Legal Medicine Lecture
Legal Medicine Lecture
Legal Medicine Lecture
CONSIDERATION
GENERAL
II.
USE OF DRUGS THAT INHIBIT THE
INHIBITOR
- Not admissible in court
A. Administration of truth serum
- Hyocine hydrobromide given
hypodermically until state of delirium which the
subject feels a compulsion to answer the
question truthfully.
B. Narcoanalysis or Narcosynthesis
- Sodium amytal or sodium penthotal
C. Intoxication with alcohol - In wine there is
truth
III.
HYPNOSIS
- alteration of consciousness, not all
subjects can be hypnotized
IV.
OBSERVATION
Physiological and psychological signs and
symptoms of guilt:
a) Sweating, color change
b) Dryness of the mouth
c) Excessive activity of adams apple
d) Fidgetting
e) Peculiar feeling inside
f) Swearing, spotless past record
g) Inability to look at the investigator
V.
INTERROGATION
- emotional appeal, mutt and jeff technique
VI.
CONFESSION
- expressed acknowledgement of his guilt.
TOKYO DECLARATION
- contains guidelines to be observed by
physician concerning torture, inhuman and
degrading punishment.
MEDICO-LEGAL ASPECTS OF
IDENTIFICATION
- determination of the individuality of a person
Importance of identifying a person:
1. In the prosecution of a crime, the identity of
the offender and victim.
2. Settlement of estates, retirement, insurance
3. Resolves anxiety of nest of kin.
4. In some transactions sales, release of dead
body
Rules in personal identification:
1. Law of multiplicity of evidence in
identification greater number of similarities
2. Value of different points of identification
fingerprints , moles
Visual recognition of relatives lesser value
than fingerprints/dental
3.The longer interval between death the more
experts are needed in establishing the identity.
4.The team to act in shortest time because it is
perishable.
5. No rigid rule in the procedure of identification
of the person.
Methods of identification:
1. By comparison Id found in the crime
scene compared with the file.
2. By exclusion
IDENTIFICATION OF PERSONS
A. Ordinary methods of identification
1. Characteristics which may easily be
changed:
a) growth of hair, beard
d)
grade of profession
b) clothing
e)
body ornamentations
c) frequent place of visit
2. Characteristics that may not be easily be
changed:
a) mental memory
f)
hands and feet
b) speech
g)
complexion
c) gait
h)
changes in the eyes
d) mannerism
i)
facies
e) handedness-left /right
j)
degree of nutrition
Points of identification applicable to both
living and dead before onset of
Decomposition:
1. Occupational marks painters have
stains
2. Race: Malay:brown, flat nose round
face, Round head, Wearing apparel
3. Stature: Tips of middle fingers of both
hands extended laterally
4. Tatoo marks
5. Weight not good point changes
from time to time
6. Deformities,
injuries leaving
permanent deformities
7. Birth marks
moles,
scar
Age of Scar:
Recently formed: Slightly elevated,
reddish/bluish, tender to touch
Few week-2 months: Inflammatory
redness, soft, sensitive
2 6 months: brownish, free from
contraction, soft
> 6 months: white, glistening,
contracted, tough
Scar formation is delayed by: sepsis,
age, depth of wound, mobility
May not develop mall, superficial,
healed by first intention.
8. Tribal marks, Sexual organs, blood exam
ANTHROPOMETRY ( BERTILLON SYSTEM)
Alphonse Bertillon
7) Body of pubis
Wider
8) Iliopectineal line
Rounded
9) Obturator foramen
triangular
10) Sacrum
narrow
Long and wide
CRANIUM
MALE
1) Shaft
Narrow
Narrow
Sharp
Egg-shaped
Short and
FEMALE
less curve
more curve
2) Mastoid process
larger
smaller
3) cranium placed horizontally rest on
mastoid process
occipital&
maxillary bones
4) Styloid process
shorter
longer/slender
5) Forehead
higher, more
oblique
less high,
more vertical
6) Superciliary ridges
less sharp,
more rounded
sharper
7) Zygomatic arches
more
prominent
less prominent
8) Lower jaw
larger &
wider
narrower
and lighter
9) Face
larger in
proportion to cranium
smaller
Determination of the duration of interment:
- All soft tissues in a grave disappear within one
year.
