WOUNDS PERMANENT INFIRMITY LOSS OF AN ORGAN OR ITS

COCHRANE WOUNDS VERSION AND DATE V1 05 JUNE 2013
ROBIN KIMMERER BINDING UP THE WOUNDS MOSSES IN ECOLOGICAL
WOUNDS NAME DATE DATE OF BIRTH

WOUNDS PERMANENT INFIRMITY LOSS OF AN ORGAN OR ITS

Wounds

Wounds


Permanent infirmity: loss of an organ or it's function.


Abrasions

Pressure abrasion: when a blunt object is in contact with a body for a long time and it takes the shape of the instrument e.g. rope in suicide.


Bruises (contusions):

Ecchymosis < bruise < contusion < hematoma (the largest)


Factors affecting the size of the bruise:

Onset of death : the faster the person dies the smaller the bruise, and the slower the death the bigger the bruise. Because there will be more bleeding.


Blood diseases: the most important factor affecting the size. MCQ


Age: kids bruise more because they have more fat, and old people bruise easily because of liver disease, atherosclerosis, and other aging blood vessels diseases.


Sex: women bruise easily due to more fat maybe.


Effect of gravity:

If the hit is on the head the bruise will be only in the upper eyelid

And you may find scratches on the head.



Difference between hypostasis and bruises

Hypostasis: the blood will be inside the blood vessels with no swelling.

Bruises: the blood is outside the blood vessels with swelling.


Bruises can be dangerous if:

They occur in a trigger zone, because there will be a parasympathetic stimulation.


Cotused (lacerated) wounds:

The most important feature is that the have irregular edges.

There will be more infection because there is minimal bleeding.


Bridging of tissue: lacerated wounds cause bridging of tissue. Nerves and tendons are intact while the subcutaneous tissue and the fat under these tendons are compressed by the instrument, so the nerves and tendons look like a bridge.


There are areas where the lacerated wounds look like cut wounds. This happens in stretched skin like the scalp and the chin of the tibia.







Incised wounds:

They have more bleeding so less infection.

If there is no sepsis: 10-15 days complete healing of primary intention. It 's different between people e.g. young and healthy against an old and diabetic.


If there is sepsis it will be more difficult for the surrounding tissue to heal.


The incised wound sometimes looks like a lacerated wound. It happens in area of loose skin e.g. sole of feet, palm of hand, obese abdomen, thigh, axilla.


Stab wound

The stab wound is penetrating in 3PMS

Pleura, Peritoneum, Pericardium, Meninges, Synovium


Complications of wounds:


Shock causes tachypnea, hypotension, subnormal weak pulse, pallor except sympathetic and septic shock. They don't cause all these features.


Neurogenic shock

Vagal shock is the most dangerous because it causes inhibition of the heart.

Can be due to anxiety due to surprise.


Sympathetic shock happens when there is anxiety and the person is prepared for the stimulus, but in parasympathetic it's a surprise to the person.


Traumatic shock

happens in torturing with blunt instruments.


Hemorrhagic shock

200 cc in pericardial sac causes cardiac temponade.


Types of hemorrhage:

Secondary hemorrhage occurs because bacteria releases lytic enzymes.


Embolism:


Venous air embolism

Happens in faulty technique of blood transfusion.


Fat embolism

Could be a bone marrow embolism after fracture of long bones or with injection of contrast media in radiological procedures.


Thromboembolism are the MOST common ones.



Infections:

In tetanus a single wound may cause death.


MCQs


Avulsion is a type of:
a. Chop wound.
b. Incised wound.
c.Laceration.
d. None of the above.


I'm not really sure about this answer, I got it from an old MCQ, online it said that avulsion is similar to abrasions but more severe. Avulsion is grade 3 of abrasions and involves damage to the subcutaneous layer and the skin, and it is an injury in which a body structure is forcibly detached.


I would choose none of the above in the exam!


Healing by color change occurs in :

a. Abrasion

b. Contusion

c. Contused wound



A cut wound may look like contused wound in :

a. Forehead

b. Over the chin of the tibia

c. Axilla

d. Forehead

e. Chest wall


Permanent infirmity means :

a. Loss of more than organ

b. Loss of organ or its function


Bridging of the tissue :

a. Contused wound

b. Cut wound


Which of the following is not a characteristic of abrasions :

a. Hemorrhage

b. Pressure

c. Embolism


ML classification of wound Is :

a. Anatomical classification

b. Depends on the shape of the wound

c. Depends on the type of instrument


If the knife penetrate the heart :

a. Stab punctured wound

b. Stab penetrating wound


Bone fracture :

a.Fat embolism


Yellow color in contusions is due to :

a. Biliverdin in the 5th day

b. Bilirubin in the 5th day


Abrasion may cause death due to:

a-neurogenic shock

b-heamorrhage

c-depressed bone

d-tetanus infection

e-embolism



A cut wound:

a- Has a regular edge

b- is caused by blunt instrument

c- Causes minimal bleeding

d- Leads to permenant infirmity

e- Is accompanied by abrasions



Lacerated wound:

a- has irregular edges

b- may be caused by a stick

c- usually lead to minimal bleeding

d- may be caused by stone

e- any of the above


Bruises are caused by:

a- Sharp instrument

b- Extravasation of blood

c- Blood heamolysis

d- Gravitation of blood

e- None of the above


Healing without scar formation occurs usually in:

a- Abrasions

b- Bruises

c- Incised wounds

d- A+b

e- A+c

f- B+c


Contusion may take the shape of striking surface if caused by:

a-Stone

b-Tire

c-stick

d-Hammer

A 55 years old man had a fracture of the right tibia. After 3 days the most expected dangerous complication is:

a-Shock

b-Fat embolism

c-Bone marrow embolism

d-Reactionary hemorrhage


Which of the following causes pressure at ….:

a-Stone

b-Knife

c-Rope

d-Stick


The most dangerous type of wound is:

a-Abrasion

b-Cut wound

c-lacerated wounds

d-bruise

e-stab penetrating wound


Abrasion never cause :

a-Pressure

b-Bleeding

c-Dry scab

d-Tetanus infection

e-embolism


The mechanism of death from stab wounds is:

a.Hemorrhage.

b.Truama

c.Shock

d.A & B

e.B & C


Hitting by thick heavy iron bar (stick) causes:

a-Abrasion.

b-Contusion

c-Curved contusion

d-Lacerated wound

e-Bruise.

A study is performed analyzing patterns of injury. One type of injury, typically made with a blunt object, can be seen on physical examination and can be dated by the color change that takes place over time. Which of the following terms is most likely to describe this injury?
a.Laceration
b. Abrasion
c. Puncture
d. Contusion
e. Incised wound

abrasions are useful in the diagnosis of :
a. ruptured hymen
b. wound by heavy stick
c. strangulation by umbilical cord
d. suicidal cut throat
e. time passed since death



One of the following is NOT a delayed cause of death from injury :
a.Tetanus.
b. Fat embolism.
c.Thromboembolism.
d. Air embolism.






if there are any notes contact me


[email protected]







どかり






Tags: infirmity means, permenant infirmity, organ, permanent, wounds, infirmity