Forensic Medicine Flashcards
A science and art of dealing with prevention, cure and alleviation of disease. It is that part of science and art of restoring and preserving health
Medicine
Is that branch of medicine which deals with the application of knowledge to the purposes of law and in the administration pf justice
Legal medicine
Use of science to elucidate legal problems without specific reference or application to a particular case. It encompasses a variety of fields in forensic science such as pathology. Anthropology, odontology, toxicology, entomology and others
Forensic medicine
A branch pf law which concerns with the aspects of law and legal concepts to medical practice. It includes right, duties and liabilities of physician, patient and health institution
Medical jurisprudence
Difference between medical jurist and ordinary physician
- An ordinary physician ignores trivial injuries not needing treatment which a medical jurist records all injuries to qualify the crime or justify the act
- An ordinary physician sees injury or disease to be able to treat while a medical jurist sees injury or disease in order to find out the cause
- The purpose of an ordinary physician is to arrive at a defenite diagnostic and institute proper treatment while a medical jurist testifies on bodily lesion seen for justice
The system used in the philippines, which is handled by a medical jurist who is a registered physician duly qualified to practice medicine in the phil. The NBI and PNP have their own medical jurist who handles medico legal cases. His duty is to examined the victim or assailant to make report, and to appear in the court as an expert witness when summoned by the proper authorities
Medico legal office system
The _____________________ system is headed by a country coroner or borough coroner who may he a barrister, solicitoror a legally qualified practitioner of not less than (5) years standing in his profession and is elected by the country council or borough council
Coroner system
Evidence is the means sanctioned by the rules of court, of ascertaining the judicial proceeding the truth responding a matter of fact
Medical evidence
This is an evidence made known or addressed tonthe senses of the court. It is not limited to that which is know tonthe sense of vision. But is extended to what the sense of hearing, tadet, Smell and touch is percieved
Autoptic or real evidence
Limitations to the presentation of autoptic or real evidence
Indescency and impropriety
A physician may be commanded to appearbefore a court for his testimony. While in the witness stand, he is obligated to answer the question profounded by the counsel and presiding officer of the court. His testimony must be given orally and under oath or affirmation
Testimonial evidence
Types of physical evidence
Corpus delicti - objects or substance which may be a part of the body pf the crime
Assosiative evidence - these are physical evidences which link a suspect to the crime
Traving evidence - these are physical evidences which may assist the investigator in loating the suspect
The greater the number of similarities and disimilarities, the greater the is the probability of the conclusion to be correct
Law of multiplicity of evidence
Methods of identification
By comparison - with the use of standard specimen, evidence under question can be compared in order to effect identification
By exclusion - is 2 or more persons have to be identified and all but one is not yet identified, the. The one whose identity is not yet established may be known by the process of elimination
Characteristics that may easily be changed
Growtg of hair Bear or mustache Clothing Frequent place of visit Grade of profession Body ornamentation
Characteristics that may not be easily changed
Mental memory
Speech
Gait (a manner of walking)
A gait which the foot is raised high , thrown forward and brought down suddenly
Ataxic gait
A gait associated with the staggering movement
Cerebellar gait
A swaying movement due to knock-knee
Cow’s gait
A gait in which the steps are short, the feet dragged, the legs held more or less widely
Paretic gait
A gait in which the legs are held together and moves in stiff manner, and toes to drag and catch
Spastic gait
A gait resembling duck
Waddling gait
A hoping gait in infantile paralysis
Frog gait
The straight line connecting the center of the succeeding steps. It is more or less in zigzag fashion especially when the legs are far apart ehile walking
Gait line
The longitudinal line drawn or each foot mark
Foot line
These are the characteristics movement of the body particullar to a person
Mannerism
Points of identification applicable to both living and dead before onset decompositiond
Occupational marks Race Stature Teeth Tattoo marks Deformities Birth marks Injuries leaving permanent result Moles Scars
Importance of tattoo
It may helpin the identification of the person
It may indicate memorable events in his life
It may indicate the social stratum to which the person belongs
It implies previous commitment in prison membership in a gang
Methods of tattoo removal
Excision
Dermabrasion
Laser
Salabrasion
Invovles an injection of a local anesthetic to numb the area after which the tattoo is removed surgically. The edges are then brought together and sutured
Excision
A small portion pf tattoo is sprayed with a solution that freezes the area. The tattoo is then sanded with rotary abrasive instrument csusing the skin to peel. Because some bleeding is likely to occur, a dressing is immediately applied tonthe area
Dermabrasion
Considered as one of the best methods of tattoo removal
Laser
A cenuries old procedure using local anesthetic applied atoundbthe tattoo area after which a solution of ordinary tap water dipped in table salt applied and an abrading apparatus such as the one used in dermabrasion or even a simplier device is used such as a wooden block wrapped in gauze
Salabrasion
Regular form and location with stuch marks
Surgical operation scars
Scars are large irregular in shape and may be keloid
Burns and scalds
Disc like with depressed center. They may be adherent to the underlying tissue
Gunshot wound scars
Irregular in shape furrowed, with edges hardened and uneven
Tubercolous sinus
Depressed scar following loss of tissue
Gumma
Located at bend of elbow, dorsum of feet, or at the temporal region
Venesection
Bluish white scar
Lupus
Short parallel scars on the lower part of the back and loin
Wetcupping
