LEGAL MED LECTURE.doc

8/14/2019 LEGAL MED LECTURE.doc

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LEGAL MEDICINE : GENERAL CONSIDERATION

Legal Medicine is a branch of medicine which deals with the application of medical knowledge to the purposes of law and in theadministration of justice.

Legal medicine Application of medicine to legal cases.Forensic medicine Application of medical science to elucidate legal problems.Medical jurisprudence Knowledge of law in relation to the practice of medicine.

SCOE: Application of medical and paramedical sciences as demanded by law and administration of justice.NAT!RE OF T"E ST!D# OF LEGAL MED:- The ability to acuire facts! arrange them and draw a conclusion from facts in the administration of justice.

Medical juris$% Medical e&aminer% Medicolegal o''icer% Medicolegal e&per$- A physician who speciali"es primarily with medico-legal duties.- #mhotep $%&' (.). earliest medico-legal e*pert.

DIFFERENCE : ORDINAR# "#SICIAN MEDICO(LEGAL OFFICERa+ #njury,isease point of iew - Treatment )auseb+ /*amine a patient iagnose Testify , justicec+ 0inor injuries #gnored 1ecords all , ualify crime

RINCILE OF STARE DECISIS:- 2hen the court has once laid an interpretation of law as applied to certain facts! it will adhere to and apply to all future cases

where the facts are substantially the same.

)ASIC RINCILES GO*ERNING ALICATION AND EFFECTS OF LA+S:3. 4#gnorantia legis nominem e*cusat 4 preent use as defense in iolation$. Law shall hae no retro-actie effect.5. 1ights may be waied! unless the waier is contrary to law! public order! public policy! morals or good customs! or prejudiced to

a third person with a right recogni"ed by law.6. )ustoms which are contrary to law! public order or public policy shall not be countenanced.7. Laws are repealed by subseuent ones! and their iolation or non-obserance shall not be e*cused by dis-use! custom or

practice to the contrary.ersons au$,ori-ed $o per'orm au$opsies:

3. 8ealth 9fficers$. 0edical officer of law enforcement agencies.5. 0embers of the medical staff of accredited hospitals.

Au$opsies s,all .e per'ormed in $,e 'ollo/ing cases.3. 1euired by special laws$. 9rder of competent court! mayor! fiscal5. 2ritten reuest of police officers6. ol;en! fiscal disinter to determine cause of death.7. 2ritten reuest of nearest kin to ascertain cause of death.

MEDICAL E*IDENCE

- is the means sanctioned by the rules of court of ascertaining in a judicial proceeding the truth respecting a matter of fact.T0pes o' e1idence:3. Autoptic or 1eal eidence made known to the senses$. Testimonial eidence oral under oath5. /*perimental eidence6. ocumentary eidenceMe$,ods o' preser1ing e1idence:3.


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DECETION AND DETECTIONKnowledge of truth is important in the administration of justice! lies solely in the ability to ealuate the statement gien by thesuspect or witness.Me$,ods o' decep$ion de$ec$ion:3. eices which record the psycho-physiological response: a+ >se of a polygraph or lie detector machine b+ 2ord association test c+ se of drugs that try to 4 inhibit the inhibitor? a+ Administration of the truth serum b+ @arcoanalysis or @arcosynthesis c+ #nto*ication5. 8ypnotism6. (y obseration7. cientific interrogation=. )onfession

I2 RECORDING OF S#C"O("#SIOLOGICAL RESONSE@erous control )@,A@ ym,


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A. Administration of truth serum - 8yocine hydrobromide gien hypodermically until state of delirium which the subject feels a compulsion to answer the uestiontruthfully.(. @arcoanalysis or @arcosynthesis - odium amytal or sodium penthotal). #nto*ication with alcohol - #n wine there is truthIII2 "#NOSIS - alteration of consciousness! not all subjects can be hypnoti"edI*2 O)SER*ATION


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d+ mannerism i+ faciese+ handedness-left ,right j+ degree of nutrition

oin$s o' iden$i'ica$ion applica.le $o .o$, li1ing and dead .e'ore onse$ o' Decomposi$ion:3. 9ccupational marks painters hae stains$. 1ace: 0alay:brown! flat nose round face! 1ound head! 2earing apparel5. tature: Tips of middle fingers of both hands e*tended laterally6. Tatoo marks7. 2eight not good point changes from time to time=. eformities! injuries leaing permanent deformitiesG. (irth marks moles! scarAge of car: 1ecently formed: lightly eleated! reddish,bluish! tender to touch Eew week-$ months: #nflammatory redness! soft! sensitie

$ = months: brownish! free from contraction! soft B = months: white! glistening! contracted! tough

car formation is delayed by: sepsis! age! depth of wound! mobility 0ay not deelop mall! superficial! healed by first intention.&. Tribal marks! e*ual organs! blood e*am

ANT"ROOMETR# 7 )ERTILLON S#STEM8 Alp,onse )er$illon

- utili"es anthropometrical measurement of the human body for identification.(asis:

3. 8uman skeleton is unchangeable after $' years.$. @o two human beings hae e*actly the same bones.5. >se of simple instrument

#nformation:3. escriptie data color of hair! eyes! shape of noseH$. (ody marks5. Anthropometric measurement height6. 0easurement of the head! limbs


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a+ @o two identical fingerprints 3 : =6!'''! '''! '''b+ @ot changeable - 6thmonth formed in the fetus


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6+ tyloid process shorter longer,slender7+ Eorehead higher! more obliue less high! more ertical=+ uperciliary ridges less sharp! more rounded sharperG+ Mygomatic arches more prominent less prominent&+ Lower jaw larger C wider narrower and lighter%+ Eace larger in proportion to cranium smaller

etermination of the duration of interment:- All soft tissues in a grae disappear within one year.

(asis of the estimate fro duration of interment:3+ Test to determine the se*:

3. ocial test$. ;enital test5. ;onadal test

6. )hromosomal test barr cells in females/idences of se*:3.


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c+ Luminescence test: 5 amino-phtalic-acid-hydra"ide-8)L! odium pero*ide! distilled water

(luish-white in a dark roomC,emical e&amina$ion:

a+ aline e*tract of the blood plus ammonia brownish B alkaline hematinb+ (en"idine test blue color in white filter paperc+ ;uaiacum test I Fan eens yas or chombeins test+ - blue

d+


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5. Apparent death or tate of suspended animation transient loss of consciousness in hysteria! uremia! electric shockSigns o' dea$,:92 Cessa$ion o' ,ear$ ac$ion and circula$ion.! >sually the auricle contract after somatic death fro a longer period than theentricle! last to stop so called !LTIMEN MARIENS2 Methods of detecting the cessation of heart action and circulation: a+ /*amination of the heart- pulse! aucultation! flouro! /);

b+ /*amination of peripheral circulation 0agnus test application of ligature around the base of the finger

- bloodless area at site of application- dead man no change

9pening of small artery- spurting #cards test injection of flourescein N

- greenish yellow discoloration in the whole skin- dead man only in the area of injection


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5. mall room6. 2arm surroundings

Eactors accelerating cooling:3. >nclothed body$. )onditions allowing the access of air5. Large room permitting the dissipation of heat6. )ooling more rapid in water than in air

Me$,ods o' es$ima$ing ,o/ long a person ,as .een dead 'rom $,e cooling o' $,e .od0:3. #f body temp. is normal at the time of death: the aerage rate of fall of the temp. during the first $ hours is of the difference of the body temperature and that of the air. the body attains the temp. of the surrounding air from 3$ to 37 hours after death in tropical countries.

$. )hemical 0ethod I chourups formula for the determination of the time of death of any cadaer whose )E is e*amined for theconcentrations of L.A.! @


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798 In$ernal Fac$ors a+ tate of the muscles

healthy appears late 9nset is hastened in: a.3 hunted animal

a.$ prolonged conulsion,lingering illnessa.5 death from- TJ! )holera!


