Notes Legal Medicine

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Abortion - is the termination of pregnancy by the removal or expulsion

from the uterus of a fetus or embryo before viability.

Algor mortis (Latin: algor - coldness; mortis - death) is the reduction


in body temperature following death.

Rigor mortis (Latin: rigor - stiffness, mortis - death") is one


of the recognizable signs of death, caused by chemical changes
in the muscles after death, causing the limbs of the corpse to
become stiff and difficult to move or manipulate.

Importance Of Rigor Mortis


- Rigor mortis is utilized to approximate the time of death.
Generalized muscular contractionsoccur from 3 to 6 hours
until 36 hours.

Autopsy - a post-mortem examination to discover the cause of death or


the extent of disease. Autopsy is derived from the Greek word
"autos" - oneself and "opsis" - sight/view.

Who are authorized to perform autopsy


1. Health officers
2. Medical officer of law enforcement agencies
3. Members of the medical staff of accredited hospitals

When Autopsy performed


1. Written request of nearest kin to ascertain cause of death
2. Order of competent court, mayor, prosecutor
3. Written request of a law enforcement officer
4. When required by special law
5. Solgen, prosecutor to determine cause of death

Principal Aim Of An Autopsy


1. To determine the cause of death
2. To determine the state of health of the person before he or
she died,
3. To determine whether any medical diagnosis and treatment
before death was appropriate.

Types of Autopsies
1. Medico-Legal Autopsy or Forensic or coroner's - autopsies
seek to find the cause and manner of death and to identify
the decedent.
2. Clinical or Pathological autopsies are performed to diagnose
a particular disease or for research purposes.
3. Anatomical or Academic Autopsies - are performed by students
of anatomy for study purpose only.
4. Virtual or Medical Imaging Autopsies - are performed utilizing
imaging technology only, primarily magnetic resonance
imaging (MRI) and computed tomography (CT).

Forensic Autopsy - is used to determine the cause and manner


of death.

Anatomy - the branch of science concerned with the bodily structure


of humans, animals, and other living organisms, especially as revealed
by dissection and the separation of parts.

Biochemistry - the branch of science concerned with the chemical and


physico-chemical processes and substances which occur within living
organisms.

Cadaveric Spasm - also known as postmortem spasm, instantaneous rigor,


cataleptic rigidity, or instantaneous rigidity, is a rare form of
muscular stiffening that occurs at the moment of death, persists
into the period of rigor mortis and can be mistaken for rigor mortis.

Cadaveric spasm occurs immediately after death and is useful


to ascertain the circumstances of death.

Cerebral Concussion – there is a brief loss of consciousness and


sometimes memory after ahead injury that doesn’t cause obvious
physical damage.

Cerebral Contusion – they are bruises to the brain, usually caused by


a direct, strong blow to the head. They are more serious than
concussions.

Circulatory System - also called the cardiovascular system, is an


organ system that permits blood to circulate and transport nutrients
(such as amino acids and electrolytes), oxygen, carbon dioxide,
hormones, and blood cells to and from cells in the body to nourish
it and help to fight diseases, stabilize body temperature and pH, and
to maintain homeostasis.
Contempt of Court - any willful disobedience to or disregard of a
court order or any misconduct in the presence of a court action that
interferes with a judge's ability to administer justice or that
insults the dignity of the court. Punishable by fine or imprisonment
or both.

Contusion - also called a bruise, is a type of hematoma of tissue in


which capillaries and sometimes venules are damaged by trauma,
allowing blood to seep, hemorrhage, or extravasate into the surrounding
interstitial tissues.

Death - Complete cessation of all cardio- pulmonary (heart-lungs)


and/or cessation of brain activity.
Death is the termination of all biological functions that sustain a
living organism.

Kinds of Death
1. Somatic or Clinical Death - permanent cessation of all vital
bodily functions.
2. Molecular or Cellular Death - refers to the death of cells.
3 to 6 hours after cessation of life.
3. Apparent death or State of Suspended Animation - a state in
which the processes of the body (such as blood circulation)
stop or become very slow for a period of time while a person
or animal is unconscious.

