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    FIREARM WOUNDS

    By

    Dr. Arif Rasheed MalikAssociate Professor & Head

    Department of Forensic Medicine & Toxicology,

    SIMS, Lahore

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    WEAPONSAREFASHIONACCESSORIESAND

    EASILYAVAILABLE

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    FIREARMWOUNDS

    Firearm wounding is a special form of trauma producing a breech through the body of a person by a bullet or shotcharge

    Pr inc ip les & Pract ice of Forensic Medic ineby Nasib R. Awan

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    Firearm

    An instrument or device with which it is possible

    to propel a projectile by means of the expansive

    force of the gases generated by the combustion

    of an explosive substance

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    HISTORYOF FIREARMS Firearms came to Europe from China To produce an efficient firearm, there are three basic criteria to

    be met. Weapon should be capable of causing substantial damage It should be reliable & convenient to use It should be reasonably accurate

    Reverend Alexander John Forsythe, in 1807, living near Aberdeen,Scotland, held the first patent for apercussion ignition system..

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    HISTORYOF PROJECTILEWEAPONRY

    Earliest weapons: bow andarrow, crossbow, simplecatapult to huge ballistics /trebuchet

    Gunpowderdeveloped in china

    1500 yrs ago; came to Europeand from 14th century used asweapon

    Gunpowder= Charcoal,Saltpetre (Potassium Nitrite),Sulphur

    Earliest guns were cannons,front then breech loading

    Early guns flintlock muzzleloading with 3 parts lock,stock and barrel

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    ASSAULTRIFLES9/13/2013

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    AK-47 Assault rifle

    Developed: 1974

    Mikael Kalashnikov

    Caliber: 5.45mmMagazine capacity: 30

    Loaded weight: 3,600g

    Killing range: 1,350m

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    BALLISTICS

    Knowledge of physical forces acting on the projectile

    & missile by Nasib R. Awan

    Interior Ballistics

    Exterior Ballistics

    Terminal / Wound Ballistics

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    Interior ballistics

    Exterior ballistics

    TH

    E

    O

    R

    E

    TI

    C

    A

    L

    P

    R

    A

    C

    T

    IC

    A

    L

    Wound ballistics

    Clear Concept

    Ballistics

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    INTERIOR BALLISTICS

    Knowledge of the forces responsible for propulsion

    of projectile within the bore of the barrel till the end

    of the projectile.

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    Understanding pre-requires knowledge of:-

    1- Missile design & cycle of fire.

    2- Ammunition design.

    Missile design & cycle of fireMissile design:-

    a- Portion containing mechanical device (not

    important).

    b- Barrel for jetting of the projectile (Importantbecause it has relation to WOUND BALLISTICS).

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    FIREARM DESIGN

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    Grip Action Barrel

    Grip or

    But StockAction

    Barrel

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    FIREARMS

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    Thompson

    9 mm

    Luger 9mmColt 45

    5.7 mm

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    CLASSIFICATIONOF FIREARMS

    Barrel Steel tube for jetting of the

    projectile. Two ends ---

    Breach & Muzzle end

    Bore

    Internal diameter of the

    barrel. May be SMOOTH

    or RIFLED

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    Classified on the basis of Barrel

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    CLASSIFICATIONOF FIREARMS

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    Smooth Bored

    Choked Non choked

    Rifled

    Short Barrel Long Barrel

    Barrel Rifling

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    CHOKINGOF SMOOTHBORE FIREARM9/13/2013

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    18.80 mm 18.40 mm

    Cylindrical portion

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    TYPES OF CHOKING OF BARREL OF SHOT GUN

    CHOKE PERCENTAGE OF

    PELLETS AT 40 YARDS

    IN 30 INCH CIRCLE

    FULL CHOKE 65 - 75

    MODIFIED CHOKE 45 - 55

    IMPROVED

    CYLINDER

    35 - 45

    CYLINDER 25 - 35

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    Cycle of fire:- Three stages:-

    i- Cartridge feeding and chambering.

    ii- Striking of fire

    iii- Extraction of fire cartridge.

