Legal Medicine (Part 3)

Penetrating wound

Depth of wound: one in which the agent enters the body but did not come out or the mere piercing of a solid organ or tissue

Perforating wound

Depth of wound: when the agent produces communication between the inner and outer portions of hollow organs

Contre-coup injury

Physical injury found opposite the site of application of force

Locus Minoris Resistencia

Injury located not at the site nor opposite the application of force but in some areas offering the least resistance to the force applied

Extensive Injury

Injury that involves a greater area of the body beyond the site of the application of force

Mutilation

The act of looping or cutting off any part or parts of the living body

Mayhem

Unlawful and violent deprival of another of the use of a part of the body so as to render him less able in fighting

>30 days

Serious physical injuries is committed by anyone who shall wound, beat or assault another and the offended party is incapacitated for labor for ___ days

Prison mayor

Penalty for serious physical injuries if it result in imbecility, impotency or blindness

Prison correcional in its medium and maximum periods

Penalty for serious physical injuries if it results in loss of speech, hearing, smell, extremity, and incapacitation for the work in which the person was habitually engaged

Prison correcional in its minimum or medium periods

Penalty for serious physical injuries if it results in deformity, loss of any member or function of his body, incapacitated for usual work for more than 90 days

Arresto mayor

Penalty for serious physical injuries if person becomes ill or incapacitated for labor for more than 30 days and impliedly less than 90 days

>10 days but <30 days

Less Serious Physical Injuries are caused when there is a period of medical attendance for this time period

1-9 days

Slight Physical Injury results to incapacitation of the victim for labor for this duration or require medical attendance during the same period

contusion

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

4-5 days

Contusion turns green after

7-10 days

Contusion turns yellow after

Hematoma

Extravasation of blood in a newly formed cavity underneath the skin

Hematoma

Hematoma or Contusion: skin is elevated

Contusion

Hematoma or Contusion: no blood when lesion is aspirated

Cerebral Contusion (Commotio Cerebri)

Jarring or stunning of the brain characterized by more or less complete suspension of its functions as a result of injury to the head

Hemorrhage

Always the most serious consequence of a stab wound

Laceration

Tear of the skin or underlying tissues due to forcible contact with a blunt instrument

Incised

Incised or Lacerated wound: clean-cut, regular and well-defined edges

Lacerated

Incised or Lacerated wound: roughly cut, irregular and ill-defined edges

Lacerated

Incised or Lacerated wound: (+) swelling

Lacerated

Incised or Lacerated wound: (+) contusion

Incised

Incised or Lacerated wound: hair bulbs are cut

Incised

Incised or Lacerated wound: faster healing

Lacerated

Incised or Lacerated wound: Irregular scar

Incised

Incised or Lacerated wound: caused by sharp-edged instrument

Lacerated

Incised or Lacerated wound: caused by blunt instrument

Abrasion

characterised by the removal of the superficial epithelial layer of the skin caused by a rub or friction against a hard, rough surface

Ante

Ante or Post-mortem wounds: edges gape

Suicide

Multiple wounds in concealed portions of the body are usually indicative of

transverse: homicide
oblique: suicide

Cut-throats are generally transverse in cases of __ and oblique in cases of __

Fissure fracture

Fracture of the skull caused by the impact of a blunt object and may appear as a radiating crack from the site of the application of force and may involve the base of the cranial fossa

Localised depressed fracture

Fracture of the skull also known as "Fractures La Signature"

Bursting fracture

An extensive fracture of the skull running parallel to the two points of contact

Subdural hemorrhage

Most common cause of cerebral compression

Post-traumatic hemorrhage

Post-traumatic hemorrhage or Cerebral apoplexy: location is the central white matter of the frontal or temporo-occipital region

Cerebral apoplexy

Post-traumatic hemorrhage or Cerebral apoplexy: location is the basal ganglia

Parietal and Frontal lobes

Most common sites of direct or coup brain laceration

Concussion of the brain

This injury of the brain is a transitory period of unconsciousness resulting from a blow on the head, unrelated to any injury to the brain

True

True or False: patient with concussion of the brain may develop automatism and may perform criminal acts which may be mistaken to be volitional or voluntary

Revolver

Type of firearm: has a cylindrical magazine situated at the rear of the barrel (usual velocity of 600 ft/sec)

Automatic pistol

Type of firearm: the empty shell is ejected when the cartridge is fired and a new cartridge is slipped into the breech automatically as a result of recoil

Automatic pistol

Type of firearm: self-loading firearm that has a usual muzzle of 1200ft/sec

Rifle

Type of firearm: with a long barrel and butt (muzzle velocity of 2500 ft/sec and range of 3000 ft)

