Situational task
Situational task № 1
Preliminary information: It's known that Mr. Wilson was found by his relatives in the hanging position. Later, he was taken out of the noose and laid on a flat surface. Emergency doctors arrived and tried to reanimate the patient.
Documental data: «Temperature in the body's rectum is 20 °C (surrounding temperature - 18 °C). Rigor mortis is well developed in mandibular muscles, neck muscles and the lower extremities; and is not presented in the muscles of upper extremities. Cadaveric lividity is seen on the posterior and lateral parts of the body (neck, back, lower extremities). It is also found in the lower part of the abdomen and the anterior surfaces of the scrotum, thighs, shins and feet. Post-mortem lividity (PML) is dark violet and looks like a series of mottled patches on the back. On the anterior surface of the skin of the abdomen, scrotum, thighs, PML is red blue. Under thumb pressure, cadaveric lividity is blanched in the area of the abdomen, anterior surface of scrotum, thighs, shins and feet and it returns to the previous color in 15-20 minutes. The pressed lividity areas of the posterior surfaces of the body (neck, back, lower extremities) completely disappear, and return to the previous color within 2-3 minutes. The eyes of the decedent are closed but Larshe stains are presented on the sclera.
Based on the objective information provide answers to the following questions:
1. Which morphological appearances prove death of Mr. Wilson?
2. Calculate probable post-mortem interval.
3. Determine the body position directly after death.
4. Are there any signs which may confirm that the position of the body has been changed?
Situational task № 2
State forensic an expert Petrov examined the patient Mr. Martin to determine the degree of severity. Mr. Martin was born in 1970 in Minsk. The examination was performed as requested by the direction of the police officer on duty from the Vitebsk regional department of the Ministry of internal affairs on the 19th January 2020.
Previous information and complains. There were no circumstances in the direction. The victim claimed that him neighbour assaulted him with a wooden stick 18th January 2020 at 6 p.m. He did not seek for any medical aid.
Objective information.
There is the triangular bruise with the dimension 7x3 cm. on the external surface of the proximal third of right thigh. There are two parallel bruises shaped as irregular strips (14cm. in length and 2,5cm. in width) on the left buttock. Also, there are two parallel bruises shaped as irregular strips (18cm. in length and 3cm. in width) on the external surface of the proximal third of left thigh. He complained of pain in the areas where he was struck. All of the bruises are red-blue with irregular edges. No other damage was presented.
Based on the objective information provide answers to the following questions:
1. What types of injury do you recognize?
2. Describe the anatomical location and shape of bruises.
3. Are the bruises caused by blunt objects?
4. What is the difference between a bruise and abrasion?
5. When was the injury caused?
Situational task № 3
State forensic an expert Sharova and state forensic an expert Kruglov examined the patient Ms. McDonald to determine the degree of severity. Ms. McDonald was born in 1980 in London. The examination was performed as requested by the direction of the police officer on duty from the Vitebsk regional department of the Ministry of internal affairs on the 21st May 2020.
Previous information and complains. There were no circumstances in the direction. The victim claimed that her husband assaulted her with a fists 20th May 2020 at 4 p.m. She did not seek for any medical aid in Belarus.
Objective information.
There are two the square bruises with the dimension 3.5x2.5 cm. and 2x3 cm. on the inner surface of the proximal third of left shoulder. There are three abrasions shaped as irregular strips (8cm. in length and 3.5cm. in width) on the right buttock. She complained of pain in the areas where he was struck. All of the bruises are red-blue with irregular edges. All of the abrasions are superficial red with irregular edges. No other damage was presented.
Based on the objective information provide answers to the following questions:
1. What types of injury do you recognize?
2. Describe the anatomical location and shape of bruises and abrasions.
3. Are the bruises and abrasions caused by blunt objects?
4. What is the difference between a bruise and abrasion?
5. When was the injury caused?
Situational task № 4
Preliminary information: It's known that Mr. Sharland was found by his wife in the hanging position. Later, he was taken out of the noose. His eyes were open.
