Вы находитесь на странице: 1из 38

FORENSIC MEDICINE NOTES 2015

I. ANTHROPOMETRY (Bertillon System) front (anterior) and back (posterior) regions.

-The study of human body measurement for use in Transverse Plane: Imagine a horizontal plane that
anthropological classification and comparison. runs through the midsection of your body. This plane
divides the body into upper (superior) and lower
Basis: It is impossible to find two human beings
(inferior) regions.
having bones exactly alike.

*note: The human skeleton is unchangeable after Anatomical Directional Terms:


th
the twentieth (20 ) year.
Anterior: In front of, front
Posterior: After, behind, following, toward the rear

INFORMATION INCLUDED IN THE SYSTEM: Distal: Away from, farther from the origin
Proximal: Near, closer to the origin
a. Desciptive data- hair color, eyes, skin; shape of the
nose… etc
Dorsal: Near the upper surface, toward the back
b. Body Marks Ventral: Toward the bottom, toward the belly

c. Anthropometrical measurements: Superior: Above, over


Inferior: Below, under
-Body measurements

-Measurements of the head Lateral: Toward the side, away from the mid-line
Medial: Toward the mid-line, middle, away from the
-Measurements of the limbs side

PORTRAIT PARLE (Spoken Picture) Rostral: Toward the front


Caudal: Toward the back, toward the tail
-Is a verbal, accurate and picturesque description of
the person identified.

Anatomical Body Planes:

Lateral Plane or Sagittal Plane: Imagine a vertical


plane that runs through your body from front to
back or back to front. This plane divides the body
into right and left regions.

 Median or Midsagittal Plane: Sagittal plane


that divides the body into equal right and
left regions.

 Parasagittal Plane: Sagittal plane that


divides the body into unequal right and left
regions.

Frontal Plane or Coronal Plane: Imagine a vertical


plane that runs through the center of your body
from side to side. This plane divides the body into

COMPILED AND ENCODED: Macky Gallego and Shem Viloro


FORENSIC MEDICINE NOTES 2015

SCIENTIFIC METHODS OF IDENTIFICATION: b.5. Injuries leaving permanent marks- like in


fractures (Malunion of Fractures)
 -Anthropometry
 -Fingerprinting b.6. Moles
 -Dental Identification
b.7. Scar
 -Handwriting
 -Identification of Skeleton b.8. Sex or Reproductive Organs
 -Determination of Sex
 -Determination of Age b.9. Blood Examination
 -Identification of Blood and Blood stains
b.10. Stature
 -Identification of hair and fibers
RULES IN IDENTIFICATION OF EVIDENCE:
IDENTIFICATION OF PERSONS:
1. The greather the number of points of similarities
Ordinary Methods of Identification:
and dissimilarities of two persons compared, the
a. Applicable to the LIVING PERSON ONLY greater probability for the conclusion to be correct.
(LAW OF MULTIPLICITY OF EVIDENCE IN
a.1 Characteristics which may easily be IDENTIFICATION)
CHANGED:
2. The value of the different points of identification
o -Growth of hair, beard, mustache varies the formulation of conclusion (e.g.
o -Clothing Fingerprints, bodily marks, dental comparison)
o -Frequent place of visit
o -Trade of profession 3. The longer the interval between the death and the
o -Body Ornamentation examination of the remains for purpose of
identification; the greater is the need for experts in
a.2 Characteristics which are NOT easily establishing identification.
CHANGED:
Dental Identification
o -Memory
o -Speech The role of the teeth in human identification is
o -Gait, Gait Pattern important for the following reasons:

-GAIT PATTERN: is the series of foot 1. The possibility of two persons to have the same
movement of a person walking or running. It is the dentition is quite remote. This is due to the fact that
manner of walking or running. human, more particularly the adults has thirty-two
teeth and each tooth gas five surfaces.
b. Applicable to BOTH LIVING and DEAD (before
onset of decay) 2. Some of the teeth may be missing, carious, with
filling materials, and with abnormality in shape and
b.1. Occupational Marks other peculiarities. This will lead to several
combination with almost infinite in number of the
b.2. RACE: Color of skin, facial features and
dental characteristics of individual person.
shape of the skull.
3. The enamel of the teeth is the hardest substance
b.3. Tattoo marks
of the human body. It may outlast all other tissues
b.4. Birth marks during putrefaction or physical destruction.

COMPILED AND ENCODED: Macky Gallego and Shem Viloro


FORENSIC MEDICINE NOTES 2015

4. The more recent the ante-mortem records of the exact location in the human body is necessary. Any
persons to be identified the more reliable is the plurality or excess of the bones after a complete lay-
comparative or exclusionary mode of identification out denotes that the remains belong to more than
that can be done. one person. However, congenital deformities as
supplementary fingers and toes must be forgotten.
5. After death, the greater the degree of tissue The un-equality in sizes, especially of the limbs may
destruction, the grater is the importance of dental be ante-mortem.
characteristics as a means of positive identification.
3. Determination of height, sex, race, and age.
6. The more recent the ante-mortem records of the several formulate using different constants have
persons to be identified the more reliable is the been forwarded in the approximation of the height
comparative or exclusionary mode of identification of a person by measuring the long bones of the
that can be done. body. In determining the sex skeleton, the following
bones must be studied, i.e., pelvis, skull, sternus,
In order to make an accurate dental record available
femur, and humerus.
for purposes of comparison with that of the person
to be identified, Presidential Decree No. 1575 was It is becoming more difficult to determine the race
promulgated, requiring practitioners or dentistry to because of the amalgamation of races. For practical
keep records of their patients. consideration there is hardly no races that is
absolutely pure. The following points may be used in
Identification of Skeleton
determining the race in the remains of a person, i.e.,
Occasionally, before a physician is called to examine extrinsic factors such as, color of the skin, facial
a dead body, the soft tissues have already features, nature of the hair, and mode of dressing;
disappeared and only the skeletal system remains. In indices such as skull, pelvis, and extremities such as
this crural index, intermembral index, and humero-
femoral index.
particular case, the study of bones must be resorted.
In the examination of bones, the following points Aside from the size of the bones and through the
can be determined approximately: conduct of dental examination, the height, age, sex,
race of the person to whom the skeleton belongs
1. Whether the remains are of human origin or not. may be determined by: appearance of the
The shape, size and general nature of the remains ossification centers, union of bones and epihyses,
and especially that of the head must be studied. The dental identification, and obliteration of cranial
oval or round shape of the skull and the less structures.
prominent lower jaw and nasal bone are suggestive
of human remains. 4. Determination of the duration of internment. The
period from the time of death up to the time of
A complete lay-out of the whole bones found and examination may be determined by the nature and
placing each of them on their corresponding places presence of the soft tissues and the degree or
in the human body will be helpful. The presence of erosion of the bones, ordinarily, all the soft tissues in
dental fixtures, rings on the fingers, earrings in the a grace disappear within a year after internment.
case of women, hair and other wearing apparels,
together with the remains are strong presumption of 5. Ante-mortem or post-mortem bone injuries.
human remains. Individual bones must be examined to detail the
possible fractures. Importance must be laid on
2. Whether the remains belong to one person or not. whether these injuries in the bones occurred during
A complete lay-out of the bones on a table in their life or in the process of exhumation. Note the

COMPILED AND ENCODED: Macky Gallego and Shem Viloro


FORENSIC MEDICINE NOTES 2015

presence of vital reaction, principally the signs of microscopic structure is characteristically ovarian or
repairs. testicular.

Determination of Sex c. Chromosomal Test. It is noticed that there was a


difference between cell derived from men and
Below are some important factors to be considered women suitably stained and examined under the
in the determination of sex: microscope. The nucleus of the cells is a densely
staining area in the cell itself and that there was a
1. Legal importance of sex determination
small part of nucleus which stained deeply that the
a. As an aid in identification, the habit, social life, rest in women‘s cells but not cell from men. It is
manner of dressing, physical features and inclination observed in the while cells from the blood cells
are generally dependent on the sex. These points are obtained by scrapping the mucous membrane of the
useful in identification. mouth. this is Barr bodies.

b. To determine whether an individual can exercise 3. Evidence of sex.


certain obligations vested by law to one sex only. For
a. Presumptive Evidence, i.e., general features and
example, under the National defense Act,
contour of the face; presence or absence of hair is
compulsory military service or training refers only to
some parts of the body; length of scalp hair.
males, twenty years of age or above.
Generally, the female has long hair in the scalp than
c. Marriage or the union of a man – any male or that of the male; clothes and other wearing apparel,
female at the age of eighteen, not under any the but not in a transvestite; figure females have
impediments mentioned in Articles 80 to 84 of the prominent pelvis, while those of the males are
Civil Code, may contract marriage. slender; habit or inclination, pseudo-hermaphrodites
are person who have the gonadad tissue of one sex
d. Rights granted by law are different in different and the behavior of the opposite sex; and voice and
sexes. Majority commences upon the attainment of manner of speech.
twenty-one years.
b. Highly probable evidences of sex, i.e., possession
e. There are certain crimes wherein a specific sex can of vagina, uterus, and accessories in female, and
only be the offender or victim. There are certain penis in male; presence of developed and large
cases that are only applicable to women, such as a breasts in female; and muscular development
rape, prostitution, adultery, and violence against distribution of fat in the body.
women and children.
c. Conclusive evidence, i.e., presence of ovary in
2. Test to determine the sex. females and testis in males.

a. Social Test. Difference in the social role of the d. Evidence of sex in mutilated or decomposed body,
sexes used to be clearly marked but now they are i.e., general physical and muscular development;
less than they used to be. Dress, hairstyle, general hairline of the scalp, face, chest, pubes, and other
bodily shape provides an immediate and accurate parts of the body; prominence of the Sdam‘s apple;
answer to the vast majority of cases. amount of subcutaneous fat in specific part of the
body; presence of linea albicantes, enlarge nipple,
b. Gonadal Test. Presence of testes in male and
cutex in fingernails and lipsticks or coloring
ovary in female – this will involve exploration of the
materials; and presence of prostate gland in male or
abdomen and in some cases a histological
uterus and ovary in female. If in doubt, a microscopic
examination of the gonad to see whether its
examination must be made on the suspicious
ovarian or testicular tissue.