Basis of the estimate fro duration of interment:
1) Presence or absence of soft tissue
adherent to the bones.
2) Firmness and weight, brittleness, dryness
of the bones.
3) Degree of erosion of the surface of the
bones.
4) Changes in the clothings, coffin, and
painting.
5. IDENTIFICATION OF SEX
Test to determine the sex:
1. Social test
2. Genital test
3. Gonadal test
4. Chromosomal test barr cells in females
Evidences of sex:
1. Presumptive evidence
= General features, hair in some parts
thin scales
RIGOR MORTIS
CADAVERIC SPASM
1. Time of appearance
death
2. Muscles involved
3. Occurrence
4. Medico-legal signif.
death
death
Approximates time of
Determine nature of
RIGOR MORTIS
MUSCLE CONTRACTION
1. Contracted muscle
Losses transparency
More or less transparent
2. Elasticity
Loss elasticity
Very elastic
3. Litmus reaction
Acidic
Neutral or sl. alkaline
4. Contraction
Absolute flaccidity
Possess inherent
contraction
2. CHANGES IN THE BLOOD
a) Coagulation of blood
= blood may remains fluid inside the blood
vessels 6-8H after death.
ANTE-MORTEM CLOT
POST-MORTEM CLOT
1. Consistency
Firm
Soft
2. Surface of blood vessels
Raw after clots are
removed
Smooth, health after
3. Clots
Homogenous;
cant be stripped
Can be stripped off in
layers
b) Post-mortem Lividity or Cadaveric Lividity ,
or Post-mortem Suggilation or Post-mortem
Hypostasis or Livor Mortis
= Stoppage of heart action and loss of tone
of b.v. accumulates in dependent areas except
in bony areas.
= capillaries coalesce > purplish in color
called Post-mortem lividity.
= Hasten by death due to cholera, uremia,
Typhus fever
= appears 3 6 H after death and fully
developed 12 H after death.
Physical characteristics of Post-mortem
Cadaveric Lividity
1. Occurs in the most dependent areas.
2. Involves the superficial layer of the skin
3. Does not appear elevated from the rest
of the skin.
4. Color is uniform.
5. No injury of the skin
Kinds of Post-mortem Cadaveric Lividity
1. Hypostatic lividity
2. Diffusion lividity
Importance of Cadaveric lividity:
1. One of the signs of death.
difference
6.
Color variegated
Uniform color
Internal hypostasis in Visceral organs:
1. Lungs
2. Loops of intestine
3. Brain
POST-MORTEM
LIVIDITY OF ORGANS
SIMPLE
CONGESTION
1. Post-mortem staining in organs Irregular,
most dependent parts
Uniform, all organs
2. Mucous membrane
Dull,lusterless
Not in congestion
3. Inflammatory exudate
Not seen
Not seen
Other changes in the blood
1. Hydrogen ion concentration acid pH CO2,
L.A., After 24H alkaline ammonia.
2. Breakdown of liver glycogen leads to
accumulation of dextrose in the IVC and the
right side of the heart.
3. Rise in NPN and Free A.A.
4. Chemical:
= chloride in the plasma/RBC decrease
due to extravascular diffusion, in 72 H only of
its content.
= Mg increases due to diffusion from
without.
= K increases due to diffusion from the
vascular endothelium.
3. AUTOLYTIC OR AUTODIGESTIVE
CHANGES AFTER DEATH
- After death, proteolytic, glycolytic&lipolytic
ferments of the glandular tissues continue to act
w/c lead to the autodigestn of organs.
4. PUTREFACTION OF THEBODY
- Is the breaking down of complex proteins into
simpler components associated with the
evolution of foul smelling gasses and
accompanied by the change of color of the
body.
