1. Intro – Physical Trauma
Physical trauma: any mild, serious, or life-threatening body damage caused by physical impact
Types we will be studying:
Abrasions
Contusions
Lacerations
Chop wounds
Incised wounds
Therapeutic wounds
Hesitation marks

2. Case Study: The Siren and the Slugger

3. Agree or Disagree?
Based on what you currently know about the case, do you think Chris Brown was in the right?
Everyone out of your seats. Stand near the doorway if you AGREE with the above statement. If you DISAGREE, stand by the back window. If you are unsure, stand by the front table.

4. Case Study: Chris Brown and Rihanna
The Situation:
Just after midnight on Sunday, February 9, 2009, police were called to the scene of a dispute in Los Angeles, CA. At the scene, officers encountered a rented Lamborghini sports car and a young woman who had visible injuries from a physical assault. The young woman was later identified as Grammy Award-winner Rihanna.

5. Background:
Rihanna had been romantically involved with fellow recording artist Chris Brown for more than a year.
That night, the pair was traveling in the rented sports car through the Hancock Park area of Los Angeles.
At that time, a verbal disagreement began about a text message Brown had received from a woman with whom he had had a previous relationship.
Brown tried to halt the argument by pulling the vehicle over and attempting to force the female singer from the car.

6. Background, Cont’d
When Rihanna refused to exit the vehicle, Brown shoved Rihanna against the window with sufficient force to cause a raised circular contusion to form on her forehead.
Then, he began to punch her in the face. Rihanna attempted to protect herself by covering her face and head with her arms.
The force and number of blows resulted in numerous contusions on her left hand and a large contusion to her left triceps.

7. Background, Cont’d
Brown then placed Rihanna in a headlock and bit her left ear. Brown stopped the car and began to choke Rihanna until she attempted to gouge his eyes. He bit her left ring and middle fingers and then released her. She turned to face him, placed her feet on his chest, and pushed him away.
He continued to punch her legs and feet, causing several more contusions.
When Rihanna began screaming for help, Brown got out of the vehicle and walked away from the scene.
A resident in the neighborhood heard Rihanna's cries and called 911.

8. The Proceedings:
When the police arrived, they processed the scene, took a statement from Rihanna, and sent the singer to the hospital for treatment. At the hospital, photographs were taken of her injuries for documentation of domestic abuse.
At about 7:00pm that evening, Brown turned himself in at a Los Angeles police station. In June 2009, Brown pled guilty to a charge of felony assault and received a sentence of five years’ probation, six months of community service, and one year of domestic violence counseling.

9. Agree or Disagree?
With the evidence provided by the police report, do you think Chris Brown was in the right?
Everyone out of your seats. Stand near the doorway if you AGREE with the above statement. If you DISAGREE, stand by the back window. If you are unsure, stand by the front table.

10. Exit Slip - Survey
Write a Yes or No in your portfolio next to your entry from earlier to answer the following question:
In the next several classes, we will be looking at and discussing pictures of different types of physical trauma. Would you feel at all uncomfortable doing this?

11. Crime in the United States

13. Impressions Activity!
What is an impression in forensic science?

14. Making an Impression – Part 1
We will analyze our own impressions using measurements and observations
On a piece of paper, create a data table that will show:
1. the width (cm) of your maxilla and mandible
2. the depth (cm) of your maxilla and mandible
3. observations of the unique characteristics of your teeth marks (slanted teeth, spaces, evidence of braces, etc.)

15. Making an Impression – Part 1
Materials – 1 per student:
Styrofoam plate
Permanent marker (need to share)
Ruler
Overhead transparency

16. Making an Impression – Part 1
Bend plate in half – top of plate will be inside
Label the top half “Maxilla” and the bottom “Mandible”
Push the plate as far back as it will go in your mouth and bite down – not too hard – you don’t want to break through the plate!
Place your transparency over your plate and trace your dental pattern as accurately as possible.
Don’t forget to label your transparency – maxilla and mandible
Make your measurements and record data in your table

17. Making an Impression – Part 2
On the same piece of paper from Part 1, create another data table that will show:
1. data for 4 different materials you will be testing
2. data includes a rating for each material and
3. observations for each material – did the material give a good impression? Why or why not?

