Intro – Physical Trauma

1. Intro – Physical Trauma • Physical trauma: any mild, serious, or life-threatening body damage caused by physical impact • Types we will be studying: • Abrasions • Contusions • Lacerations • Chop wounds • Incised wounds • Therapeutic wounds • Hesitation marks

2. Case Study: The Siren and the Slugger

3. Agree or Disagree? • Based on what you currently know about the case, do you think Chris Brown was in the right? • Everyone out of your seats. Stand near the doorway if you AGREE with the above statement. If you DISAGREE, stand by the back window. If you are unsure, stand by the front table.

4. Case Study: Chris Brown and Rihanna • The Situation: • Just after midnight on Sunday, February 9, 2009, police were called to the scene of a dispute in Los Angeles, CA. At the scene, officers encountered a rented Lamborghini sports car and a young woman who had visible injuries from a physical assault. The young woman was later identified as Grammy Award-winner Rihanna.

5. Background: • Rihanna had been romantically involved with fellow recording artist Chris Brown for more than a year. • That night, the pair was traveling in the rented sports car through the Hancock Park area of Los Angeles. • At that time, a verbal disagreement began about a text message Brown had received from a woman with whom he had had a previous relationship. • Brown tried to halt the argument by pulling the vehicle over and attempting to force the female singer from the car.

6. Background, Cont’d • When Rihanna refused to exit the vehicle, Brown shoved Rihanna against the window with sufficient force to cause a raised circular contusion to form on her forehead. • Then, he began to punch her in the face. Rihanna attempted to protect herself by covering her face and head with her arms. • The force and number of blows resulted in numerous contusions on her left hand and a large contusion to her left triceps.

7. Background, Cont’d • Brown then placed Rihanna in a headlock and bit her left ear. Brown stopped the car and began to choke Rihanna until she attempted to gouge his eyes. He bit her left ring and middle fingers and then released her. She turned to face him, placed her feet on his chest, and pushed him away. • He continued to punch her legs and feet, causing several more contusions. • When Rihanna began screaming for help, Brown got out of the vehicle and walked away from the scene. • A resident in the neighborhood heard Rihanna's cries and called 911.

8. The Proceedings: • When the police arrived, they processed the scene, took a statement from Rihanna, and sent the singer to the hospital for treatment. At the hospital, photographs were taken of her injuries for documentation of domestic abuse. • At about 7:00pm that evening, Brown turned himself in at a Los Angeles police station. In June 2009, Brown pled guilty to a charge of felony assault and received a sentence of five years’ probation, six months of community service, and one year of domestic violence counseling.

9. Agree or Disagree? • With the evidence provided by the police report, do you think Chris Brown was in the right? • Everyone out of your seats. Stand near the doorway if you AGREE with the above statement. If you DISAGREE, stand by the back window. If you are unsure, stand by the front table.

10. Exit Slip - Survey • Write a Yes or No in your portfolio next to your entry from earlier to answer the following question: In the next several classes, we will be looking at and discussing pictures of different types of physical trauma. Would you feel at all uncomfortable doing this?

11. Crime in the United States

13. Impressions Activity! • What is an impression in forensic science?

14. Making an Impression – Part 1 • We will analyze our own impressions using measurements and observations • On a piece of paper, create a data table that will show: • 1. the width (cm) of your maxilla and mandible • 2. the depth (cm) of your maxilla and mandible • 3. observations of the unique characteristics of your teeth marks (slanted teeth, spaces, evidence of braces, etc.)

15. Making an Impression – Part 1 • Materials – 1per student: • Styrofoam plate • Permanent marker (need to share) • Ruler • Overhead transparency

16. Making an Impression – Part 1 • Bend plate in half – top of plate will be inside • Label the top half “Maxilla” and the bottom “Mandible” • Push the plate as far back as it will go in your mouth and bite down – not too hard – you don’t want to break through the plate! • Place your transparency over your plate and trace your dental pattern as accurately as possible. • Don’t forget to label your transparency – maxilla and mandible • Make your measurements and record data in your table

17. Making an Impression – Part 2 • On the same piece of paper from Part 1, create another data table that will show: • 1. data for 4 different materials you will be testing • 2. data includes a rating for each material and • 3. observations for each material – did the material give a good impression? Why or why not?