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appears 5 = 8 after death and fully deeloped 3$ 8 after death.

,0sical c,arac$eris$ics o' os$(mor$em Cada1eric Li1idi$03. 9ccurs in the most dependent areas.$. #noles the superficial layer of the skin5. oes not appear eleated from the rest of the skin.6. )olor is uniform.7. @o injury of the skin

6inds o' os$(mor$em Cada1eric Li1idi$03. 8ypostatic liidity$. iffusion liidity

Impor$ance o' Cada1eric li1idi$0:3. 9ne of the signs of death.$. etermines the position of the body has been changed after its appearance in the body.5. )olor of liidity may indicate the cause of death.

a+ asphy*ia liidity is darkb+ )9 poisoning pinkc+ 8emorrhage less markedd+ 8ydrocyanic acid bright rede+


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chloride in the plasma,1() decrease due to e*traascular diffusion! in G$ 8 only of its content. 0g increases due to diffusion from without.

K increases due to diffusion from the ascular endothelium.

2 A!TOL#TIC OR A!TODIGESTI*E C"ANGES AFTER DEAT" - After death! proteolytic! glycolyticClipolytic ferments of the glandular tissues continue to act w,c lead to the autodigestn of organs;2 !TREFACTION OF T"E)OD#( #s the breaking down of comple* proteins into simpler components associated with the eolution of foul smelling gasses and

accompanied by the change of color of the body.Tissue c,anges in pu$re'ac$ion:92 C,anges in $,e color o' $,e $issue 8emolysis of blood within blood essels B 8gb diffuses through the walls 1eddish-brown in color #n the tissues B 8gb undergo chemical change ;reenish-yellow 3stseen at 1 #liac fossa MAR)OLIATION B prominence of the superficial eins with reddish discoloration which deelops on both flanks of the

abdomen! neck! and shoulder look like 4marbled? reticule of branching eins.

32 E1olu$ion o' gasses in $,e $issues )9$! ammonia! 8$! uphurated hydrogen! methane offensie odor

/ffects of pressure of gasses of putrefaction:a+ displacement of the blood bleeding in open woundsb+ bloating of the bodyc+ fluid coming out from nostrils! mouthd+ e*trusion of the fetus in a graid uterus

e+ floating of the body2 Liue'ac$ion o' $,e so'$ $issues


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&. access of air to the body after burial%. mass grae rapid3'. trauma to the body iolent death - slow

C"RONOLOGICAL SE!ENCE OF !TREFACTI*E C"ANGES OCC!RING IN TEMERATE REGIONS3-5 AJ AET/1 /AT8 - greenish discoloration oer iliac fossa! soft eyeballs5-7 AJ - frothy blood from mouth! nostrils&-3' AJ - abdominal distention! nails firm36-$' AJ - blisters all oer the body! maggots$-7 09@T8 - skull e*posed! orbits empty

IN TROICAL REGION3$ 89>1 1igor mortis all oer! hypostasis! greenish-discoloration caecum$6 89>1 1igor mortis absent all oer! abdominal distention6& 8 9a of flies! trunk bloated! face discoloredG$ 8 2hole body grossly swollen! hairs and nails loose9@/ 2//K oft iscera putrefiedT29 2//K oft tissues largely gone9@/ 09@T8 (ody skeletoni"ed

)EEN S!)MERGED IN +ATER

E#1T 6 91 7 AJ )old water little change! in rigor mortisE190 7 G AJ kin on hands! feet is bleached! face faded white3 $ 2//K Eace swollen and red! skin of hands and feet wrinkled6 2//K kin wrinkled! nail intact= & 2//K Abdomen distended! skin of hands, feet come off with nails

Fac$ors in'luencing $,e 'loa$ing o' $,e .od0 in /a$er:3. age fully deeloped! well nourished - rapid$. se* females floats sooner5. conditions of the body obese float uicker6. season of the year moist hot air putrefaction floats due to gas7. water- shallow and stagnant water of creeks! higher specific graity

- sea water floats sooner than fresh water! higher specific graity=. e*ternal influence heay-wearing apparel - slower

RR9nly $ee$,% .ones and ,airremain for an indefinite time.RRElat bones disintegrates faster than round bones.SECIAL MODIFICATION OF !TREFACTION92 Mummi'ica$ion is the dehydration of the whole body which results in the shiering and preseration of the body.

usually occurs when buries in a hot! dry with free access of hot air32 Saponi'ica$ion or Adipocere 'roma$ion a condition where the fatty tissues of the body are transformed to soft brownish-white substance known as ADIOCERE a$S le1el22 Macera$ion

softening of the tissues when in fluid medium in the absence of putrefactie mircro-org! seen in death in utero reddish or greenish color! skin peeling off and arms flaccid and frail.

"O+ LONG A ERSON "AS )EEN DEAD D!RATION OF DEAT"3.


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5. 9nset of decomposition $6-6& 8 after death manifested watery. foul smelling froth! mouth! nostrils6. tage of decomposition7. /ntomology of the cadaer $6 8 before eggs are hatched! maggots

=. tage of digestion - 5-6 8 gastric empty =-& distal ileum! cecumG.


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- comprehensie study of a dead body! in addition to the e*ternal e*amination . os$(mor$em e&amina$ion- e*ternal e*amwithout incision being made.urpose o' au$ops0:

3. etermine cause of death$. )orrelate clinical diagnosis and symptoms5. etermine effectieness of treatment6. tudy the natural course of the disease7. /ducate students and physicians

MEDICO(LEGAL OR OFFICIAL A!TOS#:3. etermine cause! manner! time of death$. 1ecoering! identifying! presering eidentiary material5.


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$.


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Degree o' Cer$ain$0 $o $,e cause o' dea$,:3. tructural abnormalities established beyond doubt the cause of death. /*. 2 with 8.$. egree of probability amounting to the cause of death. /*: /lectrical shock5. 8istory establishes cause of death and confirmed by anatomic or chemical findings.6. 2hen neither history! laboratory and anatomic findings! taken indiidually or in combination is sufficient to determine the cause ofdeath but merely speculate as to the cause of death. /*. )rib death among infants.

S$eps in $,e In$ellec$ual rocess in $,e de$ermina$ion o' $,e cause o' dea$,:3. 1ecognition of the structural organic changes or chemical abnormalities responsible for the cessation of ital functions.$. >nderstanding and e*position of the mechanism by which the anatomic and other deiations from normal caused the death.

#nstantaneous physiologic death or eath from inhibition! death from primary shock! yncope with instantaneous e*itus.- This is sudden death which is cause within seconds or minute or two after a minor trauma or peripheral stimulation of

relatiely simple nature.- The peripheral stimulation initiates the cardio-ascular inhibitory refle*.

/*: Fagocardiac slowing or stoppage of the heart. (low to the laryn*! solar ple*us! scrotum! pressure to the carotid sinus.

Diseases /i$, no speci'ic 'indings o' a disease:

3. udden infant death syndrome I#+ or crib death$. udden une*plained nocturnal death I>@+

DOA means actually dead or dying! proided the physician had not been gien ample opportunity to arrie at a working diagnosisas to the cause of death.!nde$ermined - if the physician cannot determine the cause of death.MEDICO(LEGAL CLASSIFICATION OF T"E CA!SES OF DEAT"a. @atural death cause by natural disease condition in the body.b. Fiolent death

3. Accidental death$. @egligent death5. #nfanticidal death6.


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b. Eatty or myocardial degeneration of the heart.c. 1upture of the aneurysm of the aortad. Falular heart diseasee. 1upture of the heart

5. Affections of the 1espiratory systema. Acute edema of the laryn*b. Tumor of the laryn*c. iptheriad. /dema of the lungse.