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    AMMUNITION DESIGNPROJECTILECONSISTSOF:-

    Cartridge Case

    Primer Powder charge (Black or Smokeless)

    Plastic Wad

    Shot charge (Bullet or Lead shots)

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    C

    A

    R

    T

    R

    I

    D

    G

    E

    B

    U

    LL

    E

    T

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    CARTRIDGE CASE

    Function: expands and seals chamber against rearwardescape of gases.

    Composition: usually brass (70% copper 30% zinc); also

    plastic and paper in shotgun shell tubes.

    Shape: (a) straight ("always" pistol ammunition)

    (b) bottleneck ("always" rifle ammunition)

    (c) tapered ("obsolete").

    Extractor flange: configuration at base; rimmed, semi-rimmed,

    rimless ,belted, rebated.

    Headstamp: manufacturers identifiction imprinted or embossedon cartrid e case.

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    CARTRIDGE CASE

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    I. Cartridge cases (outer covering of the cartridge) are

    made up ofCardboard & plastic.

    II. Bullet cases are made ofbrass (70% copper and

    30% zinc).

    III. A few have a nickel coating.IV. Primer casesare of similar composition (Cu-Zn).

    V. Bullet cores are most often lead and antimony,

    with a very few having a ferrous alloy core.

    VI. Bullet jackets are usually brass (90% copper with10% zinc), but some are a ferrous alloy and some

    are aluminum. Some bullet coatings may also

    contain nickel (Ravreby, 1982)

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    FUNCTIONS OF CARTRIDGE CASE

    CONTAINS AND KEEPS THE INNER CONTENTS

    IN POSITION

    PREVENTS THE BACK ESCAPE OF GASES PROTECTION TO THE CONTENTS

    TYPES OF CARTRIDGE CASES

    Rimmed, Semi rimmed, Rimless, Rebated, Belted

    CSAELESS CARTRIDGE

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    PRIMER

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    The major primer elements are Lead styphnate(Pb), Barium

    nitrate (Ba), or a Antimony sulphide(Sb). Usually, all three arepresent.

    Less common elements includeAluminum (Al), Sulfur (S), Tin

    (Sn), Calcium (Ca), Potassium (K), Chlorine (Cl), or Silicon (Si).

    Primer elements may be easier to detect in residues because

    they do not get as hot as the powder, and compounds (not justelements) may be detectable. (Tassa et al, 1982b)

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    Function: explodes on compression igniting the propellant.

    Location: (a) centrefire. Centrally placed primer assemblycomprising primer cup (struck by firing pin), primer, anvil with flash

    holes. Boxer design (USA) or Berdan design (Europe).

    (b) rimfire. No primer assembly. Primer spun into rimof cartridge case (rim struck by firing pin) and in contact with

    propellant.

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    VARIOUSTYPESOF AMMUNITION

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    POWDER CHARGE

    Modern gunpowder, or "smokeless" powder, can contain

    up to 23 organic compounds (FBI study)Nitrocelluloseis virtually always present, along with other compoundscontaining nitrate or nitrogen.

    One of these compounds, diphenylamine (used as astabilizer in the powder), can be detected using reagentscontaining sulfuric acid. (Maloney et al, 1982).

    Modern gun powders are also described as "single-base"when the basic ingredient is nitrocellulose and as"double-base" when there is additionally 1 to 40%nitroglycerine added. If nitroguanidine it is Triple base.

    Hardy and Chera (1979) describe a method todifferentiate them using a mass spectrometer .

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    BLACK GUN POWDER

    POTASSIUM

    NITRATE OR SALT

    PETER

    75% Charcoal is the fuel,

    potassium nitrate the

    oxygen supplier gives

    the mixture more density

    and makes it morereadily ignitable

    CHARCOAL 15%

    SULPHUR 10%

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    PROPELLANT

    Function: burns to produce large volumes of gases under

    pressure.