Tissue changes in putrefaction:
1. Changes in the color of the tissue
Hemolysis of blood within blood vessels >
Hgb diffuses through the walls
Reddish-brown in color
In the tissues > Hgb
undergo chemical change
Greenish-yellow 1st seen at R Iliac fossa
MARBOLIZATION prominence of the
superficial veins with reddish discoloration
which develops on both flanks of the
abdomen, neck, and
shoulder
= look like marbled
reticule of branching veins.
2. Evolution of gasses in the tissues
CO2, ammonia, H2, Suphurated hydrogen,
methane= offensive odor
Effects of pressure of gasses of putrefaction:
a) displacement of the blood
bleeding in open wounds
b) bloating of the body
c) fluid coming out from nostrils,
mouth
d) extrusion of the fetus in a gravid
uterus
e) floating of the body
14-20 DAYS
body, maggots
2-5 MONTHS
orbits empty
IN TROPICAL REGION
12 HOURS
Rigor mortis all over, hypostasis,
greenish-discoloration caecum
24 HOURS
Rigor mortis absent all over,
abdominal distention
48 H
Ova of flies, trunk bloated, face
discolored
72 H
Whole body grossly swollen,
hairs and nails loose
ONE WEEK
Soft viscera putrefied
TWO WEEKS Soft tissues largely gone
ONE MONTH Body skeletonized
BEEN SUBMERGED IN WATER
FIRST 4 OR 5 DAYS Cold water little change, in
rigor mortis
FROM 5 7 DAYS
Skin on hands, feet is
bleached, face faded white
1 2 WEEKS
Face swollen and red, skin
of hands and feet wrinkled
4 WEEKS
Skin wrinkled, nail intact
6 8 WEEKS
Abdomen distended, skin of
hands/ feet come off with nails
Factors influencing the floating of the body
in water:
1. age fully developed, well nourished rapid
2. sex females floats sooner
3. conditions of the body obese float
quicker
4. season of the year moist hot air
putrefaction floats due to gas
5. water- shallow and stagnant water of
creeks, higher specific gravity
- sea water floats sooner than fresh
water, higher specific gravity
6. external influence heavy-wearing
apparel - slower
**Only teeth, bones and hair remain for an
indefinite time.
**Flat bones disintegrates faster than round
bones.
SPECIAL MODIFICATION OF PUTREFACTION
1. Mummification
= is the dehydration of the whole body which
results in the shivering and preservation of the
body.
= usually occurs when buries in a hot, dry
with free access of hot air
2. Saponification or Adipocere fromation
= a condition where the fatty tissues of the
body are transformed to soft brownish-white
substance known as ADIPOCERE at SQ level.
3. Maceration
= softening of the tissues when in fluid
medium in the absence of putrefactive mircroorg, seen in death in utero
reddish or greenish color, skin peeling off
and arms flaccid and frail.
HOW LONG A PERSON HAS BEEN DEAD?
DURATION OF DEATH
1. Presence of rigor mortis : 2-3 hours after
death
12 H fully
developed
18-36 H disappears
concomitant with putrefaction
2. Presnce of Post-mortem lividity
3-6 H after death
appears as small
petechia-like red spots
3. Onset of decomposition
24-48 H after
death
manifested watery.
foul smelling froth, mouth, nostrils
4. Stage of decomposition
5. Entomology of the cadaver 24 H before
eggs are hatched, maggots
6. Stage of digestion
empty
- 3-4 H gastric
10
PATHOLOGICAL AUTOPSY
MEDICO-LEGAL AUTOPSY
1. Requirement
2. Confirmation
criminal act
3. Emphasis
findings
4. Conclusion
findings
5. Minor
11
12
13
SPECIAL DEATHS
1.
Judicial deaths Art. III Sec.1 Par. 19
Phil. Const. cruel and unusual
punishment shall not be
inflicted. ; electrocution, hanging,
musketry, gas chamber.
2.
Euthanasia or mercy killing
3.
Suicide
Automatism - due to drug may be
considered as accidental rather than
suicidal.
Evidences that will infer death is suicidal:
1. History of depression, mental disease.
2. Previous attempt
3. Injuries are located in areas accessible to
hand.
4. Effects of the act of self-destruction may
be found in the victim;, empty bottle
5. Presence of suicidal note.
6. Secluded, not in public view.
7. Evidences which rule out H,M, P
4.
