MEDICO LEGAL ASPECTS OF (puncture), sharp-edged and

PHYSICAL INJURIES sharp-pointed (stab wound)

c. by tearing force – laceration
Physical injuries resulting from physical d. by heat or cold – frostbite, burns
violence or scalds
Vital reaction – is the sum total of all reactions e. by chemical explosion – gunshot
of tissue or organ to trauma manifested by: wound, shrapnel wound
3. As to the manner of infliction
a. Rubor or inflammation a. hit – bolo, blunt instrument
b. Dolor or pain b. thrust or stab – dagger, bayonet
c. Calor or heat c. gunpowder explosion
d. Functio laesa or loss of function d. sliding or abrasion
4. As to the depth of the wound
The presence of vital reaction differentiates a. Superficial – involves only the
antemortem from postmortem injuries layers of the skin
b. Deep – beyond the layers of the
Classification of Wounds:
skin
1. As to severity: i. Penetrating – wounding
a. Mortal wound – capable of agent enters the body by
causing death immediately after mere piercing of a solid
infliction such as wounds organ or tissue of the
inflicted on the heart and large body
blood vessels, brain, upper ii. Perforating – wound
spinal cord, lung, stomach, liver, agent produces
spleen, intestine. communication between
b. Non-mortal wound the inner and outer
portion of the organs.
5. As to the relation of the site of
application of force and the location of
injury
a. Coup injury – located at the site
of the application of force
b. Contre-coup injury – found
opposite the site of the
application of force
c. Locus Minoris Resistencia –
located not at the site nor
opposite the site of the
application of force but in some
2. As to instrument used areas offering the least
resistance to the force applied.
a. by blunt instrument – contusion,
d. Extensive injury – involving
hematoma, laceration
greater areas of the body beyond
b. by sharp instrument – sharp-
the site of the application force.
edged (incision), sharp-pointed
 Closed Head Traumatic Brain Injury (TBI) – Coup and Conte Coup

Special Types of Wounds: 1. Closed Wound – no breach of continuity

of skin or mucous membrane
a. Defensive wound – result of instinctive a. Superficial:
reaction to avoid or repel potential injury  Petechiae
b. Patterned Wound – wound in the nature
 Contusion
and shape of the object and which infers
 Hematoma
object used
b. Deep
c. Self-inflicted wound
 Sprain
Legal classification of physical injuries  Dislocation
 Fracture
1. Mutilation  Strain
2. Serious physical injuries  Subluxation
3. Less serious physical injuries
 Internal hemorrhage
4. Slight physical injuries and maltreatment
 Concussion
 Depending on the presence or absence or
2. Open Wound – abrasion, incision, stab
intention
wound, puncture, laceration
 Depending upon the nature and character of
the wound inflicted and its consequences on Petechiae
the person of the victim (insanity, imbecility,
impotency, blindness, loss of any of the  Caused by the passage of blood from the
senses of organ, incapacity to work and capillaries
duration of resulting incapacity)  May be small or pinhead-sized but may
coalesce to form big hemorrhagic areas
Medical classification of Wounds:  In trauma: asphyxial death, coronary
occlusion, blood diseases.
Contusion

 Is the effusion of blood into the tissues

underneath the skin arising from a blunt
force
 Size is usually greater than the size of
the object causing it
 Location may not always indicate the
site of application of force
 External pattern may correspond to
shape of weapon.

Age of Contusion
After its complete Purple Fracture – disruption of bone continuity arising
development from violence or preexisting pathology
4-5 days Green
7-10 days Yellow
7-10 days Disappearance

Hematoma

 Is the extravasation of blood in a newly

formed cavity underneath the skin
 Develops when the blunt instrument is
applied over bony tissue; aspiration with
syringe will show blood