18. Making an Impression – Part 2 • I will need 3 people to help pass out ONE of each of the following: • Circus Peanut • Swedish Fish • Laffy Taffy • Star Burst • You will place the candies on your plate and make an impression + write observations and ratings for each candy. Don’t eat the candy until you have written your observations in your data table. You can eat everything except the circus peanut  • NOTE: Please complete the circus peanut first – I will come around and collect these as you work. You will need to label the maxilla side (MX) and the mandible side (MN)

19. Making an Impression - Challenge • At the front of the room I have your collected circus peanuts and transparencies. You may work in groups with as many people as you like. • One person from each group come and collect enough peanuts and transparencies for each person in your group. • Try to make matches – if you think you have one, call me over and I’ll come check. The first 5 people to have a match can have another piece of candy of your choice.

20. Making an Impression – Wrap-Up • On the paper with your data tables, write a short paragraph to summarize what you have learned about identifying bite marks. Be sure to include: • The process • How different materials affected the appearance/observations

21. Bite Marks • Types of crime involving bite marks: • Abuse • Assault • Sexual assault • Homicide • Exceptional cases such as bank robberies • It is important to remember that bite marks can be both attack injuries (and therefore present on the victim) and defensive wounds (and therefore present on the suspect) and all individuals suspected of involvement in a crime against a person need to be examined for such marks.

22. Bite Marks • It is important that dentists, doctors, police officers, social workers, and forensic pathologists know the most common locations to be able to analyze a situation • Doctors and dentists, when presented with bite mark wounds, must document what they see and keep records of this info.

23. Bite Marks - Anatomical Location • In a study, 148 bite marks were analyzed to determine most common victims and anatomical locations • Females were 4X more likely to be bitten, and over 50% of males were suspects in the case • Females more likely to be bitten on breasts, arms, and legs; children on genitals, legs, and back; males on hands, back, or face

24. Presentation of bite mark injuries • Typically present as elliptical or circular injuries, with separation near the halfway point • There is usually an absence of bruising or a diffused bruise in the center • Sometimes, only one arch of teeth is seen – most often the lower jaw • Why?

25. Warm-Up • Using what you know about the integumentary and circulatory systems, describe how bite marks or other types of contusions form. • In your description, use at least three of the following words: epidermis, dermis, hypodermis, blood, veins, arteries, capillaries

26. 3 main factors that influence the severity of injury: • The force by which the injury was inflicted • The anatomical location of injury (Why?) • The time elapsed between the time bitten and presentation to the doctor/ odontologist

27. Collection of bite mark evidence • So far we’ve discussed two aspects of forensic significance of identifying bite marks.What were they? • The third – the QUALITY OF EVIDENCE COLLECTION! • How do you think they collect evidence? • Who is “they?” • What might affect the quality?

28. Collection of bite mark evidence • Evidence is collected from both the victim and suspect • Review: how? What do investigators look at?

29. Collection of bite mark evidence • Evidence is collected from both the victim and suspect • Review: how? What do investigators look at? • Pictures of victim’s whole body (without scale), zoomed in picture of wound with scale (see below) • Measuring length and width of both maxilla and mandible • Finding unique characteristics such as gaps between teeth, misaligned teeth, etc.