COMPILED AND ENCODED: Macky Gallego and Shem Viloro


FORENSIC MEDICINE NOTES 2015

4. Problem in sex determination system for the purpose of securing the secrecy and
sanctity of the vote.
Sex determination may be possible and can
scientifically be distinguished on account of the d. Determination of the exercise civil rights. Majority
biological structure differences; however, in the commences upon the attainment of the age of
following instances there will be no way to twenty-one (21) years. The person who had reached
determine the sex: majority is qualified for all act of civil life, save the
exceptional established by the Civil Code in special
a. Gonadal Agenesis. Sex organs, testes or ovaries, cases.
have never developed.
e. Determination to contract marriage. Any male of
b. True Hermaphrodism. A state of bi-sexualioty— the age of eighteen (18) or upwards, and any female
the gonads of both sexes were present which may of the same age, not under any of the impediments
be separated or combined as ovotestis. mentioned in Article 80 to 84 of the Civil Code may
contract marriage.
Determination of Age
f. As a requisite to certain crimes. This involves
For age determination, the following points have to
crimes of rape, infanticide, seductions, and
take into considerations, as follows:
consented abduction, violence against women, and
1. Legal importance of determination of age. in instances of child abuse and exploitation.

a. Determination of criminal liability. Article 12, 2. Determination of the age of the fetus.
Revised Penal Code – circumstances which exempt
a. Application of the Hess‘s of Haases‘ Rule. For fetus
from criminal liability. The following are exempted
of less 25 cm. long, get the square root of the length
from criminal liability, i.e., a person under nine years
in centimeter and the result is the age of the fetus in
of age; and a person over nine years of age and
month. For fetus 25 cm. or more, divide the length
under fifteen, unless he has acted with discernment,
of the fetus by 5, and the results is the age in month.
in which case, such minor, shall be proceeded
against in accordance with provision of Article 80, b. Examination of the product of conception. This
Revised Penal Code. can be done by determining the months of
conception, and the nature of the product of
b. As an aid in identification. Mention of the age of
conception.
the wanted or missing person will create an
impression of the physical characteristics, social life, 3. Age determination during infancy.
and psychic and mental behavior of that person.
Although it may only be presumptive, it may be a. Age based on height of weight. The estimation of
useful in identification. the age utilizing the weight and/or the height is not
quite useful inasmuch as there is a difference in the
c. Determination of the right of suffrage. Suffrage rapidity of growth not only in children of different
shall be exercised by citizens of the Philippines not sex, but also children of the same sex.
otherwise disqualified by law, who are eighteen (18)
years of age or over, and who shall have resided in b. Physical characteristics of infant. The skin of a
the Philippines for at least one year and in the place newly born are covered with vernix caeosa and red,
wherein they propose to vote for at least six months meconium present in the rectum, lanugo hair almost
preceding the election. No literacy, property, or disappeared, and limbs and body plumps.
other substantive requirement shall be imposed on
the exercise of suffrage. The Congress shall provide a c. Age determination in childhood and adulthood are
as follows: 1) age based on the eruption of teeth, 2)

COMPILED AND ENCODED: Macky Gallego and Shem Viloro


FORENSIC MEDICINE NOTES 2015

appearance of ossification centers, 3) union of creating them give testimony and subject
epiphysis with shaft of bones, and 4) obliteration of themselves to cross-examination
cranial structure.
II. FORENSIC SCIENCE

is the scientific method of gathering and examining


METHOD CONSIDERATION information about the past which is then used in a
[1]
court of law. The word forensic comes from the
The purpose of searching a crime scene is to identify Latin forēnsis, meaning "of or before the forum."
and secure evidence, enabling proper understanding
of the events that occurred, as well as physical Forensic Biology: the DNA analysis of body fluids,
material to support possible arrest, prosecution and teeth, hair, bone and tissue to identify a person.
conviction.
Forensic Geology: The study of trace evidence, soils,
The method employed (Grid, line, link, ray, spiral or minerals and petroleum to link a suspect to a crime.
zone) will actually be chosen based on the type of
Forensic Odontology: The study of teeth and bite
crime that occurred, the crime scene location (and
marks to identify a person.
difficulty of access to it), as well as the resources and
equipment capabilities available. WEIGHT OF FORENSIC EVIDENCE

CRIME SCENE INTEGRITY -It cannot be copied, changed or fabricated---


Depending on:
Crime scene investigators often get one chance to
properly search a crime scene before contamination  The manner in which evidence was
(Introduction of foreign materials) to the scene gathered, preserved and presented to the
becomes an issue. court.
 The manner the scientific examination was
As more and more people arrive at the scene--- from
conducted and
the general public and news media to medical and
law enforcement personnel, the scene’s evidence  The correctness of the interpretation of
losses it’s integrity (ability to be introduced as examination.
evidence into a court of law) for law enforcement
CHAIN OF CUSTODY
purposes.
-Must not be broken for forensic evidence to be
EXCHANGE PRINCIPLE
entitled to weight.
(Dr. Edmond Locard, French criminologist):
-Means that from discovery, collection, examination
“Everyone involved in a crime TAKES SOMETHING and scientific analysis to submission to the court the
from the scene, and LEAVES something of himself identity, physical appearance, original state and
nature of the evidence have NOT been CHANGED,
behind…”
ALTERED or TAMPERED.
Melendez-Diaz v. Massachussets:

“Forensic evidence is not uniquely immune from the


risk of manipulation…”

Also held that crime laboratory reports may not be


used at trial unless the analyst responsible for

COMPILED AND ENCODED: Macky Gallego and Shem Viloro


FORENSIC MEDICINE NOTES 2015

III. DNA TESTING promulgated the RULE ON DNA EVIDENCE through


its En Banc Resolution dated Oct. 2, 1007, which
DNA or deoxyribonucleic acid, is the hereditary took effect on Oct. 15, 2007.
material in humans and almost all other organisms.
Tijing vs. CA [ G.R. 125901, 8 March 2001]

Woman Took 12 Year-Old Son Of Bienvenida Tijing


Whom Latter Saw Again After 4 Years But Child
Named Already After Woman Who Took Him And
Her Spouse / Tijing Filed Habeas Corpus Case

SC Ruling : Tijing’s Son / Spouses Could Not Bear


Child / Trial Court Observed Child , Tijing Had
Strong Similarities In The Face, Eyes, Eyebrows,
Head Shapes

* We Have Now Facility , Expertise For DNA For


Prompt Paternity Test / Open To Challenge / Courts
Open.
At the heart of DNA evidence is the biological
molecule itself, which serves as an instruction SC Rule On DNA Evidence [ 15 October 2007]
manual and blueprint for everything in your body
(see How Cells Work for details). A DNA molecule is a Scope: When Offered, Used, Proposed To Be
long, twisting chain known as a double helix. DNA Offered Or Used As Evidence In All Criminal, Civil
looks pretty complex, but it's really made of only Cases And Special Proceedings
four nucleotides:
Applicability: Does Not Adopt Specific Rule On
Admissibility Of DNA Evidence, General Rules On
 Adenine
Relevancy And Not Excluded By Law Or Rules [Rule
 Cytosine
128, Sec. 3] Are Only Requirements / Matters Not
 Guanine
Specifically Covered - Rules Of Court / Evidence
 Thymine
“Biological Sample” – Any Organic Material From A
In human cells, DNA is tightly wrapped into 23 pairs
Person’s Body Even If Found In Inanimate Object
of chromosomes. One member of each
Susceptible To DNA Testing [ Blood, Saliva, Body
chromosomal pair comes from your mother, and the
Fluids, Tissues, Hair, Bones, Teeth ]
other comes from your father. In other words, your
DNA is a combination of your mother's and your “DNA Evidence” – Totality Of DNA Profiles,
father's DNA. Unless you have an identical twin, your Results,
DNA is unique to you.
Other Genetic Information Directly Generated From
This is what makes DNA evidence so valuable in DNA Testing
investigations -- it's almost impossible for someone
else to have DNA that is identical to yours. “DNA Testing”– Verified, Credible Scientific
Extraction Of DNA From Biological Samples,
-Considering the importance of the DNA technology Generation Of DNA Profiles And Comparison Of
as an aide in the administration of justice and noting Information Obtained
the capability of the existing facilities and forensic
experts in the Philippines, the Supreme Court

COMPILED AND ENCODED: Macky Gallego and Shem Viloro


FORENSIC MEDICINE NOTES 2015

To Determine With Reasonable Certainty Whether inaccurate because of sample degradation,


DNA Obtained From Two Or More Distinct contamination or failure to observe
Samples Originates From The Same Person [ Direct scientific procedures in testing.
Identification] Or Originates From Related Persons
[Kinship Analysis] BASIC INSTANCES WHEN DNA FINGERPRINTING
HAS BEEN USED WORLDWIDE:

 Establishing Paternity
People v. Vallejo  Solving of Crime- DNA evidence to prove
whether the person was or was not at the
The courts admitted the importance of DNA test as
crime scene.
the court applied the totality of evidence to
 Identification of body- Identify victims of
conclude that the accused appellant is guilty of the
bombings, shipwreck, fire and other mass
crime charged (Rape with homicide)
disasters where bodies or body parts are
available.

