Effects of blows

Intro

Blows have consequences. When you strike another person, you may injure the part of your body used to do the striking. And, of course, when you strike another person, you may injure or kill that person. The following describes some the effects bows may have on various body targets.

Blows to the arms

A blow to the dorsal surface of the upper arm (the middle part between the biceps and triceps) may result in trauma to the ulnar and median nerves and blood vessels of the upper arm. This produces pain in the chest and neck and the loss of motor functions. The blow may fracture the humerus bone. The ulna, radial, and median nerves may be injured causing paralysis of the arm.
A blow to the lateral surface of the elbow may result in trauma to the ulnar nerve producing pain in the chest and neck also causing the loss of motor functions. Blow to the elbow may tear the bursa (the lubricating sac of the joint) causing tremendous swelling and pain.
A blow to the arm may tear muscles or ligaments or pull them loose. The branchial artery may also be damaged.
A blow to the dorsal surface of the wrist (the space between the ends of the radius and ulna bones) may result in trauma to the median nerve and the loss of motor functions to the hand.
A blow to the inside wrist (the area between brachioradialis and flexor muscles of the fingers) may result in trauma to the underlying nerve and artery, leading to pain that affects the chest and throat regions and causes the loss of motor functions and the loss of consciousness.
A blow to the back of the hand (especially the points between thumb and the index finger, also points between middle and ring finger) may result in loss of consciousness due to shock to the median nerve leading to pain in the chest and throat regions that will produce the loss of motor function. A similar result may occur from striking any one of the bones on the back of the hand.

Blows to the legs

A blow to thigh may fracture or dislocate the femur and may result in the inability to stand.
A break in the muscle sheath may cause a lump where the muscles protrude.
A blow to the back of the knee may damage popliteal blood vessels causing a large hematoma. It may damage the tibial nerve causing paralysis below the knee. The blow may tear muscles or ligaments.
A blow to the front of the knee may cause light to heavy sprain, ruptured blood vessels, torn bursa, torn ligaments, or abraded or torn semilunar cartilage. Very painful since the bones may rub against each other.
A blow to shin may break tibia and/or fibula. If only one breaks the other may act as a splint. Bones may shatter because of the weight on them
A blow to the medial malleolus (a point on the medial surface of the tarsal bone just below the ankle) may result in trauma to the tibial artery, causing pain in the hip area that leads to the loss of motor function.
A blow to Achilles tendon may sprain it or cause backward dislocation of the foot.
A blow to the top lateral part of foot just below the heads of the fourth and fifth metatarsals may cause pain and inability to walk.

Blows to front high section of the body (above the shoulders)

Blow to top of the head

A blow to the coronal suture, the line of the juncture of the frontal bone and the parietal bones may cause death due to severe trauma to the cerebrum and disruptive stimulation of cranial nerves.
A blow to the frontal fontanel, the region between the forehead and the coronal suture that is exposed and seen to pulsate in a newborn infant, may cause death due to concussion and trauma to cranial nerves.

Blow to the forehead

If the head is moving toward the blow, the brain membrane (dura) may be torn causing a concussion. Also, if one is knocked unconscious and falls, the relaxed head may hit the ground causing a concussion,
The blow may snap the head back, whiplash, which may chip the spinal process and cause great pain.
A blow to the frontal sinus may cause one to two black eyes or may cause a fracture that may cause bleeding from the nose and may push bone fragments into the brain.
Blow to temple
A fracture of the temporal region of the skull may result in middle meningeal hemorrhage. The artery is in a grove in the skull and may be easily pinched during a skull fracture. If the artery is cut, there may be massive hemorrhage and quick death. A small leak may cause an extradural hematoma with delayed death.
If the blow is one inch below the temple, a fracture of the zygomatic process may occur causing painful operation of the mouth. A blow to the suture of zygomatic (cheekbone) and frontal bone may cause loss of consciousness due to trauma to cranial nerves or a loss of sensory and motor functions.
Blow to the temporal region may also rupture an eardrum.

Blow to the ears

The blow may cause a concussion.
If the eardrum ruptures, the rushing air may cause the auditory canal and Eustachian tubes to swell causing great pain. There may also be ear, nose, and mouth bleeding.
The blow may break or dislocate the jaw hinge.

Blow to the eyes

The blow may cause loss of consciousness due to severe trauma to cerebrum resulting in disruptive stimulation of cranial nerves and loss of sensory and motor functions.
A blow to the upper and lower parts of the eye socket, the circumorbital region, may cause "black eyes." Loss of consciousness may result from cerebral trauma and the resulting loss of nervous control.
The eye bulb may be ruptured causing blindness.
If the eyeball is even touched excessive watering may cause temporary blindness.
A cut and bleeding eyelid may cause temporary blindness.