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- Art $75 1


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Sec 99; RAC Rig,$ o' cus$od0 Any person charged by law with the study of burying the body of a deceased person is entitled to the custody of such body forthe purpose of burying it! e*cept when an inuest is reuired by law for the purpose of determining the cause of death. #f communicable! the local board of health or local health officer or municipal council.

Concep$ o' possession the right of custody oer a dead body.. The right of custody does not mean ownership of the dead body.

/*ecutors right of custody superior to the right of spouse dead body. An e*ecutor is the person mentioned in a will who will carry onthe proision of the will. #n the absence of a testamentary disposition! the right of the suriing spouse is paramount.

MET"ODS OF DISOSAL OF T"E DEAD )OD#92 Embalming = to & uarts of antiseptic solutions of formalin! perchloride of mercury or arsenic which is carried into the

internal carotids and the femoral arteries.2. Burial or inhumation

a. ec 3'%$ 1A) buried within 6& hours if unembalmed. 2ithin 3$ hours! if communicable.

E&cep$:3. ubject of legal inestigation. $. Authori"ed by the local health authorities that may be buried more than 6&8.

5. #mpliedly when embalmed.

b. eath certificate necessary before burial:ec. 3'&G 1A) 1euirement of eath )ert. and the duty of the physician to issue or the local health officer! or if none by

the mayor! secretary! councilor of the municipality to issue the certificate..Sec J9 2D2 4? Code o' Sani$a$ion K )urial reuiremen$:

- death cert.! issued by physician. c.


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Sec2 J code o' Sani$a$ion )urial Grounds reuiremen$s3. #t shall be unlawful for any person to bury the remains in places other than those legally authori"ed .$. At least $7 meters from any dwelling house and no house shall be constructed within the same distance from any burial

ground.5. @ot within 7' meters from any water source.

O$,er .urial reuiremen$s:3. hipment of remains abroad shall be goerned by the rules and regulations of the (ureau of Nuarantine.$. The burial or remains in city or municipal grounds shall not be prohibited due to race! nationality! religious or political

reasons.5. /*cept when reuired by legal inestigation or when permitted by the local health authority! no embalmed remains shall

remain unburied longer than 6& hours.

F!NERALSAr$2 4 CCThe duty and the right to make arrangements for the funeral of a relatie shall be in accordance with the order ofsupport under Art. $%6.

escendants : /ldestAscendants :


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Sec2 J 2D2 4? Code o' Sani$a$ionpecial precautions for safe handling of cadaers containing radioactie isotopes.

RA ;J as amended .0 RA 94? "!MATIONThe deceased buried may be raised or disinterred upon the lawful order of the proper authorities.

Sec 93 RAC )emetery permits een to @(# agentsSec2 9J@ RAC /*humation in case of death from dangerous communicable disease after 7 years from burial.Sec J3 Code o' Sani$a$ion

5 years if non-dangerous communicable disease. 1emains shall disinfected before burial.Reuiremen$s $o .e sa$is'ied in e&,uma$ion:

3. uration of interment as reuired.$. /*humation permit5. )ompliance of sanitary reuirements

rocedures 'ollo/ed in MedicoLegal E&,uma$ions:3. A formal reuest from any of the law enforcement agency or any person authori"ed by law.

a. @ame of the person! place of interment! date of interment! suspicion as to cause of death.b. To determine the cause of death.c. To determine as to identity of the person.d. To recoer organs or tissues for further e*amination for :

To*icological analysis 8istopath e*ams

mears from aginal canal and blood for alcohol determination

$. et the date and time of e*humation! if physician has a strong reason to beliee that for the justification and strongprobability.

5. 2ritten reuest to the 1egional director or ecretary of 8ealth.6. ;rae must be properly identified by the person who was present when the body was interred.7. After opening the coffin! the body must be iewed by any person who can identify the deceased.=. Actual autopsy and adoption of the procedure is needed to accomplish the purpose of the e*humation.G. isinfection of the body and all areas inoled must be carried out with the assistance of the local health officer and the

return of the body to the burial place.

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MEDICO(LEGAL ASECTS OF "#SICAL INH!RIES,0sical injur0: is the effect of some of stimulus on the body. tab wound the effect is immediate but a blunt object is delayed production on the contusion.

Causes o' ,0sical Injuries3. CET:ital reactions not seen een if injury inflicted during life: 3. uring agonal state of a liing person were cells dont react to the trauma.

$. udden death as in sudden coronary occlusion.

CLASSIFICATION OF +O!NDS:. &$ -+ $EE*%-#

a. 0ortal wound caused immediately after infliction that is capable of death.

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6. )astration by amputation of the penis7. Trichotillomania- pulling of body hair

LEGAL CLASSIFICATION OF "#SICAL INH!RIES3. M!TILATION Art. $=$ 1


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$. There are circumstances adding ignominy to the offense.5. The ictims is the offenders parents! ascendants! guardian! curators! teachers.6. The ictim is a person of rank or person of authority! proided the crime is not direct assault.


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Con$usion)uticle was probably abraded by the same iolence that produced the bruise. #n small punctures such as fleas bites! this is notobsered.os$(mor$em ,0pos$asis)uticle unabraded! because the hypostasis is a mere sinking of the blood! there is no trauma.Con$usionA bruise appears at the seat of and surrounding the injury. This may or may not be a dependent part.os$(mor$em ,0pos$asisAlways in a part which for the time of information is dependent.Con$usion9ften eleated because eleated blood and subseuent inflammation swell the tissues.os$(mor$em ,0pos$asis@ot eleated! because either the blood is still in the essels or at most has simply soaked into and stained the tissues.Con$usion#ncision shows blood outside the essels.This is the most certain test of differenceC can be obsered een in ery small bruises.os$(mor$em ,0pos$asis#ncision shows the blood is still in its esselsC if any oo"ing occurs! drops can be seen issuing from the cut mouths of the essels.Con$usion)olor ariegated. This is only true of bruises that are the same days old d,t the changes in the hemoglobin produced during life.os$(mor$em ,0pos$asis

)olor is uniform. The well known change in color produced in blood /*traasated #nto liing tissues does not occur in dead tissueswith the same regularity.Con$usion#f the body happens to be constricted at or supported on a bruised place! the actual surface of contact may be a little lighter thanthe rest of the bruise but will not be white.os$(mor$em ,0pos$asis#n a place which would otherwise be the seat of hypostasis pressure of any kind een simple support is sufficient to obliterate thelumen of the enules and capillaries and so to preent their filling with blood. 2hite lines or patches of pressure bordered by thedark color of hypostasis are produced and marks of floggings! strangulation! etc. are thus sometimes simulated.

FACTORS INFL!ENCING T"E DEGREE AND E>TENT OF CONT!SSION92;eneral condition of the patient.

$.


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#n hematoma the skin is always eeleated.5. #n contusion! puncture or aspiration with syringe of the lesion! no blood can be obtained.

#n hematoma shows presence of blood and subseuent depression of the eleated lesion.RRAbscess! gangrene! hypertrophy! fibroid thickening and een malignancy are potential complications of hematoma.