A common practice of some tribes in africa is to place some marks on the exposed parts pf the body
Tribal marks
The presence of testes in the male and ovaries in the female
Sexual organs
Basis of bertillon’s method of identification
Human skeleton does not change after 20 years
It is impossible for two human beings to have bones alike
Measurement easily taken with the aid of simple instrument
Whence was Anthropometry first introduced
Paris France in 1882 by alphonse bertillon
Experiment have shown that the best known person cannot be recognized under the clearest moonlight at a distance of 16 to 17 yards and by starlight any further than 10 to 13 yards
Clearest moonlight or starlight
A person can hardly recognize another person at a distance further than 100 yards if the person has neber been seen before; but person who are almost stranger may be recognized at a distance pf 25 yards
Broad daylight
Produces sufficient light fron the identification of individual provided that the person’s eye is focused towards the individual he wishes to identify during the flash
Flash of lightning
The identification is relative to the kind and intensity of the light
In case of artificial light
The ovum is about 1.0 cm with limb buds only present
1st month of fetus
The ovum has a length of 2.5 cm with an embryo about 1.0 cm long with head, ears and hands well formed
2nd month of fetus
The length is 9.0 cm. With nail begining to appear and the placenta can be differentiated
3rd month of fetus
The length is 16.0 cm and the sex can be differentiated, with the fingers beginning to open and hair beginning to appear on the head
4th month of fetus
Fetus processes hair in the head and lanugo over the body body surfaces. Nails are distinct. Skin shows sebaceous secretion. Dental gum appears at the mandible
5th month of fetus
Fetus weigh 2.5 kg. Lanugo and vernix present in the skin are dark and wrinkled. Meconium is present in the small intestine and at the beginning of the large intestine. Brain show convolutions the testis is found in the abdominal cavity. Hair and eyebrow or eye-lashes begin to appear
6th month of fetus
The body is dark red and plump, with hair on the scalp, the testis begins to descend towards the scrotum
7th month of fetus
Fetus has rosy skin, and nails reach the ends of the finger-tips convolutions of the brain are more distinct second piece os sternum ossified papillary membrane disappears
8th month of fetus
Brain convolution reach the grey matter. The scrotum is occupied by the testis. The body surface is now pale. Sebaceous secretion is formed at the flexures of joints, nails fully formed and developed
9th month of fetus
Is the sum total of all vital processes by which the physical integrity of the body is maintained
Life
The state of complete persistent cessation of the vital function of the body such as function of the heart, the lings and the brain
Death
Kinds of death
Clinical or somatic death - type of death usually declared by the members of the immediate family of the diseased or the physician
Molecular or cellular death - type of death characterized by death pf individual cells (one at a time) after the somatic death the nerve cells and brain cells die earlier at about 5 minutes due to loss of food and oxygen while the muscles live longer until the onset pf the rigor mortis which about two or three hours after death
Apparent death - a trancient loss of consiousness of the temporary cessation of the vital function of the body on acount of disease , external stimulus other forms of influence
Signs of death
Cessation of respiration
Cooling of the body
Cessation of heart and circulation
Insensibility of the body and loss of power to
move
Changes in the eyes
Changes in skin
(Period of the muscle irritability) muscles are relaxed and capable pf contracting when stimulated; pupil are dilated incontinence of urination and defection lasts 3 - 6 hours
Primary flacidity
3 - 6 hours after death and may last 24 - 36 hours, body becomes rigid due to contraction of the muscles
Stage of post morten rigidity
Body is exposed to temperature above 77 degree ceslius, pugllistic attitude and more or less permanent
Heat stiffening
Due to solidification of fat when the body is exposed to freezing temperature
Cold stiffening
Rigidity of the miscles which occur at the moment of death due to nervous tension, exhaustion and injury to the nervous system
Cadaveric spasm or instantaneous rigor
Due to dissolution of the muscles, protein onset of putrefaction, the body becom limp again and the muscles are no longer capable of responding to mechanical or electrical stimulus. Notes about 48 hours of death
Stage of secondary flacidity or secondary relaxation
The stasis of the blood due to the cessation of the circulation enhances the coagulation of blood vessel. Blood cloting is accelerated incases of death by infectious fevers and delayed in cases of asphyxia, poisoning by opium, hydrocyanic acid or carbon monoxide poisoning
Coagullation of the blood
It is the discoloration of the body after death when the blood tends to pool on the blood vessels for the most dependent portion of the body. The blood remains fluid in the body after for 6 - 8 hours and gradually clot until its fully developed at about 12 hours, the appearance of post mortem lividity usually starts about 20 - 30 minutes after death, thus, it can also be means in approximating the time of death of the person. But is more useful in determining the position of the body after death
Post mortem lividity
Stages of lividity
Hypostatic lividity - it is the lividity when the dicoloration is due to the blood pooled in the most dependent areas of the body
Diffusion lividity - it is a fixed or permanent discoloration when the blood clotted, inside the blood vessels or has diffused to different parts of the body
It is the breaking down of the complex protein into simplier components assosiated with the evolution foul smelling gases and accompanied by the change of color of the body. Decomposition by bacteria; noted after 48 hours after death; firts appears as a greenish dicoloration, body swelling and reddish discoloration along the lines of superficial veins occur: called MARBLING
Putrefaction
Principal changes undergone by the soft tissue of the body during putrefaction
- Changes in the color of the tissue
- Evolution of gasses in the tissues
- Liquification of the soft tissues
A fee hours after death, there is hemolysis of the blood in the blood vessel and as a result of which hemoglobin is liberated.
