Table 1.

Definitions

Uniform Definitions related to IPV and SV	Definition and Citation
Intimate Partner Violence	Physical, sexual, or psychological harm by a current or former partner or spouse. It IPV can occur among heterosexual or same-sex couples and does not require sexual intimacy (Saltzman et al., 2002).
Physical Violence	The intentional use of physical force with the potential for causing death, disability, injury, or harm. Physical violence includes, but is not limited to: scratching, pushing, shoving, throwing, grabbing, biting, choking, shaking, poking, hairpulling, slapping, punching, hitting, burning, use of a weapon (gun, knife, or other object), and use of restraints or one’s body, size, or strength against another person. Physical violence also includes coercing other people to commit any of the above acts (Saltzman et al., 2002).
Physical Injury	Any physical damage occurring to the body resulting from exposure to thermal, mechanical, electrical, or chemical energy interacting with the body in amounts or rates that exceed the threshold of physiological tolerance, or from the absence of such essentials as oxygen or heat (Saltzman et al., 2002).    Genital injury- physical damage to the external genitalia (labia majora, labia minora, periurethral area, perineum,    posterior fourchette, and fossa navicularis); internal genitalia (hymen, vagina, cervix); and anus (anus, rectum).    (Sommers et al. 2008).    Non-genital injury- physical damage to the body outside the external, internal, and anal areas.
Rape	Forced sexual intercourse including both psychological coercion as well as physical force. Forced sexual intercourse means vaginal, anal or oral penetration by the offender(s). This category also includes incidents where the penetration is from a foreign object such as a bottle. Includes attempted rapes, male as well as female victims and both heterosexual and homosexual rape. Attempted rape includes verbal threats of rape (U.S. Department of Justice, 2011).
Sexual Assault	A wide range of victimizations, separate from rape or attempted rape. These crimes include attacks or attempted attacks generally involving unwanted sexual contact between victim and offender. Sexual assaults may or may not involve force and include such things as grabbing or fondling. Sexual assault also includes verbal threats (U.S. Department of Justice, 2011).
Sexual Violence	Use of physical force to compel a person to engage in a sexual act against his or her will, whether or not the act is completed; an attempted or completed sex act involving a person who is unable to understand the nature or condition of the act, to decline participation, or to communicate unwillingness to engage in the sexual act (e.g., because of illness, disability, or the influence of alcohol or other drugs, or due to intimidation or pressure); abusive sexual contact (Saltzman et al., 2002).
Injury Definitions	Definition	Subcategory Definitions
Tear (some practitioners prefer that the word “laceration” replace tear)	Any breaks in tissue integrity including fissures, cracks, lacerations, cuts, gashes or rips.	Cut: Wound made by a sharp instrument or object, but may also be caused by splitting of the skin from blunt trauma. Cuts are deeper rather than wider and tend to be in a line. Fissure: Break in the skin, usually where it joins the mucous membrane, producing a crack-like wound. Gash: Wound made by cutting; slash. Incision: Purposeful cut made by a sharp instrument. Laceration: Injury caused by tearing or splitting of the skin from a blunt object; has irregular margins and often a free outer opening; tends to be wider rather than longer; tends to not be in a line; often over a bony surface. Rip: Tear or split in the skin.
Ecchymosis (some practitioners prefer that the word “bruising” replace ecchymosis)	Skin or mucous membrane discolorations, known as “bruising” or “black and blue” areas; due to the damage of small blood vessels beneath the skin or mucous membrane surface.	For practical purposes bruising and ecchymosis are defined similarly, but technically they are different. Bruise (contusion): Bleeding underneath the tissue due to blunt force; discoloration due to hemorrhage into tissue from ruptured blood vessels from beneath the skin surface without the skin itself being broken; color is red-blue-purple-yellow-green. As blood is absorbed, the skin discoloration changes from red/blue to yellow and green Ecchymosis: Skin discoloration caused by the escape of blood into the tissues from ruptured blood vessels; bleeding into the skin or purpura due to anticoagulants, aspirin, or other product or other products. Many experts also include trauma as a cause of ecchymosis.
Abrasion	Skin excoriations caused by the removal of the epidermal layer and with a defined edge.	Abrasion: Superficial wound caused by rubbing or scraping the skin or mucous membrane. Avulsion: Tearing away a structure or part of a structure; removal of all of the layers of skin in an abrasion.
Redness	Erythemous skin that is abnormally inflamed due to irritation or injury without a defined edge or border.	Erythema: redness of the skin due to capillary congestion from irritation, injury, infection, allergy, or radiation.
Swelling	Edematous tissues; transient engorgement of traumatized tissues due to fluid accumulation.	Edema: Fluid accumulation in the interstitial space.

Other Definitions: In documentation of sexual assault that goes to court, these injuries would be described (appearance, size, shape) but there would be no attribution as to causation by the examiner. These descriptions are simply to provide information on the nature and scope of possible injuries.

Chop wounds: Deep gaping wounds, often involving major structures, that result from the use of relatively heavy and sharp objects such as meat cleavers, axes, machetes, and brush hooks. If the instrument is fairly sharp, wounds may show a mixture of both sharp and blunt characteristics. Key to recognizing them is the combination of force and depth.

Defensive injuries (defense wounds, parrying wounds): Injuries incurred in attempts to ward off blows of a weapon or assailant or while trying to grasp a sharp weapon. Injuries often occur on the forearm(s) or hand(s).

Petechiae: Small (<3 mm), pin-point, non-raised, round areas that are purple or red; caused by blood leaking from capillaries as a result of tissue injury or disorders leading to minor intradermal or submucosal hemorrhage such as thrombocytopenia.

Purpura: Purple patches that are greater than 3 mm in size and that occur in the skin, organs, and mucous membranes (including the lining of the mouth). Caused by bleeding in the skin layers due to injury or illness.

Puncture: Wound that occurs because of piercing of the skin with a pointed object or instrument; wound is circular.

Skin injury may take on the form of the object inflicting the trauma.

• Belt injury: Tissue trauma with linear, red, areas and imprint of corners; often thickened discolorations that are raised and sometimes with repeating pattern on it from the pattern on belt.

• Cigarette burn: Circular wound or discoloration, 0.5 cm, round, with scab or crusting and red perimeter or frame; redness, blisters, and/or oozing occurs depending on degree of burn.

• Fingertip injury: Bruises or redness from pressure or choking (strangulation); marks are oval/circular or bluish; often four circular bruises about half centimeter round on the right and left sides of neck; thumb print injury looks wider than fingertip injury.

• Ligature: Soft tissue swelling, redness, abrasions, lacerations, or contusions at the neck (or the area that the ligature was used) and sometimes accompanied by fracture of the upper or lower thyroid horns; conjunctival petechiae; hoarseness.

• Shoe print: Mark that occurs from being kicked or stepped on; usually oblong, irregular, circular, with red and blue bruising, and sometimes with a repeating pattern.

• Twisting injury: Mark with red/blue coloration; pattern is more linear. Sometimes area is wide because of holding and letting go; tender to touch.

• Bite injury: Wound is round or oval shaped with an uninjured portion in the center; wounds are red and tender and sometimes with breaks in skin.

• Fist injury: Bruise or set of oval or circular bruises; represents knuckle marks with redness, tenderness, and swelling.