M!SC!LO(S6ELETAL INH!RIES3. prain - partial or complete disruption in the continuity os a muscular or ligamentous support of a joint! due to a blow! kick or

torsion force.$. islocation displacement of the articular surface of bones entering into the formation of a joint.5. Eracture solution of continuity of bone resulting from iolence or some e*isting pathology.

a. )lose or imple E* no break in continuity of the oerlying skin.b. 9pen or )ompound E* E* is complicated by an open wound caused by the broken bone which protruded with other

tissues of the broken skin.c. )omminuted E* Eractured bone is fragmented into seeral pieces.d. ;reenstick E* E* wherein only one side of the bone is broken while the other is merely bent.e. Linear E* when the E* forms a crack usually in flat bones.f. piral E* break in the bones forms a spiral manner as seen in long bones.g. @@#@; 9E T8/ (1A#@ )8A1A)T/1#M/ (J 091/ 91 L/ )90LT 9E #@S>1J T9 T8/ 8/A 2,) L/A T9 90/ )9009T#9@ 9E T8/ )/1/(1AL >(TA@)/.- is more seere when the moing or mobile head struck a fi*ed hard object as compared when the head is fi*ed and struck by a

hard moing object.igns and ymptoms

3. unconsciousness which is more or less complete.$. muscles are rela* and flaccid.5. eyelids are closed and the conjunctiae are insensitie.6. surface of the body is pale! cold and clammy.7. respiration is slow and sighing.=. pulse is rapid! weak! faltering and scarcely perceptible to the fingers.G. temperature is subnormal.&. sphincters are rela*ed with unconscious eacuation of the bowel and bladder.%. refle*es are present but sluggish and in seere cases may be absent.

RRLoss of memory for eents just before the injury is a constant effect of cerebral concussion and is of medico-legal importance.

2. +!E( +U(D$

a2 A.rasion 7 Scra$c,% gra-e% impression mar=% 'ric$ion mar= +- it is an injury characteri"ed by the remoal of the superficial epithelial layer of the skin caused by a rub or friction against a

hard rough object.- )ontusion with abrasion forcible contact before friction occurs.

- the shape aries and the raw surface e*udes blood and lymph which later dries and forms a protectie coering as )A(or )1>T.

Characteristics of abrasion:3. #t deelops at the precise point of the force causing it.$. ;rossly or with the aid of a hand lens the injury consists of parallel linear injuries which are in line with the direction of rub

or friction causing it.

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=. )lothes will also show a clean cut if cut by the instrument.G. Easter healing if without complications.&. #ncised wound made by broken glasses maybe irregular! needs to be remoed.

C,anges $,a$ occur in an incised /ound:3. After 3$ hours edges are swollen! adherent with blood and with leukocyte infiltration.$. After $6 hours proliferation of the ascular endothelium and connectie tissue cells.5. After 5= to 6& hours capillary network complete! fibroblasts running at right angles to the essels.6. After 5 to 7 days essels show thickening and obliteration.

+,0 a person su''ers 'rom incised /ound:3. As a therapeutic procedure.$. As a conseuence of self-defense5. 0asochist may self-inflict incised wounds for self-gratification.6. Addicts and mental patients.

uicidal wounds usually located in peculiar parts of the body! accessible to the hand.- the most common site is the wrist! radial artery and the neck.

8omicidal wounds usually deep! multiple and inoles both accessible and non-accessible parts.- clothing are usually inoled- efense and other forms of wounds are present.

Accidental wounds multiple incised wounds obsered on the passenger and drier of 0FA due to broken windshields.- kitchen knies in the preparation of food.

SUICIDAL WOUNDS HOMICIDAL WOUNDS

#1/)T#9@ 9bliue from below left ear!downwards across front >sually hori"ontal below the adams apple neck just aboe the Adams apple/F/1#TJ >sually not so deep C may only inole trachea! >sually deep and may cause inolement

carotid C esophagus of the cartilage C bones>T >su present before the commencement of deeper 2ound @#@; Eirmly grasp Icadaeric spasm+, found lying beside the 2eapon is absent2/AT#9@ 8and smeared with blood. 8ands are clean.09T#F/ 8istory of mental depression! Einancial! social problem! Absence of such history alcoholism 8* 0ay be present Always absent9f /LE-/T1>)T@

3. $-&B +U(D$ is produced by the penetration of a sharp and a sharp-edged instrument like a knife! scissors.- if the sharp edge is the one that comes in contact with the skin then it is an incised wound.- #f the sharp pointed portion first come in contact! it is a stab wound.

surface length may reflect the width of the wounding instrument. smaller when the wound is not so deep.

wider if upon withdrawal is not in the same direction as seen in slashing moement. The presence of an abrasion from thee*tremity of the skin defect is in line with direction of the slashing moement.

The e*tremities of stab wound may show the nature of the instrument used.- a doubled bladed weapon shows both e*tremities to be sharp.- A single bladed weapon one of its e*tremities as rounded and contused! not seen if instrument is uite thin.

The direction of the surface defect may be useful in the determination of the possible relatie position of the offender and the ictimwhen the wound was inflicted.

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As to whether the wound is slit-like or gaping depends on the direction of the wound to the Langers line.

T,e dep$, o' $,e /ound ma0 .e in'luence .0:3. si"e and sharpness of the instrument.$. area of the body inoled5. the degree of force applied

RR8emorrhage is always the most serious conseuence of stab wound due to the seerance of blood essels or inolement ofbloody organs.

"o/ $o descri.e s$a. /ound:3. length of the skin defect edges must be coaptated first Tailing the direction of withdrawal of the wounding weapon.$. condition of the e*tremities sharp e*tremity B sharpness of the instrument used. #f (oth e*tremity are sharp B double bladed weapon is used.5. condition of the edges. edges are regular and clean cutB due to one stabbing act. serrated or "ig"ag in appearance B seeral stabbing wounds I series of thrust and withdrawal.+6. linear direction of the wound it may be running ertically! hori"ontally! or upward medially or laterally.7. location of the stab wound to include e*act measurement from anatomical landmarks.=. direction of the penetration must be tridimentional

G. depth of the penetration&. tissue and organs inoled

S$a. /ounds ma0 .e: A2Suicidal

3. Located oer ital parts of the body.$. >sually solitary5. Llocated oer coered parts of the body! the clothing is not inoled6. tab wound is accessible to the hand of the ictim7. 8and of ictim is smeared with blood=. wounding weapon is firmly grasp by the hand of the ictim.

G. #f stabbing is accompanied w,slashing moementThe wound tailing abrasion is seen towards the hand inflicting the

injury.&. uicide not may be present%.


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contusion of the edgesB if end is not sharp opening may beB round! elliptical! diamond shaped or cruciate.- /*ternal hemorrhage is limited although internal injuries may be seere.B blood essels and bloody organs is fatal if no

interention applied.- ite of e*ternal wound can be easily sealed by dried bld! serum! or clotted bld.-


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- this may be produced by a semi-sharped edged instrument which causes irregular edges on the wound like hatchet andchoppers.

Lacerated wounds are rarely suicidal.

INCISED +O!NDS LACERATED +O!NDS

/dges are clean cut! regular! well defined edges are roughly cut! irregular! ill-defined@o contusion or swelling around the #ncised wounds swelling and contusion around the lacerated wounds

/*tremities of the wound are sharp! may be 1ound! or contused e*tremities are ill-defined and irregular/*amination by means of a hand lens shows that hair bulbs are cut hair bulbs are presered

8ealing is faster healing is delayed)aused by sharp edged instrument caused by a blunt instrument

33


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GAING OF +O!ND - eparation of the edges especially in deep wound may be due to the following:92 mec,anical s$re$c,ing or dila$a$ion

- the presence of a mechanical deice on the edges to preent coaptation will cause separation. /*ample: drain in anabscess! retractor during operation.

32 loss o' $issue due $o:a. estruction due to pressure! inftion! cell lysis! burning! chemical reaction.

b. Aulsion or physical or mechanical stretching resulting to separation of a portion of the tissue.c. Trimming of the edges debridement of the skin which come in contact with the bullet at the entrance and e*it of ;2 and

remoal of necrotic materials.2 re$rac$ion o' $,e edges

- underneath the skin are dense networks of fibrous and elastic connectie tissue fibers running on the same direction andforming a pattern more or less present in all persons.

