissue characteristics Signup and view all the answers

Why do children tend to bruise more easily compared to adults?

Their skin is loose and delicate Signup and view all the answers

Which group is considered to bruise more easily due to physiological factors?

Elderly individuals with less supportive tissue Signup and view all the answers

In which area are contusions likely to be incurred more readily?

Thin, lax skin and fatty areas Signup and view all the answers

Which of the following factors does NOT have an influence on the size of a bruise?

The weather conditions at the time of injury Signup and view all the answers

Which statement accurately describes the likelihood of bruising in different tissue types?

Bruising is more likely in soft, lax, vascular tissues like the eyelids. Signup and view all the answers

What is a common misconception regarding the origin of bruising?

A bruise's location directly indicates the source of injury. Signup and view all the answers

Which of the following bruise locations corresponds correctly with the described injury?

Blow to the temple -> bruise on cheek. Signup and view all the answers

In which situation would bruise detection be more challenging?

When bruises occur on the scalp without swelling. Signup and view all the answers

What color does a bruise typically appear two days after the injury due to the presence of oxyhemoglobin?

Red Signup and view all the answers

Which pattern is most likely to appear in bruises caused by specific impacting objects?

Distinct grooves or ridges that mimic the impacting object. Signup and view all the answers

Which factor is most likely to delay the resolution of a bruise?

Size and depth of the bruise Signup and view all the answers

How do subconjunctival bruises change over time after their initial appearance?

The redness is gradually absorbed. Signup and view all the answers

What distinguishes antemortem bruises from postmortem bruises?

Postmortem bruises are caused by capillary ruptures after death. Signup and view all the answers

Which medical situation is NOT typically associated with causing bruises?

Fractures from falls Signup and view all the answers

Study Notes

Wound Definition

A wound is a disruption of tissues caused by an external mechanical force.
Injury is often used interchangeably with wound but can have a broader meaning.

Wound Types

Wounds are classified based on the force that caused them:
- Mechanical force (blunt or sharp)
- Heat, cold, chemicals, electricity, or radiation

Severity Factors

The severity of a wound depends on the force delivered and the time it was applied.

Legal Wound Classification

Simple wounds: Heal quickly (less than 20 days), with no permanent infirmity.
Dangerous wounds: Serious injuries, may cause permanent infirmity or take more than 20 days to heal, but are not fatal.

Permanent Infirmity

Defined as the loss of a functioning organ or loss of function (total or partial).
Loss of a non-functional eye is considered disfigurement, not permanent infirmity.

Abrasions (Scratch, Graze)

Injury where the superficial epithelial layer is removed by friction or compression.
Types of Abrasions:
- Pressure (imprint) abrasions: Fingernail marks, ligature marks.
- Friction (sliding) abrasions: Car accidents.
- Patterned abrasions.

Medico-Legal Importance of Abrasions

Often indicate struggle and resistance, as they take the shape of the causative instrument.
Common shapes and their causes:
- Semilunar abrasions: Fingernails (throttling/smothering).
- Rope marks: Rope (hanging/strangulation).
- Sliding abrasions: Dragging (car accident).
- Tyre impression: Tyre (car accident).

Abrasions: Types

Human bites: Two curved rows of teeth marks.
Animal bites: Two parallel rows of teeth.

Abrasion Location

Occur at the site of force application, and may be the only visible trauma evidence.

Abrasion Healing Stages

Four stages:
- Scab formation: Immediate visible skin damage.
- Epithelial Regeneration: Skin starts to regenerate.
- Sub-epithelial granulation and epithelial hyperplasia: These processes occur.
- Regression of epithelium and granulation tissue: Regression occurs.

Abrasion Characteristics

Immediately after injury: Reddish, tender, and oozing serous fluid.

Abrasion Healing Progression

Day 1-2: Soft, brownish-red scab.
About three days: Scab becomes brown-red and dry, consisting of exudates.
Gradually (within a week): Scab dries and darkens in color.
About one week: Scab falls off, leaving no scar.
2-3 weeks: Normal skin restored.

Antemortem vs. Postmortem Abrasions

Antemortem: Occur before death, showing hyperemia, vital tissue reactions, and specific dermal damage under a microscope.
Postmortem: Occur after death, lack hyperemia, vital reactions, and specific microscopic features, usually from dragging a dead body.

Bruises (Contusions, Ecchymoses)

Hemorrhage into soft tissue due to ruptured blood vessels from blunt trauma.
Can occur in skin and internal organs (lung, heart, brain, muscle).
Severity depends on force, tissue structure, and vascularity.

Medico-Legal Importance of Bruises

Bruising can reflect the impact of force, but size is influenced by factors:
- Force of trauma
- Size of striking object
- Age
- Sex
- Health condition
- Site and type of tissue struck.

Bruising: Factors Influencing Size

Children and elderly: More easily bruised due to thin skin and loss of subcutaneous support.
Women, especially if obese: May bruise more easily.
Well-conditioned, muscular individuals: More resistant to contusions.

Location and Direction of Bruises

Does not necessarily pinpoint injury origin.
Bleeding follows the path of least resistance, influenced by gravity and movement:
- Blow to the temple: Bruise on cheek.
- Jaw fracture: Bruise on neck.
- Hip fracture: Bruise on thigh.
- Blow to the forehead: Bruise on eyelids.
- Blow to the lower abdomen: Bruise on scrotum or labia.
Scalp bruises may be invisible externally unless there is swelling.
Bruises are harder to detect in darker skin tones.

Bruising Patterns and Shapes

Bruises may reflect the shape of the impacting object.
Example: Grooves or ridges can match the pattern of the object.

Bruise Age and Color Changes

Color changes are due to hemoglobin breakdown.
- 2 days: Red (oxy Hb).
- 3 days: Blue (reduced Hb).
- 2 weeks: Green (biliverdin).
- 3 weeks: Yellow (bilirubin).

Factors Affecting Bruise Characteristics

Adequate lymphatic and venous drainage: Affects resolution.
Size and depth of the bruise: Larger or deeper bruises take longer.
Anatomical site: Influenced by local blood flow.
Age and general health: Affect healing.

Medical Conditions Causing Bruises

Sternal and cardiac massage: Result in bruising on the sternum and heart area.
Needle puncture marks: Bruising around the area of the puncture.

Subconjunctival Bruises

Appear initially bright red, but fade due to phagocytic removal of red blood cells.

Antemortem vs. Postmortem Bruises

Antemortem: Before death.
Postmortem: After death, usually caused by a significant trauma within hours of death.

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Description

This quiz covers the definitions, types, and classifications of wounds. It distinguishes between simple and dangerous wounds and discusses severity factors that affect healing. Understand the differences in terms of legal classifications and clinical implications.