MLC Injury

download MLC Injury

of 25

  • date post

    13-Nov-2014
  • Category

    Documents

  • view

    1.300
  • download

    4

Embed Size (px)

description

A brief note on Injuries

Transcript of MLC Injury

Wound

Surgically: Breach in continuity of skin or mucus membrane. Legally: Any lesion, external or internal, caused by violence,

with or without breach in continuity of tissue. Injury Legally: As per sect.44 IPC, any harm whatever illegally caused

Trauma Assault

Battery Hurt Simple hurt Grievous hurt (8 clauses)

to any person, in respect of body, mind, reputation or property. Injury which is associated with loss of tissue is called wound. All wounds are injuries but all injuries are not wounds. An insult either physical or mental affecting ones state of well being. Whoever makes any gesture, or any preparation intending or knowing it to be likely that such gesture or preparation will cause any person present to apprehend that he who makes that gesture or preparation is about to use criminal force to that person, is said to commit an assault. Execution of assault is battery. Wounding will constitute battery which includes even mere touch by a finger. As per sect.319 IPC, Whoever causes bodily pain, disease or infirmity to any person is said to cause hurt. Those which do not come under the category of grievous hurt & are simple in nature & heal rapidly without leaving any permanent deformity or disfiguration. As per sect.320 IPC, 1)Emasculation: It means loss of masculine power by -castration -cutting of penis -injury to testis -injury to spinal cord at the level of L2 to L4 vertebra. 2) Permanent privation of sight of either eye. 3) Permanent privation of hearing of either ear. 4)Privation of any member or joint Member: Any organ or limb of subject responsible for performing distinct function.e.g.eyes,ears,nose etc 5) Destruction or permanent impairment of power of any member or joint. 6) Permanent disfigurement of head or face. Disfigurement: Change in configuration or personal appearance1

Dangerous injury

Injury likely to cause death Injury sufficient to cause death in ordinary course of nature Dangerous weapon

of subject. 7) Fracture or dislocation of bone or tooth. 8) Any hurt which endangers life or which causes sufferer to be in severe bodily pain or unable to follow his ordinary pursuits during the space of 20 days. Ordinary pursuits: means day to day personal activities of individual like attending natures call, taking food or bath, wearing clothes etc Is the one, which possess imminent danger to life by its direct or imminent effects, because of, being extensive in nature, involving important structure of body or organs and also being likely to prove fatal in absence of surgical aid. e.g. injury to internal organs or large blood vessels. Is the one which constitutes great threat to life on account of its great severity & involvement of important structures of body or because of pre-existing conditions e.g. old age,infancy,diseased state of health. e.g. hypostatic pneumonia. Is the one, which by virtue of its own direct effects can bring about a fatal result. e.g. injury to brain/spinal cord, injury to heart or large blood vessels, cumulative effects of injury, extensive burns. Any instrument used for shooting, stabbing or cutting, or any

instrument which, when used as weapon of offence, is likely to cause death, or by means of fire or any heated substance, or by means of any poison or any corrosive substance, or by means of any explosive substance, or by means of any substance which it is deleterious to human body to inhale, to swallow or to receive into the blood, or by means of any animal.

2

On the basis of its causation

Medicolegal classification of injuries I] Mechanical injury: Def.: Damage to any part of body d/t application of mechanical force. Factors responsible for mechanical injury: a) Force b) Area over which it acts c) Specific effects of the force d) Time taken over which kinetic energy is transferred. 1)Abrasion 2)Contusion 3)Laceration 4)Incised wound 5)Puncture/stab wound 6)Fractures II] Thermal injury III] Chemical injury -d/t corrosive acids/alkalies -d/t irritants like animals, vegetable etc IV] Firearm injury

On the basis of gravity of injury

On the basis of time of infliction On the basis of nature of infliction

I]Simple injury II]Serious injury III]Grievous injury IV]Dangerous injury V]Fatal injury I]Antemortem: recent/old II]Postmortem I]Suicidal II]Accidental III]Homicidal IV]Defence /Protective wounds V]Fabricated /Self- inflicted wounds Def:-These are the wounds produced on the body by oneself (self- inflicted) or with the help of other person (fabricated) & characterized by following i.e. a) usually seen over the accessible parts of the body & are superficial injuries.