14
15
16
MV2
Kinetic energy = __________
2
17
18
19
>
Contusion
=A bruise appears at the seat of and
surrounding the injury. This may or may not be
a dependent part.
Post-mortem hypostasis
=Always in a part which for the time of
information is dependent.
Contusion
=Often elevated because elevated blood and
subsequent inflammation swell the tissues.
Post-mortem hypostasis
=Not elevated, because either the blood is still
in the vessels or at most has simply soaked into
and stained the tissues.
Contusion
=Incision shows blood outside the vessels.This
is the most certain test of difference& can be
observed even in very small bruises.
Post-mortem hypostasis
=Incision shows the blood is still in its vessels&
if any oozing occurs, drops can be seen issuing
from the cut mouths of the vessels.
Contusion
=Color variegated. This is only true of bruises
that are the same days old d/t the changes in
the hemoglobin produced during life.
Post-mortem hypostasis
=Color is uniform. The well known change in
color produced in blood Extravasated Into living
tissues does not occur in dead tissues with the
same regularity.
Contusion
=If the body happens to be constricted at or
supported on a bruised place, the actual surface
of contact may be a little lighter than the rest of
the bruise but will not be white.
Post-mortem hypostasis
=In a place which would otherwise be the seat
of hypostasis pressure of any kind even simple
support is sufficient to obliterate the lumen of
the venules and capillaries and so to prevent
their filling with blood. White lines or patches of
pressure bordered by the dark color of
hypostasis are produced and marks of floggings,
strangulation, etc. are thus sometimes
simulated.
FACTORS INFLUENCING THE DEGREE AND
EXTENT OF CONTUSSION
1.General condition of the patient.
2.Part of the body affected. Fatty tissues,
bloody parts > contused easily
Fibrous areas,
muscle
> less
3. Amount of force applied The greater the
force, the more effusion of blood.
4. Disease Contusion may develop with or
without application of force.
20
21
22
ANTEMORTEM ABRASION
POSTMORTEM ABRASION
COLOR
reddish-bronze due to slight
exudation of blood
yellowish and
transparent
LOCATION
any area
over bony prominence rough handling of the
cadaver
VITAL
with intravital reaction
shows not vital reaction and
REACTION
may show remains of damaged
Epithelium
characterized by a
separation of the epidermis from
Complete loss of the former.
b. Incised wound ( cut, slash, slice)
produced by a sharp-edged ( cutting)
or sharp-linear edge of the instrument like a
knife, razor, bolo, glass etc.
= Impact cut > when there is forcible contact
of the cutting instrument with the body surface.
= Slice cut > when cutting injury is due to the
pressure accompanied with movement of the
instrument
= Chopped or Hacked wound > when the
wounding instrument is a heavy cutting
instrument like saber, injury is severe
Characteristics of incised wound:
1. Edges are clean cut.
2. The wound is straight
3. Usually the wound is shallow near the
extremities and deep at the middle
portion.
4. Profuse hemorrhage because of the
clean cut on the vessels.
5. Gaping is usually present due to the
retraction of the edges.
6. Clothes will also show a clean cut if cut
by the instrument.
7. Faster healing if without complications.
8. Incised wound made by broken glasses
maybe irregular, needs to be removed.
Changes that occur in an incised
wound:
1. After 12 hours edges are swollen,
adherent with blood and with leukocyte
infiltration.
2. After 24 hours proliferation of the
vascular endothelium and connective
tissue cells.
3. After 36 to 48 hours capillary network
complete, fibroblasts running at right
angles to the vessels.
4. After 3 to 5 days vessels show
thickening and obliteration.
Why a person suffers from incised
wound:
1. As a therapeutic procedure.
2. As a consequence of self-defense
23
24
25
LACERATED
WOUNDS
edges are roughly cut,
irregular, ill-defined
swelling and
contusion around the
lacerated wounds
extremities are illdefined and irregular
hair bulbs are
preserved
healing is delayed
caused by a blunt
instrument
26
GAPING OF WOUND
- Separation of the edges especially in deep
wound may be due to the following:
1. mechanical stretching or dilatation
- the presence of a mechanical device on
the edges to prevent coaptation will
cause separation. Example: drain in an
abscess, retractor during operation.