METHODS OF DNA TESTING:


As early as 1995 the SC of the Philippines noted the
importance of DNA when it stated in its obiter 1. Restriction Fragment Length Polymorphism (RFLP)
dictum in the case of People v. Teehankee (where
the appellant was convicted of murder on the Restriction enzymes cut the DNA extracted >
testimony of 3 eyewitnesses) that: Electrophoresis (solution with DNA fragments placed
on a gel and exposed to electric current) > pattern of
“While eyewitness identification is dozens of parallel bands (there are more than 10
significant, it is not as accurate and billion probable patterns from the individual
authoritative as the scientific forms of assortment of polymorphisms.)
identification evidence such as the
fingerprint or the DNA test result.” 2. Polymerase Chain Reaction (PCR)

In 1999, the court made a categorical The copying process uses the enzyme polymerase to
pronouncement that DNA typing is more ACCURATE replicate DNA regions in a test tube. By repeating
and AUTHORITATIVE means of identification than the copying process, a small number of DNA
eyewitness testimony (Andal v. People) molecules can be reliably increased up to billions
with several hours.

DNA samples analyzed by scanning in 13 regions


POSSIBLE RESULTS OF DNA TESTING: (Loci or markers)

 Exclusion- DNA profile from the evidence >With scanned DNA data, profiles of the suspect and
sample does not match the profile of of the person whose DNA was found at the crime
suspect’s reference sample, the suspect is scene created.
excluded as a source evidence.
 Inclusion- DNA profile of the reference >Profiles are then matched
sample matches that of the evidence
sample, the suspect is included as potential Uniqueness of DNA:
source of evidentiary DNA.
The possibility that another person has the same
 Inconclusive- It is not possible to determine
DNA profile for a particular set of 13 loci is about
the sample are the same or test are

COMPILED AND ENCODED: Macky Gallego and Shem Viloro


FORENSIC MEDICINE NOTES 2015

one in a billion. It is more accurate than an


eyewitness account. • 80% of the human population are secretors

SOURCES OF DNA EVIDENCE: • Blood cells contain several different enzymes in


them that can be identified. The best enzymes to
 -Bite mark or area licked or dribbled identify for forensic purposes are those that are
 -Fingernail scraping (blood or skin cells) polymorphic or have iso-enzymes.
 -Surface of condom (Semen or skin cells)
• The more factors that are identified in a
 -Blankets, sheets, pillows or other bed bloodstain, the smaller its frequency of occurrence.
linens (Semen, sweat, hair, or saliva)
 -Clothing, including garments worn during
and after the assault (Hair, semen, blood, IDENTIFICATION OF BLOOD AND BLOOD STAINS:
sweat)
 -Hat, scarf, mask (Sweat, skin cells and
saliva) Legal Importance of the Study of Blood:
 -Tissue Paper, wash cloth (Saliva, semen, 1. In disputed parentage.
hair, skin cells or blood)
2. As circumstantial and corrobative evidence as
 -Cigarette Butt, toothpick (Saliva) pepretrator of crime.
 -Tape or Ligature (Skin cells…)
3. In the crime scene : cause of death, direction of
IV. INTRODUCTION TO BLOOD escape, approximate time of death

 Recent blood is bright red in color, bloodstains


• Four blood types – A (39%), B (11%), AB (4%) exposed to air become dry (hemoglobin to
and O (46%) hematin)

 Solution with blood when heated produces a


Blood Antigen Antibody % muddy precipitate
Type (blood population
 Bloodstains within certain solutions added
group) emit bluish white luminescence in dark room

A A Anti-B 40  chemical, microscopic, microchemical,


spectroscopic, biologic examinations

Blood grouping

B B Anti-A 10 Value of the test: it may solve disputed parentage. A


positive result is not conclusive of paternity or
maternity. If a negative result, he or she is not the child
of a person he claims to be his parent.
AB A&B none 5 Blood pattern Analysis (BPA), Is the examination of the
size, shape, location and distribution pattern of
bloodstains.

O H Anti-A & 45 Interpreted to show the relative positions of the people


Anti-B involved, the degree of force used and the angle of
attack at a crime scene or whether the perosn has lost
blood in an intended or accidental way? - confirm
• Rh Factor -83% of population are positive 3 main categories

• Testing for blood type is done through  Passive bloodstains


agglutination and antibodies
 Transfer bloodstains

COMPILED AND ENCODED: Macky Gallego and Shem Viloro


FORENSIC MEDICINE NOTES 2015

 Projected bloodstains  Handedness of assailant/s


Blood splatters can ascertain:  Position and movements of the victim and
the assailant during and after the attack
Type and velocity of weapon, wounds, number of
 Wounds inflicted first
blows, duration of the crime, handedness of assailants.
 Types of injuries
 Duration of the crime committed
Blood Splatter Rules  Whether death was immediate or delayed.

1. Surface texture effects bloodstain patterns. MAIN CATEGORIES:

• Harder and less porous the surface the less a. Passive Bloodstains- drops formed by the force of
splatter. gravity acting alone.

2. Direction of Blood’s travel may be shown by the b. Transfer bloodstain- exemplified by a bloody hand
stains shape or footwear created on a surface.

• Pointed end of a bloodstain always faces the c. Projected bloodstains- Formed by blood from a
direction it traveled. punctured or damaged artery.

3. It is possible to determine the impact angle of BLOOD PATTERN ANALYSIS (BPA)


blood on a flat surface by measuring the degree of
circular distort. Is the examination of the SIZE, SHAPE, LOCATION
and DISTRIBUTION PATTERN of bloodstains.
• Larger angles beyond 90 degrees the more
elongated the stain. Interpreted to show the relative positions of the
people involved, the degree of force used and the
4. The origin of a Blood splatter can be established angle of attack at a crime scene, or whether the
by drawing straight lines through the long axis of person has lost blood through a medical condition or
several individual bloodstains. an accidental or self inflicted injury.

• The point of convergence of the lines represents BLOOD GROUPING


the point from which the blood originated.
Principle: Blood of all human beings belong to any of
TYPES OF BLOOD SPLATTERS the four principal blood groups. A normal suspension
of human red cells when mixed with similar serum
results in even suspension.

When mixed with another group/s AGGLUTINATION


results (Dumping of red blood cells)

The RBC contain AGGLUTINOGENS (Antigens) and


the serum contains Antibodies.

Value of the test

BLOOD SPLATTERS CAN ASCERTAIN: It may solve disputed parentage. A positive result is
not conclusive of paternity or maternity, but a
 Type and Velocity of weapon negative result is CONCLUSIVE the he/she is not the
 Number of blows child of the alleged parent.

COMPILED AND ENCODED: Macky Gallego and Shem Viloro


FORENSIC MEDICINE NOTES 2015

V. MEDICO-LEGAL ASPECTS OF DEATH  -General Rule: If there is no heart action for


a period of 5 minutes DEATH IS REGARDED
Importance of death determination: AS CERTAIN.

 -The civil personality of a natural person is


Methods of Detecting:
extinguished by death.
 -Palpation of the pulse
 -The property of a person is transmitted to
 -auscultation for Heart Sounds
his/her heirs at the time of death.
 -Fluoroscopic Examination
 -The death of a partner is one of the causes
of dissolution of partnership agreement.  -Electrocardiography
 -The criminal liability is extinguished by 2. Cessation of RESPIRATION
death.
 -The civil case for claims which does not  -Must be CONTINUOS and PERSISTENT
survive is dismissed upon the death of the  -A person can hold his breath NOT LONGER
defendant. than 3 ½ minutes. Maybe suspended in:
Divers or swimmers, Cheyne-Strokes
DEATH- is the termination of life.
respiration, Apparent drowning, newborns.
KINDS OF DEATH:
Methods of Detecting:
 SOMATIC or clinical death- persistence of
 -Observing the movement of chest
vital functions. The state of the body in
and abdomen for inspiration and
which there is complete, persistent and
expiration.
continuous cessation of vital functions of
 -Auscultation over base of the
the brain, head and lungs which maintains
anterior and posterior neck (Air
life.
passing through trachea)
 MOLECULAR or cellular death- 3 to 6 hours
after cessation of life, when there is no 3. Cooling of the body (ALGOR MORTIS)
evidence of excitability of muscles and
other functions of individual cells. This is  -Progressive fall of the body temperature
affected by previous state of health, when the metabolic processes in the body
infection, climate…etc ceases.
 APPARENT death or state of suspended  -Cooling is rapid during the first 2hours
animation- transient loss of consciousness after death and slows down as the body
in hysteria, uremia, electric shock, catalepsy approaches the temperature of the
in drowning cases before resuscitation. environment.

SIGNS OF DEATH: Factors delaying cooling:

1. Cessation of heart action and circulation  -Febrile diseases, sudden death in good
health, obesity, death from asphyxia,
 -Usually the auricle contracts after somatic clothing, warm surroundings.
death for a longer period than the ventricle,
last to stop so called “ULTIMEN MARIENS” Factors accelerating cooling:
 -Respiration stops before the cessation of
 -Body leanness, extreme age, chronic
heart contraction and circulation.
illness, absence of clothing, body in water.

