Firearm injuries: bevelling of skull wounds: practice question

A Forensic Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Forensic Medicine · Firearm injuries: bevelling of skull wounds

Sample item

At autopsy a flat bone of the skull shows a circular perforation. The hole is small and sharp-edged on the outer table and wide and crater-like on the inner table. Which conclusion is correct?

AThe wound was made by a blunt weapon from within the skullBAn exit wound, as the missile travelled from the inner table towards the outer tableCThe hole is a postmortem artefact caused by the saw during autopsyDAn entry wound, as the missile travelled from the outer table towards the inner table

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. An entry wound, as the missile travelled from the outer table towards the inner table

A bullet passing through a flat bone produces a cone-shaped hole that is narrower at the surface where it enters and wider where it leaves, as the bone fragments break away on the exit side. Bevelling of the inner table therefore indicates an entry wound in the skull, and bevelling of the outer table indicates exit. This helps to establish the direction of fire.

Option by option

A. The wound was made by a blunt weapon from within the skull
A blunt weapon would produce a depressed or comminuted fracture rather than a sharp-edged cone.
B. An exit wound, as the missile travelled from the inner table towards the outer table
Outer table bevelling would be present if the bullet had left through the outer side.
C. The hole is a postmortem artefact caused by the saw during autopsy
An autopsy saw cut is linear and does not leave a conical bevelled perforation.
D. An entry wound, as the missile travelled from the outer table towards the inner table (correct)
Correct. Inner table bevelling shows that the bullet travelled from outside to inside.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Forensic Medicine question

What is the answer to this Forensic Medicine question?

The best answer is D, An entry wound, as the missile travelled from the outer table towards the inner table. A bullet passing through a flat bone produces a cone-shaped hole that is narrower at the surface where it enters and wider where it leaves, as the bone fragments break away on the exit side.

Why is "The wound was made by a blunt weapon from within the skull" not the answer?

A blunt weapon would produce a depressed or comminuted fracture rather than a sharp-edged cone.

Why is "An exit wound, as the missile travelled from the inner table towards…" not the answer?

Outer table bevelling would be present if the bullet had left through the outer side.

Why is "The hole is a postmortem artefact caused by the saw during autopsy" not the answer?

An autopsy saw cut is linear and does not leave a conical bevelled perforation.

What concept does this question test?

It tests Firearm injuries: bevelling of skull wounds in Forensic Medicine. Bevelling of the inner table therefore indicates an entry wound in the skull, and bevelling of the outer table indicates exit. This helps to establish the direction of fire.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Firearm injuries: bevelling of skull wounds?

Learn postmortem changes with their timelines, and toxicology as poison, sign, test and antidote. Then use the flashcards and the other Forensic Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.