Leading Causes of Death In The World


1. Ischaemic heart disease
2. Stroke (cerebrovascular diseases)
3. Lower respiratory infections
4. Chronic Obstructive Lung Disease

Signs Of Death
1. Cessation of heart action and circulation
2. Cessation of respiration
3. Cooling of the body (Algor Mortis) - The temperature of
15–20 degrees Fahrenheit is considered as ascertain sign of
death.
4. Loss of motor power
5. Loss of sensory power
6. Changes in the skin
7. Changes in and about the eye - There is loss of corneal reflex

Declaration of Tokyo - is a set of international guidelines for


physicians concerning torture and other cruel, inhuman or degrading
treatment or punishment in relation to detention and imprisonment,
which was adopted in October 1975 during the 29th General assembly
of the World Medical Association.

Defloration - is the laceration or rupture of the hymen as a result


of sexual intercourse.

Dermis - the thick layer of living tissue below the epidermis which
forms the true skin, containing blood capillaries, nerve endings,
sweat glands, hair follicles, and other structures.

Digestive System - digestive system is a group of organs working


together to convert food into energy and basic nutrients to feed the
entire body.

Dr. Pedro P. Solis - Philippines father of Legal Medicine.

Ecchymosis - a discoloration of the skin resulting from bleeding


underneath, typically caused by bruising.

Endocrine System - refers to the collection of glands of an organism


that secrete hormones directly into the circulatory system to be
carried towards a distant target organ.

Epidermis - the outermost layer of the skin of a human or other


vertebrate animal.

Euthanasia - Meaning good death ( well or good ), Refers to the


practice of ending life in a painless manner. Deliberate intervention
undertaken with the express intention of ending life, to relieve
intractable suffering.

Excretory System - is a passive biological system that removes excess,


unnecessary materials from an organism, so as to help maintain
homeostasis within the organism and prevent damage to the body.

Homeostasis -means remaining stable or remaining the same.


Firearm identification - used to determine whether the gun that is
subject of the investigation has the same gun used or fired.

Forensic Medicine - application of medical science to elucidate


legal problems.

Forensic Science - involves the application of the sciences to answer


questions of interest to the legal system.

Four 4 Signs of Inflammation


1. Rubor - redness
2. Calor - heat
3. Tumor - swelling
4. Dulor - pain

Fracture - comes from the Latin word “fractura” which means a break in
the continuity of the bone. It is also a combination of a break in
the bone and soft tissue injury.

Frostbite - injury to body tissues caused by exposure to extreme cold,


typically affecting the nose, fingers, or toes and often resulting
in gangrene.

Frostnip - the initial stages of frostbite.

Gynecology - the branch of physiology and medicine which deals with


the functions and diseases specific to women and girls, especially
those affecting the reproductive system.

Hematoma - is a collection of blood outside of a blood vessel.

Incision - a surgical cut made in skin or flesh.

Injury - is the damage to a biological organism caused by physical


harm.

Coup Injury - injury at the site of application of force.

Contre-Coup Injury - injury opposite the site of application


of force.

Coup-Conre-Coup Injury - injury at the site and opposite the


site of application of force.

Locus Minoris Resistentiae - injury not at the site and not


opposite the site of application of force but at the site
offering least resistance.

Extensive Injury - injury on greater area more than the site


of application of force.

Integumentary system - is the organ system that protects the body


from various kinds of damage, such as loss of water or abrasion from
outside. The system comprises the skin and its appendages, including
hair, scales, feathers, hooves, and nails.

Laceration - a deep cut or tear in skin or flesh. A wound that is


produced by the tearing of soft body tissue. This type of wound is
often irregular and jagged.

Lazarus Syndrome - is also called Lazarus Phenomenon, is the


spontaneous return of circulation after failed attempts at
resuscitation.

Lazarus Sign - or Lazarus reflex is a reflex movement in brain dead


patients, which causes them to briefly raise their arms and drop
them crossed on their chests.

Legal Medicine - Branch of medicine which deals with the application


of medical knowledge to the purpose of law and in the administration
of justice. Application of medicine to legal cases.

Livor Mortis - is a settling of the blood in the lower (dependent)


portion of the body, causing a purplish red discoloration of the skin.
From the latin word "livor" - bluish color and "mortis" - of death.
Also known as post-mortem lividity.

Mayhem - intentional maiming of another person.

Mechanical Trauma - is an injury to any portion of the body from a


blow, crush, cut, or penetrating wound.

Medical Evidence - is the means sanctioned by the rules of court of


ascertaining in a judicial proceeding the truth respecting a matter
of fact.