COMPILED AND ENCODED: Macky Gallego and Shem Viloro


FORENSIC MEDICINE NOTES 2015

CHANGES IN THE BODY FOLLOWING DEATH: Chemically, there is an increase of lactic acid and
phosphoric content of the muscle. The reaction
1. Changes in the Muscle becomes acidic. There is no definite explanation as
to how such contraction of muscles occurs although
After death, there is complete relaxation of the
it has been proven that there id coagulation of the
whole muscular system. The entire muscular system
plasma protein.
is contractile for three to six hours after death, and
later rigidity sets in. secondary relaxation of the In the medico-legal point of view, post-mortem
muscles will appear just when decomposition has set rigidity may be utilized to approximate the length of
in. the following are the stages of the entire time the body has been dead. In temperate
muscular tissue after death: countries it usually appears three to six hours after
death, but in warmer countries it may develop
a. Primary Flaccidity or Post-Mortem Muscular
earlier.
Irritability
In temperate countries, rigor mortis may last for two
Immediately after death, there is complete
or three days but in tropical countries the usual
relaxation and softening of all the muscle of the
duration is twenty-four to forty-eight hours during
body. The extremities may be flexed, the lower jaw
cold weather and eighteen to thirty-six hours during
falls, the eyeball loses its tension, and there may
summer. When rigor mortis sets in early, it passes
incontinence of urination and defecation.
off quickly and vice-versa.
To determine whether the muscles are still irritable,
Conditions Stimulating Rigor Mortis
apply electric current and note whether there is still
irritability of the muscles. Normally during the stage 1. Heat Stiffening
of primary flaccidity, the muscles are still contractile
and react to external stimuli, mechanical or electrical If the dead body is exposed to temperature above
owing to the presence of molecular life after somatic 75o it will coagulate the muscle protein and cause
death. the muscles to be rigid. The stiffening is more or less
permanent and may not be easily affected by
This stage is usually lasts about three to six hours putrefaction. The body assumes the ―pugilistic
after death. In warm places, the average duration is attitude‖ with the lower and upper extremities
only one hour and fifty minutes. Chemically, the flexed and hands clenched because the flexor
reaction of the muscle is alkaline and the normal muscles are stronger than the extensors.
constituents of the individual muscle proteins are
the same as life. 2. Cold Stiffening

b. Post-Mortem Rigidity or Cadaveric Rigidity or The stiffening of the body may be manifested when
Death Stiffening or Death Struggle of the Muscles or the body is frozen, but exposure to warm conditions
Rigor Mortis will make such stiffening disappear. The cold
stiffening is due to solidification of fat when the
Three to six hours after death the muscles gradually body is exposed to freezing temperature. Forcible
stiffen. It usually starts at the muscles of the neck stretching of the flexed extremities will produce a
and lower jaw and spreads downwards to the chest, sound due to the frozen synovial fluid in the elbows
arms, and lower limbs. Usually the whole body and knees.
becomes stiff after twelve hours. All the muscles are
involved-both voluntary and involuntary. In the
heart rigor mortis may be mistaken for cardiac
hypertrophy.

COMPILED AND ENCODED: Macky Gallego and Shem Viloro


FORENSIC MEDICINE NOTES 2015

3. Cadaveric Spasm or Instantaneous Rigor 3. Occurrence

This is the instantaneous rigidity of the muscles Rigor mortis is a natural phenomenon which occurs
which occurs at the moment of death due to after death, while cadaveric spasm may or may not
extreme nervous system or injury to the chest. It is appear on a person at the time of death.
principally due to the fact that the last voluntary
contraction of muscle during life does not stop after 4. Medico-Legal Significance
death but is continuous with the act of cadaveric
Rigor mortis may be utilized by medical jurists to
rigidity. In case of cadaveric spasm, a weapon may
approximate the time of death, while cadaveric
be held in the hand before death and can be
spasm may be useful to determine the nature of
removed with difficulty.
crime.
For practical purposes it cannot be possible for the
c. Secondary Flaccidity or Secondary Relaxation
murderer or assailant to imitate the condition. In
cadaveric spasm, only group of muscles are involved After the disappearance of rigor mortis, the muscle
and they are usually asymmetrical. The findings of becomes soft and flaccid. It does not respond to
weapon, hair, pieces of clothing, weeds on the palms mechanical or electrical stimulus. This is due to the
or even firearms in the hands, and firmly grasped by dissolution of the muscle proteins which have
the victim are very important medico-legal point in previously been coagulated during the period of
the determination whether it is case of suicide, rigor mortis.
murder or homicide.
The body while at the stage of rigor mortis, if
The presence of weeds held by the hands of a stretched or flexed to become soft will no longer be
person found in water shows that the victim was rigid. This condition of the muscles is not considered
alive before disposal. Instantaneous rigor may also as a secondary flaccidity.
be found following the ingestion of cyanide but
usually it is generalized and symmetrical. Strychnine 2. Changes in Blood
may produce the same, but rigidity may appears
a. Coagulation of the Blood
sometime after ingestion.
The stasis of the blood due to cessation of
Rigor Mortis vs. Cadaveric Spasm
circulation enhances the coagulation of blood inside
1. Time of Appearance the blood vessels. The clotting of the blood is
accelerated in cases of death by infectious fevers
Rigor mortis appears three to six hours after death, and delayed in cases of asphyxia, poisoning by
while cadaveric spasm appears immediately after opium, hydrocyanic acid or carbon monoxide
death. Rigor mortis is a natural phenomenon, while poisoning.
livor mortis is situational.
Ante-Mortem Clot Post-Mortem Clot
2. Muscles Involved
1. Firm consistency. 1. Soft in consistency
Rigor mortis involves all the muscles of the body
whether voluntary or involuntary, while cadaveric 2. Surface of the blood vessels 2. Surface of the blood vessel
raw after the blood is removed. clots are smooth and healthy
spasm involves only a certain muscle or group of after clots are removed.
muscles and are asymmetrical, and that is rigid from
farthest part away from the body and less rigid 3. Clot homogenous in 3. Clots can be stripped into
closer to the body. construction so it cannot be layer.
stripped into layer.

Clots with distinct layer.


4. Clots with uniform color.

COMPILED AND ENCODED: Macky Gallego and Shem Viloro


FORENSIC MEDICINE NOTES 2015

The clothing of blood is very slow process that there is a already fully developed. This also involves all the internal
tendency for the blood to separate forming a red clot at organs.
the lower level and above it is a while clot known as
chicken-fat clot. Blood may remain fluid inside the blood Characteristics of Post-Mortem Lividity
vessels after death.
 It occurs in the most extensive areas of the most
b. Post-mortem Lividity dependent portions of the body.
 It only involves the superficial layer of the skin.
Blood accumulates in most dependent portions of the  It does not appear elevated from the rest of the
body. skin.
 The color is uniform, but the color may become
Importance:
greenish at the start of the decomposition.
 There is no injury of the skin.
 -It is one of the signs of death
 -Determines the position of the body has been
changed after it’s appearance in the body.
 -Color of lividity may indicate the cause of 3. Putrefaction of the Body
death
 -Determines how long the person has been Putrefaction is the breaking down of the complex protein
dead into simpler components associated with the evolution of
 -Gives us an idea as to the time of death foul smelling gasses and accompanied by the change of
color of the body.
The stoppage of the heart action and the loss of tone of
blood vessels cause the blood to be under the influence Tissue Changes in Putrefaction
of gravity. Blood begins to accumulate in the most
The following are the principal changes undergone by the
dependent portions of the body. The capillaries may be
soft tissues of the body after putrefaction.
distended with blood. The distended capillaries coalesce
with one another until the whole area becomes dull-red or
 Changes in the Color of the Tissues
purplish in color known as post-mortem lividity. If the
 Evolution of Gases in the Tissues
body is lying on his back, the lividity will develop on the
back.

Areas of bone prominence may not show lividity on Effects of Gases on Putrefaction
account of the pressure. If the position of the body is
moved during early stage of its formation, it may 1. Displacement of the Blood
disappear and develop again in the most dependent area
in new position assumed. But if the position of the body There may be post-mortem bleeding in open wounds on
has been changed after clotting or the blood has set in or account of the increased pressure inside the body brought
when blood has already diffused into the tissue of the about the accumulation of gases. The lividity may be
body, a change of position of the body will not alter the shifted to other parts of the body.
location of the post-mortem lividity.
2. Bloating of the Body
Ordinarily, the color of post-mortem lividity is dull-red or
On account of the accumulation of gas, the body is blown-
pink or purplish in color, but in death due to carbon
up and swollen. The eyes may be protruding from it
monoxide poisoning, it is bright pink. Exposure of the dead
sockets, the tongue may come out of the mouth, and the
body to cold or hot may cause post-mortem lividity to be
face is black with thick lips having the appearance of a
bright-red in color. The lividity usually appears three to six
Negro or ―tete de negri‖.
hours after death and the condition increases until blood
coagulates. The time of its formation is accelerated in
cases of death due to cholera, uremia and typhus fever.
Twelve hours after death, the post-mortem lividity is

COMPILED AND ENCODED: Macky Gallego and Shem Viloro


FORENSIC MEDICINE NOTES 2015

3. Fluid Coming Out of Nostrils and Mouth 2. Presence of POST MORTEM LIVIDITY

Fluid coming out of both nostrils and mouth is usually in  -Develops 2-6 hours after death in the most
the form of froth. It is due to the putrefaction of the upper dependent portions of the body depending upon
gastro-intestinal and respiratory tracts. the position assumed at the time of death

4. Extrusion of the Festus in Gravid Uterus 3. Onset of DECOMPOSITION

On account of the increased intra-abdominal pressure, the  -Average time is 24 to 48 hours after death.
contents of the gravid uterus may expelled, but this event Manifested by watery, foul-smelling froth
is quite doubtful when the product of conception is coming out of the nostrils and mouth.
nearing full terms because of the difficulty of expulsion.
There is more likehood for the uterus to rupture inside the
abdominal cavity.
VI. MEDICO-LEGAL INVESTIGATION OF DEATH
5. Floating of the Body
INQUEST OFFICER
The specific gravity of a decomposed body is much less as
compared with recently dead. This is due to the increase  Is an official of the state charged with the duty of
of gaseous content and increase in volume due to bloating inquiring into certain matters.
without any increase in weight.  In medico-legal examination: manner and cause
of death
6. Liquefaction of the Soft Tissues
OFFICIALS AUTHORIZED TO MAKE DEATH
As decomposition progresses, the soft tissues of the body INVESTIGATIONS:
undergo softening and liquefaction. The eyeballs, brain,
stomach, intestine, liver and spleen putrefy rapidly, while  -Provincial and City Prosecutors
highly muscular organs and tissues relatively putrefy late.  -Judges of the RTC, MTC
 -Director of NB!
CHRONOLOGIC CHANGES IN TROPICAL REGION  -Solicitor General

12 hours after death Rigor mortis all over, Stages of Medico-Legal Investigation:
hypostasis, greenish
discoloration of the caecum  Crime Scene Investigation- investigation of place
24 hours Rigor mortis absent all of commission of the crime.
over, abdominal distention
-Place where the essential ingredients of the
48 hours Ova of flies, trunk bloated,
crime took place.
face discolored
72 hours Whole body grossly  Autopsy- Investigation of the body of the victim.
swollen, hairs and nails loos Comprehensive study of a dead body, in addition
1 week Soft viscera putrefied to the external examination.
2 weeks Soft tissues largely gone
One month Body Skeletonized Post-Mortem Examination- External exam without incision
being made.