Changes in the color of the tissue
Carbon dioxide, ammonia, hydrogen, sulphurated hydrogen, phosphoretted hydrogen and methane gases are formed. The offensive oddors are due to this gases and also due to a small quantity of mercaptans.
Evolution of gases in the tissues
Effects of the pressure of the gases of putrefaction
Dicplacement of the blood
Bloating of the body
Fluid coming out of both nostrils and mouth
Extrusion of the fetus in a gravid uterus
Floating of the body
As decomposition progresses, the soft tissues of the body undergo softening and liquefication. The eyeball, brain, stomach, intestine, liver and spleen putrefy
Liquefication of the soft tissues
Factors affecting rate of putrefication
Internal factors
- age
- cause of death
- condition of the body
External factors
- air and moisture
- condition and type of the soil
- presence of water
- effect of clothing
- effect of coffin
- depth of burial
- mass grave
Special forms of putrefaction
Mummification
Saponification
Maceration
Classes of death
Natural death - due to desease or ailment
Violent death - due to injuries of outside force
Violent deaths
Accident death - art 12 par 4 Negligent death Infanticidal death - art 255 Parricidal death - art 247 Homicidal death - art 249 Murder - art 248 Suicidal death - art 253 Euthanasia (mercy killing)
Pathological Classification of death
Death of syncope - Loss of consciousness, fall of blood pressure, cardiac standstill, cerebral metabolism, hyperventilation, cardiac desease, tussive syncope and hysterical syncope
Death of asphyxia - lack of oxygen in the air or from an obtructing mechanism to respiration
Death of comma - profound stupor in sick ess or after severe injury
Types of asphyxia
Anoxic death - assosiated with the faiulure of arterial blood to become normally saturated with oxygen
Anemic anoxic death - due to a deseased capacity of the blood to carry oxygen
Stagnant anoxic death - brought about by the failure of the circulation
Histotoxic anoxic death - due to the failure of the cellular oxidative process, although the oxygen is delivered to the tissues, it cannot be utilized properly
Types of mechanicsl asphyxia
Strangulation (throttling) Smothering or suffocation Hanging Chocking Crushing or traumatic asphyxia Drowning
Death as punishment
Death by lethal injection
Death by electrocution (200-5000) voltage
Death by gas chamber
Death by hanging
Death by musketry
A comprehensive study of a dead body performed by trained physician using recognized dissection procedures snd techniques, primary to determine the true cause of death. Indicates that in addition to an external examination, the body is opened and internal examination is conducted
Autopsy
Refers to an external examination of a dead body witjout incision being made, although blood and other fluidsay be collected for examination
Post mortem examination
Kinds of autopsies
Hospital or non-official autopsy
Medico legal or official autopsy
Negative autopsy
Negligent autopsy
Methods of diposal of the dead body
Embalming
Burial
Funeral
Cremation
Disposal of the dead body to the sea
Use of dead body for scientific
purposes
It is the raising or disinterring of the dead body or remains from the grave
Exhumation (Disinterring)
Scientific impairment of the body structure or function caused by outside force or agent
Injury
An injury pf the body caused by physical agents which is the application of stimulus to the body producing damage or injury to the tissue
Physical injury
A break or or solution in the continuity of the skin or tissues of the body
Wound
A specific tissue response to the injury by the living or inanimate agents, ot to electrical or chemical etc, characterized by vascular dilatation, fluid exudation and accumulation of leukocytes in the tissues
Inflammation
Classification of wound or physical injury
A. As to severity
mortal wound
non mortal wound
B. As to kind pf instrument used
blunt - lacerated
sharp-edged - incised
sharp-pointed - punctured
sharp-edged and pointed - stab
rough - abrasion
C. As to the manner of infliction
D. As to the depth of wound
E. As to the relation of the site of application of force and injury
Coup injury
Contre coup
Coup contre coup
Locus minoris resistencia
Extensive injury
F. Medico legal classification
Mutilation
Slight physical injury ( 1-9 days)
Less serious physical injury (10-30 days)
Serious physical injury (more than 30 days)
Administration of injurious substance or
beverages