- This pattern of fiber arrangement is called cleaage direction or lines of cleaage of the skin and their linear representationon the skin is called Langers line.

rac$ical /a0s o' de$ermining ,o/ muc, o' $,e s=in sur'ace is in1ol1ed in an injur0 or disease:- skin functions as a mechanical protection of the body! storage of water.- etermination of how much skin is inoled is important in the mode of treatment and prognosis especially in burns! contusion..

burns of G'O in children and older age group are fatal.

rule o' nine is used2 8ead and neck % O %O one upper e*tremity %O 3&O

front chest and abdomen 3&O 3&Oposterior chest and abdo 3&O 3&O

one lower e*tremity front %O 3&O one lower e*tIback+ %O 3&O

pudendum 3O 3O

Fac$ors responsi.le 'or $,e se1eri$0 o' $,e /ound:3. 8emorrhage may influence the seerity of wound by: a. loss of blood incompatible with life - blood constitutes 3,$' of the body weight of an adult.

- 7 to = uarts of blood I one uart is %6= cc+ - loss of 3,3'thof its olume will cause no significant change. - loss of one uartB fainting

- loss of 3,5rdto $,7thB irreersible shock- males can withstand more loss of blood than females.

- hypertension causes more e*cessie and rapid bleeding.

b. 8emorrhage may result in an increase in pressure in or on the ital organs to affect the normal function. - intracranial hemorrhage cause compression of the ital centers of the brain. - hemopericardium B pericardial tamp

- hemorrhage to the chestB diminution of the respiratory outputBano*ia.

c.. 8emorrhage may cause mechanical barriers to the function of organs. - into tracheo-bronchial luminaB asphy*ia

- into muscles B disturbance in their contractility.

)auses of hemorrhage: a. trauma - destruction of its blood essel wall

b. natural causes - intracerebral hemorrhageIapople*y+B lenticulostraite br. 0)A

- pontaneous subarachnoid hemorrhage B saccular berry aneurysm - rupture of arteriosclerotic aneurysm

34


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- rupture of esophageal arices- pulmonary hemorrhage due to


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c. scarring effectd. secondary shock

NAT!RE OF DEAT" D!E TO SECONDAR# CA!SES3. )hanges whose natural seuence are direct C obious sepsis! tetanus$. )hanges producing separate pathological lesions which in turn proes to be fatal

/*: operation to ligate essel but died of peritonitis despite diligence,skill5. )hanges where a definite pathological condition was present before the injury.

/*.


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Ou$line o' $,e medico(legal in1es$iga$ion o' p,0sical injuries:92 General in1es$iga$ion o' $,e surroundings:

a. e*amination of place where crime is committed.b. /*amination of clothing! stains! cuts! hair! f.b. in the crime scenec. #nestigations on possible witnesses to the incidentd. /*amination of the wounding instrumente.


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ANTE(MORTEM +O!NDS OST(MORTEM +O!NDS

8/09118A;/: -0ore profuse! arterial due to loss of tone of essels! light or none! enous Absence of heart actionP nless if ictim is weakened

#;@ 9E 1/@ w,c is not remoed by washing can be remoed by washing

/dges gape owing to the reaction of the skin and /dges do not gape! but are closely muscle fibers appro*imated to each other unless if the

wound is 3 to $ hrs after death

DETERMINATIONS IF +O!ND IS:

"OMICIDAL S!ICIDAL ACCIDENTAL

A(1A#9@ @ot common unless 1arely obsered /*tensie#f dragged 9r if ictim resisted abrasions 0FA

)9@T>#9@ 1are e*cept when Eound in any portionjumping from a height of the body - Eall

#@)#/ )ommonly obsered )ommonly obsered Ereuent but rarely29>@ R depth! location and surroundings cause of death

oin$s $o consider in $,e de$ermina$


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6. punctured wounds sharp pointed7. abrasion body surface is rubbed on a hard surface=. ;2 the diameter of the wound of entrance may appro*imate the caliber of the wounding instrument.

Could $,e injur0 ,a1e .een in'lic$ed .0 a special /eapon A physician cant determine that a specific weapon was used in inflicting a wound. #t is possible that it is caused by a certaininstrument presented. 8e must be cautious in giing categoric statements

+,ic, o' $,e injuries sus$ained .0 $,e 1ic$im caused dea$, #f with conspiracy no need co" the act of one is the act of all. #f none- offenders are only responsible for their indiidual acts. #f multiple injuries: which of the wound injured a ital organ. 9r if same organ which caused the degree of damage.+,ic, o' $,e /ounds /as in'lic$ed 'irs$#f multiple for the ualification of the offense committed. Eirst treachery ! murder Last - homicide)onsider:

3. relatie position of the assailant and the ictim when the first injury was inflicted on the latter.$. trajectory,course of the wound inside the body of the ictim

5. organs inoled and the degree of injury6. testimony of witness7. presence of defense wounds inflicted first.

E''ec$ o' medical and surgical in$er1en$ion on $,e dea$,: #f death followed after operationB offender is responsible if death was ineitable and that een with operation death is normaland direct conseuence of the injury! and the physician is competent and in spite of e*ercise of degree of diligence still death is theoutcome. #f death ensued een the wounds are minor! and death due to the negligence or incompetence of the physician then theoffender cant be responsible.E''ec$ o' negligence o' $,e injured person on $,e dea$, #f death occurred from complications arising from a simple injury owing to the negligence of the injured person in its proper care

and treatment the offender is responsible for the death a person is not bound to submit himself to medical t* for the injuries receied during the assault. unless if it is proen that the negligence of the ictim is deliberate so offender is not responsible but only for physical injuries.

o/er o' 1oli$ional ac$s o' $,e 1ic$im a'$er recei1ing a 'a$al injur0: dying declaration! attempt to kill the offender after the first blow of the offender

Rela$i1e posi$ion o' $,e 1ic$im and assailan$ /,en injur0 /as in'lic$ed:3. location of the wound$. direction of the wound5. nature of instrument used in inflicting the injury6. testimony of the witness

E>TRINSIC E*IDENCES OF T"E +O!NDS3. eidences from the wounding weapon position of the weapon - near or grasp by ictim

blood on weapon - may be stained with blood hair and other substance on weapon $. eidences in the clothing of the ictim

soaked with blood - hemorrhage gunpowder - distance tears - struggle

5. eidences deried from the e*amination of the assailant paraffin test! tears in clothing! blood stains! into*ication etc.

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6. eidences deried from the crime scene amount of hemorrhage! wounding instrument etc.

"#SICAL INH!RIES IN T"E DIFFERENT ARTS OF T"E )OD#. "E&D &(D (EC/ not be underestimated bleeding from ears! nose! mouth B basal fractures may hae normal *-rays yet with seere head injury Eactors influencing the degree and e*tent of head injuries :

a. nature of the wounding weaponB degree of iolence applied depends on the thickness of the scalpC the weight of the weapob. #ntensity if the force B intensity and heay agentc. point of impact Be*tensie in f* of aults at side or back

d. mobility of the skull at the application of force if head is mobile! freeB effect on the brain is due to the shearing moement imparted to the brain. B may produce contusion! laceration without f*.

#f head is fi*ed and unsupportedB jarring moement of the brain is absent but the fracture is e*tensie.

"ead injuries are classi'ied as $o $,e si$e o' $,e applica$ion o' 'orce:3. irect or )oup injuries$. #ndirect injuries

a. contr-coup injuries

b. remote injuries fall hitting buttocksB basal f*c. locus minoris resistencia - injury in areas with less resistance

5. )oup-contre-coup injuries I direct and indirect injuries+

+ounds in $,e Scalp:3. it is difficult to preent the spread of infection$. there is pro*imity of the scalp to the brain5. there are free ascular connection between the structures inside and outside the brain6. it is freuently difficult to determine the e*tent of damage of the skull.