18. Making an Impression – Part 2
I will need 3 people to help pass out ONE of each of the following:
Circus Peanut
Swedish Fish
Laffy Taffy
Star Burst
You will place the candies on your plate and make an impression + write observations and ratings for each candy. Don’t eat the candy until you have written your observations in your data table. You can eat everything except the circus peanut 
NOTE: Please complete the circus peanut first – I will come around and collect these as you work. You will need to label the maxilla side (MX) and the mandible side (MN)

19. Making an Impression - Challenge
At the front of the room I have your collected circus peanuts and transparencies. You may work in groups with as many people as you like.
One person from each group come and collect enough peanuts and transparencies for each person in your group.
Try to make matches – if you think you have one, call me over and I’ll come check. The first 5 people to have a match can have another piece of candy of your choice.

20. Making an Impression – Wrap-Up
On the paper with your data tables, write a short paragraph to summarize what you have learned about identifying bite marks. Be sure to include:
The process
How different materials affected the appearance/observations

21. Bite Marks Types of crime involving bite marks:
Abuse
Assault
Sexual assault
Homicide
Exceptional cases such as bank robberies
It is important to remember that bite marks can be both attack injuries (and therefore present on the victim) and defensive wounds (and therefore present on the suspect) and all individuals suspected of involvement in a crime against a person need to be examined for such marks.

22. Bite Marks
It is important that dentists, doctors, police officers, social workers, and forensic pathologists know the most common locations to be able to analyze a situation
Doctors and dentists, when presented with bite mark wounds, must document what they see and keep records of this info.

23. Bite Marks - Anatomical Location
In a study, 148 bite marks were analyzed to determine most common victims and anatomical locations
Females were 4X more likely to be bitten, and over 50% of males were suspects in the case
Females more likely to be bitten on breasts, arms, and legs; children on genitals, legs, and back; males on hands, back, or face

24. Presentation of bite mark injuries
Typically present as elliptical or circular injuries, with separation near the halfway point
There is usually an absence of bruising or a diffused bruise in the center
Sometimes, only one arch of teeth is seen – most often the lower jaw
Why?

25. Warm-Up
Using what you know about the integumentary and circulatory systems, describe how bite marks or other types of contusions form.
In your description, use at least three of the following words: epidermis, dermis, hypodermis, blood, veins, arteries, capillaries

26. 3 main factors that influence the severity of injury:
The force by which the injury was inflicted
The anatomical location of injury (Why?)
The time elapsed between the time bitten and presentation to the doctor/ odontologist

27. Collection of bite mark evidence
So far we’ve discussed two aspects of forensic significance of identifying bite marks. What were they?
The third – the QUALITY OF EVIDENCE COLLECTION!
How do you think they collect evidence?
Who is “they?”
What might affect the quality?

28. Collection of bite mark evidence
Evidence is collected from both the victim and suspect
Review: how? What do investigators look at?

29. Collection of bite mark evidence
Evidence is collected from both the victim and suspect
Review: how? What do investigators look at?
Pictures of victim’s whole body (without scale), zoomed in picture of wound with scale (see below)
Measuring length and width of both maxilla and mandible
Finding unique characteristics
such as gaps between teeth,
misaligned teeth, etc.