    Shape: sheets of smokeless powder cut into disc, flake or

    cylinder shapes.

    Alternatively produced as ball and flattened ball smokelesspowder (Winchester) which may be coated with silver-black

    graphite.

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    CHAINOF EVENTS

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    StrikePrimer ignites

    Powder charge burns

    Temperature increases

    Gases produce

    Chamber pressure increases

    Bullet/Shot charge moves

    Exit of bulletChamber pressure zero

    Gases produced:Carbon dioxide, Carbon monoxide

    Nitrogen, Sulphurated hydrogen

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    CHAMBER PRESSURE:-

    i- Revolver:- 4 tons

    ii- Pistol:- 6 tons

    iii- Rifle:- 20 tonsBullet:- Forward & rotational motion.

    Shot charge:- Forward movement.

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    EXTERIOR BALLISTICS

    Interactions of forces:-

    1- Forces originating from the bullet motiona- Velocity:- i- Forward (Rate of motion (speed) andDirection

    ii- Rotational :- It varies (length of the barrel)

    b- Velocity of bullet at the muzzle end for various firearms:-

    i- Revolver:- 600 900ft/sec

    ii- Pistol:- 1200 1440 ft/seciii- Rifle:- 2000 3500 ft/sec

    2- Forces present in the medium

    a- Air resistance

    b- Gravity

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    Knowledge of forces acting on the shot while it

    leaves the barrel till it reaches the target

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    FORCESORIGINATINGFROMTHEPROJECTILE

    Velocity

    1- Speed or Rate of motion also called Muzzle velocity

    Rifles upto 2000 3000 fps

    2- Direction of motion

    Forward motion

    Also Rotational motion in bullets due to rifling

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    Bullets do

    not typically

    follow a

    straight line

    to the target.

    Rotational

    forces are in

    effect that

    keep the

    bullet off a

    straight axisof flight.

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    DEFINITIONS

    YAW: is the oscillation around the long axix of the

    bullet.

    PRECESSION: is a circular Yawabout the center of

    gravity which takes the shape of a decreasing spiral.

    Nutation: is a rotational movement in a small circle

    which forms a rosette pattern like a spinning top.

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    FORCESPRESENTINTHEMEDIUM

    1- Air resistance

    2- Gravity

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    Curved path

    Projectile

    Follows..

    Trajectory of bullet

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    TRAJECTORYOFBULLET 9/13/2013

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    TAILWAGPHENOMENON9

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    Inside barrel projectile is

    supported by walls of

    barrel Entering new medium

    loses balance due to air

    resistance & force of

    gravity

    Regains balance aftercovering some distance

    Tail wag

    Initialtail wag

    Intermediatetail wag

    Terminaltail wag

    B

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    BULLETTHROUGHAGLASS

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    Intermediate tail

    wag

    Secondarymisslies

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    TAILWAGPHENOMENONFORPISTOLUPTO 60 YARDS

    FOR RIFLEUPTO 200 YARDS9

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    Medicolegal importance

    Atypical firearm entry wounds

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    TERMINAL/ WOUND BALLISTICS

    Mechanism of Wound productionLaceration & Crushing

    Shock waves

    Cavitation

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    It is concerned with the effect of bullet on thetarget at impact until it comes to rest

    by Naseeb R. Awan

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    MECHANISMOF WOUNDPRODUCTION

    INTERACTION BETWEEN THE FIRE BLAST AND PART STRUCK

    FORCES IN THE FIRE - BLAST FACTORS IN THE PART STRUCK

    PROJECTILE & ITS RESISTANCE OF THE TISSUE

    DIAMETER DEPENDS UPON

    SHAPE NATURE,

    WEIGHT DESIGN &

    RIGIDITY DENSITY

    TERMINAL VELOCITY (MOSTIMPORTANT)

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    LACERATION & CRUSHING

    Velocity is a key factor to the overall extent of gunshot

    wounds

    According to the kinetic energy equation: (kinetic

    energy = mass/ 2 x velocity2) Doubling the mass

    doubles the energy, however doubling the velocity

    quadruples the energy Therefore a small-caliber bullet traveling at high speed

    can produce a more extensive injury than larger caliber

    bullet traveling at a lower speed

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    Kinematicsis the science of motion. In gunshot

    wounds we can use this to determine the extent of

    injury from the forces and motion involved.