E1A)T>1/ 9E T8/ K>LL p. 5'$

C"ATER 9G!NS"OT +O!NDSDea$, or p,0sical injuries .roug,$ a.ou$ .0 po/dered propelled su.s$ances:

3. Eirearm shot the injury is caused by the missile propelled by the e*plosion of the gunpowder located in the cartridge shell and the

rear of the missile.$. detonation of high e*plosies - grenades

e*plosion inside the metallic container will cause fragmentation of the container.

%. 0%*E&*1 +U(D Eirearm : is an instrument used for the propulsion of a projectile by the e*pansie force of gasses coming from the burning of

gunpowder. Itechnical definition+

includes rifles! muskets! shotguns! reolers! pistols! other deadly weapons which a bullet! ball! shell or other missile may bedischarged by means of gunpowder or other e*plosies.

includes air rifle e*cept of small calibers and limited range. the barrel of any firearm shall be considered as a complete firearm for all purposes thereof.

enal pro1isions o' la/s rela$i1e $o 'irearm:a. ec. $=%$ 1A) unlawful manufacture! dealing in acuisition! disposition or possession of firearms or ammunitions therefore

or instrument used or intended to be used in the manufacture of firearms or ammunition.b. ec. $=%' 1A) selling of firearms to unlicensed purchaser.c. ec. $=%3 1A) - failure of personal representatie of deceased licensee to surrender firearm.

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d. Art. 377 1IT +O!ND

Appears to be smaller than the missile 9wing to the elasticity of the tissue Always bigger than the missile

/dges are inerted /dges are eerted>sually oal or round depending upon the angle of approach of the bullet oes not manifest any definite shape

)ontusion collar or contact ring is present due to inagination of the skin andspinning of the missile

Absent

Tattooing or smudging may be present when firing is near Absent

>nderlying tissues are not protruding >nderlying tissues may be seen


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32 Fac$ors /,ic, ma=e $,e /ound o' en$rance smaller $,an $,e cali.era. fragmentation of the bullet before penetrating the skinb. contraction of the elastic tissues of the skin

O$,er e1idences or 'indings used $o de$ermine en$rance o' GS+3. e*amination of the clothing! if inoled in the course of the bullet a. fabric shows punch in destruction

b. particle of gunpowder$. e*amination of the internal injuries caused by the bullet

a. bone fragments! cartilage! soft tissues are drien away from entrance woundb. destruction of the bone is oal! with sharp edges at the e*it it is irregular! bigger and beelledc. testimony of witness

De$ermina$ion o' $,e $rajec$or0 o' $,e .ulle$ inside $,e .od0 o' $,e 1ic$im3. e*ternal e*amination a. shape of wound of entrance when bullet is fired at right angle with the skinB the wound of entrance is circular e*cept in case of near fire.

if fired at another angle ! it is oal when the bullet is deformed no such characteristics findings will be obsered.

b. shape and distribution of the contusion collar contusion collar is widest at the side of the acute angle of approach of the bullet.

if the bullet hits the skin perpendicularlyB collar will hae a uniform width around the ;2 e*cept when bullet is deformedor in near fire.

c. difference in leel between the entrance and e*it wounds d. by probing the wound of entrance not with too much force$. internal e*amination a. actual dissection and tracing the course of the wound at autopsy

b. fracture of bones and course in isceral organsc. location of bone fragments and lead particle

d. *-ray e*am5. other eidences to show trajectory

a. relatie difference in the ertical location of entrance and e*it in the clothingb. relatie position and distance of the assailant from the ictim in the reconstruction of re-enactment of the crime.

c. testimony of witness

E>IT +O!NDS OR OFFS"OOT +O!NDoes not show characteristic shape unlike the entrance wound due to the absence of e*ternal support beyond the skin so the

bullet tends to tear or shatter the skin.

hored ;2 of e*it: if pressed on a hard object like when ictim is lying: 2ound of e*it is circular or nearly circular with abrasion.

ODD AND E*EN R!LE IN GS+ #f the number of entrance and e*it wound is een so presumption that no bullet is lodge in the body.

erified by *-ray

"o/ $o de$ermine $,e num.er o' 'ires made .0 $,e o''ender:3. determination of the number of spent shells$. determination of entrance wounds in the body of the ictim number of entrance wounds may not show the e*act number of fire:

a. not all fire made may hit the body of the ictimb. the bullet may in the course of its flight hit a hard object thereby splitting it C each fragment may produce separate wounds of

entrance.c. (ullet may hae perforated a part of the body and then made another wound in some other parts of the body

5. number of shots heard by the witness

42


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Ins$ances /,en $,e num.er o' GS+ o' en$rance is less $,an $,e num.er o' GS+ o' e&i$ in $,e .od0 o' $,e 1ic$im:3. a bullet might hae entered the body but split into seeral fragments! each of which made separate e*it.$. one of the bullets might hae entered a natural orifice of the body. /*. nose5. there might be two or more bullets which entered the body through a common entrance and later making indiidual e*it wounds6. in near shot with a shotgun! the pellets might hae entered in a common wound and later dispersed while inside the body and

making separate wounds of e*it.

Ins$ances /,en $,e num.er o' GS+ o' en$rance is more $,an $,e num.er o' GS+ o' e&i$ in $,e .od0 o' $,e 1ic$im:3. when one or more of the bullet is not through and through and the bullet is lodged in the body.$.when all of the bullets produce through and through wounds but one or more made an e*it in the natural orifices of the body.5. when different shots produced different wounds of entrance but two or more shots produced a common e*it wound.

Ins$ances /,en $,ere is no GS+ o' e&i$ .u$ $,e .ulle$ is no$ 'ound in $,e .od0 o' $,e 1ic$im:3. when the bullet is lodged in the ;#T and e*pelled through the bowel or lodged in the pharyn* and e*pelled through the mouth.$. near fire with a blank cartridge produced a wound of entrance but no slug may be recoered.5. the bullet may enter the wound of entrance and upon hitting the bone the course is deflected to hae the wound of entrance as

the wound of e*it.An$emor$em GS+ hemorrhage! swelling! ital reaction. - microscopically: congestion and leucocytic infiltration.

ro.lems con'ron$ing Forensic ,0sician in $,e iden$i'ica$ion o' GS+:3. alteration of the lesion due to natural process:drying of wound! infn! healing proc..$. medical and surgical interention: refer to clinical record of patient5. embalming6. problems inherent to the injury itself.7. *-ray e*am migratory! e*ternal souenirs

T,e e''ec$s o' $,e clo$,ing on $,e mo1emen$ o' $,e .ulle$ depend on:3. number of layers of fabric between the mu""le and subjacent skin$. nature of the fabricP closely woen5. mu""le- clothing distance

E&amina$ion o' $,e e&$ernal /earing apparel o' $,e 1ic$im o' GS+ ma0 .e signi'ican$ in in1es$iga$ion .ecause:3. it may establish the possible range of the fire: a.contact fire tear in the clothing coering the skin! fibers turn outward away from body soot deposit! gunpowder tattooing! burning of fibers around the turned fiber mu""le imprint dirt and greasy deposit may be wipe out and isible in the torn clothing

b.not contact but near shot same with Ia+ e*cept for absence of mu""le imprint and beyond flame range

c. far fire there is a hole tear with inward direction of the thread

$. it may be useful in the determination as to which is the point of entry and of e*it of the bullet. /ntry- the fiber are inerted.5. it may be useful in locating the bulletSpecial considera$ion on .ulle$s