30. Physical Trauma – in general
Forensic nurses evaluate physical trauma and interpret injuries to look for clues regarding the events that lead up to the crime
Some injuries can provide a profile of the suspect (what does this mean?)
The location of the trauma on victim’s body helps determine how tall perpetrator is and position of victim at time of attack
Angle of impact helps determine if perpetrator is left- or right-handed

31. Evidence of physical trauma
Appearance and extent of injuries depends on the following:
The amount of force applied to the body
The weapon’s surface area and mass
Anatomical location

32. Force
Review: What is force?

33. Force Force = mass x acceleration
(acceleration is the change in speed over time; speeding up or slowing down)
The important thing to remember here is the relationship between mass, force, and acceleration.
So an object with larger mass that is moving quickly upon impact will cause a more serious injury
Smaller objects or slowly moving objects upon impact will cause less serious injuries

34. Example
High speed accident:
Low speed accident:

35. Today we will be learning about:
How investigators classify injuries to the body:
Blunt force trauma
Caused by victim hit by something hard
Caused by falls or is pushed into a hard object
Sharp force trauma
Stab wounds
Incised wounds
Chop wounds
Therapeutic wounds

36. Blunt Force Trauma - Abrasions
When the skin rubs against a rough surface, an abrasion forms
Examples?
Abrasions are deep/not deep?
In life, they appear reddish-brown and heal relatively quickly
Postmortem (?), abrasions appear yellow, almost transparent

37. 3 Types of abrasions
Brush: when force is applied parallel to skin; epidermis is scraped off in layers; skin damaged in direction of force
Impact: when force applied perpendicular to skin, skin is crushed; most commonly seen on bony parts of body
Patterned: if object that caused impact or brush abrasion leaves an impression; these leave unique clues about weapon used

38. Blunt Force Trauma - Contusions
Bruises caused by broken blood vessels deep in the skin
Usually not fatal, but if a victim sustains many at once, he/she may suffer severe blood loss, which could lead to shock and death (what is shock?)
Can also form on internal organs such as ?
When internal contusions form, the collected blood can cause swelling – this is called ?
How can doctors/investigators see internal contusions?
Severity of contusions is based on – think back to bite marks! 1. 2.
3. general health of the victim – who do you think might bruise more easily?

39. Blunt Force Trauma - Lacerations
Tear in the tissue (which tissues?) caused by an extreme sliding or crushing force
Blunt objects, falls, vehicle accidents
Marks produced have irregular edges, but sometimes patterned – since skin tears it does not usually hold the unique shape of the pattern
May occur internally or externally

40. Sharp Force Trauma – Stab Wounds
Sharp force trauma caused by incised wounds that are shorter in length than they are deep in the body
Most are caused by single-edge kitchen, pocket, or folding knives
Wounds that result in a punctured organ are called penetrating wounds
Wounds that puncture an organ and come out the other side of the organ are called perforating wounds

41. Sharp Force Trauma – Incised Wounds
Also called cuts; are produced by any object with a sharp edge such as a knife, glass, metal, or even paper
Difference from stab wound – the wounds are longer than they are deep
Usually the force is applied parallel to the body, so these types of wounds do not give good clues about the weapon used

42. Sharp Force Trauma – Chop Wounds
Produced by heavy tools such as axes, machetes, swords, meat cleavers, etc.
Produce incised wounds on the surface of the body as well as deep internal injuries, including bone fractures
What clues might investigators use to identify this type of wound and the weapon used?

43. Sharp Force Trauma - Therapeutic
Any incision made in a medical setting
Surgery
Biopsy
Others?

44. Check In – can you identify the types of wounds?
Is this a sharp force or blunt force wound?
Which type of sharp or blunt force is it?

45. Check In – can you identify the types of wounds?
Is this a sharp force or blunt force wound?
Which type of sharp or blunt force is it?

46. Check In – can you identify the types of wounds?
Is this a sharp force or blunt force wound?
Which type of sharp or blunt force is it?

47. Check In – can you identify the types of wounds?
Is this a sharp force or blunt force wound?
Which type of sharp or blunt force is it?

48. Presence of tissue bridging?
Laceration
Incised Wound
Cause
Blunt force trauma
Sharp force trauma
Edges
Ragged/ irregular
Cleanly divided
Bruising/abrasions?
Yes No
Depth
Variable
Can be uniform
Presence of tissue bridging?
Position
Particularly bony prominences
Any location
Presence of foreign bodies?
Often contaminated wounds
Usually clean (unless caused by glass)
Hairs
Intact hairs may cross the wound
Hairs are cleanly divided
Bony injury
May have associated fractures
Scoring or chipping of bone may occur
Healing
2° intention (with extensive scarring)
1° intention – good if wound edges apposed. Generally leaves fine scarring
Read more: 

49. Intro to Autopsy - Lividity
When a person dies, the heart stops pumping blood through the body
Where do you think the blood goes?

