DEPT OF FORENSIC MEDICINE AND TOXICOLOGY Five families of poisonous snakes Viperidae Elapidae Hydrophidae Colubridae Atractaspididae Sense organs of snakes Vision Eyes without eyelids ID: 1006581
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1. ophidiaDR.SANJU.SASSISTANT PROFESSORDEPT. OF FORENSIC MEDICINE AND TOXICOLOGY
2. Five families of poisonous snakes Viperidae Elapidae Hydrophidae Colubridae Atractaspididae
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4. Sense organs of snakesVision Eyes without eyelids For moving objectsTouch Quite effectiveHearing No external ear So doubtfulSmell Strong smell sensation
5. VibrationJacobson’s sense organsSpecial sensitive cells in the palateTemperature variation Pit vipers have pits On each side of the head Sensitive to temperature variation Pythons-on the lips
6. Poison glandsSalivary glands of snakesSituated behind the eyesAbove the upper jaw
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8. Trait Poisonous snakesNon-poisonous snakes General Stout, dull coloured,Slender,bright coloured,Head Usually triangular in shapeUsually rounded or ovalHead scalesSmall Large Belly scalesBroadSmall, does not extend across entire width
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11. Trait Poisonous snakesNon-poisonous snakes Tail Rounded or flattenedAlways roundedFangs Present; Grooved or channellised All teeth uniform ,not grooved or channellisedSaliva(Venom) Contains toxic peptides and enzymesSaliva is non-toxic
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16. COBRA & VIPERTraitCobraViperBodyLong and cylindricalShort,narrow neckHeadSmall, seldom broader than the body covered with large scalesLarger, triangular.and covered mostly with smaller scales PupilsCircularVertical,slit-likeNeckNot prominentNarrow, prominent
17. TraitCobraViperTailLess taperingMore taperingFangsShorter and groovedLonger and channellisedOther teethPresent in the upper jawAbsentReproductionsOviparousViviparousVenomNeurotoxicHaemolytic
18. SNAKE VENOMNeurotoxinHaemolysinProteolysinFibrinolysinCholinesteraseCoagulaseCardiotoxinNucleotidaseHyaluronidaseRNA aseDNAaseHistaminesSerotoninPhospholipidase-A etc
19. Common krait.(Bengarus caerulus3 to4 to5 feet in lengthShining steel black colourNarrow single or double bands across the backBelly creamy whiteHead is covered with large shieldsFour shields on either side of lower lipScales on the central row on back are hexagonalTail is roundPlates under belly undividedVenom is NEUROTOXIC
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22. Common Cobra (Naja naja5-6 feetvariable colour-usually blackWell marked hoodDouble or single spectacle markon the dorsal sideArea surrounding spectacle mark is speckledHood cannot be seen in dead cobraA tiny triangular shield –wedge shield-between 4and5InfralabialsCaudal scales are doubleVenom is NEUROTOXIC
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25. Russels viperBuff or ljght brown colour4-51/2 feet in lengthstouter than other poisonous snakesNarrows towards tailHead flat heavy triangularWhite V shaped mark with apex pointing forwardsNostrils biggerThree rows of brown or black spots along its backOuter 2 rows-spots ringed with whiteEntire broad plates on the bellySmall scales on headShields beneath tail divided into two rows
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27. Saw scaled viper (echis carinataLength of 1 1 /2 feetBrown or brownish greyHead triangularUpper surface of head-small white mark resembling bird’s foot printDiamond shaped areas of darker colourbetwwen the upper curves of two wavy linesBack covered with rough scalesRidge on the middle of each scale dented like a sawBroad plates on the bellySmall scales on headEntire shields beneath tail
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29. OPHITOXAEMIAPOISONING BY SNAKE BITE
30. SYMPTOMATOLOGY OF SNAKE BITECobra and krait Local-Burning or tingling painRednessIrritation Swelling Inflammation
31. Constitutional 15 mins-1to2 hrsgiddinesslethargyMuscular weaknessDrowsinessIntoxicated feelingNausea and vomitingWeakness of musclesDevelops into paralysis of lower limbsStaggers or falls on attempt to standParalysis spreads to trunksAffects the head-droops
32. PtosisDysphagia and difficulty in talkingBreathing-laboured Death due to respiratory paralysisConscious till endKrait-convulsions and violent abdominal pain sometimesDrowsiness morePain –lesserAlbumin in urine
33. RUSSELS VIPER AND ECHIS CARINATE50% symptomless as little or no venom is injected spot develops severe painarea around bite is red and painfulswelling starts within 15 minutesblood stained discharge from wound
34. In moderate poisoningMarked feeling of intense painVomiting GiddinessSweatingAbdominal painDialatation of pupils-get insensitive to lightMarked collapseComplete loss of consciousnessSkin temperature-raisedTingling and numbness of tongue mouth or scalpParaesthesia around woundLocal extravasation of blood
35. In severe casesMain feature is persisting shockBlood –early haemoconcentration -then decrease in RBC and plateletsUrine contains blood, sugar,proteinsBleeding and clotting time-prolongedHges from gum, rectum, site of biteHaemoptysisHaemoglobinuria and renal failure
36. IN SYSTEMIC POISONINGBlood becomes defibrinatedWill not clotIncreasing respiratory depressionGiddinessHeadacheWeaknessTowards the end-extensive suppuration and sloughingMalignant oedema of bitten areaDEATH due to SHOCK and HAEMORRHAGE
37. SEA SNAKES Bites cause little or no local reaction ½ to1 hr-pain stiffness andweakness of skeletal musclespolymyositis with limb girdle distributionmuscle enzymes increasedplasma potassium increasedMyoglobinuria with renal failureweakness of skeletal muscles persist for months
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39. FD,FPFATAL DOSE :- Cobra-12mg Russel’s viper 15mg Echis-8mg Krait-6mgFATAL PERIOD –cobra and krait-1/2 -6hrs -viper-1-2 days
40. FIRST AIDReassure the patientapply firm pressure over bitten areaSutherland wrapImmobilise the bitten limbMake parallel incisions through fang marksClean the wound with sterile saline or water
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43. TREATMENTPolyvalent anti snake venom serum(4 hrs)20ml given IVRepeated 1 hrFurthur doses every 6 hrsIf not available-antiveninIn viper bite-inject around site alsoNeostigmine if there is neuroparalysisIn severe poisoning-normal saline or transfusion of blood and plasmaHaemodialysis or peritoneal dialysis
44. PM APPEARENCESOne or two fang marksColubrine bite-site-haemolysed bloodViperine-discolouration swelling cellulitis hgesHges into bowelPurpuric spots on pericardiumHges into lungsKidneys inflamedInternal organs-congested
45. CIRCUMSTANCES OF POISONINGAccidentalOccasionally murderOccasionally cattle poison
46. NON POISONOUS SNAKES
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