Documental data: «Temperature in the body's rectum is 21 °C (surrounding temperature - 17 °C). Rigor mortis is well developed in mandibular muscles, neck muscles and the lower extremities; and is not presented in the muscles of upper extremities. Cadaveric lividity is found in the lower part of the abdomen, scrotum, thighs, shins and feet. Post-mortem lividity on the surface of the skin of the abdomen, scrotum, thighs and feet is red blue. Under thumb pressure, cadaveric lividity is blanched in the area of the abdomen, anterior surface of scrotum, thighs, shins and feet and it returns to the previous color in 16-19 minutes. The eyes of the decedent are closed. Larshe stains are presented on the sclera.
Based on the objective information provide answers to the following questions:
1. Which morphological appearances prove death of Mr. Sharland?
2. Calculate probable post-mortem interval.
3. Determine the body position directly at the time of death.
4. Are there any signs which may confirm that the position of the body has been changed?
Situational task № 5
Previous information. There was a fight near the bus stop in the evening on the 16th April 2020 in Brest. Mr. Stanton was injured during this fight and hospitalized in the district hospital. He remained there until 20th May 2020. Documentary information
There is an information in the copy of medical card №1203 that Mr. Stanton was admitted to the trauma department of the central district hospital 16th April 2020 at 10.50 p.m. His condition was satisfactory. He complained of a sharp pain in the right foot and he said that he couldn't stand on it. After he was examined the conclusions was: the general condition of the patient is satisfactory. There is a smell of alcohol from his mouth. His pulse rate was 78 per minute, arterial pressure is 125/75 mm Hg. There are no violations in the activity of organs of pectoral and abdominal cavities. There are five dark red, bleeding abrasions of indefinite, which have sizes from 0.8x0.4 cm to 4x3 cm, on his face. There is a bruise in the area of the left eye and it's 5.5x4.5 cm in size. The right ankle joint is deformed and increased in size. The tissue in this area is swollen. There is a bruise (8x4 cm in size) on the external surface of the distal third of right shin. There is a transversal fracture of the tibia bone at the distal third, with cracks which go away to the external surface of shin on the x-ray of the right shin. Plaster-of-Paris bandage was imposed.
Mr. Stanton began to walk with crutches on 30th April. Now there is no edema, but the remaining deformation of the right ankle. The motions in the right ankle are limited due to pain. He was discharged from hospital to continue outpatient treatment on 20th May 2020. The clinical diagnosis is: Closed fracture of the right tibia bone at the distal third, deformation of the right ankle. Bruises of the face and right shin.
Based on the objective information provide answers to the following questions:
1. What kind of injuries were caused to Mr. Stanton?
2. What is the possible instrument inflicted these injures?
3. Time of the injuries?
4. Determine the degree of severity.
Situational task № 6
Previous information. There was a fight near the train station Vitebsk early in the morning on the 10th April 2020. Mr. Brown was injured during this fight and hospitalized in the hospital. He remained there until 14th May 2020.
Documentary information
There is an information in the copy of medical card №1382 that Mr. Brown was admitted to the trauma department of the hospital 10th April 2020 at 8.00 a.m. His condition was satisfactory. He complained of a sharp pain in the left foot and he said that he couldn't stand on it. After he was examined the conclusions was: the general condition of the patient is satisfactory. His pulse rate was 72 per minute, arterial pressure is 130/80 mm Hg. There are no violations in the activity of organs of pectoral and abdominal cavities. There are three dark red bruises of indefinite, which have sizes from 2.5x1.5 cm to 6x4 cm, on his face and neck. The left ankle joint is deformed and increased in size. The tissue in this area is swollen. There is a bruise (8x4 cm in size) on the external surface of the distal third of left shin. There is a transversal fracture of the fibula bone at the distal third on the X-ray of the left shin. Plaster-of-Paris bandage was imposed.
Mr. Brown began to walk with crutches on 30th April. Now there is no edema, but the remaining deformation of the left ankle. The motions in the left ankle are limited due to pain. He was discharged from hospital to continue outpatient treatment on 14th May 2020. The clinical diagnosis is: Closed fracture of the left fibula bone at the distal third, deformation of the left ankle. Bruises of the face, neck and left shin.