50. Intro to Autopsy - Lividity
Blood pools downward with the force of gravity
What do you think this looks like?
Lividity begins to appear ~30 minutes – 2 hours after death and continues to become more apparent (darker) for up to 12 hours
Why does it become darker?
What happens after the body is cooled down?

51. We will talk about Autopsy next
We will learn about how medical examiners identify time of death, manner of death, mechanism of death, and cause of death, as well as how they document their findings

52. Death Investigation and Autopsy
What is an autopsy?
What is the purpose of an autopsy?

53. Autopsy in a nutshell What is the purpose of an autopsy?
Medical examination, postmortem
Performed if the cause of death is not known, to document injuries, to exclude other causes of death, and to determine factors that contributed to death
The report typically includes a heading, information about the internal and external examinations, description of any evidence of injury, and the medical examiner’s findings and opinions

54. Report:

55. Report:

56. Report:

57. By law, a death must be investigated if:
It was a violent crime, suicide, or accident
It occurred within 24 hours of entering a hospital or as result of surgery
It was a natural death and the patient was not under care of a doctor
It occurred in police custody or in a correctional facility
The death resulted from a communicable disease that may pose a threat to public health

58. Medical examiner determines:
Time of death – how?
Manner of death – what is this?

59. Manner of death is the way a person dies:
Description
Natural
Most common; body function failure as a result of age, illness, or disease
Accident
Unintentional
Suicide
Victim intentionally takes his or her own life; cause of death is usually a gunshot, hanging, or poisoning
Homicide
One individual takes the life of another intentionally or through a negligent or reckless act; court decides if it is murder; sometimes the result of self-defense
Undetermined
The pathologist is unable to determine the manner of death, even after all internal and external exams and toxicological tests are evaluated

60. Death Investigation – 3 steps
At the death scene – preliminary investigation
Medical examination (autopsy) – external and internal investigations
Lab tests on biological evidence collected during autopsy

61. At the Death Scene
CSIs take photos and make sketches of the body at the scene to
Document position of the body
ID the face later on
Underneath body to record lividity, blood, and possible trace evidence
Document any signs of trauma
Document signs of
Livor mortis – dark coloring from pooling of blood (appears 30 mins – 2 hrs after death; becomes fixed 8-12 hrs after death)
Rigor mortis – stiffening of body due to lack of ATP in muscle cells (appears 2 – 4 hrs after death; subsides within 36 hrs)
What does this help determine?

62. At the Death Scene CSIs look for scene markers – what might these be?
Investigators protect victim’s hands and feet before transporting – why?
While body is being processed and transferred, investigators begin to interview witnesses
Once identified, investigators interview family, review victim’s medical history and police reports

63. Medical Examination - External
Purpose of autopsy – to determine manner, mechanism, and cause of death
At the morgue, medical examiner looks at external body, documents trauma
Looks at clothes – what might this tell about what happened?
Biological, nonbiological, and trace evidence are collected, preserved, and processed in lab
Examples of each?
X-rays are ordered

64. Medical examination - Autopsy
What is algor mortis?
How do they take internal temp?
Time since death =
Normal body temp (F) – current body temp
1.4

65. Medical Examination - Autopsy
After estimating time of death, medical examiner removes:
Brain
Larynx
Hyoid bone
Heart
Lungs
What might these organs tell the examiner?

66. Medical Examination - Autopsy
Fluids collected – blood, urine, bile
For what?
Internal organs then removed – mass is recorded
Stomach contents are analyzed
What kinds of clues can be found here?

67. Laboratory Analysis
Toxicology
Histology
Neuropathology
Serology