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Medical Science Optional daily answer writing practice for CSE 2023 – Aug 3

Topic: Forensic examination of injuries and wounds; Examination of blood and seminal stains

Question: Write brief notes on, 1.Secondary impact and secondary injuries. 2.Partial hanging 

Click here for Reference Material-This material is informational alone and is not specifically prepared as an answer for any question. Readers may do their own research before finalising diagnoses according to the characteristics unique to each question. Readers should not proceed without cross-referencing with relevant textbooks as well as standard guidelines available.

1. Secondary Impact and Secondary Injuries

– Secondary impact occurs when the body strikes an object or surface after the initial impact that caused injury.

– Can lead to additional injuries called secondary injuries.

– Examples:
    – Fall from height – initial impact is when person hits ground. Secondary impact when body then hits a rock or curb.

    – MVA – initial impact is collision. Secondary impact when occupant hits interior of vehicle.

– Secondary injuries often more serious as energy from secondary impact is absorbed by already damaged body.

– Common secondary injuries:
    – Fractures – long bones, vertebrae, ribs, skull
    – Intracranial hemorrhage
    – Solid and hollow organ injuries – spleen, liver, bladder
    – Spinal cord injuries

– Management involves stabilizing primary injuries first, then identifying and treating secondary injuries.

2. Partial Hanging

– Hanging where the body is partially supported and some body parts touch the ground.

– The noose does not completely occlude the airway as in complete hanging.

– Death can occur due to compression of carotid arteries and jugular veins reducing cerebral blood flow.

– Other mechanisms:
    – Laryngotracheal injury
    – Vagal reflex bradycardia/asystole
    – Cerebral hypoxia from reduced CBF

– Incomplete occlusion → longer survival period → higher chances of neurologic recovery if rescued fast.

– Findings: petechiae, cyanosis of face, conjunctival hemorrhages, inverted V-shaped ligature mark.

– Management involves airway protection, oxygenation, revival of circulatory status. Imaging to assess injuries.

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