2. loss of tissue due to:
a. Destruction due to pressure, inftion, cell
lysis, burning, chemical reaction.
b. Avulsion 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
exit of GSW and
removal of necrotic
materials.
3. retraction of the edges
- underneath the skin are dense networks
of fibrous and elastic connective tissue
fibers running on the same direction and
forming a pattern more or less present in
all persons.
- This pattern of fiber arrangement is
called cleavage direction or lines of
cleavage of the skin and their linear
representation on the skin is called
Langers line.
Practical ways of determining how much of
the skin surface is involved in an injury or
disease:
- skin functions as a mechanical protection of
the body, storage of water.
- Determination of how much skin is involved is
important in the mode of treatment and
prognosis especially in burns, contusion..
= burns of 70% in children and older age
group are fatal.
= rule of nine is used.
Head and
neck
9%
9%
one upper
extremity
9%
18%
front chest and
abdomen
18%
18%
posterior chest
and abdo
18%
18%
one lower
extremity front
9%
18%
one lower
ext(back)
9%
18%
pudendum
1%
1%
27
28
c. degree of rest or
immobilization
d. nature of the injury
2. Aberrated healing process:
a. formation of exuberant
granulation or proud flesh
b. keloid formation
c. stricture
d. fistula or sinus formation
MEDICO-LEGAL INVESTIGATION OF
WOUNDS
Rule to follow by a physician:
1. all injuries must be described
2. description of wound must be
comprehensive, sketch/photograph
3. examination must be influenced be any
other information obtained from others in
making a report or a conclusion.
- determination
- determination
produce permanent deformity
- determination
produces shock
- determination
produces complications
if injury is fatal
if injury will
if wound
if wound
29
WOUNDS
ANTE-MORTEM
POST-MORTEM WOUNDS
HEMORRHAGE:
-More profuse, arterial due
to loss of tone of vessels,
Slight or none,
venous
Absence of heart action;
Post-mortem clotting of
blood inside b.v.
-Marks of spouting of blood
from arteries
No spouting of blood
-Clotted blood
Bld not clotted,or soft clot
SIGNS OF INFLAMMN:
Inflammation &
reparative process; Swelling in the area, None
Effusion of lymph, pus;
Adhesion of the edges
Unless if victim is weakened
SIGNS OF REPAIR: Fibrin formation; growth of
epithelium; Scab/ scar formn
No time of
repair
RETRACTION OF THE
Deep staining of
the edges and cellular tissues
Not
deeply stained
EDGES OF THE WOUND
w/c is not removed
by washing
can be removed by washing
Edges gape owing to the
reaction of the skin and Edges do not gape, but
are closely
muscle fibers
approximated to each
other unless if the wound is 1 to 2 hrs after
death
DETERMINATIONS IF WOUND IS:
HOMICIDAL
SUICIDAL
ACCIDENTAL
ABRASIONS
If
Commonly observed
Commonly observed
Frequent but rarely
of
WOUNDS
surroundings
30
31
32
EXIT WOUND
Always bigger than
the missile
Edges are everted
Does not manifest
any definite shape
Absent
Absent
Underlying tissues
may be seen
Protruding from
the wound
May be absent, if
missile is lodged in
the body
Negative
b. particle of gunpowder
2. examination of the internal injuries caused by
the bullet
a.
bone fragments, cartilage, soft
tissues are driven away from
entrance wound
b.
destruction of the bone is oval, with
sharp edges at the exit it is
irregular, bigger and bevelled
c. testimony of witness
Determination of the trajectory of the
bullet inside the body of the victim
1. external examination
a. shape of wound of entrance
= when bullet is fired at right angle with
the skin> the wound of entrance is circular
except in case of near fire.
= if fired at another angle , it is oval
= when the bullet is deformed no such
characteristics findings will be observed.
b. shape and distribution of the contusion
collar
33
1.