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    LACERATION & CRUSHING

    .PRODUCEDBYTHEDIRECTEFFECTOFBULLET

    1- Missile velocity2- Shape & composition of

    projectile orFrontal area

    3- Angle of impact

    4- Flight characteristics asyaw, tumbling & nutation

    5- Fragmentation

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    LOW VELOCITY BULLET

    a. PART STRUCK SOFT AND ELASTIC TISSUE

    b. PUSHES & STRETCHES THE SKIN & UNDERLYING

    TISSUE.

    c. ROTATES UPON ITS AXIS

    d. INDENTATION IS PRODUCEDe. PERFORATION OF TISSUE

    f. PASSAGE OF BULLET

    g. ENERGY OF BULLET RADIATES LATERALLY

    h. DAMAGE PROPORTIONATE TO DIAMETER OF THEBULLET

    i. REPRESENTED BY THE PATH OR TRACK OF THE

    BULLET

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    SHOCK WAVESI. DEMONSTRATED ONLY BY HIGH SPEED PHOTOGRAPHY OR

    RADIOGRAPHY

    II. IN HIGH VELOCITY BULLETS

    III. TRACK IS FORCED THROGH SOLID TISSUE.

    IV. MEDIUM IS COMPRESSED BY MISSILE IN FRONT OF IT

    V. REGION OF COMPRESSION MOVES AS A SHOCK WAVE OF SPHERICALFORM, 4800/FT/S

    VI. CHANGES OF PRESSURE REMAINS FOR A MILLIONTH OF SECONDBUT MAY REACH PEAK VALUE UP TO 100atm.

    VII. So damage at a distance from wound track.

    VIII. Solid tissues like Muscle, Liver, Spleen & brain are very susceptible.

    IX. Conducted particularly well along tube filled tubes like arteries &veins to cause damage at a distance.

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    Shock Waves

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    SHOCKWAVES. GENERATEDINTISSUESBYHIGHVELOCITYBULLETS, GREATERTHAN

    2,500/FEET/SEC

    Last only for 15-25 microsecondsAre of high energy creating over 1000 lbs/sq inch of

    pressure

    Easily rupture gas filled organs

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    TYPESOFCAVITATIONS

    Temporary:

    Permanent: High velocity missile

    Main destructive effect

    Release of energy, absorbed by the local tissue. Accelerated violently forwards & outwards.

    Continue to move even after passage of missile.

    A large cavity is produced (temporary cavity), reaches its maximumsize, have sub atmospheric pressure, collapses in a pulsatilefashion and permanent cavity left.

    Soft tissues pulped, blood vessels disrupted and bone may beshattered.

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    CAVITATION. CREATEDBYTHEBULLETSTRAVELLINGATSPEEDS > 1000 FT/SEC

    Size & shape depends upon the capacity of the bullet todisperse energy in the surrounding tissues

    Tissues are moved forward & laterally away from the bullet Continues for few milliseconds after bullet has passed

    This creates a cavity which sucks air in from entry & exit wounds &may be 30 times more in diameter than that of the bullet

    Permanent cavity if exists is much smaller than the temporary

    cavity

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    M/L IMPORTANCE

    OF

    WOUND

    BALLISTICS

    1- Recognition ofEntry & Exit wounds

    2- Distance of Fire

    3- Direction of fire & Wound track

    4- Relative position of weapon/victim & angle of fire

    5- Cause of death

    6- Manner of death7- Identification of firearm

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    COMPONENTSOFA SHOTRESPONSIBLEFORDAMAGE

    1- Shot charge(bullet/pallet)