DURATION OF DEATH: Hospital or Non-offical Autopsy:

1. Presence of RIGOR MORTIS -Done with the consent of the deceased person’s relatives
for the purpose of:
 -Sets in from 2-3 hours after death. Fully
developed in 12 hours. May last 18-36 hours and  Determining the cause of death
its disappearance concomitant with onset of  Providing correlation of clinical diagnosis and
putrefication. clinical symptoms.
 Determining effectiveness of therapy
 Studying the natural course of disease process;

COMPILED AND ENCODED: Macky Gallego and Shem Viloro


FORENSIC MEDICINE NOTES 2015

 Educating students and physicians Disposal of the Dead Body:

Right Person to GIVE CONSENT (order) Revised Administrative Code:

 Spouse a. If the deceased was a married man or woman,


 Descendants (nearest) the duty of burial shall devolve upon the
 Ascendants (nearest) surviving spouse if he/she possesses sufficient
means to pay the necessary expenses.
Medico-Legal or Official Autopsy b. If the deceased was an unmarried man or
woman, or a child, and left any kin, the duty of
Done for the purpose of: the burial shall devolve upon the nearest kin of
the deceased, if they be adults and within the
 Determining the cause, mode, and time of
Philippines and in possession of sufficient means
death;
to defray the necessary expenses.
 Recovering, identifying, and preserving
c. If the deceased left no spouse or kindred
evidentiary material;
possessed of sufficient means to defray the
 Providing interpretation and correlation of facts
necessary expenses, the duty of burial shall
and circumstances related to death;
devolve upon the municipal authorities.
 Providing a factual, objective medical report for
law enforcement, prosecution, and defense
 -They shall perform such duty within
agencies; and
48 hours after death.
 Separating death due to disease from death due
to external cause for protection of the innocent. Right of CUSTODY to the Body:

The dead belongs to the state for the protection of public Any person charged by law with the duty of burying the
interest until after the investigation is completed. body of a deceased person is entitled to the custody of
such body for the purpose of burying it EXCEPT: when
WHEN SHALL AUTOPSY BE PERFORMED ON A DEAD INQUEST is required by law in case of death due to
BODY? communicable disease

 Whenever required by special laws VII. HANDWRITING ANALYSIS


 Upon order of a competent court, a mayor and a
provincial or city fiscal; Examines the penmanship of a person, how he signs his
 Upon written request of police authorities name, writes, slants, forms and punctuates his letters,
 Whenever the Solicitor General, provincial or city sentences and paragraphs.
fiscal as authorized by existing laws- shall deem
it necessary to disinter and take possession of The analysis is done by comparing the forged or
the remains for examination to determine the questioned document to the true writing of person for
cause of death; similarities and differences.
 Whenever the nearest kin shall request in
CONS: the technique appears to be subjective and lacking
writing the authorities concerned in order to
in controlling standards.
ascertain the cause of death.
PROS: Those who are defending handwriting analysis on
Persons authorized to perform Autopsies:
scientific grounds cited a study of Sargur Srihari, computer
 Health officers science professor at the State University of New York:
 Medical officers of law enforcement agencies
 -1,550 writing samples to computer
 Members of the medical staff of accredited
analysis, he concluded that in 96% of
hospitals
cases the writer of a sample could be
positively identified based on the
number of handwriting features such
as letter dimensions and pen pressure.

COMPILED AND ENCODED: Macky Gallego and Shem Viloro


FORENSIC MEDICINE NOTES 2015

SIGNATURE FORGERY- is the deliberate attempt to make it 1. Rubor- Reduces or congestion of the area due to an
appear that a person has participated in the execution of a increase of blood supply as a part of the reparative
document. mechanism. (redness)

Classification: 2. Calor- Sensation of heat or increase in temperature.

a. TRACED FORGERY is basically drawing and lacks 3. Dolor- Pain on account of the involvement in the
free natural movement in a normal writing. sensory nerve.
b. SIMULATED FORGERY is an attempt to copy in a
freehand manner a genuine signature. 4. Loss of Function
c. SPURIOUS FORGERY- no attempt is made to copy
On account of the trauma, the tissue may not be able to
the genuine writing.
function normally. The presence of vital reaction
DISGUISED WRITING- is the deliberate attempt of writer differentiates ante-mortern from post-mortem injury.
to alter his writing with a new style or by imitating the
In the following instances -vital reactions or changes may
writing of another person.
not be observed even if injury was -inflicted during life:
 By changing the direction of slant or speed in
a. If the physical injuries are inflicted during the
writing or size of letters, by deliberate
agonal state of a living person. The body cells or
carelessness, by using left or right hand.
tissue during the period may have the potential
 Characterized by inconsistencies in slant or letter
capacity to react to the trauma; and
formation, lack of free flowing movement and
a. If death is so sudden as not to give the tissues of
rhythm, unnatural starts and stops, irregular
the body, the chance to react properly‘. This is-
spacing.
commonly observed in deaths due to sudden
The Standard writing with which the questioned writing coronary occlusion.
has to be compared are of two types:
Classifications of Physical Injuries
 COLLECTED (Procured) STANDARD- handwriting
The following are the classifications of physical injuries:
by the person who is suspected to have written
the questioned document found in private or 1. As to severity.
public records. IF CLEAR and SUFFICIENT- is the
most appropriate standard. a. Mortal Wound
 REQUESTED STANDARD- made by the alleged
writer upon request of the examiner or persons Wound is caused immediately after infliction or shortly
interested in the examination, application to thereafter that is capable of causing death. Parts of the
recently written questioned documents. body where the wounds inflicted are considered mortal,
i.e., heart and big blood ‗vessels, brain and upper -portion
of the spinal cord; lungs―, stomach, liver, spleen and
intestine.
VIII. PHYSICAL INJURIES RESULTING FROM PHYSICAL
VIOLENCE b. Non-Mortal Wound

Vital Reactions This is a type of wound which is not capable of producing


death immediately after infliction of the external, stimuli
It is the stun total of all reaction of tissue or organ to or outside _ force or shortly thereafter.
trauma. The reaction may be observed microscopically The
following are the common reactions of a living tissue to 2. As to the kind of instrument used
trauma.
a. Wound brought about by blunt instrument, i.e.,
contusion hematoma, and lacerated wounds.

COMPILED AND ENCODED: Macky Gallego and Shem Viloro


FORENSIC MEDICINE NOTES 2015

b. Wound brought about by sharp instrument; i.e., sharp a. .Coup injury


edged instrument-incised wound, sharp pointed
instrument-punctured would, sharp-edged and sharp Physical injury which is located at the site of the
pointed instrument stab wound. application of force.

c. Wound brought about by tearing force lacerated wound. b. Contre-Coup Injury

d. Wound brought about by change of atmospheric Physical injury found opposite at the site of the application
pressure barotrauma. of the force.

e. Wound brought about by heat or cold-frostbite, burns c. Coup Contre-Coup Injury


or scald. f. Wound brought about by chemical explosion-
Physical injury located at the site and also opposite the site
gunshot or shrapnel wound. g. Wound brought about by
of application of force.
infection.
d. Locus Minoris Resistencia
3. As to the manner of infliction.
Physical injury located not at the site nor opposite the site
That is, hit-bolo, blunt instrument, axe; thrust or stab-
of the application of force but in some areas -offering the
‗bayonet, dagger; gunpowder explosion-projectile or
least resistance to the force applied. A blow on the
shrapnel "wound; and siding or rubbing abrasion.
forehead may cause contusion at the region of the eyeball
4. As regards to the depth of the wound because of the fracture on the papyraceous bone forining
the roof of the orbit.
a. Superficial
e. Extensive Injury
When the wound involves only the layers of the skin.
Physical injury involving greater area of they body beyond
b. Deep the site of the application of force. It has not only the wide
area" of injury but also the varied types of injury. A fall
When the wound involves the inner structure ‗beyond the from a height or a run-over victim of vehicular accident
layers of the slain. may suffer from multiple fractures, laceration of organs,
and all types of skin injuries.
l) Penetrating .
When a stationary head is hit by moving object, there is
It is one in-which the wounding agent enters the body but
tendency for the development of contusion on the brain
did not Come out or the mere piercing of a solid organ or-
_at the site of impact. When the moving head hits a firm,
tissue of the body. Penetrating wound, it is a wound where
fixed and hard. object, brain contusion may develop at the
the dimension of depth and direction is an important
opposite of the site of impact. A coup,-contra-coup
factor in its description. It involves the skin of mucous
location of brain injury may be found a fixed head is hit
‗surface and deeper underlying tissues or organs, caused
with a moving object and then falls -on another hard
directly by the wounding instrument. Puncture, stab, and
object.
gunshot wounds usually belong to this type of wound.
6. As to regions or organs of the body.
2) Perforating ' -
That is, head and neck, injuries in the chest, abdominal
It is produced when the wounding agent produces
injuries, pelvic injuries, and extremities -upper and lower.
communication between the inner and outer portion of
the hollow organs. It may also mean piercing or traversing 7. Special Types of Wounds
completely a particular part of the body causing
communication between the points of u entry and exit of a. Defense Wound
the instrument or substance producing-it.
It is a-wound which is the result of a person‘s instinctive
5. As regards to the site of the application. reaction of self-protection. Injuries suffered by a person to
avoid or repel potential injury contemplated by the

COMPILED AND ENCODED: Macky Gallego and Shem Viloro


FORENSIC MEDICINE NOTES 2015

aggressor. A person who is -conscious that he is going to The hemorrhage maybe small or pinhead sized but several.
be hit by a blunt instrument "on the head may raised his petechiae may coalesced to form a bigger-hemorrhagic
flexed forearms over his head, causing injuries to the area. Mosquito or other insect bites may
forearms.
cause the formation of circumscribed hemorrhages.
If someone is going to stab another with a sharp
instrument the tendency of: the potential victim is to take Petechiae are not always a product of trauma. Petechial
hold of the instrument thus causing the production -of an hemorrhage may be a post-mortem in death by hanging.
incised stab wound on the palm. There are- gravitation of blood into the most dependent
part of the body which eventually leads to rupture of over-
b. Patterned wound distended capillaries seen at the region of the leg.