ODD AND EVEN RULE IN GSW
= If the number of entrance and exit wound is
even so presumption that no bullet is lodge in
the body.
= verified by x-ray
How to determine the number of fires
made by the offender:
1.
determination of the number of spent
shells
2.
determination of entrance wounds in the
body of the victim number of entrance
wounds may not show the exact number
of fire:
a.
not all fire made may hit the body of the
victim
b.
the bullet may in the course of its flight
hit a hard object thereby splitting it & each
fragment may produce separate wounds of
entrance.
c.Bullet may have perforated a part of the
body and then made another
wound in some other parts of the
body
3. number of shots heard by the witness
Instances when the number of GSW of
entrance is less than the number of GSW
of exit in the body of the victim:
1.
a bullet might have entered the body but
split into several fragments, each of which
made separate exit.
2.
one of the bullets might have entered a
natural orifice of the body. Ex. nose
3.
there might be two or more bullets which
entered the body through a common entrance
and later making individual exit wounds
4.
in near shot with a shotgun, the pellets
might have entered in a common wound and
later dispersed while inside the body and
making separate wounds of exit.
Instances when the number of GSW of
entrance is more than the number of GSW
of exit in the body of the victim:
1. when one or more of the bullet is not through
and through and the bullet is lodged in the
body.
2.when all of the bullets produce through and
through wounds but one or more made an exit
in the natural orifices of the body.
3. when different shots produced different
wounds of entrance but two or more shots
produced a common exit wound.
Instances when there is no GSW of exit but
the bullet is not found in the body of the
victim:
34
35
36
Effects of COLD:
A. Local effect ( Frostbite, Immersion
foot, Trench foot )
1st Blanching , paleness of the skin due
to vascular spasm.
2nd Erthyma, edema, swelling due to
vascular dilatation, paralysis and
increased capillary permeability.
3rd - Blister formation
4th Necrosis, vascular occlusion,
thrombosis and gangrene.
Microscopically: Vacuolization,
degeneration of epidermal cells
: Necrosis of the collage of
the SQ tissue
: Occlusion of the vessels
due to clumping of RBC
B. Systemic effects:
- Reflex in nature due to the stimulation
and paralysis of the nerves
- Pulmonary ,Cardiac action is slowed down
due to cerebral anoxia> resulting to
lethargy, delirium, convulsions, coma/
death.
2. DEATH OR INJURY FROM HEAT effect
may be local or general
Classifications of Heat Injury:
a) General or Systemic effects:
a.1 Heat cramps
a.2 Heat exhaustion
a.3 Heat stroke
b) Local effects:
b.1 Scalding
b.2 Burns
= Thermal
= Chemical
= Electrical, lightning
= Radiation
GENERAL OR SYSTEMIC EFFECT: death
usually accidental
1. Heat cramps( Miners Camp, Firemans
Camp, Strokers camp)
- Involuntary spasmodic painful contraction of
muscles due to dehydration and excessive loss
of chlorides by sweating
- Tx: Fluids with chlorides
2. Heat Exhaustion ( Heat collapse,
Syncopal Fever, Heat syncope, Heat
prostration)
- Due to heart failure, cause:Heat precipitated
by exertion/warm clothes
= Sudden syncope, face turns pale, dim
vision
- Tx: removal from the heated area
37
3. Heat stroke(Sunstroke,Heat
Hyperpyrexia,Comatous form,Thermic
Fever)
- Working in ill-ventilated places with dry
temperature or exposure to the sun
LOCAL EFFECTS OF HEAT
1. Scald: Caused by hot liquid
The injury by scalding is not severe as burns:
a. Scalding liquid runs on the body surface
distributing the heat
b. Easily cools off
c. Temperature not as high except : oils
and molten metals
2. Thermal burns: Caused by heat or chemical
substances like fire, radiant heat, friction, solid
substances, electricity.
: Classification of burns/
DUPUYTRENS CLASSIFCATION
1st Degree erythema
2nd
- vesicle
formation
3rd
- destruction of
the cuticle, part of true skin, painful
4th
- whole skin is
destroyed, ulceration, not painful
5th
deep fascia,
muscles
6th
- charring of the
limbs
1. CAUSE
2. LOCATION
3. SINGEING
4. BOUNDARY
OF NORMAL
5. INJURY
6.