3. souenir bullet$. bullet migration5. tandem bullet

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E*IDENCES S"O+ING T"AT T"E G!NS"OT +O!NDS MA# )E S!ICIDAL3. shot fired in a closed locked room! or open uninhabited place.$. death open near the place ictim was found5. shot fired with the mu""le of the gun in contact with the part of body inoled6. location of entrance wound accessible part of body7. shot usually solitary=. direction of fire is compatible with the trajectory of bulletG. personal history may reeal social! economic! business or marital problem which cannot be sole.&. gunpowder presence in the hand of the ictim%. entrance wound usually does not contain clothing3'. fingerprints of ictim on the butt33. suicide note at the icinity3$. no disturbance in the place of death

Russian roule$$e unfortunate ictim has no predetermined desire of self-destructionE*IDENCES T"AT GS+ IS "OMICIDAL

3. site of wound of entrance has no point of election$. fire is made when the ictim is at some distance5. signs of struggle or defense wounds6. disturbance in the surroundings7. wounding firearm usually not found in the scene of the crime

=. testimony of witnessE*IDENCES TO S"O+ T"AT GS+ IS ACCIDENTAL

3. usually one shot$. no special area of body inoled5. consideration on the testimony of the assailant and determination as to whether it is possible by knowing the relatie

position of the ictim6. testimony of the witness

OINTS TO )E CONSIDERED AND INCL!DED IN T"E REORT OF T"E "#SICIAN3. complete description of the wound of entrance and e*it$. location of the woundP part of body inoled! distance of wound from midline! distance of wound from heel or buttock.5. direction and length of the bullet track

6. organs or tissues inoled in its course7. location of the missile! if lodged in the body=. diagram. ECTED TO ANS+ER IN CO!RTK3. )9>L 29>@ T8/ 29>@ (/ #@EL#)T/ (J T8/ 2/ALJDG. # #T 1J 2A >TA#@/D

&. 28/1/ 2A T8/


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Capaci$0 o' a 1ic$im $o per'orm 1oli$ional ac$s depends upon the area of the body inoled! inolement of ital organs and theresistance of the ictim.

DETERMINATION AS TO T"E LENGT" OF TIME A FIREARM "AD )EEN FIRED3. odor of the gas inside the barrel$. chemical changes inside the barrel5. eidences that may be deduced from the wound

DETERMINING +"ET"ER T"E +O!NDING +EAON IS AN A!TOMATIC ISTOL OR A RE*OL*ER3. location of the empty shells reoler the empty shells are found in the cylindrical maga"ine chamber after the fire$. nature of the spent shell automatic firearm bullet is copper jacketed5. nature of the base of the cartridge or spent shell base of a reoler has a wider diameter than that of the cylindrical body to

keep the cartridge stay in the maga"ine chamber.

#t may be possible for a person who is accustomed to the sounds of firearms of different calibers to identify the firearm by the soundproduced.

#t is not possible to determine the direction of the shot by determining the direction of the sound e*cept when the flash or the personfiring the shot is seen at the time the shot was fired.

GS+ ma0 no$ .e a near 'ire or ma0 no$ appear $o .e near 'ire:3. when a deice is set up to hold the firearm and to enable it to be discharged at a long range by the ictim.$. when the ;2 of entrance does not show characteristics of a near shot bec the clothing are interposed bet. the ictim C the firea5. when the e*amining physician failed to distinguish between a near or far shot wound6. when the product of a near shot has been washed out of the wound.

>(ra03. facilitate the location and e*traction of the wound$. reeals fragmentation and its location5. shows bone inolement like fracture6. reeal trajectory of the bullet7. shows effect of the bullet wound! like hemorrhage! escape of air! laceration

S"OTG!N +O!NDS#s a shoulder fired firearm haing a barrel that is smooth-bored and is intended for the firing of a changed compound of one or moreballs or pellets.

Measure $,e dis$ance .e$/een $,e $/o 'ar$,es$ s,o$7pelle$s8 in inc,es and su.$rac$ one% $,e num.er o.$ained /ill gi1e $,emu--le($arge$ dis$ance in 0ards2

De$ermina$ion o' $,e presence o' gunpo/der and primer componen$s:Impor$ance:3. etermination of the distance of the gun mu""le from the ictims body when fired. >sually not more than $6 inches when fired.$. etermining whether a person has fired a firearm. dorsum of the hand

metallic residues! burning and unburned gunpowder in suicide found in the palm

rocedures in de$ermining $,e presence o' gunpo/der:3. ;ross e*amination use of hand lens Eine black powder not conclusie$. 0icroscopic e*amination5. )hemical test:Tes$s 'or $,e resence o' o/der residues

1. 9n the skin orsum of the hand or 2ound of entrance Dermal ni$ra$e $es$ 7 ara''in $es$% Dip,en0lamine $es$% Lung


46/59

small particles with nitrate or nitrite B blue reaction not conclusie: fertili"ers! cosmetics! cigarettes! urine

@egatie is not conclusie: thorough washing $. 9n clothings +al=er(ra0 anal0-er

T"ERMAL INH!RIES OR DEAT"S

- are those caused by deiation from normal temperature! capable of producing cellular or tissue changes in the body.- /*posure to seere cold Erost bite- e*posure to high temperature burning scalding

92 DEAT" OR INH!R# FROM COLD - not common in the


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b.$ (urns Thermal )hemical /lectrical! lightning

1adiationGENERAL OR S#STEMIC EFFECT: dea$, usuall0 acciden$al92 "ea$ cramps7 Miner@A1J 9E @910AL @ot clear istinct

7. #@S>1J eere Limited=. )L9T8#@; #noled @ot burned

roo's $,a$ $,e 1ic$im /as ALI*E )EFORE .urned $o DEAT":3. 0/@


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Di''eren$ial diagnosis o' .lis$ers:3. ue to putrefaction fluid content is blood stained watery fluidP asso. with putrefactie changes in other parts of body.$. ue to disease - heat by the si"e! distribution5. ue to friction - 8* of application of heat

2 C,emical .urns)haracteristics of lesions:

a. Absence of esicationb. taining of the skin or clothing by the chemicalc. lceratie patches of the skine. #nflammatory redness of the skin surfacef. elayed healing

C"EMICAL )!RNS T"ERMAL )!RNS3. (L#T/1 Absent (TA@)/ hows chemical cause of corrosion Absent6. L/#9@ (orders are distinct iffused

C,arac$eris$ic lesions .0 di''eren$ c,emicals:a2 Sulp,uric acid 7 Oil o' *i$riol8 most intense action! considerable destruction ulcerations where acid flowed! clothings destroyed

blackish-brown sloughs.2 Ni$ric acid )lothing is destroyed! brown yellow or yellowish brown sloughc2 "0drocloric acid not so destructie intense irritation! locali"ed ulceration red or reddish-gray.d2 Caus$ic soda and o$as,

)orrosie action on the tissues with bleached appearance

;2 Elec$rical .urns )ontact burns! spark burns! Elash burns42 Radia$ion .urns *-ray! >F light burns

"#SICAL INH!RIES OR DEAT" )# LIG"TNING AND ELECTRICIT#Lig,$ning is an electrical charge from the atmosphere. - 3 million olts, $''' amperesElemen$s o' lig,$ning $,a$ produces injur0:

3. irect effect from the electrical charge.$. urface flash burns from the discharge - electrical into heat energy.5. 0echanical effect e*pansion of air B laceration

6. )ompression effect 4sledgehammer blow?

pasmodic contraction of cerebral essels B shockElec$rici$0 - main cause of death is shock - Aboe 5'' olts are like the effect of lightning!

Fac$ors /,ic, in'luence $,e e''ec$ o' elec$rical s,oc=:3.


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6. leep increases resistance7. Amperage or intensity of the electrical current principal factor

G'-&' in A) and $7' in ).=. 1esistance of the bodyG. @ature of current A) is more dangerous&. /arthing- shock is enhanced%. uration of contact3'.