Wound in the nature and shape of an object or instrument 2) Contusion


and which infers the object or instrument causing it.
Impact on the face of the radiator grill of a car may cause Contusion is the effusion of blood into the tissues
imprint of the radiator grill on face. underneath the skin on account of the rupture of the
blood vessels as a result of the application of blunt force or
A person run over by a wheel of a car, tire marks are violence. When a blunt force is applied, it momentarily
shown on the body. Due to-hanging, the nature of the compresses the blood vessels at the-point of contact,
abrasion mark on the neck may infer material used. thereby temporarily forcing the blood out of the area and
Contusion produced by belt, branch of tree metallic rod setting up a fluid wave under pressure.
etc. may have the shape of the wounding instrument.
When the pressure exceeds the cohesive force of the cells
c. Self-lnflicted Wound forming the capillary, arteriole, or venule wall, the vessel
ruptures. Inasmuch as it used to take more time for the
Self-inflicted wound is a- wound produced one oneself. As blood to get out of the blood vessels, contusion does not
distinguished from suicide, the person has no intention to immediately develop after the application force. It may
end.-his life. develop after a lapse of minutes or even hours after the
application force.
Medical Classifications of Wounds
The variation depends on the part of the body injured,
Enumerated hereunder are the different medical
tenderness of the tissues affected, condition of the blood
classification of wounds:
vessels involved, and natural disease. Women are much
more easily bruised than men while boxers are less prone
Closed "Wounds
to suffer contusion despite of heavy punishment. The size
There is no breach of continuity of the skin or mucous of the contusion is usually greater than the size of the
membrane. object causing it.

a. Superficial 3) Hematoma

When the wound is just beneath the layers of the --skin or Hematoma is the extravasations or effusion of blood in a
mucous membrane. newly formed cavity underneath the skin. It usually
develops". when the blunt instrument is applied in part of
1) Petechiae . the body where bony tissues is superficially located, like
the head, chest and the anterior respect of legs.
This is circumscribed extravasations of the blood in the
subcutaneous tissue or underneath the mucous The force applied causes the sub-cutaneous tissues
membrane. The cause of passage‗ of blood from rupture on account of the presence of a hard structure
capillaries may be due to the increase intra- capillary underneath. The destruction of the sub-cutaneous will
pressure or increased permeability of the vessel. lead to the accumulation of blood causing it to elevate.

COMPILED AND ENCODED: Macky Gallego and Shem Viloro


FORENSIC MEDICINE NOTES 2015

Contusion vs. Hematoma (e) Linear Fracture - when -the fracture forms a crack
commonly observed flatbones.
a. In contusion the effused blood are in the interstices of
the tissue underneath the skin, while the hematoma blood (f) Subluxation - incomplete or partial dislocation of the
accumulates in a newly formed cavity underneath the skin. bones.

b. In contusion, the skin shows no elevation and if ever" (g)- Spiral Fracture" _l the break in the bone form a spiral
elevated, the elevation is slight and is on account of manner as observed in long bones. (h) Pathologic Fracture
inflainrnatory changes while in hematoma the outer layer – fracture caused by weakness of the bone due to disease
of the skin is always elevated making "it visible to naked rather than violence.
eye.
(i) Strain - the over-stretching, instead of an actual tearing
c. In contusion, puncture or aspiration with syringe of the or the rupture of a muscle or ligament which may not be
lesion, no blood can be obtained, while in .hematoma, associated with the joint.
aspiration will show presence of blood and subsequent
depression of the elevated lesion. Abscess, fibroid b. Internal Hemorrhage
thickening, and even malignancy are " potential
Rupture of blood vessel which may cause hemorrhage
complications of hematoma.
maybe due to the following, i.'e., traumatic intracranial
b. Deep hemorrhage, -rupture of parenchymatous organs and
laceration -of other parts of the body.
a) Musculo-Skeletal Injuries
c. Cerebral Concussion-Commotion Cerebri
1) Sprain
Cerebral concussion is ' the jarring or stunning of the brain
Partial _ or complete disruption in the community of a characterized by more or less complete suspension of its
muscular or ligarnentous support of a joint. It is usually functions, as a result of injury to the head, which leads to
caused by a blow kick or torsion force. some commotion of the cerebral substance. Cerebral
concussion is much more severe when the moving or
2.) Dislocation mobile head struck a fixed object as compared when the
head is fixed and struck by a hard object loving.
Displacement of the articular surface of bones entering
into the formation of a joint. Signs and Symptoms of Concussion

3) Fracture -. 1) Unconsciousness which is more or less complete.

Dissolution of the continuity of bone resulting from 2) Muscles relaxed and flaccid.
violence or some existing pathology.
3) Eyelids are closed and the conjuctivae are insensitive.
(a) Close or Simple Fracture - fracture wherein -there is no
break in continuity of the over-lying skin or where the 4) Surface of the body is pale, cold and clammy.
external air has no point of access to the site of injury.
5) Respiration is slow, shallow and hanging.
(b) Open or Compound Fracture the fracture is
complicated by an open wound caused by the broken 6) Temperature is sub-normal.
bone which protruded with other tissues of the broken
7) Pulse is rapid, weak,― faltering and scarcely
skin
perceptible to the fingers.
(c) Greenstick Fracture — fracture wherein only one side
8) Sphincters are relaxed perhaps with unconscious
of the bone while the other side is merely bent.
evacuation of the bowel and bladder.
d) Comminuted Fracture, - the fractured. bone is
9) Reflexes are present but sluggish and in severe cases
fragmented into several pieces.
may be absent. Loss , of memory for events just before the

COMPILED AND ENCODED: Macky Gallego and Shem Viloro


FORENSIC MEDICINE NOTES 2015

injury retrograde anmesia, is a constant effect of cerebral called clipped or shacked wound. The injury is quite
concussion and its medico-legal importance. severe, and edges― may or may not be contused
depending on the nature of the sharpness of the
Open -Wound instrument used in producing the wounds.

There is a breach of continuity of the skin-or mucous Characteristics of Incised Wounds


membrane
1) Edges are clean-out and both extremities are sharp,
a. Abrasion-Scratch, Graze and Friction Mark except in areas where the skin is loose or folded at the
time when the injury was inflicted.
It is an injury characterized by the removal of the
superficial epithelial layer of the skin caused by a" rub or 2) The wound is straight-and may be -shelving if inflicted
friction against a hard rough surface. Whenever, there is with the wounding instrument applied with an acute angle
forcible contact before friction occurs. There may be _to the surface of the body involved.
contusion associated with abrasion, The shape varies and
the raw surface exudes blood and lymph which later dries 3) Because the blood vessels ‗involved are clean-cut
and forms a protective covering known as scab or crust. profuse hemorrhage is invariably a feature.

Characteristic of Abrasions 4) Gaping is usually present due to retraction of-the edges


but its presence and degree of retraction depends on the
1) Grossly or with the aid of hand lens the injury consists‗ direction of the incised wound with the line of cleavage-
of parallel linear injuries which are in line -with the Langer‘s Line.
direction of the rub or friction causing it;
5) If the incised Wound is located in parts of the body
2) It may exhibit the pattern of the wounding material; and covered with clothes, the clothing itself will show clean-cut
it develops at the precise point of impact of the force, of the cloth textures and fibers.
causing it; and it is usually ignored by the attending
physician?-for it does not require medical treatment but it 6) Usually the Wound is shallow near the extremities and
has importance in the medico legal view point. deeper at the middle portion. However, this findings may
be modified by the shape of the wounding instrument and
a) Abrasions caused by finger nails may indicate -struggle -the part of the body involved in the application of
or assault and are usually located in the face, neck- chest, external stimuli.
forearms, and hands.
7) ―In the absence of complication and/or when there is
b) Abrasions resulting front friction on rough surfaces, no deeper involvement present, healing is relatively fast
either intentional or accidental are located on bony parts and the scar may not or ‗may develop colispicuously.
of the body and usually associated with contusion and
laceration. c) Nature of the abrasions may infer the 8) incised wound ―caused by broken edges of the glass
damage or pressure nature of the rubbing object and the may be irregular and may appear like a punctured or stab
direction of movement wound. Fragments of the glass may be removed from tile
incised wound. Examination with the aid of a magnifying
b. Incised-wound-Cut, Slash or Slice lens is necessary to determine the presence and –removal
of particles of flakes of glasses in the wound.
This is produced by a sharp-edged-cutting or ‗sharp-linear
edge of the instrument, like a knife, razor, bolo, edge of Suicidal, Homicidal or Accidental Wounds
oyster shell, metal sheet, glass, etc . It may be an impact
cut when there is forcible contact of the cutting 1) Suicidal
instrument with the body surface, or slice cut when cutting
injury is due to the pressure accompanied with movement Located in peculiar parts of the body, like the neck, flexor
of the instrument. surfaces of the extremities i.e., elbow, groin, knee, wrist,
and accessible to the hand in inflicting the injury. The most
When the wounding instrument is a heavy cutting common instrument used is the barber‗s razor blade with
instrument, like axe, big bole, the wound produced is an improvised handle.

