LEGAL MED Flashcards by Ashley Salvador

This is the investigation of cases that are unique and often require special training to fully understand their broad significance. Homicide, robbery, rape & sexual offenses, kidnapping. carnapping, bomb threat & explosion, illegal-recruitment, and terrorist activities are examples of cases that call for special crime investigation.

SPECIAL CRIME INVESTIGATION

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A physician who specializes or is involved primarily with medico- legal duties. To be involved in medico- legal duties. a physician must possess sufficient knowledge of pathology, surgery, gynecology, toxicology and such other branches of medicine germane to the issues involved.

Medical Jurist/ Medical Examiner/ Medico- Legal Officer/ Medico- Legal Expert

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Point of view of treatment

The purpose is to arrive at a definite diagnosis so that appropriate treatment can be instituted.

ORDINARY PHYSICIAN

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Point of view of cause

The purpose is to include bodily lesions in his reports and testify before the court or before an investigative body, thus giving justice to whom it is due.
Must record all bodily injuries even if they are small or minor, because these injuries may be proofs to qualify the crime or to justify the act.

MEDICAL JURISTS

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Point of view of cause

MEDICAL JURISTS

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The Earliest Recorded- Legal Expert

Imhotep (2980 B. C)-

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the oldest code law (2200 B.C) included legislation on adultery, rape, divorce. incest. abortion and violence

Code of Hammurabi-

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discussed the lethality of wounds.

Hippocrates

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fixed animation of fetus at the 40* day after conception.

Aristotle

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gave information on poison including aconite, arsenic and opuim.

The Chinese Materia Medica

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That bodies of all women dying during confinement should immediately be open in order to save the child’s life was promulgated.

Numa Pompilius in Rome

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the first police surgeon or forensic Pathologist.

Antistius

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he mentioned that a physician is not an ordinary witness and that a physician gives judgment rather than testimony. This led to the recognition of expert witness in court.

Justinian (483- 565 B. C)

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first text book in Legal medicine which was promulgated in 1532 during the reign of Emperor Charles V in Germany.

Constituto Criminalis Carolina

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issued an edict providing for the appointment of doctors to the courts for the determination of the nature of wounds.

Pope Innocent III (1209)

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in 1234 caused the preparation of Nova Compilatio Decretalium. Concerned medical evidence. marriage, nullity, impotence, delivery, caesarian section, legitimacy, sexual offenses, crime against persons and witchcraft.

Pope Gregory IX

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In China, this book was published. It is a five volume book dealing with inquest, criminal, abortion, infanticide, signs of death. assault, suicide, hanging, strangling, drowning. burning. poisoning and antidotes, and examination of the dead.

Hsi Yuan Lu (Instructions to Coroner)

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expressed the need of experts in the ecclesiastical courts in the diagnosis of leprosy and medico- legal documents.

Pope John XXII

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considered legal medicine as a separate discipline and he discussed in his book, abortion, infanticide, death by lightning. hanging, drowning, feign diseases, distinction between ante-mortem and postmortem wound and poisoning by carbon monoxide and by corrosives.

Ambroise Pare

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a papal physician, regarded as the “Father of Forensic Medicine”. He published Questiones Medico- Legales which dealt with the aspects of wounds and the first two chapter dealt with the detection of secret homicide.

Paulus Zacchias

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published in Paris a work on virginity and defloration. He confirmed the existence of the hymen and that it may not rupture during sexual intercourse.

Severin Pineau

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introduced chemical methods in Toxicology. Considered as the Founder of Modern Toxicology

Matthieu Orfila (Traite’ des Poison)-

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An evidence made known or addressed to the senses of the court

Autoptic or Real Evidence

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A physician may be commanded to appear before a court to give his testimony.

Testimonial Evidence

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A physician who testifies in court on matters he perceived from his patient in the course of physician- patient relationship is considered as an ordinary witness.

Ordinary Witness

A physician on account of his training and experience can give his opinion on a set of medical facts. He can deduce or infer something, determine the cause of death, or render opinion pertinent to the issue and medical in nature.

Expert Witness

A medical witness may be allowed by the court to confirm his allegation or as a corroborated proof to the opinion he previously stated.