Based on the objective information provide answers to the following questions:
1. What kind of injuries were caused to Mr. Brown?
2. What is the possible instrument inflicted these injures?
3. Time of the injuries?
4. Determine the degree of severity.
Situational task № 7
Previous information. There was a fight near the train station Orsha in the evening on the 9th April 2020. Mr. Watson was injured during this fight and hospitalized in the district hospital. He remained there until 11th May 2020.
Documentary information
There is an information in the copy of medical card №1402 that Mr. Watson was admitted to the trauma department of the central district hospital 9th April 2020 at 10.30 p.m. His condition was satisfactory. He complained of a sharp pain in the left shoulder and he said that he couldn't lift it. After he was examined the conclusions was: the general condition of the patient is satisfactory. His pulse rate was 70 per minute, arterial pressure is 135/85 mm Hg. There are no violations in the activity of organs of pectoral and abdominal cavities. There are five dark red bruises of indefinite, which have sizes from 3x2 cm to 6.5x4.5 cm, on his face. The left shoulder joint is deformed and increased in size. The tissue in this area is swollen. There is a bruise (7.5x5 cm in size) on the external surface of the left shoulder joint. There is a transversal fracture of the humerus at the proximal third on the X-ray of the left shoulder. Plaster bandage was imposed.
Now there is no edema, but the remaining deformation of the left shoulder. The motions in the left shoulder joint are limited due to pain. He was discharged from hospital to continue outpatient treatment on 11th May 2020. The clinical diagnosis is: Closed fracture of the left humerus at the proximal third, deformation of the left shoulder. Bruises of the face and left shoulder.
Based on the objective information provide answers to the following questions:
1. What kind of injuries were caused to Mr. Watson?
2. What is the possible instrument inflicted these injures?
3. Time of the injuries?
4. Determine the degree of severity.
Situational task № 8
Previous information. There was a fight near the train station Orsha in the evening on the 4th September 2020. Mr. Hudson was injured during this fight (he fell down the stairs) and hospitalized in the district hospital. He remained there until 5th October 2020.
Documentary information
There is an information in the copy of medical card №1569 that Mr. Hudson was admitted to the trauma department of the central district hospital 4th September 2020 at 11.00 p.m. His condition was satisfactory. He complained of a pain in the right forearm. The motions in the right wrist are limited due to sharp pain. After he was examined the conclusions was: the general condition of the patient is satisfactory. His pulse rate was 80 per minute, arterial pressure is 130/85 mm Hg. There are no violations in the activity of organs of pectoral and abdominal cavities. The right wrist is deformed and increased in size. The tissue in this area is swollen. There is a bruise (8x5.5 cm in size) on the front and back surfaces of the right wrist. There is a transversal fracture of the radius at the distal third on the X-ray of the right forearm. Plaster bandage was imposed.
Now there is no edema, but the remaining deformation of the right forearm. The motions in the right wrist are limited due to pain. He was discharged from hospital to continue outpatient treatment on 5th October 2020. The clinical diagnosis is: Closed fracture of the right radius at the distal third, deformation of the right forearm. Bruise of the right wrist.
Based on the objective information provide answers to the following questions:
1. What kind of injuries were caused to Mr. Hudson?
2. What is the possible instrument inflicted these injures?
3. Time of the injuries?
4. Determine the degree of severity.
Situational task № 9
Previous information. Mr. Johnson stated that he was attacked by unknown persons in the evening on the 8th June 2020. Mr. Johnson was injured during this fight and hospitalized in the surgical department of hospital. He remained there until 10th July 2020.
Documentary information
The patient is of middle height, normal body structure. Skin and visible mucosal membranes are of normal color. Percussion of chest reveals clear lung sound all over the lungs. Upon auscultation of the lung, vesicular breathing was heard. Percutory heart borders are equal to age norms. During auscultation, heart tones are rhythmical, clear. Pulse is 70 per minute, of satisfactory filling and tension. Arterial pressure - 130/85 mm Hg. Abdomen actively takes part in breathing act. At palpation it is soft and painless. Stool and urination were not disturbed. Distal third of left forearm and region of left radio-carpal joint were swollen. At palpation, there is pain by the radial bone; it is more revealed in its distal third. Active and passive movements are limited because of the acute pain. On X-ray examination of left forearm in both projections, there is a fracture of radial bone in typical place without displacement. Plaster bandage was imposed.
