Forensics - Blunt Force Trauma Test

When a blunt object scrapes off the superficial skin it is described as

Brush abrasion

An area of hemorrhage into soft tissue is described as

Contusion

Blunt force applied directly perpendicular to the skin is described as

Impact abrasion

If an imprint is visible in the skin, either by the object or material in between the skin and the object, it is described as

Pattern Abrasion

Shearing or crushing forces that cause a tearing in tissue are described as

Laceration

Penetrating, local, crush, and bumper are what type of fractures that can be sustained to the skeletal system?

Direct Force

Traction, angulation, rotational, compression, and combinations of these forces can cause what type of skeletal fractures?

Indirect Force

What term is used to describe the connective tissue that attempts to hold the skin and underlying tissue together during a blunt force injury?

Bridging

The severity, extent, and appearance of a blunt force injury depends on what five factors?

1. Amount of force applied

2. Time over which force is delivered

3. Region of body struck

4. Extent of body surface

5. Nature of weapon

A sudden violent impact to the front of the chest can cause instant cardiac arrest known as

Commotio Cordis

When air enters the pleural cavity it is known as

Pneumothorax

What is the minimum amount of blood needed to fill the pericardium to cause cardiac arrest

150ml

Shock to soft tissues can be caused by

Severe Crushing forces

Compound Fractures

Hemorrhage of tissues can be caused by

A. Lacerations 

B. Traumatic Amputation 

C. Compound Fracture 

D. Avulsion Wounds

When tissue becomes so damaged that it becomes neurotic due to tremendous force it is described as

Crushing Syndrome

In Chin-Sternum- Heart Syndrome an examine should expect to see what types of injuries?

Broken Cervical Spine

Lacerated Chin

Cardiac Injury

Broken Sternum

Blunt force trauma to the heart can cause

Lacerations

Contusions

Transections

Cardiac Arrest

Blood in the pleural cavity is known as

Hemothorax

Blood and air in the pleural cavity is known as

Hemopneumothorax

Most cysts in the pancreas are due to pancreatitis (T/F)

True

The most common cause of fetal death is separation of the placenta (T/F)

True

Intra peritoneal rupture of the bladder may release urine into the victim’s abdominal cavity (T/F)

True

Blunt force trauma to the flank can cause kidneys to hemorrhage causing blood in the urine (T/F)

True

Gastrointestinal injuries due to blunt force trauma are rare due to the elasticity of the abdominal wall and protection from clothing (T/F)

True

Rupture of the spleen can be caused by infection (T/F)

True

The liver is the most frequently damaged internal organ due to blunt force trauma (T/F)

True

It is possible to have major internal organ injury to the abdominal cavity with no external sign of trauma due to the elasticity of the abdominal wall (T/F)

True

insertion of a needle to remove blood from the thoracic cavity can cause immediate death for no known medical reason (T/F)

True

Most aortic injuries are caused by accleration/deceleraton injuries

True

What structures/organs make up the thoracic cavity?

12 Thoracic vertebra,

11 ribs

Sternum

Diaphragm

Heart

Lungs

Aorta

What is the difference between a contusion, laceration, and transection?

Contusion - Bruise, collection of blood

Laceration - tissue damage from crushing/shearing force

Transection - Cut in half

What are the four types of rib fractures?

• Pathological

• Iatrogenic

• Direct Violence 

• Indirect Violence

Describe how the fractures of ribs will differ in indirect violence depending on the direction of the force applied.

• Force from front to back ~ rib fracture curves

• Force from side to side ~ rib fracture on opposite side & spine/sternum

Under what circumstance can blunt force trauma cause the lungs to rupture?

If the glottis is closed during impact

What is an avulsion wound?

Body part forcibly torn away

What is venous thrombosis?

Blood clot in the veins

Why are blunt force trauma injuries to the Kidneys rare?

Its protected by elasticity of stomach wall and other organs

Severity of blunt force injury to abdominal organs depends on what three factors?

1. Size of object used

2. Amount of force

3. Organ and its condition at time of impact

Describe the flow of blood through the heart starting at the vena cava and ending with the release through the aorta.

Vena Cava —> Right Atrium —> Right Ventricle —> Pulmonary artery —> Pulmonary Veins —> Left Atrium —> Left Ventricle —> Aorta

Injuries caused when an object strikes the skull are

Impact Injuries

Low velocity impacts over an large area like falling on an hard surface are characterized by what type of skull fracture

Linear Fracture

Large amounts of velocity at time of impact that causes severe deformation of skull are what type of fractures

Depression Fracture

A linear fracture that has smaller marks radiating from the fracture point are known as

Circular fracture

A fracture at the base of the skull that completely transects the base is known as what type of skull fracture

Hinge Fracture

Fractures around the foramen magnum due to compression of spinal column into the skull are

Ring Fracture

Force applied to the top of the head will result in what type of skull fracture

Cranial Vault Fracture

Force applied to the side of the head will result in what type of skull fracture

 Fractures to the temporal bone

Force applied to the back of the head will result in what type of skull fracture

 Linear Fractures

Force applied to the mid front of the skull will result in what type of skull fracture

Fractures to the orbits and maxilla

Epidural symptoms may take 48 hours to present themselves

False

Epidural hematoma can cause nausea, drowsiness, and headache

True

Contusions result in hemorrhage and necrosis

True

Gliding contusions are associated with skull fractures

False

Coup Contusions occur on the opposite side of impact

False

Hyperextension of the neck that forces the head against the windshield in a MVA can cause brain stem to avulse

True

90% of intra cerebral hemorrhage are fatal

False

The Dura attaches the brain to the skull

True

Lesions are dark disk shaped pooling of blood

False

Countercoup contusions occur on opposite side of impact

True

What is the most common lethal injury to the brain due to blunt force trauma?

Subdural hematoma

What does DAI stand for?

Diffuse axonal injury

What are the three levels of DAI and how are they determined?

Mild - Coma 6-24 hours

Moderate - Coma 24+ hours without signs of brainstem dysfunction

Severe - Coma 24+ with signs of brainstem dysfunction

When are signs and symptoms developed for acute, sub-acute, and chronic subdural hematomas?

Acute - less than 72 hours

Sub-acute - 3 days to 2-3 weeks

Chronic - 3+ weeks

It is possible for a person to die from a concussion without having any structural damage to the brain or skull (t/f)

True

What is the difference between mild and cerebral concussions?

Victims of mild concussions do not lose consciousness, while victims of cerebral concussions do immediately

What effect does alcohol have on concussions

Alcohol intensifies concussion, can cause death

Slurred speech, droopy faces, impaired memory, dementia from repeated blows to the head of a boxer are all signs of what syndrome?

Punch drunk syndrome

What are the four types of cervical spine injuries?

1. Flexion distraction

2. Flexion compression

3. Extension distraction

4. Extension compression

What is the difference between distraction and compression injuries?

1. Distraction - damage to ligaments and soft tissues

2. Extension - damage to ligaments and soft tissues, and fractures to cervical spine

What effects does swelling and edema have on the brain?

Increases pressure on skull, injures other vital body parts

What types of actions could result in damage to vertebral arteries?

Blows to neck, falls, MVAs, Cervical Spine Manipulation

How many mL of blood pooling in the brain due to a subdural hematoma is considered fatal?

50 mL

What are the five categories of acceleration/deceleration injuries?

1. Diffuse Axonal Injury

2. Subdural hematomas

3. Linear fractures

4. angulation/rotation fractures

5. Combo of both (linear and angulation fractures)

What is second-impact syndrome?

a minor head injury, followed by second head injury before symptoms of the first have disappeared