Blow to the bridge of the nose

The blow may cause fracture and/or dislocation of nasal bone and septum which may cause massive hemorrhage and temporary blindness.
If a person is knocked unconscious, choking may occur from blood in the windpipe.
The blow may fracture the orbital socket causing cerebrospinal fluid to leak from around the brain. The leakage may seem like normal drainage at first. The sense of smell may be dulled.
A blow to the glabella, area at the base of the nose between the eyes, may result in loss of consciousness due to severe trauma to the cerebrum that may disrupt stimulation of cranial nerves and cause a loss of sensory and motor functions.

Blow under the nose

A blow to the upper lip just under the nose, philtrum, may cause excessive eye-watering.
The blow may split the lip or chip or knock out teeth. If teeth get into the windpipe, they may cause suffocation.
The blow may fracture the upper jaw on one or both sides causing great pain.
The blow may cause concussion or shock.
A blow to the juncture of left and right upper jawbones just below the nose, the intermaxillary suture, may result in loss of consciousness due to trauma to cranial nerves and loss of sensory and motor functions.

Blow to the jaw

A blow to the center of the jaw, one-half inch below the lower lip, may result in loss of consciousness due to trauma to cranial nerves and loss of sensory and motor functions.
A blow to the base of the mandible, the lower ridge of the lower jaw, or the articulation below and in front of the ears, may result in a fracture or dislocation that may cause loss of consciousness due to concussion and loss of nervous coordination.
A blow to the base of the mandible may cause a fracture of the styloid process, a sharp spine that projects downward and forward from the inferior surface of the temporal bone just in front of the stylomastoid foramen and that is derived from cartilage of the second visceral arch. This is a fragile bone, but it is well protected and difficult to break. However, a powerful punch to the side of the face may break it causing swelling in the throat which may then lead to asphyxiation in a few minutes.
If the face is stuck on the cheekbone, zygoma, it may fracture or dislocate sending bone fragments into the maxillary sinus that may cause blood to fill the throat. The blow may also cause a concussion.
If the facial nerve is injured, it may result in paralysis on one side of the face.
Fracture of the lower jaw may tear tongue ligaments causing it to spasm. If a person is unconscious, the tongue may be swallowed.

Miscellaneous unexplained head injuries

People have hit their head or been struck on the head and died, even though there was little actual trauma to the head or brain. These cases have been blamed on the "transmission of a concussive force through the reticular activating system."

Trauma to the carotid artery

Located in the side of the neck, the carotid artery provides blood to the head. Pressure on the carotid sinus, an especially sensitive area where the artery divides into two branches, may damage the blood vessel walls, leading to stroke followed by partial paralysis, other neurological problems, or possibly death. The precipitating event may be surprisingly trivial; a knife-hand strike has been known to cause the trauma, but so has the strain of blowing too hard on a French horn.

Blow to throat

The blow may strike the internal jugular vein. The jugular vein pulsates during respiration. It is full and hard during expiration and collapses to a limp, soft ribbon during inspiration. If it is struck during expiration when it is full of blood, it could be crushed against the cervical vertebra, rupture, and cause a quick death. If the vein is bruised, it may swell causing loss of consciousness.
The blow may strike the internal carotid vein. A contusion may cause vessel wall spasm and restrict blood flow. The blow may cause a blood clot that may move to the brain and cause cerebral thrombosis and death.
The vertebral artery runs through the spinous vertebral process, so it can be damaged by a chip or a fracture of the process caused by a heavy blow.
The vagus nerve controls heart contraction and lung contraction. From the brain, it branches out to one nerve on each side of the neck. Striking one side may not be fatal but it could cause spasms of the lungs and heart, which could cause shortness of breath and irregular heart palpitations.
A blow to the phrenic nerve that runs from the fourth cervical vertebra down into the chest, the thorax, to merge with the diaphragm may cause it the diaphragm to spasm and cause a feeling of getting the "wind knocked out" of you.
The laryngeal nerve, a branch of the vagus nerve, goes to the vocal cords, larynx, and epiglottis. It closes the trachea so no foreign objects can get into the windpipe. If injured, it may shut off the air and cause suffocation.
The hypoglossal nerve controls the tongue. If it is injured, it may cause a loss of control of the tongue which may cause it to be swallowed leading to suffocation.
The carotid sheath encloses the jugular and carotid veins and the vagus nerve. If blood builds up in the sheath, it could cause a hematoma that grows with each heartbeat. A large swelling on the neck could result in pressure on the trachea cutting off air.
The blow may chip or fracture the spinous process. This is dangerous not only because of the fracture but because of damage to everything else in the spinous process. The blow may cause whiplash or spinal cord shock that may injure the spinal cord without breaking it.
A frontal blow to the throat (Adams's apple) may fracture the thyroid or cricoid cartilage or damage the laryngeal nerves that may lead to suffocation.
The sternocleidomastoid muscle leads down the side of the neck. A blow may cause loss of consciousness due to trauma to the carotid artery and the pneumogastric nerve that may lead to shock and loss of sensory and motor functions.
A blow to the supraclavicular fossa, the front portion of the throat on either side, just above the collar bone at the origin of the lateral head of the sternocleidomastoid muscle, may cause trauma to the artery located below the collar bone and to the sublingual nerve, which may lead to shock and loss of motor functions.