Now patient's status is satisfactory. He complains of pain in the region of facture. Bandage does not present changes. There is no swelling of the hand. Patient is recommended for further outpatient treatment. He was discharged from hospital to continue outpatient treatment on 10th July 2020.
Based on the objective information provide answers to the following questions:
1. What kind of injuries were caused to Mr. Johnson?
2. What is the possible instrument inflicted these injures?
3. Time of the injuries?
4. Determine the degree of severity.
Situational task № 10
Previous information. The patient Ivanov Peter had a trauma at work - struck by a cutting tool on his left leg. An accident happened on the 1st October 2020. The patient Ivanov Peter was hospitalized in the surgical department of hospital. He remained there until 9th October 2020.
Documentary information
The patient complains of pain in the region of left shin, presence of wound. There are no complains of other organs and systems. General status of the patient is satisfactory. Activity of heart is rhythmical. Tones are clear. Pulse - 72 per minute, of satisfactory properties, rhythmic. Arterial pressure is 135/75 mm Hg. Lung auscultation reveals vesicular breathing. Tongue is wet, clear. Abdomen is soft, painless. Symptoms of Schotkin-Blumberg and Pasternatskiy are negative. Urination and stool are not disturbed.
On the front and outer surfaces of the left shin, on the border between middle and lower thirds, there is a linear wound; length is 6.5 cm, depth – 2.5 cm. It is edges are defined, direct, without ruptures. Edges of the wound are acute; depth in them is decreasing from the center to periphery, with the presence of large venous bleeding. The wound reaches deep muscular layer.
Operation: under local anesthesia haemostatic cetgut stitches were performed on the muscles in the wound. Silk stitches were performed on the skin, with an aseptic bandage. The patient left the surgery in a satisfactory condition.
Now general status of patient is satisfactory. There are no complains. There are no pathological changes in the heart and lungs. Pulse is 70 per minute, of satisfactory properties. Arterial pressure is 130/70 mm Hg. Sleep is calm, appetite is good. Aseptic bandage is dry. The patient is recommended for further outpatient treatment.
Based on the objective information provide answers to the following questions:
1. What kind of injuries were caused to Ivanov Peter?
2. What is the possible instrument inflicted these injures?
3. Time of the injuries?
4. Determine the degree of severity.
Situational task № 11
Previous information. The patient Petrov Denis had a trauma at home - struck by a cutting tool on his right leg. It happened to patient on the 10th February 2020. The patient Petrov Denis was urgently hospitalized in the surgical department of hospital. He remained there until 25th February 2020.
Documentary information
The patient complains of sharp pain in the right thigh, presence of wound and bleeding. General status of the patient is serious. Activity of heart is rhythmical. Pulse - 105 per minute insufficient properties. Arterial pressure is 90/70 mm Hg. Lung auscultation reveals vesicular breathing. Tongue is wet, clear. Abdomen is soft, painless. Symptoms of Schotkin-Blumberg and Pasternatskiy are negative.
On the front surfaces of the right thigh, at the middle thirds, there is a linear wound; length is 7.5 cm, depth – 3.0 cm. It is edges are defined, direct, without ruptures. Edges of the wound are acute; depth in them is decreasing from the center to periphery, with the presence of massive arterial bleeding. The femoral artery is damaged. The wound reaches deep muscular layer. The patient was operated on. Then the patient left the surgery in a satisfactory condition.
Based on the objective information provide answers to the following questions:
1. What kind of injuries were caused to Petrov Denis?
2. What is the possible instrument inflicted these injures?
3. Time of the injuries?
4. Determine the degree of severity.
Situational task № 12
Previous information. The patient was transported to the admission department of hospital in a car immediately in severe status. About an hour ago, she had an accident with the truck (the driver brought her to the hospital). It happened to patient on the 15th December 2020. She remained in the hospital until 2nd February 2020. Status of the patient became better. Then the patient was recommended for further outpatient treatment.