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Eailure of arterial blood to be normally saturated with 9$ due to:a+ (reathing in an atmosphere with insufficient 9$- 8igh altitudeb+ /*ternal obstruction of the air passage traumatic crush asphy*iac+ IA )# STRANG!LATION Tightened by force not the weight

"ANGING STRANG!LATION +IT" LIGAT!RE3.8J9# (9@/ Ereuently injured Ereuently spared

50


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$.#1/)T#9@ 9E L#;AT>1/ 0A1K: #nerted F-shape >sually hori"ontal5. L#;AT>1/ L9)AT#9@ At leel of 8yoid bone (elow laryn*6. L#;AT>1/ ;199F/ eepest opposite the knot >niform depth7. F/1T/(1AL #@S>1J Ereuently obsered @ot obsered

Manual s$rangula$ion or $,ro$$ling:- form of asphy*ial death where the constricting force is the hand.

C2 AS"#>IA )# S!FFOCATION- 9cclusion of air fr. the lungs by closure of air openings, obstruction of the air passageway fr. the e*ternal openings to the air s

Smo$,ering: A form of asphy*ial death caused by closing the e*ternal respiratory orifices.O1erla0ing most common in children : pressure of pillows

Gagging application of materials to preent air to hae access to mouth and nostrils.las$ic .ag su''oca$ionC,o=ing(Eorm of suffocation by the impaction of E.(. in the respiratory passage.

D2 AS"#>IA )# S!)MERSION OR DRO+INING- Eorm of asphy*ia where the nostrils and mouth has submerged in watery fluid.

Time reuired 'or dea$, in dro/ning:- ubmersion for 3 minutes considered fatal.- Aerage time reuired for death in drowning is $ to 7 minutes.

Emergenc0 $rea$men$ in Dro/ning3. chaefers methodEace down! prone position:operator e*erts pressure in ribs$. ylesters method- Lying on his back! astride oer body! swinging arms

os$(mor$em 'indings:92 E&$ernal 'indings a+ 2et clothes! pale face! E.(. clinging on skin surface b+ 4)utis anserine? or 4goose flesh? skin is pale ! contracted @9T *tic

c+ 2asherwomans hands and feet skin of hands C feet:bleached @9T *ticd+


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Ge$$lerIA )# )REAT"ING IIRESIRA)LE GASES92 Car.on mono&ide silen$ =iller%colorless! insoluble in water and alcohol. - formed by the incomplete combustion of carbon fuel. -0ain action is 9$ depriation

uali$a$i1e $es$ 'or CO in $,e .looda+ Kunkels test 6 olume of water V 5* its olume of 3O tannic acid

- crimson red if positieb+


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The inhalation of pure )9$ may cause immediate agal inhibition with spasm of the glottis and death. manhole! poorlyentilated rooms

Tes$s 'or $,e presence o' CO33. (arium nitrate white precipitate of (arium carbonate with carbonic acid$. siler nitrate white ppt. of siler carbonate when carbonic acid is added.

2 "0drogen sul'ide 7 "3S% Sulp,ure$$ed ,0drogen 8 ro$$en egg odor - Eormed during decomposition process of organic substances containing sulphur - )auses titanic conulsion! delirium! coma! death

;2 "0drogen c0anide one of the most to*ic! rapid acting gas - Eormed by the addition of acid to potassium or sodium salt of cyanide - Eound in plantsP leaes of cherry laurel! bitter almond! kernels of common cherry! plum! peaches! ordinary bamboo shoots!

certain oil seed and beans- )ontains AM#GDALINwhich in the presence of water and natural eny"me

EM!LSINis readily decomposed to "#DROC#ANIC ACID% glucose and .en-alde,0de2 ='-%' mg of 8ydrogen cyanide is fatal! death in $ to 3' min.

42 Sul'ur dio&ide ( 8eaier than air! pungent odor

- employed as disinfectant! bleaching agent!- found in eruption of olcano

+AR GASESClassi'ica$ion .ased on $,e p,0siological ac$ion92 Lacrima$or or Tear gas Bcauses irritation with copious flow of tears a+ )hloracetphene I).A.


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6. isease7. )hemical factor)2 EN*IRONMENTAL FACTOR-


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7. .A.-#njuries to genetalia! peri-rectal! peri-aginal=. @eglect: 0alnutrition! poor hygiene! infection! poor growth,deelopment

Social reac$ion $o $,e C,ild a.use and Neglec$:3. 1eport of 0altreated or abused child within 6& 8

- Ereedom from liability of the reporting person or institution$. The court may deprie parents of their authority oer the child or adopt other measures for the welfare of the child.5. /stablishment of public and priate welfare institutions for the care of abused! neglected! abandoned! infirmed! or other

conditions which reuire aid! support or treatment.6. Abuse! neglect or abandonment of children is made a criminal act or omission.

MEDICO(LEGAL ASECTS OF SE> CRIMES*irgini$0 Bis a condition of a female who has not e*perienced se*ual intercourse And whose genetalia hae not been altered by

carnal connection*ir$uous 'emale(if her body is pure and if she ha neer had any se*ual intercourse with another! though her mind and heart is

impure.A woman is presumed to be irgin if she is unmarried and o' good repu$a$ion.De'lora$ion Bis the laceration of the hymen as a result of se*ual intercourse.

Dura$ion o' lacera$ion:

3. Eresh bleeding laceration- recent origin$. Eresh healing with fibrin formation and with edema of the surrounding tissue After $685. 8ealed laceration with congested edges and with sharp coaptible borders 6 to 3' days.6. 8ealed laceration with sharp coaptible borders without congestion 3' days or $ to 5 weeks.7. 8ealed laceration with rounded non-coaptible borders and retraction of edges B a month

Rape: )0 ,a1ing carnal =no/ledge:3. (y using force or intimidation- manifested and tenacious resistance$. eprie of reason! unconscious- insane! under alcohol! drugs5. >nder 3$ y.o.- tatutory rape! een if prosti! or with consent

een if the woman is inchaste.

Carnal =no/ledge is the act of a man in haing se*ual bodily connection with a woman.! een with slightest penetration. absence of sperms does not negate the commission of the crime of rape.T,e 'ollo/ing specimens ma0 .e e&amine 'or seminal 'luid and sperms:

3. 2earing apparel of the ictim and the alleged accused$. Faginal smear from the ictim5. tains on the body of the ictim and of the accused6. tains found at the site of the commission of the offense.

Examination for seminal fluid and sperms3. ;ross e*aminations$. 0icro-chemical e*aminations

a+ Elorence testb+ (erberios test specific of spermatic fluidc+


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a.3 The accused was laboring under such defect of reason or from a disease of the mind as not to know the nature anduality of the act he was doing. 9r

a.$ #f he did know! he did not know what he was doing was wrong.

b+ Irresis$i.le Impulse Rule A person is considered insane when mental disease has rendered him incapable ofrestraining himself! although he understands what he is doing and knows it is wrong.

c+ Dur,amrk teste. )ocaine )obalt Thiocyante test

ALCO"OLISME$,0l alco,ol /thanol or grain alcohol fermentation of arious )89 in grains! fruits or flowers

- >sed as solents! antiseptic! beerageAlco,olic .e1erages 0i*ture of water and ethyl alcohol

Congeners : substances simultaneously produced during fermentation.

: odor of alcohol

Drun=ard A person who habitually uses any into*icating alcoholic liuor."a.i$ual drun=ard 9ne who e*cessiely uses into*icating drink.

ro1isions o' La/ regarding alco,olism:

57


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3. #@T9Q#)AT#9@ # A@ ALT/1@AT#F/ )#1)>0TA@)/ T9 )1#0#@AL L#A(#L#TJ Art. 37! 11/ 9E L#N>91 2#T89>T L#)/@/ # FAL#.7. T8/ TAT/ 0AJ


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3. eere head injuries$. 0etabolic disorders! iab.

LEGAL MED LECTURE.doc

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