1 / 17

Regional Injuries

بسم الله الرحمن الرحيم. Regional Injuries. د/ عبد المنعم جودة مدبولى دكتوراة الطب الشرعي و السموم الإكلينيكية, مدرس الطب الشرعي و السموم الإكلينيكية, استشاري علاج التسمم بمستشفى بنها الجامعي عضو لجنة مراجعة البرامج و المقررات بوحدة الجودة. Incised wound in neck “ Cut throat ”:

cassandrabrown
Download Presentation

Regional Injuries

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. بسم الله الرحمن الرحيم Regional Injuries د/ عبد المنعم جودة مدبولى دكتوراة الطب الشرعي و السموم الإكلينيكية, مدرس الطب الشرعي و السموم الإكلينيكية, استشاري علاج التسمم بمستشفى بنها الجامعي عضو لجنة مراجعة البرامج و المقررات بوحدة الجودة

  2. Incised wound in neck “ Cut throat ”: • They are seen in suicide & homicide and rarely accidental. • Accidental cut throat may be caused by glass injury that can produce an incised wound. It can be identified by the presence of fragments of glass in the wound, by small side cuts in its margin and by the circumstances.

  3. Homicidal Cut Throat Suicidal cut throat

  4. Mechanism of death in cut throat : 1-Neurogenic shock:from vagal cardiac inhibition . 2-Hemorrhage:from injured carotid & jugular vessels. 3-Venous air embolism:through the opened big veins in the neck. 4- Mechanical Asphyxia (Chocking):if the trachea is opened ,blood may be inhaled & chocking occurs.Orthe soft parts of the neck fall in & closure of the airway results in mechanical asphyxia. 6-Delayed causes:due to edema of the glottis or sepsis of the wounds & aspiration pneumonia=== 2ry bronchopneumonia.

  5. سؤاااال هاااام • سؤاااال هاااام • When cut simulate lacerated wound? • 1- Homicidal cut throat • 2- Cut with serrated sharp object • 3- Corrugated skin (axilla & scrotum) • When lacerated simulate cut wound? • Only in scalp laceration

  6. Traumatic asphyxia:- • The thoracic cage is squeezed for a considerable time, with sufficient force to impair respiratory movements. • Fractures of the ribs & sternum:- • Fractures of the ribs are dangerous if :- سؤال هام • Multiple; prevent expansion of the chest causing fatal respiratory embarrassment. • Fractured ends which penetrate pleura &lungs causing he & pneumothorax. • Pleural & muscular pain that limit respiratory effort. Fractures of the ribs are dangerous if :- سؤال هام

  7. Flail Chest • Multiple rib fracture >3 consecutive ribs. • Commonly occurs in frontal violence e.g. stamping assaults or motor car accidents. • Loss of rigidity of the chest cage, attempts at expanding chest volume during inspiration are impaired & the loose section is sucked inwards during inspiration “paradoxical respiration”. • C/P. : dyspnea , cyanosis ,hypoxia in extreme degree of flail chest. • NB. Injury to liver (ribs 7-10), spleen (9-10) & kidney(11-12) Flail Chest

  8. Paravertebral fractures & child abuse: • The ribs of infants and children are very pliable and accidental fractures are uncommon except in gross injury. • However, lateral compression of the infant chest by adult hands in the battered child syndrome can cause multiple paravertebral fractures.مهمممممممم.........

  9. Stab wounds of chest: Most common homicidal stabbing [heart, lungs, & great vessels; pulmonary a. , aorta} • Stab w. in the atria,Rt.V. ,or great vessels are often more rapidly fatal than Lt.V. ? سؤااال........ Contraction of the thick muscles of the Lt.V. can partially close the stab w. “valve mechanism”. • Rt.V. is more often injured ? as it forms a great part of the anterior surface of the heart.سؤااال.... • Rupture aorta due to acc /dec →rapid death Stab w. in the atria,Rt.V. ,or great vessels are often more rapidly fatal than Lt.V. ? سؤااال........ Rt.V. is more often injured ? as it forms a great part of the anterior surface of the heart. سؤااال....

  10. Mechanism of death due to Stab wounds of chest: • Internal hemorrhage into the pleural cavity, the mediastinum, or the pericardial sac (cardiac tamponade).200 ml مهممممم.......................................... • However there may be little external bleeding.

  11. Abdominal Injuries Blunt inj. of the abdomen: • Kicking or impact against the steering wheel in MVA. • To the ant. Abdominal wall causing compression of the viscera ,with lacerations & contusions. Stomach, intestine & mesentery: • In adults, can tear the mesentery or intestine , leading to hge & peritonitis. • In infants ,compression of the intestine & mesentery against the rigid lumbar spine can tear them. D.D. Bet. traumatic & pathological rupture: سؤاال..... • 1st one shows irregular edges surrounded by bruises with bulging of m.m.to the outside &normal other parts of G.I.T. • 2nd one shows regular edges surrounded by fibrosis with evidence of disease as typhoid or peptic ulcer. D.D. Bet. traumatic & pathological rupture: سؤاال

  12. Urinary Bladder: • More common in males than in females ?سؤاااال.........

More Related