    2- Flame & heat3- Hot explosive gases

    4- Smoke

    5- Wad

    6- Unburnt gun powder7- Grease from the

    barrel

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    All these elements affect:

    I. Body of the victim as signs & symptoms

    II. At the place of strike or target produce

    characteristic changes

    Result is FIREARM WOUND COMPLEX

    This has two components:

    a. Wounding component

    b. Non wounding component

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    Firearm-wound complex has four parts:

    1. An entry wound

    2. A track with its direction

    3. Place of resting of bullet or shot-charge.4. Exit wound

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    ENTRY WOUND

    SINGLE HOLE:

    SIZE : depends upon skin elasticity, tail wag,

    explosive blast effect of gases so either

    proportionate to the diameter of the bullet,

    SMALLER or much larger having STELLATESHAPE.

    SHAPE: depending upon the angle of firearm with

    the target. Circular, Oval, Elliptical, An elongated

    furrow. Inverted margins. May be everted.

    Collar of abrasion: shape depends upon the

    angle of firearm with the target.

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    FLAME

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    BURNING

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    SMOKE

    Carbon particles

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    scattered on

    HISTOLOGICAL

    examination

    Burning: Few inches in case of

    revolver & one foot in case of a

    Blackening: Absent after one

    yard

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    revolver & one foot in case of a

    Shotgun

    by Naseeb R. Awan

    yard

    by Naseeb R. Awan

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    TATTOOING(DUETOUNBURNTGUNPOWDERPARTICLES)

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    Beyond 2 yards,

    tattooing is not

    present

    by Naseeb R.

    Awan

    They pierce under the superficial skin layers causing

    punctate abrasions of smaller blood vessels under the

    skin

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    Un-burnt gunpowder particles pierce the skin while blood

    stains are washable

    Tattooing Blood stains

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    SKINCHANGES

    Gross splitting: Seen in high velocity bullet & contact

    wound of low velocity bullet . Tail wag/range/gas

    penetration. BLOW BACK PHENOMENON

    Bruising (at or around entry wound due to general tissue

    trauma) MUZZLE IMPRINT, Gases of the blast ballooning

    & bruising the skin/Vital reaction / Inflammatory reaction

    Collar of Abrasion: Rub raw of the superficial skin layers

    while projectile enters the skin. More prominent in rifledfirearms due to their rotational motion

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    T il h

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    5/3/200440

    Tail wag phenomenon

    Medicolegal importance

    Atypical firearm entry wounds

    Bigger entry wound

    X-shaped entry wound

    Key hole orslit like entry wound

    Multiple entry wounds of a single fire

    Skin deep / muscle deep wounds

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    Key hole or Slit like entry wound

    C ll Of Ab i

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    Collar Of Abrasion

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    CLASSIFICATIONOF FIREARM RIFLED ENTRY

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    Contact entrywound

    Hard/Firmcontact

    Loosecontact

    Close range:Up to 2 yards

    Near distant:within six

    inches

    Intermediaterange:

    1 2 yards

    Distant range:Beyond 2

    yards

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    FEATURES OF ENTRY WOUND9/13/2013

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    Lacks exterior residue.

    No imprints of components offire externally.

    Burning, blackening, tattooingpresent in the track or interiorof wound or on interveningbone.

    Pinkish discoloration due toCoHb.

    Muzzle imprint on closeexamination.

    Entry wound of variable shapewith collar of abrasion.

    As small gap betweenbody & weapon.

    Circular defect.

    Collar of abrasion.

    Circular soot material.

    Tattooing, blackening &burning in the woundtrack.

    No scorching, singeingexternally.

    Muzzle imprint.

    Pinkish discoloration

    FIRM CONTACT LOOSE CONTACT

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    FEATURES OF ENTRY WOUND9/

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    Barrel is held close to

    skin in the range of

    flame & smoke. Central defect.

    Collar of abrasion.

    Inverted margins.

    Burning, scorching,

    singeing, blackening &

    tattooing present.