Experimental Evidence

A document is an instrument on which is recorded by means of letters, figures, or marks intended to be used for the purpose of recording that matter which may be evidentially used.

Documentary Evidence

These are articles and materials which are found in connection with the investigation and which aid in establishing the identity of the perpetrator or the circumstances under which the crime was committed, or in general assist in the prosecution of a criminal.

Physical Evidence

Objects or substances which may be a part of the body of the crime.

Corpus Delicti

These are physical evidences which link a suspect to the crime

Associative Evidence

These are physical evidences which may assist the investigator in locating the suspect.

Tracing Evidence

, audio and/ or video tape, micro- film, photostat, xerox, voice tracing

Photographs

If no scientific apparatus to preserve evidence is available then a rough drawing of the scene or object to be preserve is done. It must be simple. identifying significant items and with exact measurement.

Sketching-

Description- This is putting into words the person or thing to be preserved.

Description

In a miniature model of a scene or of a human body indicating marks of the various aspects of the things to be preserved.

Manikin Method-

A person who perceived something relevant for proper adjudication of a case may be a witness in court if he has the power to transmit to others what he perceived. He would just have to make a recital of his collection.

Preservation in the mind of the witness

That which proves the fact in dispute without the aid of any inference or presumption. The evidence presented corresponds to the precise or actual point at issue.

Direct Evidence

The proof of fact/s from which, taken ether singly or collectively, the existence of a particular fact in dispute may be inferred as a necessary or probable consequence.

Circumstantial Evidence

involves the examination of biopsy samples taken by surgeons to determine whether or not a growth is cancerous to examining the bodies of victims which could be used in the investigation and prosecution.

Anatomic Pathology-

is the study and diagnosis of diseases by analyzing body fluids such as blood and urine.

Clinical Pathology

is the application of the study of human skeleton (osteology) in cases where the human remains are in the advanced stages of decomposition.

Forensic anthropology –

is the application of standard biochemical techniques and assays to criminal investigations.

Forensic biochemistry

is the identification of the type of tissue and the age of a sample found at the crime scene using genetic information.

Molecular biology

it involves the assessment and treatment of mentally abnormal offenders, as well as the legal aspects psychiatric practice, civil law and issues of criminal responsibility.

Forensic psychiatry

Is a generic term of a crime involving death of a victim. The unlawful killing of a person which are neither parricide, murder nor infanticide

Homicide

The unlawful killing of any person which is not parricide or infanticide provided that any of the following circumstances enumerated under Art. 248 are present:

Murder u

this is the termination of life. It is the complete cessation of all the vital functions without possibility of resuscitation. It is an irreversible loss of the properties of living matter.

DEATH

This is a continuing process while death is an event that takes place at a precise time.

DYING

This is the state of the body in which there is complete, persistent and continuous cessation of the vital functions of the brain, heart and lungs which maintain life and health.

Somatic Death or Clinical Death

After cessation of the vital functions of the body there is still animal life among individual cells. About three to six hours later, there is death of individual cells. It occurs one at a time after somatic death.

Molecular or Cellular Death

This condition Is not really death but merely & trunster loss of consciousness or Lemporary cessation of the vital functions of the body on account of disease, external stimulus or other forms of influence.

Apparent Death or State of Suspended Animation

Examination of detecting the cessation of heart Action and Circulation

CESSATION OF HEART ACTION AND CIRCULATION

pulsation of the peripheral blood vessels may be made at the region of the wrist or at the neck.

Palpation of the Pulse

the rhythmic contraction and relaxation of the heart is audible through microscope.

Auscultation for the heart sound at the Precordial Area

examination of the chest will reveal the shadow of the heart in its rhythmic contraction and relaxation.

Fluoroscopic Examination

the heart beat is accompanied by the passage of electrical charge through the impulse conducting system of the hear which may be recorded in an electrocardiograph machine. This is the best method of determining heart action but quite impractical.

By used of Electrocardiograph

a ligature is applied around the base of a finger with moderate tightness

Magnus' Test-

in the living blood escapes in jerk and at a distance.

Opening of small Artery

this consists of the injection of a solution of fluorescein subcutaneously.