Types of Evidence
1. Real Evidence/Autoptic - made known to the senses
2. Testimonial Evidence - oral testimony under oath
3. Experimental Evidence
4. Documentary Evidence

Medical Jurisprudence - knowledge of law in relation to the practice


of medicine.

Medico-Legal officer - (medical examiner) a physician who determines


the cause of injury/death/disease by examining the patient/cadaver
and testify in court to aid in the administration of justice.

Mental Deficiency – or mental retardation, is sub average intellectual


ability present from birth or early infancy. Intelligence is both
determined by heredity and environment. In most cases of mental
deficiency, the cause is unknown.

Classification of Mental Deficiency


1. Idiot – The idiot’s intelligence never exceeds that of a
normal child over 2years old. The IQ is between 0 – 20.
This is usually congenital.
2. Imbecile – the imbecile’s intelligence is compared to a normal
child from 2 –7 years old and the IQ is 20 – 40.
3. Feeble Minded – his mentality is similar to that of a normal
child between 7 – 12 years old and an IQ of 40 – 70.

The Legal Importance of determining the person’s state of mind


are the following:
1. In Criminal law, insanity exempts a person from criminal
liability.
2. In Civil law, Insanity is a restriction of the capacity of a
natural person to act as provided in Article 38 of the
Civil Code.
3. Insanity modifies or limits the capacity of a natural person
to act as provided in Article 39 of the Civil Code.
4. Insanity at the time of marriage of any or both parties is a
ground for the annulment of marriage.

Mental Health Disorders – include disturbances in thinking, emotion,


and behavior. There is a complex interaction between the physical,
psychological, social, cultural and hereditary influences.

Factors that Contribute to the Development of Mental Disorders


1. Heredity – the most frequent factor that contributes to
insanity and a good history will reveal the ascendants
afflicted with the same.
2. Incestuous Marriage – The mental illness is accentuated when
they are blood relative.
3. Impaired Vitality – Stress, tension, worry,grief may
predispose to insanity.
4. Poor Moral Training and Breeding – Corrupt moral upbringing
in the family due to immorality of the parents.
5. Psychic Factors – Factors like love, hate,rage, anger,
passion disappointments.
6. Physical Factors
a. Non toxic factors – exhaustion resulting from severe
physical and mental strain and traumatic injuries
to the head.
b. Toxic factors – drug addiction,infections of
the brain.

Kinds of Mental Health Disorders


1. Psychosomatic disorders – physical disorders caused by
psychological factors.
2. Somatiform disorders – encompasses several psychiatric
disorders in which people report physical symptoms but deny
having psychiatric problems.
3. Generalized Anxiety Disorders
4. Panic Attacks and Panic Disorder
5. Phobic Disorders
a. Agoraphobia
b. Specific phobias
c. Social phobia
6. Obsessive Compulsive Disorder
7. Post Traumatic Stress Disorder
8. Depression and Mania
9. Bipolar Disorder
10.Suicidal Behavior
11.Eating Disorders
a. Anorexia nervosa
b. Bulimia nervosa
c. Binge eating disorder
12.Personality Disorders
a. Paranoid
b. Schizoid
c. Histrionic
d. Narcissistic
e. Antisocial
f. Borderline
g. Avoidant
h. Dependent
i. Obsessive – Compulsive
j. Passive Aggressive
k. Dissociative
13.Schizophrenia – a serious mental disorder characterized by
loss of contact with reality(psychosis), hallucinations,
delusions (false beliefs), abnormal thinking, disrupted
work and social functioning.

Types of Schizophrenia
a. Paranoid - is a mental disorder characterized by
paranoia and a pervasive, long-standing
suspiciousness and generalized mistrust of others.
b. Hebephrenic - it is characterized by disorganized
behavior and speech, as well as disturbances in
emotional expression.
c. Catatonic - does not respond to external stimuli.
characterized by a marked lack of movement,
activity, or expression.

14.Delusional Disorder
15.Psychological Incapacity – a waste basket diagnosis because
it is so broad a term, that it covers all possible Mental
Disorders.

Some Manifestations of Mental Disorders


1. Disorders of Cognition (Knowing)
a. Illusion
b. Hallucination
2. Disorders of Memory
a. Dementia
3. Disorders in the Content of Thought
A. Delusion
a. Delusion of grandeur
b. Delusion of persecution
c. Delusion of reference
d. Delusion of Self – Accusation
e. Delusion of infidelity
f. Nihilistic delusion
g. Delusion of poverty
h. Delusion of control
i. Delusion of depression
B. Obsession
4. Disorders in the trend of thought
Types a. Mania
b. Melancholia
5. Disorders of Emotions or Feelings – a disorder in the state
of mind, fervor, or sensibility, not in accord with reality.
6. Disorders of volition or conation (doing)

Conation - the mental faculty of purpose, desire, or will


to perform an action; volition.