Documentary information
Consciousness is clear. Her skin is pale. The patient is with satisfactory body structure. Tongue is wet. Pharynx is clear. In lungs there is vesicular breathing. Heart tones are clear. Pulse is 95 per minute, rhythmic, of satisfactory properties. Arterial pressure is 140/70 mm Hg. Abdomen is soft, painless. Liver and spleen cannot be palpated. Movements in joints are free. Left shin is deformed, swollen, and the foot hangs freely. On the anterior surface of the shin, there is a large laceration of irregular shape. It is size is 5x7 cm. Wound edges are not defined. In upper part of the wound, there is projection of a loose osseous body with the size of 4x3 cm. Proximal part is cleaved. Fibula is not projected in the wound, but it is fractured. Movements of toes fingers are limited. Foot is warm, sensation preserved. The patient was operated on. Then the patient left the surgery in a satisfactory condition.
Based on the objective information provide answers to the following questions:
1. What kind of injuries were caused to patient?
2. What is the possible instrument inflicted these injures?
3. Time of the injuries?
4. Determine the degree of severity.
Situational task № 13
Previous information. The patient was transported to the admission department of hospital in a Taxi immediately in severe status. About an hour ago, he was stabbed by a sharp object. It happened to patient on the 15th November 2020. He remained in the hospital until 1st December 2020. Status of the patient became better. Then the patient was recommended for further outpatient treatment.
Documentary information
Examination of urgent surgeon. Patient complains on pain in abdomen. General status is satisfactory. The patient is of middle height, normosthenic type. Skin and visible mucosal membranes are of pale-pink color. Lymph nodes cannot be palpated. Cor-activity is rhythmic, tones are clear. Pulse is 90 per minute, of satisfactory properties. Arterial pressure is 115/75 mm Hg. Lungs - vesicular breathing on both sides. Percussion - tympanic lung sound. Urinary system does not reveal any disorders. Abdomen is round-shaped, takes part in breathing. Palpation reveals it is soft, painful in left part, mostly in inguinal region where the wound is situated. The wound is fissure-like, its size is 2.2x0.7 cm, with defined edges, right angle of the wound is M-like and left angle is acute. Depth of the wound is 7 cm. large intestines is presented in the wound, size is 6x3. cm. Bleeding is small.
The patient was operated on the 15th November 2020 at 11.00 a.m. Operation: Middle laparotomy, resection of large intestine, stitching of the defect of mesentery of small intestine, drainage of abdominal cavity. Endotarcheal narcosis. Treatment of operative approach was performed by Filonchykov. Prolapsed large intestine was put into the wound, silk stitches were performed. Middle laparotomy, cleaning of abdominal cavity from blood. Revision of abdominal cavity — there are no injuries of small or large intestine. In mesentery of the small intestine, there is radial incision with the length of 2 cm with spot bleedings. Defect is sticked with silk. Wound of the anterior abdominal wall was stitched with cetgut. Tubal drainage was inserted through the wound canal into small pelvis. Middle wound is stitched layer by layer. Stitches performed on the skin, with aseptic bandage.
Now general status of patient is satisfactory. There are no complains. Abdomen is soft, painless. Post-operational scar is healing by primary tension. Post-operational period present no complications. Stitches were removed on 8th day. Patient was recommended for outpatient treatment.
Based on the objective information provide answers to the following questions:
1. What kind of injuries were caused to patient?
2. What is the possible instrument inflicted these injures?
3. Time of the injuries?
4. Determine the degree of severity.
Situational task № 14
Previous information. The patient was transported to the admission department of hospital in a truck immediately in severe status. He was stabbed by a sharp object. It happened to patient on the 10th November 2020. He remained in the hospital until 30th November 2020. Status of the patient became better. Then the patient was recommended for further outpatient treatment.
Documentary information
Examination of urgent surgeon. Patient complains on pain in abdomen. General status is satisfactory. The patient is of tall, normosthenic type. Skin and visible mucosal membranes are of pale-pink color. Lymph nodes cannot be palpated. Cor-activity is rhythmic, tones are clear. Pulse is 92 per minute, of satisfactory properties. Arterial pressure is 115/75 mm Hg. Lungs - vesicular breathing on both sides. Percussion - tympanic lung sound. Urinary system does not reveal any disorders. Abdomen is round-shaped, takes part in breathing. Palpation reveals it is soft, painful in right part, in umbilical region where the wound is situated. The wound is fissure-like, its size is 1.7x0.5 cm, with defined edges, left angle of the wound is M-like and right angle is acute. Depth of the wound is 8 cm. Bleeding is small.