COMPILED AND ENCODED: Macky Gallego and Shem Viloro


FORENSIC MEDICINE NOTES 2015

There are usually superficial tentative cut-hesitation cuts, production of both extremities sharp. A single bladed
and the direction varies with the location and the hand— instrument may produce as one of its extremities rounded
left_ or right used in inflicting the injuries. The most and contused.
common site of suicidal incised wound was on the wrist
with involvement of the radial artery and the neck. This distinction may not be clearly observed if the
instrument is quite thin. The direction of the surface
2) Homicidal defect may be useful in the determination of the possible
relative position of the offender and the victim when the
The incised wounds- are deep, multiple and involve both wound was inflicted. As to whether the wound is a slit like
accessible and non-accessible parts of the body to the or gaping depends on the looseness of the skin and the
hands of the victim. Defense and other forms of wounds direction of the wound to the line of cleavage -Langer‘s
may be present. Clothing is always involved. Line.

3) Accidental The depth may be influence by the size and sharpness of


the instrument, area of the body involved, and the degree
Multiple incised wound is commonly observed on the
of force applied. Involvement of the bones may cause
passengers and driver of vehicular accidents on account of
clean-out fracture on it. A-portion of the wounding
the broken windshield and glass. parts of windows.
instrument, usually the tapering part, may remain -in. the
Stepping on oyster shell, broken glasses, sharp edges of
body. X-ray examinations may. -be needed to reveal its
metal sheets are common causes of incised wound on the
location. Hemorrhage is always the most serious
sole of the foot.
consequence of stab would. This is due to the severance of
blood. vessels or involvement of bloody organs.
Those associated in the use of kitchen knives in the
preparation of food, carpenters. and handicraft workers
Inclusions in Description of a Stab Wound
who - use sharp edged instruments are frequent victims of
accidental incised wounds. 1) Length of the Skin Defect

c. Stab Wound The edges must be coaptated before the length is


measured. If the abrasion tailing is present in one of the
Stab wound is produced by -the penetration of a sharp-
extremities, it must, not be included in the measurement.
pointed and sharp edge instrument, like a knife, saber,
The length of the tailing must be mentioned separately.
dagger, and scissors. It may involve the skin or mucous
The tailing infers direction of withdrawal of the wounding
surface. If the sharp edge portion of the wounding
weapon.
instrument is the first to come in contact with the skin, the
wound produced is an incised wound, but if the sharp- 2) Condition of Extremities
pointed portions first come in contact, then the wound is a
stab wound. A sharp extremity may infer the "sharpness of the edge of
the instrument used. If both extremities are sharp, it may.
As a general rule, like an incised wound, the edges are be inferred that a double-bladed weap-on was used.
clean,-cut, regular and distinct. The surface length of a
stab wound may reflect the width of the wounding 3) Condition of the Edges
instrument. It may be smaller When" the wound is not so
deep inasmuch as it is only caused by the penetration of If the injury is due to stabbing act, the edges are regular
the tapering portion of the pointed instrument. and clean-cut. However, if the wound is caused by several
stabbing acts, i.e., series of thrust and withdrawal, the
It may be made wider if the -withdrawal is not on the edges may be serrated, or zigzag in appearance.
same direction when it was introduced or the stabbing is
accompanied by a slashing movement. In the latter case, 4) Linear Direction of Surface Wound
the presence of an abrasion from the extremity of the skin
It may be running vertically, horizontally, or upward
is in line with direction of the slashing movement.
medially or laterally. 5) Location of the Stab Wound
The extremities of stab wound may show the nature of the
instrument used. A double-bladed weapon may cause the

COMPILED AND ENCODED: Macky Gallego and Shem Viloro


FORENSIC MEDICINE NOTES 2015

Aside from mentioning the region of body where the a) There are more than one stab wounds, and stab wounds
wound is located, ‗its exact measurement to some are deep, and the stab wound are located in different
anatomical landmarks must be stated. parts of the body or on parts of the body Where -vital
organs are located.
6) Direction of Penetration
b) Stab wound with serrated or zigzag borders" infers
This must be tri-dimensional, backwards or forwards, alternative thrust and withdrawal of the wounding
upwards or downwards, and medially or laterally. weapon to increase internal damages.

7) Depth of Penetration c) Irregular or stellate shape skin defects may be due to


changing direction of the weapon with portion of the
8) Tissue and Organs Involved
instrument at the level of the skin as the lever. In this way
a greater area of involvement internally will be realized.
Suicidal, Homicidal or Accidental Stab Wounds
Different measurement of the stab wounds may possibly
1) Evidence showing that the stab wound is suicidal:
be produced by one weapon if it is tapering towards the
a) It is located over the vital parts of the body. sharp point. Withdrawal of the instrument not on the '
same direction as when it was introduced may increase
b) It is usually solitary. If multiple, they are located on one the length of the skin defect.

part of the body. A sharpened three-cornered file-tres cantos, when used as


a stabbing weapon will produce three-cornered-
c) If located on covered parts of the body the clothing re extremities, skin defect. The most common immediate
not involved. cause of death is hemorrhage particularly when located in
the chest or abdomen.
d)- The stab Wound is accessible to the hand of the victim.
Accidental stab wounds are quite rare and are usually
e) The hand of the victim is sin eared with blood.
caused by falling against a projecting sharp object like
f) The wounding weapon is firmly grasped -by the hand of broken pieces of glass or flattened and pointed iron bars.
the victim-cadaveric spasm.
d) Punctured Wound
g) If stabbing is accompanied with slashing movement, the
Punctured wound is the result of a thrust of a sharp
wound tailing abrasion is seen towards the hand inflicting
pointed instrument. The external injury is quite "small but
the injury.
the depth is to a certain degree. It is commonly produced
h) A suicide note may be present. i) There is presence of a by an ice-pick, needle, nail, spear, pointed stick, thorn,
motive for self-destruction. fang of animal and hook.

j) No disturbance in the death scene, wounding instrument The nature of the external injury depends on the
is found near the victim. sharpness and shape of the end of the wounding
instrument." Contusion of -the edges may be present if the
2) Evidence showing that the stab wound is homicidal: end is not so sharp. The opening maybe round, elliptical,
diamond-shape or cruciate.
a) Injuries other than stab Wound may be
present, stab: wound may be located in any part of the An accurate cross—section nature of the wounding object
body, and usually there are more than one stab wound. may be well appreciated when there is involvement of flat
hard parts of the body especially the skull. External
b) There is ‗a motive for the stabbing. If without hemorrhage is quite limited although internal injuries may
motive the offender must be insane or under the influence be severe. How ever direct involvement of blood vessels
of drugs, and there is disturbance in the crime scene. and bloody organs may cause fatal consequences unless
appropriate medical intervention is applied.
3) Medical Evidences Showing Intent of the Offender to
Kill the Victim.

COMPILED AND ENCODED: Macky Gallego and Shem Viloro


FORENSIC MEDICINE NOTES 2015

The site of the external wound can be easily sealed by the e. Lacerated Wound-Tear, Rupture, Stretch
dried blood, vessels and bloody organs clotted blood so
that introduction of pathogenic microorganism which does Lacerated wound is a tear of the skin and the underlying
not require the presence of air in its growth multiplication tissues due to forcible contact with blunt instrument. It
may find the place favorable and may produce fatal may be produced by a hit with a piece of wood, iron bar,
consequences. Punctured wound is usually accidental but first blow, stone, butt of firearm, or other objects without
in rare instances it may be homicidal or suicidal. sharp objects. If the force applied to a tissue is greater
than its cohesive force and elasticity, the tissue tears and a
Characteristics of Punctured Wounds laceration is produced.

1) The opening on the skin is very. small and may become Since the skin is composed of several types of tissues,
unnoticeable because of clotted blood and elasticity of namely: epidermis, connective tissue, fat, blood vessels,
‗the skin. The wound is much deeper than it is wide. nerves, glandular cells, etc. each having its own breaking
point, the laceration will be irregular and having strands of
2) External hemorrhage is limited although internally it tissues bridging. The rupture of continuity may only extend
may be sever. deeper to the stronger layer like that of the galea
aponeuritica in case of scalp injury.
3) Sealing of the external ‗opening will be favorable‗ for
the growth and multiplication of anaerobic microorganism Characteristics of Lacerated Wounds
such as like bacillus tetani.
1) The shape and size of the injury do not correspond of
Evidence to Show it is Homicidal the wounding instrument.

1) It is multiple and usually located in the different. parts- 2) The tear on the skin is rugged with extremities irregular
of the body. It may however be found in certain areas of and ill- defined.
the body.
3) The injury developed is at the site where the blunt force
2) The wound are deep, there are defense wounds on the is applied.
victim, and there is disturbance in the crime scene-sign of
struggle or presence of violence. 4) The borders of the wound are contused and swollen.

Proof to Show it is Suicidal 5) It is usually developed on the areas of the body where
the bone is superficially located. Like the scalp, face, legs;
1) Located in areas of the body where the vital organs are and foot, etc,
located, and usually singular but may be ―multiple and
located in one area of ' the body. 6) Examination with the aid of the hand lens show bridging
tissue joining the edges and hair bulbs intact.
2) Parts of the-body involved is accessible to the hand of
the victim, and clothing usually is not involved. 7) Bleeding is not extensive because the blood vessels are
severed evenly; and healing process is delayed and has
3) 'Wounding is made by the weapon while the victim is in more tendency to develop scar.
sitting or standing position. There is bleeding towards. the
lower part of body or clothing. Classifications of Lacerated Wound

4) No disturbance of the crime scene, presence of suicide 1) Splitting caused by crushing of the skin between two
note, and wounding instrument found near the body of hard objects.
the victim.
This is best seen in laceration of the scalp caused by a hit
Caused by Poisonous Instrument 1) Poison dart-cyanide or of a blunt instrument, cut eyebrow of boxer and laceration
nicotine, fish spines, and dog bites with hydrophobia virus. of the chin of motorcyclist.