Blow to collarbone

Fracture of the collarbone may disable the arm on that side and cause the shoulder to drop.
Fracture of the clavicle may injure the brachial nerve plexus that may cause paralysis to all or part of the affected arm.
The subclavian artery may be cut or pinched by muscles that could cause blood to be shut off. If blood is shut off too long, gangrene may occur.
A heavy blow may drive a broken bone into a lung and puncture the pleurae (the thin sac membrane covering the lung) which may collapse the lung and lead to air starvation, dizziness, coma, and death.

Blows to the middle front of the body

Blows to the front middle section (the area between the shoulders and hips, except the arms)

Blows to the chest and abdominal regions may result in trauma to internal organs with disruptive effects on the sympathetic nervous system, which in turn affects the cranial nerves leading to the loss of consciousness due to shock and loss of breathing. However, blows to the head do not always lead to loss of breathing despite the loss of sensory and motor functions.

Blow to chest

A blow to the suprasternal notch (the concave area on the ventral surface of the neck, between the sternum (breastbone) below and the hyoid bone above) may block the windpipe and cause suffocation.
A blow to the sternal angle (the area just below the juncture of the manubrium and the sternum) may cause trauma to the heart, bronchus, arteries supplying the upper part of the body, and the pulmonary artery that may result in a malfunction of the respiratory system and shock.
A blow to the xiphoid process (the lowest part of the sternum) may cause trauma to the liver, stomach, and heart, leading to shock and disturbance of the nervous system followed by loss of motor functions.
A blow to the solar plexus (the concave area just below the sternum) may cause trauma to the stomach and liver, leading to damage to adjacent regions.
A blow to the side of the rib cage may result in a greenstick fracture where a rib fractures longitudinal along its length rather than across.
A blow to the side of the rib cage may break a rib and cause it to puncture a lung. The collapsed lung may let the heart to shift toward the other lung causing spasm and death. The diaphragm may rise and strike a broken rib causing it to retract causing shallow breathing. Intercostal rib muscles can only handle breathing for a short time if the diaphragm is injured. If the diaphragm is irritated by blood, it may cause hiccups. For maximum effect, two blows should be used to ribs; the first to break a rib, the second to force the broken rib into the lungs. Lower floating ribs are not connected to the spine and are difficult to break since they are too flexible.
Commotio Cordis. Also known as cardiac concussion. This is a syndrome in which a nonpenetrating impact to the chest causes heart failure but causes little or no structural damage to the body or the heart. A common victim is a player who takes a baseball, hockey puck, or another hard object in the chest, but it also could be a punch or kick. About half the time, the victim collapses immediately; otherwise, it usually occurs within a minute or two. Death is thought to result from ventricular fibrillation, a state in which the lower heart chambers start fluttering and stop pumping blood.

One study of 128 cases reported that 84 percent of the victims died, with nearly all the survivors receiving prompt defibrillation. Relatively little force is required for the killing blow; one researcher estimates that the blunt instrument needs to be moving at only 30 mph. Although this is a proven medical phenomenon, animal experiments indicate that one must strike within a 15-20 millisecond window in the heartbeat cycle to have a reasonably good chance of taking down an attacker; therefore, in a self-defense situation, it is practically useless.