CLOTHINGS
BURNS
Dry heat
flame, heated
solid, radiant
heat
At or above
the site of
contact
of hair is
present
Not clear
SCALDS
Moist heat
liquid, steam
Severe
Involved
Limited
Not burned
Occurs at or
below
Absent
Distinct
BURNS
MORTEM BURNS
MORTEM BURNS
1. BLISTERS
albumin/chlorides
Scanty
albumin/chlorides
2. AREA OF INFLAMMATION
antemortem burn
Absent
3. BASE OF THE VESICLE
ANTEPOST
Abundant
Around the
Red
Not much
change in color
4. TRACHEO-BRONCHIAL LUMEN Particles of
soot or carbon
No findings
5. BLOOD
Abundance of
carboxy-Hgb
Absent
Differential diagnosis of blisters:
1. Due to putrefaction fluid content is
blood stained watery fluid; asso. with
putrefactive changes in other parts of body.
2. Due to disease
- heat by the size,
distribution
3. Due to friction
- Hx of application of
heat
3. Chemical burns
Characteristics of lesions:
a. Absence of vesication
b. Staining of the skin or clothing by the
chemical
c. Presence of the chemical substance
d. Ulcerative patches of the skin
e. Inflammatory redness of the skin surface
f. Delayed healing
CHEMICAL BURNS
THERMAL BURNS
1. BLISTERS
Absent
2. SKIN/CLOTHINGS
Stained by
chemicals
No staining
3. ANALYSIS OF SUBSTANCE Shows chemical
cause of corrosion
Absent
4. LESION
Borders are distinct
Diffused
Characteristic lesions by different
chemicals:
a. Sulphuric acid ( Oil of Vitriol)
= most intense action, considerable
destruction
= ulcerations where acid flowed,
clothings destroyed
= blackish-brown sloughs
b. Nitric acid
= Clothing is destroyed, brown
= yellow or yellowish brown slough
c. Hydrocloric acid
= not so destructive
= intense irritation, localized ulceration
red or reddish-gray.
38
39
cmpression.
DEATH BY ASPHYXIA
Asphyxia Applied to all forms of violent death
due to interference with process of respiration
- Conditions in which the supply of O2
to the blood or tissues or both has been reduced
below normal level.
Types of asphyxial death:
1. Anoxic death
Failure of arterial blood to be normally saturated
with O2 due to:
a) Breathing in an atmosphere with
insufficient O2- High altitude
b) External obstruction of the air passage
traumatic crush asphyxia
c) Paralysis of the respiratory center
poisoning, injury, anesthesia
d) Mechanical interference of the passage
of air- drowning, asthma
e) Shunting of blood
2. Anemic anoxic death
=Decrease capacity of the blood to carry O2
due to Hge, CO poisoning, Low Hgb
3. Stagnant anoxic death
=Failure of circulation due to Heart failure,
shock, arterial venous obstruction
4.Histotoxic anoxic death
=Failure of the cellular oxidative process,
cannot be utilized in the tissues. Cyanide
ASPHYXIA BY SUFFOCATION
- Occlusion of air fr. the lungs by closure of air
openings/ obstruction of the air passageway fr.
the external openings to the air sacs
ASPHYXIA BY HANGING
40
41
42
Pedestrian-Vehicle Collision:
Death or Physical Injuries to pedestrian
1.Primary impact Contact with vehicle
2. Secondary impact Subsequent impact of the
pedestrian to the ground
- Accounts for the multiple
injuries
3. Run over Injuries
4. Hit and run Injuries
43
44
1.
FEIGNED INSANITY
TRUE INSANITY
Develops suddenly
Insidiously
45
Regulated drugs:
1. Self-inducing sedatives such as secobarbital,
phenobarbs
2. any salt of an isomer of amphetamine like
benzidrine
3. Hypnotic drugs such as methaqualone
46
400 mg %
level
47