The patient was operated on the 10th November 2020 at 10.00 a.m. Operation: Middle laparotomy, stitching of the defect of mesentery of small intestine, drainage of abdominal cavity. Endotarcheal narcosis. Treatment of operative approach was performed by Filonchykov. Middle laparotomy, cleaning of abdominal cavity from blood. Revision of abdominal cavity - there are no injuries of internal organs. In mesentery of the small intestine, there is radial incision with the length of 1.5 cm with spot bleedings. Defect is sticked with silk. Wound of the anterior abdominal wall was stitched with cetgut. Middle wound is stitched layer by layer. Stitches performed on the skin, with aseptic bandage.
Now general status of patient is satisfactory. There are no complains. Abdomen is soft, painless. Post-operational scar is healing by primary tension. Post-operational period present no complications. Stitches were removed on 8th day. Patient was recommended for outpatient treatment.
Based on the objective information provide answers to the following questions:
1. What kind of injuries were caused to patient?
2. What is the possible instrument inflicted these injures?
3. Time of the injuries?
4. Determine the degree of severity.
Situational task № 15
Previous information. The patient was transported to the admission department of hospital in a car immediately in severe status. About two hours ago, he was stabbed by a sharp object. It happened to patient on the 12th September 2020. He remained in the hospital until 10th October 2020. Status of the patient became better. Then the patient was recommended for further outpatient treatment.
Documentary information
Examination of urgent surgeon. Patient complains on pain in the chest on the right and bleeding. There is a smell of alcohol from his mouth. General status is severe. The patient is of middle height, hypersthenic type. Skin and visible mucosal membranes are of pale-pink color. Lymph nodes cannot be palpated. Cor-activity is rhythmic, tones are not clear. Pulse is 105 per minute insufficient properties. Arterial pressure is 90/70 mm Hg. Lungs: vesicular breathing on the left, on the right is weakened. Percussion - tympanic lung sound on the left. There is a wound on the back surface of the right half of the chest under the scapula. The wound is fissure-like, its size is 2.4x0.7 cm, with defined edges, right angle of the wound is M-like and left angle is acute. Lung is presented in the wound. Bleeding is large. Abdomen is round-shaped, takes part in breathing. Palpation reveals it is soft and painless. Symptoms of Schotkin-Blumberg and Pasternatskiy are negative. Urinary system does not reveal any disorders. The patient was operated on the 12th September 2020 at 10.30 a.m.
Now general status of patient is satisfactory. There are no complains. Post-operational period present no complications. Post-operational scar is healing by primary tension. Stitches were removed on 8th day. Patient was recommended for outpatient treatment.
Based on the objective information provide answers to the following questions:
1. What kind of injuries were caused to patient?
2. What is the possible instrument inflicted these injures?
3. Time of the injuries?
4. Determine the degree of severity.
Situational task № 16
Previous information. State forensic an expert Ivanov and state forensic an expert Kruglov examined the patient Ms. Stanton to determine the degree of severity. Ms. Stanton was born in 1961 in Oxford. He is an English citizen. The examination was performed as requested by the direction of the police officer on duty regional department of the Ministry of internal affairs on the 15th April 2020.
Previous information and complains. There were no circumstances in the direction. There was a fight in the local pub “Seven Stars” in the evening on the 14th April 2020. Landlord Mr. Stanton was injured during this fight. He did not seek for any medical aid.
Objective information.
He complained of pain in the area where he was struck. There is a bruise in the area of the left eye and it's 6x4 cm in size. Bruise is red-blue with irregular edges. No other damage was presented.
Based on the objective information provide answers to the following questions:
1. What kind of injuries were caused to Mr. Stanton?
2. What is the possible instrument inflicted these injures?
3. Time of the injuries?
4. Determine the degree of severity.
Situational task № 17
Previous information. Mrs. Lewis was transported to the admission department of hospital in a diesel truck immediately in severe status. About two hours ago, she had road traffic accident with the diesel truck (the driver brought her to the local hospital). It happened to patient on the 6th May 2020. Mrs. Lewis remained in the hospital until 25th April 2020. Status of the patient became better. Then the Mrs. Lewis was recommended for further outpatient treatment.