Blow to the right side of the abdomen

May cause a deep fissure in the liver causing peritonitis, hiccupping from bile or blood irritating the diaphragm, pain, tenderness, or death.
May tear the gallbladder; before a meal, the gall bladder fills with digestive juices and is easily burst. Juices would start to digest internal organs. Only surgery would prevent death.
Blow to the middle of the abdomen
May rupture the stomach or compress duodenum against the spine, which would spill their contents into the abdominal cavity causing peritonitis and death.
If the solar plexus area is struck while inhaling, the pancreas may compress on the spine and split. A spasm of abdominal and intercostal rib muscles may cause respiratory paralysis and death.
·Abdominal aorta vein a large vein in front of the spine may hit the front of the lumbar spine and cause massive bleeding.
Percussive shock may cause a minute plural tear in a lung, which may result in a partial lung collapse causing shallow breathing and great pain in breathing.
A blow to Tanjong (a point about one inch below the navel and the center of the ki in oriental philosophy) may cause trauma to the small intestine and bladder and may damage the large blood vessels and nerves in the abdomen causing shock and loss of motor functions.
A blow to the abdomen may result in abdominal splinting where the body cavity fills with blood resulting in high temperature and rigidity of the abdomen.
A blow to the lower abdomen may injure the diaphragm causing it to relax causing extreme expiration until the diaphragm can function normally again.

Blow to the left side of the abdomen

The blow may damage the stomach.
The blow may damage the spleen that is beside the left kidney under the diaphragm parallel to the ninth, tenth, and eleventh ribs. The spleen stores blood when the body is under stress. A rupture may cause death within forty-eight hours. An injury that later bursts may cause delayed death months or years after the original injury.

Blows to the low front section of the body (the area below the hips, except the legs)

A blow to the inguinal region (inner area of the upper thigh, part of the musculature of the pubic bones) may cause loss of consciousness due to trauma of the underlying artery and nerve causing an unusual type of pain in the hip and abdomen that produces the loss of motor function.
Lateral Lower Thigh: Middle part of the lateral vastus muscle. The cause of the loss of consciousness is cramping of the muscle in the thigh, leading to pain in the lower Abdomen and the loss of motor function in the leg.
A blow to the upper groin may cause hernia by letting bowel, bladder, or abdominal membrane protrude through the inguinal and femoral rings (holes in the abdominal wall that allow nerves and veins to exit). A hernia may cause thrombosis or cut off blood to the leg.
A blow to the groin may rupture the bladder, especially when it is full, and spill urine into the body. If the bladder is bruised, it may cause urinary retention. The chance of infection is great.
A blow to the center of the pubic bone, its weakest area, may fracture it causing great pain when moving legs
Blow to the testes may cause trauma to the nerves and arteries of the testicles and groin, inducing the testicles to rise and in turn producing the loss of motor function, the inability to breathe, and loss of consciousness. The urethra may rupture resulting in bloody or no irritation.

Blows to rear high section of the body (the back of the neck)

The neck is the thinnest section of the spine. it should be stuck with a forward and downward blow or with a neck twist.

The blow may cause a whiplash injury. Symptoms of neck pain and headaches may occur later.
The blow may break the neck causing complete paralysis below the break. If the break is above the fifth cervical vertebra, death may be immediate. The break may cause loss of bladder and bowel control. The spinal cord is made up of numerous nerves; damage to any one of them may cause problems.
A blow to the phrenic nerve, which leads to the diaphragm between the second and fourth vertebra, may sever it and cause death due to respiratory paralysis. The nerve may be easily injured.
A blow to concavity behind the ear between the mastoid process and the lower jaw may cause trauma to the cranial nerves and the spinal cord, resulting in the loss of sensory and motor function.
Shock waves from the blow may reach the brain and cause a concussion.

Blows to the middle rear section of the body (from the shoulders to the hips)

A blow to the middle of the scapular ridge of the spine at the level of the third intercostal space may cause trauma to the lungs and spinal cord producing difficulty in breathing and blood circulation with the loss of motor function.
A blow to the spine in the area between fifth and sixth thoracic vertebrae may cause trauma to the spinal cord, aorta, heart, and lungs, leading to the loss of sensory and motor functions and breathing stoppage.
A blow to the lumbar region of the spine to the left and right sides of the ninth and eleventh thoracic vertebrae. These two areas are more effective points for attack. A kidney may be ruptured by the hydrostatic pressure of the impact or by impact with the twelfth rib although kidneys are usually injured by puncture by a broken rib. The kidney may be torn from its mooring causing bleeding or a kink in the ureter causing blockage and infection. A blow to the spine may result in a slipped disk that may have varying effects.
A blow to the tip of the spine may result in trauma to the entire spinal cord, leading to cerebral trauma and the loss of sensory and motor function.

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