Icard's Test

if pressure is applied on the fingernails intermittently, there will be a zone of paleness at the site of the application of pressure which become livid on release.

Pressure on the Fingernails

fingers are spread wide and the finger webs are viewed through a strong light.

Diaphanous Test

if heated material is applied on the skin of a dead man, it will not produce true blister. There are no sign of congestion, or other vital reactions.

Application of Heat on the skin

Deals with the interaction of medical science with the law.

forensic medicine

A person can hold his breath for a period not longer than 3- ½ minutes.

CESSATION OF RESPIRATION

After death the metabolic process inside the body ceases. No more heat is produced but the body loses slowly its temperature by evaporation or by conduction to the surrounding atmosphere. The progressive fall of the body temperature is one of the most prominent signs of death. The rate of cooling of the body is not uniform. It is rapid during the first two hours after death.

COOLING OF THE BODY a.k.a POSTMORTEM FRIGIDITY

This is the rise of temperature of the body after death due to rapid and early putrefactive changes or some internal changes. It is usually observed in the first two hours after death.

Post- Mortem Caloricity-

After death the whole body is insensible. No kind of stimulus is capable of letting the body have voluntary movement. This condition must be observed in conjunction with cessation of heart beat and circulation and cessation of respiration.

INSENSIBILITY OF THE BODY AND LOSS OF POWER TO MOVE -

This test is useful to determine whether death occurred before or after the application of heat. The heat is applied to a portion of the leg or arm. If death is real, only a dry blister is produced. The epidermis is raised but on pricking the blister, no fluid is present. There is no redness of the surrounding skin.

ACTION OF THE HEAT ON THE SKIN

Firearms which are of Medico-Legal Interest:

Revolver Automatic Pistol Rifle Shotgun

A revolver has cylindrical magazine which holds six rounds of cartridges. Muzzle velocity: 600 feet per second

revolver

Auto loading pistol. The detachable vertical magazine holds 17 rounds. Muzzle velocity: 1200 feet or more per second

automatic pistol

Muzzle velocity: 2,500 feet per second and range of 3,000 feet

rifle

Things coming out of the Gun

Bullet Flame Heated, compressed and expanded gas Residues

This is what the above components may look like after discharge and collision with a target.

residues

circular / stellate muzzle imprint no “powder burns”

CONTACT FIRE

Dense powder tattooing With soot Less than 1 cm

NEAR CONTACT:

Scattered tattooing No soot Within 2-4 ft.

INTERMEDIATE FIRE:

No tattooing No soot No burnt edges More than 4 feet

DISTANT FIRE:

When a bullet enters the skull it produces a sharp-edged "punched-out" hole in the outer table, with a larger corresponding "beveled-out" hole on the inner table

entrance site

This is a contact range gunshot entrance wound with gray-black discoloration from the burned powder

smoke smudging

The surface of the skull demonstrates the heavy soot in this contact range entrance wound, as well as radiating fracture lines. The direction of fire was thus toward the back of this picture.

soot

This is an intermediate range gunshot entrance wound in which there is powder "tattooing" around the entrance site.

gunpowder tatooing

The abrasion ring, and a very clear muzzle imprint, are seen in this contact range gunshot wound.

contussion collar

Histologic examination of the entrance wound site on the skin demonstrates black gunshot residue and coagulative necrosis.

microscopic exam

As the bullet exits the cranial cavity, the inner table appears "punched-out" with beveling on the outer table

exit site

it is an injury characterized by the removal of the superficial epithelial layer of the skin caused by rub or friction against hard rough surface.

ABRASIONS

- the effusion of blood into the tissues underneath the skin on account of the rupture of the blood vessels as a result of the application of blunt force or violence.

CONTUSIONSbruise (discolored skin caused by a blow)

extravasation or effusion of blood in a newly formed cavity underneath the skin

HEMATOMA

a tear of skin and the underlying tissues due to forcible contact with blunt instrument

LACERATION

produce by the penetration of a sharp-pointed and sharp edge instrument like knife, saber, dagger or scissor

STAB WOUNDS

this is a slash or slice cut produce by sharp edge cutting instrument

INCISED WOUND