Documentary information
The patient complains of a sharp pain in the left thigh and she said that she couldn't lift leg. General status is severe. Consciousness is clear. The patient is with satisfactory body structure. Her skin is pale. Tongue is wet. Pharynx is clear. In lungs there is vesicular breathing. Heart tones are not clear. Pulse is 105 per minute, rhythmic, of satisfactory properties. Arterial pressure is 90/75 mm Hg. Abdomen is soft, painless. Liver and spleen cannot be palpated. Left thigh is deformed, swollen, and the foot hangs freely. On the posterior surface of the thigh, on the border of the middle and lower third, there is a laceration of irregular shape. It is size is 4.5x6 cm. There is bleeding from the wound. Wound edges are not defined. In upper part of the wound, there is projection of a loose osseous body with the size of 5x3.5 cm. Proximal part is cleaved. Movements in the knee joint are limited. Foot is warm, sensation preserved. The patient was operated on. Then the patient left the surgery in a satisfactory condition.
Based on the objective information provide answers to the following questions:
1. What kind of injuries were caused to patient?
2. What is the possible instrument inflicted these injures?
3. Time of the injuries?
4. Determine the degree of severity.
Situational task № 18
Documental data: A 30 year old male was found in the room with thermal burns III-IV degree with a lesion area more than 15% of the body surface. The tongue was protruding out. Body was in pugilistic attitude with heat ruptures, peeling of skin and heat hematoma and heat fractures of skull. Carboxyhemoglobin (CO) was 65% and soot particles were present in trachea, bronchi, bronchioles and alveoli.
Based on the objective information provide answers to the following question:
1. What is the cause of male death and the probable mechanism of it is development ?
2. Which of the combination of two findings will establish that the burns were ante-mortem in nature?
Situational task № 19
Previous information. State forensic an expert Pavlov and state forensic an expert Petrov examined the patient Ms. Rowling to determine the degree of severity. Ms. Rowling was born in 1963 in Cambridge. He is an English citizen. The examination was performed as requested by the direction of the police officer on duty regional department of the Ministry of internal affairs on the 2nd October 2020.
Previous information and complains. There were no circumstances in the direction. There was a fight in the local pub “Elephant & Castle” in the evening on the 1st October 2020. Mr. Rowling was injured during this fight. He did not seek for any medical aid. There were no violations in the activity of brain and organs of pectoral and abdominal cavities.
Objective information.
There was a smell of alcohol from his mouth. He complained of pain in the area where he was struck. There is a wound in the right parietal region of the head. The tissue in this area is swollen. Bleeding is small. The wound is star-like, its size is 2.0x0.8 cm, with small tissue defect in the centre and circular abrasion around the wound. Edges are irregularly with tissue bridges in depth of wound, ends are pointed. No other damage was presented.
Based on the objective information provide answers to the following questions:
1. What kind of injuries were caused to Mr. Rowling?
2. What is the possible instrument inflicted these injures?
3. Time of the injuries?
4. Determine the degree of severity.
Situational task № 20
Documental data: A 35 year old farmer has taken two bottles of wine from the local shop. Approximately two hours later, he was found dead in a room with a wound to the frontal region of the head on the right. The body was on the floor, the hunting rifle was at his feet.
Objective information.
There is a wound in frontal region of the head on the right. The shape of the wound is round with tissue defect in the centre and cross-like ruptures of skin; its diameter is 1.1 cm. The wound has regular and inverted margins. An “abresion rim” and “metallizational rim” are seen around the hole. They are narrow, not more then 2 mm. in width. Blackening and tattooing are so extensively deposited around the hole. They are circular too. There were no other injuries on the body.
Based on the objective information provide answers to the following question:
1. Is the injury on the skin caused by discharge of firearm?
2. Is it an entry or an exit wound?
3. What distance was the shot fired from?
4. Which projectile (bullet or pellets) caused the wound?