30. Physical Trauma – in general • Forensic nurses evaluate physical trauma and interpret injuries to look for clues regarding the events that lead up to the crime • Some injuries can provide a profile of the suspect (what does this mean?) • The location of the trauma on victim’s body helps determine how tall perpetrator is and position of victim at time of attack • Angle of impact helps determine if perpetrator is left- or right-handed

31. Evidence of physical trauma • Appearance and extent of injuries depends on the following: • The amount of force applied to the body • The weapon’s surface area and mass • Anatomical location

32. Force • Review: What is force?

33. Force • Force = mass x acceleration (acceleration is the change in speed over time; speeding up or slowing down) • The important thing to remember here is the relationship between mass, force, and acceleration. • So an object with larger mass that is moving quickly upon impact will cause a more serious injury • Smaller objects or slowly moving objects upon impact will cause less serious injuries

34. Example • High speed accident: • Low speed accident:

35. Today we will be learning about: • How investigators classify injuries to the body: • Blunt force trauma • Caused by victim hit by something hard • Caused by falls or is pushed into a hard object • Sharp force trauma • Stab wounds • Incised wounds • Chop wounds • Therapeutic wounds

36. Blunt Force Trauma - Abrasions • When the skin rubs against a rough surface, an abrasion forms • Examples? • Abrasions are deep/not deep? • In life, they appear reddish-brown and heal relatively quickly • Postmortem (?), abrasions appear yellow, almost transparent

37. 3 Types of abrasions • Brush: when force is applied parallel to skin; epidermis is scraped off in layers; skin damaged in direction of force • Impact: when force applied perpendicular to skin, skin is crushed; most commonly seen on bony parts of body • Patterned: if object that caused impact or brush abrasion leaves an impression; these leave unique clues about weapon used

38. Blunt Force Trauma - Contusions • Bruises caused by broken blood vessels deep in the skin • Usually not fatal, but if a victim sustains many at once, he/she may suffer severe blood loss, which could lead to shock and death (what is shock?) • Can also form on internal organs such as ? • When internal contusions form, the collected blood can cause swelling – this is called ? • How can doctors/investigators see internal contusions? • Severity of contusions is based on – think back to bite marks! • 1. • 2. • 3. general health of the victim – who do you think might bruise more easily?

39. Blunt Force Trauma - Lacerations • Tear in the tissue (which tissues?) caused by an extreme sliding or crushing force • Blunt objects, falls, vehicle accidents • Marks produced have irregular edges, but sometimes patterned – since skin tears it does not usually hold the unique shape of the pattern • May occur internally or externally

40. Sharp Force Trauma – Stab Wounds • Sharp force trauma caused by incised wounds that are shorter in length than they are deep in the body • Most are caused by single-edge kitchen, pocket, or folding knives • Wounds that result in a punctured organ are called penetrating wounds • Wounds that puncture an organ and come out the other side of the organ are called perforating wounds

41. Sharp Force Trauma – Incised Wounds • Also called cuts; are produced by any object with a sharp edge such as a knife, glass, metal, or even paper • Difference from stab wound – the wounds are longer than they are deep • Usually the force is applied parallel to the body, so these types of wounds do not give good clues about the weapon used

42. Sharp Force Trauma – Chop Wounds • Produced by heavy tools such as axes, machetes, swords, meat cleavers, etc. • Produce incised wounds on the surface of the body as well as deep internal injuries, including bone fractures • What clues might investigators use to identify this type of wound and the weapon used?

43. Sharp Force Trauma - Therapeutic • Any incision made in a medical setting • Surgery • Biopsy • Others?

44. Check In – can you identify the types of wounds? • Is this a sharp force or blunt force wound? • Which type of sharp or blunt force is it?

45. Check In – can you identify the types of wounds? • Is this a sharp force or blunt force wound? • Which type of sharp or blunt force is it?

46. Check In – can you identify the types of wounds? • Is this a sharp force or blunt force wound? • Which type of sharp or blunt force is it?

47. Check In – can you identify the types of wounds? • Is this a sharp force or blunt force wound? • Which type of sharp or blunt force is it?

48. Read more: http://www.forensicmed.co.uk/wounds/sharp-force-trauma/

49. Intro to Autopsy - Lividity • When a person dies, the heart stops pumping blood through the body • Where do you think the blood goes?

50. Intro to Autopsy - Lividity • Blood pools downward with the force of gravity • What do you think this looks like? • Lividity begins to appear ~30 minutes – 2 hours after death and continues to become more apparent (darker) for up to 12 hours • Why does it become darker? • What happens after the body is cooled down?