Kinds of Conation
A. Impulsion or Impulse (Compulsion) – a sudden and
irresistible force compelling a person to the conscious
performance of some action without motive or forethought.

Types of Compulsion
a. Pyromania - from the Greek word "pyr" - fire, is an
impulse control disorder in which individuals
repeatedly fail to resist impulses to deliberately
start fires in order to relieve tension or for
instant gratification.
b. Kleptomania - is the inability to refrain from the
urge to steal items and is done for reasons other
than personal use or financial gain.
c. Dipsomania - an uncontrollable craving for alcoholic
liquors.
d. Homicidal impulse - occurs when one person kills
another suddenly and without premeditation or
planning.
e. Sex impulse - a sudden strong and unreflective urge
or desire to have sex..
f. Suicidal impulse - recurring thoughts of or
preoccupation with suicide.

Mortal Wound - capable of causing death.

Muscular System - is an organ system consisting of skeletal, smooth


and cardiac muscles. It permits movement of the body, maintains
posture, and circulates blood throughout the body.

Mutilation - or maiming is an act of physical injury that degrades


the appearance or function of any living body.

Nervous System - consists of the brain, spinal cord, sensory organs,


and all of the nerves that connect these organs with the rest of the
body.

Obstetrics - branch of medecine that deals with pregnancy, childbirth,


and postpartum period, including care of the newborn.

Paraffin test or Dermal Nitrate test – present on the skin of the


hand or site of the wound of entrance. This test is not
conclusive because fertilizers, cosmetics, cigarettes, urine and other
nitrogenous compounds with nitrates will give a positive reaction.
A negative test is also not conclusive . The test usually gives a
positive result even after a lapse of 3days or even if the hands
are subjected to ordinary washing.

Pathology - the science of the causes and effects of diseases,


especially the branch of medicine that deals with the laboratory
examination of samples of body tissue for diagnostic or forensic
purposes.

Paulus Zacchias - (1584–1659) is the Father of Forensic Medicine.

Petechiae – a circumscribe extravasation of blood in the subcutaneous


tissue.

Physical Injury - is the effect of some stimulus on the body.

Physical injuries - include those caused by mechanical trauma, heat


and cold, electrical discharges, changes in pressure, and radiation.
Mechanical trauma is an injury to any portion of the body from a
blow, crush, cut, or penetrating wound.
Physics - The subject matter of physics includes mechanics, heat,
light and other radiation, sound, electricity, magnetism, and the
structure of atoms.

Physiology - the branch of biology that deals with the normal


functions of living organisms and their parts.

Post-Mortem - (meaning after death) internal examination of the


dead to determine the cause of death.

Ante-Mortem - before death.

Post-Mortem Caloricity - is the rise of temperature of the body after


death due to rapid and early putrefactive changes, usually in the
first two hours.

Post Mortem Lividity - it occurs in most extensive areas of the most


dependent portions of the body.

Puncture Wound - is usually caused by a sharp pointy object such as


a nail, animal teeth, or a tack. This type of wound usually does not
bleed excessively and can appear to close up.

Putrefaction - or decomposition is the final stage following death,


produced mainly by the action of bacterial enzymes, mostly anaerobic
organisms derived from the vowel. Other enzymes are derived from
fungi and sometimes from insects.

Kinds of Putrefaction:
1. Mummification - is the preservation of a body.
2. Saponification – also called Adipocere Formation.
3. Maceration - Softening of the tissues after death by
autolysis.

Reproductive System - or genital system is a system of sex organs


within an organism which work together for the purpose of sexual
reproduction. Many non-living substances such as fluids, hormones,
and pheromones are also important accessories to the reproductive
system.

Respiratory System - (or ventilatory system) is a biological system


consisting of specific organs and structures used for the process
of respiration in an organism. The respiratory system is involved
in the intake and exchange of oxygen and carbon dioxide between an
organism and the environment.

Scald - is a type of burn injury caused by hot liquids or gases.

