Which factor most strongly determines the tissue damage produced by a bullet?

• A. Bullet size
• B. Exit wound
• C. Bullet speed
• D. Trajectory

Answer: (C)

The amount of tissue damage from a bullet is governed mainly by how much energy the bullet transfers to the tissue, which is driven almost entirely by its speed. A bullet’s kinetic energy is proportional to velocity squared, so higher speed means a much larger energy payload that is dumped into surrounding tissues as the bullet decelerates. This energy transfer creates the permanent wound track and a larger temporary cavity from tissue expansion, leading to more extensive damage and potential injury to nearby structures.

Bullet size does influence the size of the wound channel, but it does not determine how much energy is delivered into the tissue. The exit wound simply reflects how tissue and the bullet behaved after entering; it doesn’t set the amount of energy deposited. Trajectory affects which tissues are hit, yet the overall extent of damage is still most strongly tied to speed and the energy transfer that occurs as the bullet slows down inside the body.