3

b)history of assault not compatible with the injuries. c) If injuries made by sharp cutting weapon,then injuries not correspond with cuts on wearing apparels. d)Injuries may be detected in different stages of healing. c) motive behind the injuries are - to bring a false charge against enemies - to bring a false charge of sexual offence - to claim more compensation & draw more attention & sympathy -to alter the appearance of injury i.e. from simple to grievous one -to avoid hard duties -to prevent linking the criminal with the crime -to show that the injuries are the result of resisting commission of crime Defence wounds/Protective wounds: These are the wounds received by the victim in case of assault,by the way of immediate & instinctive reaction of self protection,by raising the arm to prevent the attack or by grasping the weapon. Usually noticed over palmar aspect of hand,wrist & inner & outer aspect of forearm. It depends upon: -type of weapon used -degree of force applied Absent under following circumstances: -when attacked from back -when asleep -under the influence of intoxicating agent -child /elderly persons

Definition

Abrasion It is a type of mechanical injury characterized by destruction of superficial layers of epithelium or mucus membrane d/t4

Types

application of mechanical force which may be either friction (sliding) type or pressure (compression) type. Scratch: It occurs when a body comes in contact with (Linear) object having pointed end. e.g.fingernail,thorn,nail,pin,tip of dagger The object causing scratch carry torn epithelium in front of it.Thus, the direction of injury is indicated by sharp edge initially & heaped up epithelium at the end. Graze: (Brush/Scraping/ Grinding/Sliding) It occurs when wider part of body comes in

contact with rough, hard surface either body grazing past or surface grazing past the body. e.g. vehicular traffic accidents It is also called as brush/friction burn because it is caused by frictional force of rubbing against a surface & resembles a burn after drying. Here, the direction of injury is indicated by serrated border initially & heaped up epithelium at the end. It occurs when superficial cuticles being

Pressure: (Crushing/Friction)

destroyed d/t sustained pressure by hard, rough object. e.g. ligature mark in cases of hanging & strangulation. Type of pressure abrasion where the body is

Imprint: (Impact/Compact/ Patterned)

being pressed by rough, hard object having a definite shape giving the impression of offending object. e.g. forceful impact with a radiator grill or cycle chain etc.

5

Atypical: Age of abrasion

It results d/t application of sustained pressure. e.g. teeth bite marks Healing occurs by 2 processes: a) Contraction of wound b) Replacement of loss tissue Macroscopically Fresh: bright red in colour Within 12-24hrs: Scab/crust forms (Scab: Collection of injured epithelium, dried blood/serum & lymph) which is initially reddish in colour but becomes reddish-brown in 2-3 days. 4-7 days: Epithelium starts growing from periphery to centre. 7-10 days: Scab dried, shrinks, separates & falls off leaving behind depigmented area which becomes normal in colour with passage of time. Microscopically 4-6hrs: Cellular infiltration starts. 12 hrs: Appearance of fibrin network with red cells, polymorphs & collagen tissue. 48 hrs: Regeneration of epithelium from periphery. 4-5 days: Abrasion is completely covered with epithelium. 5-7 days: Granulation tissue is formed under the epithelium 7-9 days: Reticular fibres appear. 9-12 days: Collagen fibres are detected.

MLI

It gives idea about: Site of impact & direction of injury (Though these are simple & superficial in nature but sometimes, it may be external sign of serious internal injury). Identification of object Time of occurrence of injury Site of occurrence d/t presence of foreign body over it. Manner of injury can be ascertained by following: -Abrasion in & around nose & mouth s/o smothering.

6

D/Ds

-Cresentric nail scratch abrasion over neck s/o throttling. -Patterned abrasion of ligature mark around neck s/o hanging or strangulation. -Abrasions over face, breast, genitals, inner aspect of thigh s/o sexual assault. -Abrasion over prepuce & glans s/o forceful sexual act or narrow vaginal passage. -Abrasion in & around anus s/o passive agent of sodomy. -Multiple abrasions associated with other mechanical injuries s/o machinery accidents, railway accidents or road traffic accidents. -Abrasion over cornea results into corneal opacity & loss of vision which amounts to grievous hurt. Postmortem abrasion Usually results d/t rough handling of body i.e. dragging the body after death & are seen over bony prominences. No e/o colour changes & inflammatory reaction. Abrasions produced by animals (e.g. ant bite/rodents/ cockroaches/aquatic animals) Nappy rash These are multiple, small, pale, dry, irregular with nibbed edges. Usually seen over moist regions of body such as,eyes,nose,mouth,axilla, genitals. U