G. As to the type of wound
Closed wound
Open wound
Injury at the side of the application
Coup injury
Injury found opposite the side of application
Contre coup
Injury both at the side and opposite side of the application
Coup contre coup
Injury is found on same area offering the least resistance to the force applied
Locus minoris resistencia
Involves a greater area of damage
Extensive injury
Minute pinpoint circumscribed extravasation of blood in the subcutaneous tissues or underneath the mucous membrane
Petechiae
Wound in the substance of the true skin and the subcutaneous cellular tissuescharacterized by swelling and discoloration of the tissue due to extravasation of blood
Contusion (bruise)
Large extravation of blood in a newly formed cavity secondary to trauma characterized by swelling, dicoloration and effusion of blood underneath the tissue
Hematoma
The straining or tearing of the articular tendons, ligaments and muscles characterized by swelling and discoloration of the tissue involve and extreme pain
Sprain
It is a break or solution in the continuity of the bone tissues resulting from violence ( it can be either simple, compound or comminuted )
Fracture
Displacement of the articular surfaces of the bones forming the joints usually secondary to trauma (simple or compound)
Dislocation
Condition of the brain resulting from a sudden jarring or stunning of the brain which follows a blow on the head characterized by headache or dizziness, unconscious or semi unconscious, relax and flaccid muscle, slow and shallow respiration and rapid buy weak pulse
Cerebral concussion
It is the bleeding usually in the cavity or organes inside the body (intra-cranial, rupture of organs and laceration of organs)
Internal hemorrhage
A condition of the female who has not experienced sexual intercourse and whose genital organs have not been alterred by carnal correction
Virginity
Kinds of virginity
Moral virginity
Physical virginity
Demi-virginity
Virgo intacta
State of not knowing the nature of sexual life and not having experienced sexual relation
Moral virginity
A physical condition whereby a woman is conscious of the nature of the sexual life but not have experiences sexual intercourse. Applies to woman who have reached sexual maturity but not experienced sexual maturity
Physical virginity
A condition whereby a hymen is intact, with the edges distinct and regular, and the opening is small to barely admit the tip of the smallest finger of the examiner even if the thighs are separated
True physical virginity
A condition whereby a hymen is unruptured but the orifice is wide and elastic to admit two or more finger of the examiner with a lesser degree of resistance
False physical virginity
Applied to woman who have had previous physical act but not yet given birth
Virgo intacta
A condition of a woman who permits any form of sexual liberties as long as they abstain on rupturing the hymen by sexual act
Demi virginity
The laceration or rupture of the hymen as a result of sexual intercourse
Defloration
Sexual deviations
Homosexuality (bading) Infantosexuality (bata) Bestosexuality (hayop) Autosexuality (masturbate) Gerontophilia (matanda) Necrophilia (patay) Incest (kadugo) Satyriasis (libog sa lalake) Nymphomania (libog sa babae) Fellatio (chupa) Cunnilingus (kain pepe) Anilingus (kain pwet) Sadism (gusto nananakit) Masochism (gusto nasasaktan) Fetishism (object) Pygmalionism (statue) Frottage (kiskisan) Voyeourism (silip)
a skin injury caused by scraping off of superficial skin due to friction against a rough surface.
Abrasion
a peculiar waxy substance consisting of salts and fatty acids and formed from the decomposition of corpse tissues, specially in moist habitats, also called grave-wax.
adipocere
the reproductive organ of a male insect.
aedeagus
impairment or loss associated with brain injury of the ability to recognized or comprehend the meaning of stimuli including familiar objects and and symbols.
agnosia
any part of the respiratory tract thought which air passes during breathing.
airways
the smallest of the lungs airways that connect terminal bronchioles and alveolar sacs, sometimes called bronchioles.
Alveolar ducts
microscopic air sacs in which gas exchange between the blood and the lungs occur.
alveoli
partial or total loss of memory for past experiences.
amnesia
loss of the ability to form words accurately caused by brain lesion or damage to peripheral nerves that carry impulses to the articulatory muscles.
anarthria