Shotgun

Type of firearm: projectile is a collection of lead pellets which varies in sizes with the type of cartridge applied

True

True or False: the greater the density of the tissue struck by the bullet, the greater the damage

Inverted edges

Characteristic of wound edges in short- and medium-range gunshot wound

Exit

Entrance or exit gunshot wound: always bigger

Exit

Entrance or exit gunshot wound: everted edges

Entrance

Entrance or exit gunshot wound: usually oval or round

Entrance

Entrance or exit gunshot wound: (+) contusion collar

Exit

Entrance or exit gunshot wound: tattooing or smudging always absent

Exit

Entrance or exit gunshot wound: underlying tissues may be seen protruding from the wound

Entrance

Entrance or exit gunshot wound: always present

Exit

Entrance or exit gunshot wound: paraffin test always negative

Souvenir bullet

Bullet that has been lodged and remained in the body and its presence causes development of a dense fibrous tissue capsule around the bullet causing no untoward effect

Suicidal

Suicidal/Homicidal/Accidental GSW: death weapon almost always found near the place where the victim was found

Suicidal

Suicidal/Homicidal/Accidental GSW: entrance wound do not usually involve clothing

Suicidal

Suicidal/Homicidal/Accidental GSW: shot fired in a closed or locked room

Homicidal

Suicidal/Homicidal/Accidental GSW: site or sites of GSW has no point of election

Accidental

Suicidal/Homicidal/Accidental GSW: no special area of the body involved

Contact or near contact

Near contact or long range shotgun: more damage

Burns

Burns or Scalds: singeing of hair present

Burns

Burns or Scalds: site of application at or above the site of contact of the flame

Scalds

Burns or Scalds: application of moist heat

Scalds

Burns or Scalds: boundaries distinct, usually like a geographical relief map

Thermal

Thermal or Chemical burn: blistering may be present

First degree

Dupuytren Classification of Burns: Erythema or simple redness of the skin associated with superficial inflammation and slight swelling

Second degree

Dupuytren Classification of Burns: (+) vesicle formation with acute inflammation; superficial layers of the epithelium are destroyed

Third degree

Dupuytren Classification of Burns: destruction of the cuticle and part of the true skin; burned area is very painful

Fourth degree

Dupuytren Classification of Burns: the whole skin is destroyed with formation of slough which is yellowish brown/parchment like; not very painful

Fifth degree

Dupuytren Classification of Burns: there is involvement of deep fascia and muscles

Sixth degree

Dupuytren Classification of Burns: there is charring of the limb involving subjacent tissues, organs, and bone

Sulfuric acid

Lesion by this chemical leads to formation of blackish brown sloughs (aka oil of vitriol)

Nitric acid

Lesion by this chemical leads to formation of yellowish brown sloughs

Hydrochloric acid

Lesion by this chemical causes intense irritation and localised ulceration of a red or reddish gray color

Arborescent pattern

Pattern of lesion in lightning burns

High voltage burns

Crocodile skin appearance of the skin is secondary to __

Shock

Main cause of death from electricity

AC

Alternating or Direct Current: more dangerous

Lynching

Homicidal hanging practiced by Americans against Negroes

True

True or False: Hanging is suicidal unless proven otherwise

Hanging

Hanging or Strangulation with Ligature: hyoid bone frequently injured

Ligature

Hanging or Strangulation with Ligature: mark is usually horizontal and knot is on the same horizontal plane

Hanging

Hanging or Strangulation with Ligature: vertebral injury present

Throttling

Asphyxia produced by compression of the neck by human hands

Smothering

Caused by the closing of the external respiratory orifices, either by the use of the hand or by some other means

Overlaying

Most common accidental smothering in children

Cafe coronary

Sudden heart attack in the middle of dinner due to asphyxia by choking.

2-5 mins

Average time required for death in drowning

Schaefer method

Emergency treatment in drowning: patient in prone position and the operator exerts pressure on the lower ribs at the rate of 12-15 times a minute

Sylvester method

Emergency treatment in drowning: swings the arms of the patient forward and then pressing the chest wall. This is repeated every 3-5 seconds.

Champignon d'ocume

Whitish foam that accumulates in the mouth and nostrils of people who drowned

Gettler Test

Quantitative determination of the chloride content of the blood in the right and left ventricles of the heart. Demonstration of a difference of at least 25 mg proves that death occurred in fresh or salt water pool and drowning is the cause of death

Tete de negri

Bronze color of the head and neck of a person who dies in water during the process of decomposition