Bruise Ecchymosis

An external bruise represents bleeding beneath the skin. If sufficient bleeding occurs to create a lump, this is called a hematoma. Such injuries result from direct force applied to the skin surface, resulting in the tearing of subcutaneous blood vessels. The pattern of bleeding may be circular, surrounding a central bleeding point where the blow has stretched and torn a blood vessel wall. When multiple blood vessels are torn because of the use of a specific instrument, the bleeding pattern may conform to the outline of that instrument. For example, a blow inflicted with a human fist can produce multiple circular bruises in a pattern that conforms to the tips of the knuckles (.F..ig,.,2.57..:.2.). Similarly, pressure from fingertips such as occurs when someone grabs another by the arm may produce around of circular oval bruises. In contrast, a strike with a police baton can produce parallel linear bruises conforming to the diameter of the baton ( Fig 2.5.7:3.).

FIG. 257-2. Bruise pattern from knuckles.
FIG. 257-3. Parallel linear bruises from police baton.

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