    Within 1 2 yard

    Hole

    Collar of abrasion.

    Inverted margins.

    Blackening fades.

    Tattooing present

    NEAR DISTANT INTERMEDIATE RANGE

    FEATURES OF ENTRY WOUND

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    FEATURES OF ENTRY WOUND:

    DISTANT RANGE

    Hole

    Collar of Abrasion

    Grease collar inside the collar of abrasion also

    called smudge ring

    No flame & gun powder effect.

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    CONTACT FIREARM ENTRY WOUND

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    CONTACT FIREARM ENTRYWOUND

    Muzzle of firearm pressed hard on some hard bony

    area as forehead / skull

    Gases cant enter skull & escape from sides causing

    lacerations in the scalp Star shaped projections in scalp

    Components of shot present inside skull in the track

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    Stellate Firearm wound

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    CLOSE RANGE FIREARM ENTRYWOUND

    Examination of clothes is important

    Burning, blackening, tattooingpresent

    Collar of abrasionpresent

    Grease collar / Dirt collarmay be present

    Marginsmay be inverted

    Wadmaybe present in the track in case of smooth

    bored firearm

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    SHOTGUN CARTRIDGE

    Construction:chamber primer/powder/wad/shot

    Shot types Bird, Buck, Slugs

    Pellets Rarely exit

    Variable factors

    Range

    Gauge

    Choke

    HIGH ENERGY TRANSFER

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    Plastic WAD struck with the wall

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    FIREARM EXIT WOUND

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    There may be no exit wound

    May be multiple exit wounds of one entry wound due to

    Secondary missiles May be large typical exit wound with everted margins

    No close range characteristics

    Shored exit wound:Collar of abrasion present

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    5/1/200425

    Bullet through a glass

    Intermediate tailwag

    Secondarymisslies

    Intermediate tailwag

    Secondarymisslies

    SHOT GUN WOUNDS

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    SHOTGUNWOUNDS

    Contact shotgun wound are most destructive

    Bursting rupture of head is rule rather than exception

    Skull may be largely fragmented leading to Egg-shell

    fractures

    Scalp is extensively lacerated

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    The unfavorable ballistic shape of shotgun pallets combined

    With lack of stabilizing spin, causes a rapid fall-off in velocity &

    Thus Kinetic energy by Naseeb R. Awan

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    SHOTGUN ENTRYWOUNDCOMPLEX 9/

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    Fanning

    phenomenon

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    Pallets traveling in a single mass & wad getting behind

    Shot gun Firearm wounds

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    Entry Wound By contact to 2 ft birdshot

    produces a single wound

    By 3 ft there will be Rat-hole

    type of entry wound

    By 4 ft scatteredsatellite

    pallet holes

    By 10 ft there is great variation

    in type of entry wound

    The diameter of spread ofpallets on body in inches is

    roughly equal to the distance

    from muzzle in yards

    Wadmay travel upto 6 ft &

    may be found in track of injurywithin that distance

    Billiard Ball Ricochetting

    phenomenon: Important in

    giving distance of fire

    THIS COOKIE CUTTER TYPE WOUND SHOWS A FEW

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    THISCOOKIECUTTER TYPEWOUNDSHOWSAFEW

    SEPARATEPELLETINJURIESFORMINGASTHEDISTANCEINCREASES. THIS

    ISNOTASUICIDE.9/13/2013

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    LOOSECONTACTSHOTGUNWOUNDANDALARGER, MORE

    RAGGEDEXITWOUND.9/13/2013

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    BILIARD BALL RICOCHETTINGPHENOMENON

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    Misguides

    distance of fire

    I

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    IMPORTANTDEFINITIONS

    Bone of skull is dipoc (has 2 layers).

    Table which is struck first by projectile is supported frombelow so has comparatively small circular hole & clean

    margins. Table which is 2nd to be struck has no support so has a

    bigger irregular hole & beveled margins.