Sex Crimes - generally involve illegal or coerced sexual conduct by


one person towards another.

Chaste – An unmarried woman who has had no carnal knowledge


with men or that she never voluntarily had unlawful sexual
intercourse. These also denotes purity of mind and innocence
of heart.

Virgin – A woman who has had no carnal knowledge of man.


Her genital organs have not been altered by carnal connection.

Kinds of Virginity
1. Moral virginity – the state of not knowing the nature
of sexual life and not having experience sexual
relation.
2. Physical Virginity – A condition whereby a woman is
conscious of the nature of sexual life but has not
experienced sexual intercourse.
3. Demi–virginity – This term refers to a condition of
a woman who permits any form of sexual liberties as
long as they abstain from rupturing the hymen by
sexual act. The woman allows sexual intercourse, but
only inter femora or even inter labia, but not to the
extent of rupturing the hymen.
4. Virgo intacta – A truly virgin woman. There is no
structural change in her organ,not withstanding the
fact of a previous sexual intercourse.

Carnal Knowledge - is the act of a man in having sexual bodily


connection with a woman. There is carnal knowledge if there
is the slightest penetration in the sexual organ of the female
by the sexual organ of the male.

Shrapnel - fragments of a bomb, shell, or other object thrown out


by an explosion.
Skeletal System - gives the body its basic framework, providing
structure, protection, and movement.

Subpoena - order issued by the court to a person to appear in court.

Subpoena ad Testificandum´- is a court summons to appear and give


oral testimony for use at a hearing or trial.

Surgery - is an ancient medical specialty that uses operative manual


and instrumental techniques on a patient to investigate and/or treat
a pathological condition such as disease or injury, to help improve
bodily function or appearance or to repair unwanted ruptured areas.

Topinard and Rolet - two french anatomist who devised a formula for
the determination of the height for male and female.

Toxicology - the branch of science concerned with the nature, effects,


and detection of poisons.

Trauma - injury, a physical wound to the body caused by an external


source.

Virginity - A condition of a female who has not experience sexual


intercourse and whose genital organs have not been altered by carnal
connection and whose hymen is still intact.

Virgo Intacta - literally the term refers to a truly virgin woman;


that there are structural changes in her organ to infer previous
sexual intercourse and that she is a virtuous woman.

Virtuous Female - If her body is pure and if she has never had any
sexual intercourse with another though her mind and heart is impure.

Vital Reaction - the response of living body tissues to injury.

Wound - in legal medicine,it means strictly a solution of continuity.


An injury to living tissue caused by a cut, blow, or other impact,
typically one in which the skin is cut or broken.

Open Wound - there is a break in the continuity of the skin.


1. Abrasion - a wound consisting of superficial damage to
the skin. Scratch, friction mark.
2. Bruise - is a common skin injury that results from the
breakage of tiny blood vessels leaking under the skin. Blood
from damaged blood vessels beneath the skin collects near
the surface of the skin to appear as what we recognize as
a black and blue mark. Cause by a blunt injury to the
tissues which damage blood vessels beneath the surface,
allowing blood to extravasate or leak into the surrounding
tissues.
3. Incised Wound - caused by a clean, sharp-edged object such
as a knife, razor, or glass splinter.
4. Stab Wound - is a specific form of penetrating trauma to
the skin that results from a knife or a similar pointed
object that is "deeper than it is wide".
5. Punctured Wound - is a deep wound caused by something sharp
and pointed, like a nail. The opening on the skin is small,
and the puncture wound may not bleed much. Puncture wounds
can easily become infected.
6. Perforating Wound - a wound with an entrance and exit opening.
7. Lacerated Wound - that occurs when skin, tissue, and/or
muscle is torn or cut open. Lacerations may be deep or
shallow, long or short, and wide or narrow. Most lacerations
are the result of the skin hitting an object, or an object
hitting the skin with force.
8. Bite - is a wound received from the teeth of an animal,
including humans.
9. Gunshot Wound (GSW) - (Ballistic Trauma) is a form of physical
trauma sustained from the discharge of arms or munitions.

Barotrauma - wound/injury caused by a change in atmospheric


pressure.

Defense Wound - or self-defense wound is an injury received by


the victim of an attack while trying to defend against the
assailant. often found on the hands and forearms, where the
victim has raised them to protect the head and face or to fend
off an assault, but may also be present on the feet and legs
where a victim attempts defense while lying down and kicking
out at the assailant.

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