Musculoskeletal injuries

Sprain – partial or incomplete disruption of

muscle or ligament caused by blow or torsion
force
Dislocation – displacement of the articular
surface of bones forming a joint
Kinds of fractures
1. Simple or close fracture – no break of
overlying skin
2. Open or compound fracture – with open
wound caused by broken bone
3. Comminuted fracture – Bone is
fragmented into several pieces
4. Greenstick fracture – where only one
side of the bone is broken while the
opposite side is bent
5. Spiral fracture – break is spiral in shape
as in long bones
6. Linear fracture – Where fracture forms a
crack, especially in flat bones
7. Pathologic fracture – caused by
weakness of the bone due to disease
Comminuted fracture

Greenstick fracture Spiral fracture Traverse or linear fracture

Cerebral concussion – It is the jarring or the 5. Hacking wound – when the instrument is
brain characterized by: a heavy cutting instrument like axe,
saber, bolo
1. Temporary loss of function
2. Unconsciousness Characteristics of incised wounds:
3. Relaxed muscles
4. Slow respiration, rapid pulse 1. Edges are clean cut
5. Subnormal temperature 2. Usually the wound is shallow near the
6. Relaxed sphincter extremities and deeper at the middle
7. Sluggish reflexes portion
8. Retrograde amnesia (loss of memory for 3. Profuse hemorrhage is invariably a
events just before the injury) feature
4. Gaping due to retraction of the edges is
Kinds of open wounds present

1. Abrasion (scratch, graze, impression Incised wounds may be:

mark, friction mark)
 Characterized by the removal of the 1. Suicidal
superficial epithelial layer of the skin caused 2. homicidal
by rub or friction against a hard tough 3. accidental
surface Suicidal wounds – located in the neck, flexor
 Develops at the precise point of impact of surfaces of the extremities (elbow, groin, knee,
the force causing it wrist) and accessible to the hand in inflicting the
 Consists of parallel linear injuries in line injury
with the direction of the friction causing it
 May show pattern of the wounding material It is usually with hesitation cuts and the direction
 Far-reaching importance in the medico-legal varies with the hand used in inflicting the
viewpoint injuries
 Abrasion caused by fingernails may indicate
Homicidal wounds – incised wounds are deep;
struggle or assault located in the face, neck,
multiple and in both accessible and non-
forearms and hands
accessible parts of the body to hands of the
 Abrasions on bony parts may be from victim
friction or surfaces
 May infer the degree of pressure, nature of Accidental wounds – usually multiple as those
the rubbing object and the direction of from broken windshield and glass parts
movement
Suicidal Homicidal
wound wound
2. Incised wound (cut, slash, slice) -
Direction Oblique, Horizontal,
Produced by a sharp-edged instrument across front of below Adam’s
like a knife, razor, bolo, metal sheet, neck above apple
glass Adam’s apple
3. Impact cut- when there is forcible Severity Usually not so Usually deep
contact of the cutting instrument with deep and may
the body surface involve
4. Slice cut –when cutting injury is due to cartilage and
bones
the pressure accompanied with
Superficial cut Usually Absent,
movement of the instrument (hesitation) present except when
victim
 struggled
Wounding Firmly Absent
weapon grasped
(cadaveric
spasm) or
beside victim
Blood In front part of At the back of
distribution the body the neck

Punctured wound – Is the result of a thrust of a

sharp pointed instrument (icepick, needle, nail
pointed stick, hook)

External injury is small, but depth is to a certain

degree

Lacerated wound – Is a tear of the skin and

underlying tissues due to forcible contact with a
blunt instrument; a hit with piece of wood, fist
blow, stone, butt of firearm

The shape and size of injury do not correspond

to the wounding instrument

Skin tear is rugged with extremities irregular and

ill-defined.

Stab wound – Is produced by the penetration of

a sharp-pointed and sharp-edged instrument

General rule: the edges are clean cut,

regular and distinct

 Surface length of wound reflects width of

the wounding instrument
 The extremities of wound may show the
nature of the instrument used. Double blade:
both extremities are sharp; Single-bladed:
one extremity rounded and contused
 Direction of surface defect determines
relative positions of offender and victim
 Multiple stab wounds in different parts of
the body shows homicidal intent
 Stab wound with serrated borders infers
alternative thrust and withdrawal of weapon