    M/L importance Gives direction of fire

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    Beveling of skull bone

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    Beveled margins

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    IMPORTANTDEFINITIONS

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    Birdshot

    Buckshot

    Dustshot

    Blankammunition

    Dum dumbullets

    Size of pallet is 2-9

    Pallets larger than size 9

    Pallets smaller in size

    Only powder no projectile present

    Either non-jacketed or partiallyjacketed. They may expand or flatten

    on impact thus increasing energydissipation & tissue destruction

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    IMPORTANTDEFINITIONS

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    Ballisticcoefficient

    Fragmentation

    Embolised bullets

    Swallowed bullets

    Tandem bullets

    Ricochetted bullet

    Efficiency of a bullet in overcoming air resistance Breaking up of a jacketed bullet through some

    bone or non-jacketed bullet through soft tissues

    Bullet gains access to blood circulation & carriedaway to distant location

    Bullet that enters GI tract & carried away byperistalsis

    Bullets remaining in barrel due to defect & thencome out subsequently one after the other

    Bullet which deviates from its course by strikingan intermediate object

    DU

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    UM-DUM

    BULLET

    A hollow point is anexpanding bulletthat hasa pit or hollowed out shapein its tip, generally intendedto cause the bullet toexpand upon entering a

    target in order to decreasepenetration and disruptmore tissue as it travelsthrough the target. It is alsoused for controlledpenetration, where over-penetration could causecollateral damage (suchas on an aircraft).

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    http://en.wikipedia.org/wiki/Expanding_bullethttp://en.wikipedia.org/wiki/Tissue_(biology)http://en.wikipedia.org/wiki/Collateral_damagehttp://en.wikipedia.org/wiki/Collateral_damagehttp://en.wikipedia.org/wiki/Tissue_(biology)http://en.wikipedia.org/wiki/Expanding_bullet
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    TANDEMBULLET

    Tandem cartridge if used could result in multipleentrance wounds in a single fire.

    If the first bullet fails to leave the barrel and is

    ejected by the subsequent fired bullets. The bullets

    are ejected one before the other and are called astandem bullets.

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    KENNEDY PHENOMENON

    Surgical alteration or suturing of gunshot woundscreates problem. in this situation the evaluation of

    the wound whether it was an entrance or exit

    wound becomes difficult. This phenomenon is

    called as Kennedy phenomenon.

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    BILLIARD BALL RECHOCHETTING

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    BILLIARD BALL RECHOCHETTING

    Diagnosing long-range injury based on the pattern of pellet spreadis difficult. When shotgun pellets are tightly clustered or widelyspread out, close-range injury or long-range injury (respectively) isusually suspected. However, in close-range injuries, the billiard-ball effectmay cause considerable pellet spread.16 When thetightly clustered group of shot at close range contacts the skin, the

    pellets at the front of the group are slowed. The pellets behindthem in the group strike the pellets in front, with an effect like abilliard-ball break. This causes much more pellet spread in tissuethan would be expected at close range. On radiographs,particularly in trunk wounds, this effect can simulate the pelletspread of a longer-range injury.16 Correlate the physical

    examination with the radiologic findings. If there is only oneentrance wound hole, it is a close-range injury. If the distribution ofthe multiple skin entrance wounds is the same as the pellet spreadon the radiograph, the injury occurred at longer range.

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    GUN SHOT WOUNDINMOUTH

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    Gun Shot Wound in mouth

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    Multiple Firearm

    Wounds

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    SHOTGUNPELLETS 1

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    SHOTGUNPELLETS 2

    GUN SHOT WOUND ON HEAD

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    GUN SHOT WOUNDON HEAD

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    GROIN GUN SHOT WOUND

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    GROIN GUN SHOT WOUND

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    GUN SHOT WOUNDONHAND

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    GUN SHOT WOUNDONHANDINX-RAY

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    Gun Shot Wound on shoulder

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    Firearm wounds are one type of wounds you may never

    get hold on. Even 1000th case of your professional lifewill bring another chapter of mystery & new learning

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    THANKYOU !