2) Injection of Air and Poison as a way of euthanasia. 2) Overstretching of the Skin .

COMPILED AND ENCODED: Macky Gallego and Shem Viloro


FORENSIC MEDICINE NOTES 2015

When pressure is applied on one side of the bone, the skin Underneath the skin are dense networks of fibrous and
over the area will be stretched up to breaking point to elastic connective tissue fibers running on the same
cause laceration and exposure of the fractured bones. In direction and forming a pattern more of) less present in
avulsion, the edge of the remaining tissue is that of persons. This pattern of fiber arrangement is called
laceration. cleavage direction or lines of cleavage of the skin and their
linear representation on the skin is called Langer‗s Line,
3) Grinding Compression These lines of cleavage are different in different parts of
the body.
The weight and the grinding movement may cause
separation of the skin with the underlying tissue. If an incised wound or stab wound was inflicted wherein
the long axis of the wound is parallel or on the same
f. Tearing
directions as the cleavage line of the part of the body
involved, the wound will appear narrow or slit-like because
This may be produced by a semi-sharp instrument which
the edges of the wound will lot be subjected to the lateral
causes irregular edges on the wound, like hatchet and
pull of the severed connective tissue fibers. If the long axis
choppers. Laceration wounds may involve deeper tissues
of the wound is perpendicular to or with an angle with the
like laceration of .the muscles and fracture of bones
lines of cleavage, the tendency of the borders of the
depending upon the degree of force applied in causing it.
wound is to separate on account of the retraction of the
It may be homicidal or accidental but rarely, it is suicidal.
severed fibers.
An insane person may hit his head on a concrete Wall but
when loss of consciousness develop she will not be able to
Fatal Effects of Wounds
continue further his act of self-destruction.
The following are the fatal effects of wounds:
g. Gaping Wound
l. Wound may be Directly Fatal by Reason of: -
It is the separation of the edges especially in deep .Would
may be due to the following: a. Hemorrhage

1) Mechanical Stretching An incised wound at the lateral aspect of the neck


involving the carotid artery without surgical -intervention
The presence of a mechanical device on the edges to –
is fatal due to hemorrhage. While wounds in some areas of
prevent coaptation will cause separation. The presence of
the body where big blood vessels are not present and the
a canula in tracheostomy, drain rubber or gauze in an
reaction of tissue are. strong, death will. not be a direct
incise abscess, or a retractor during operation are
result due to hemorrhage ill the absence of complication -
examples of this type of gaping.
that may set it.
2) Loss of Tissue
b. Mechanical Injuries on the Vital Organs
Separation of the edges of a wound may be on account of
A blow on the head may not necessarily produced external
loss of tissue bridging them; The loss of the body tissue
lesions, but may produce severe meningeal hemorrhage
maybe -due to the following.
producing compression of the brain. A punctured wound
of the heart, even though how small, may produce sudden
a) Destruction by pressure, infection, cell lysis, burning or
death on account of the tamponade of the heart.
chemical. reaction, and avulsion or physical or mechanical
–stretching resulting to separation of a portion of the
2. Wound may be Indirectly Fatal by Reason of:
tissue.
a. Secondary Hemorrhage Following Sepsis
b) Trimming of the edges or debridment of the skin which
come in contact with the bullet at the gunshot wound-of A wound because of its nature and location is not capable
entrance and the removal of the 'necrotic material in an of producing severe hemorrhage, but on account of
infected wound may cause separation of the edges. infection that set in, deeper tissues are involved including
big blood vessels thereby producing severe hemorrhage.
3) Retraction of the Edges

COMPILED AND ENCODED: Macky Gallego and Shem Viloro


FORENSIC MEDICINE NOTES 2015

b. Specific Infection f. As to the Nature of the Wound Inflicted

Pathogenic microorganisms may develop and multiply in g. Abrasions


the wound causing septicemia, bacteremia, or toxemia.
Tetanus, gas gangrene infections are common in open Extensive abrasions on the body are always suggestive of
wounds. accidental death due to traffic accident. In suicidal death,
abrasions are rarely observed. In case of murder, abrasions
Ante-Mortem vs. Post-Mortem Wounds are not common except when the body is dragged on the
ground. In homicide, abrasion may commonly be
Ante-Mortem Post-Mortem observed, especially when the victim offered some degree
of resistance to the attacker.
Hemorrhage more of Hemorrhage slight or
less copious. none at all and always 2. Contusion
venous.
Contusion is rarely observed in suicidal death, except
Marks of spouting of No spotting of blood.
when the suicide act was done by jumping from a height. A
blood form arteries.
person contemplating to commit suicide will not choose a
blunt instrument.
Clotted blood. Blood is not clotted, if all
is a soft clot. Contusion in accidental death may also be found in any
portion of the body. It is often due to a fall and due to a
Deep staining of the The edges of the cellular forcible contact with some hard objects.
edges and cellular tissues are not deeply
tissues, which are not stained. The staining can 3. Incised Wounds
removed by washing. be removed by washing.
Incised wounds are commonly observed in suicide and
The edges gape owing to The edges do not gape, homicide. The depth, location and other surroundings
the reaction of the skin but are closely circumstances will differentiate one from the other.
and muscle fibers. approximated to each Accidental cuts are frequent everyday occurrences, but
other, unless the wound rarely as a cause of death.
is caused within one or
two hours after death. 5. Other Information

Inflammation and No inflammation of a. Signs of Struggle


reparative process. reparative process.
Absence of signs of struggle is more in suicide, accident or
murder. Contusion or abrasion may indicate trauma due to
fist, finger or feet of the assailant. Presence of hair or
Homicidal vs. Suicidal vs. Accidental Wounds portion of the skin on the nails of the assailant or
deceased may be a clue in the determination whether
a. External signs and circumstances related to the position death is suicidal, homicidal or accidental.
and attitude of the body when found.
b. Number and Direction of Wounds
b. Location of the weapon or the manner in which it was
held. Multiple wounds in concealed portions of the body are
generally indicative of homicide. Single wound located in a
c. The motive underlying the commission of the crime and position that the deceased could have been conveniently
the like. inflicted is usually indicative of suicidal wound.

d. The personal character of the deceased. c. Direction of the Wound

e. The possibility for the offender to have purposely This is important in the case of cut-throat. The direction
changed the truth of the condition. wound is generally transverse in case of homicide while it
is oblique in case of suicide.

COMPILED AND ENCODED: Macky Gallego and Shem Viloro


FORENSIC MEDICINE NOTES 2015

d. Nature and Extent of the Wound wound was inflicted by the offender. In this case, medical
evidence as to the duration of
Homicidal wounds may be brought about by any wound
instrument. Suicidal wounds are frequent due to sharp survival is merely corroborative.
instruments. Accidental physical injuries may be of any
kind. Possible Instrument Used by Assailant

e. State of the Clothing . The determination of the wounding instrument may be


made from the nature of the wound found in the body of
There is usually no change in the condition of the clothing the victim:
in suicide case. In homicidal death, on account of the
struggle which took place before death, the clothing of the 1. Contusion-produced by blunt object or instrument,
victim is in a disorderly fashion. usually; by hitting the victim.

Length of Survival of the Victim 2. Incised wound—-produced by sharp-edged instrument


inflicted by hitting.
In the approximation of the length of survival of the victim
after receipt of the physical injury, the following factors 3. Lacerated wound-produced by blunt instrument.
must be taken into considerations, to wit:
4. Puncture wound-produced by sharp-pointed
1. Changes in Body in Relation to Time of Death instrument.

The length of time -in the survival of the victim may be 5. Abrasion, body surface is rubbed on a rough hind
approximated from the systematic changes in the body. surface.
The degree of wasting, anemia, condition of the face and
6. Gunshot wound the diameter of the wound of entrance
bed sore formation may be a basic as to how long a person
may approximate the caliber of the wounding fire arm; .
survived.

2. Age of the Blood Stain

The age of the blood stain may be determined from the


physical color changes of the skin, although it is not
reliable." Although there are some basis for such method,
it must not be relied upon because the physical changes of
the blood is modified by several external factors.

3. Degree! of Healing

The injured portion of the body undergoes certain


chemical and physical changes as a normal course of
repair. The capillaries are dilated and edema develops at
once. This is followed by the migration of the white cells
from the capillaries to the damage area.

Fibroblast begin to proliferate later with the formation of


the granulation tissues. Sings of repair of the wound
appear in less than a day after the infliction of injury. By
the degree of granulation tissue formation and other
reparative changes, the age -of the wound may be
estimated.

4. Testimony of Witness When Wound was Inflicted The


actual witness may testify in courts as to exact time the

COMPILED AND ENCODED: Macky Gallego and Shem Viloro


FORENSIC MEDICINE NOTES 2015

ADDITIONAL NOTES FOR MIDTERMS: Practical uses:

I. Methods of determining the height of the person: 1. To establish the identity of the dead bidy or unknown
missing persons
1. Distance from the tip of the middle finger of
both arms with the arms extended laterally. 2. To associate person and weapons used in the crimes

2. Height= 2x length of one arm +12 inches from Given weight by the court because it is permanent,
the clavicle and 1.5 inches from sternum. unchangeabe and unique.

3. Height= 2x length from vertex of skull to Friction ridges- minute raised ridges of skin on the inside
symphysis pubis. surface of the hands and fingers and on bottom surfaces

4. Distance between suprasternal notch and


symphysis pubis= 1/3 of height.
Classifying fingerprints:
5. Height= Length of head x 8
1. Plastic prints: impression from a finger or palm
Identification of the skeleton deposited in a material that retains the shape of ridges
details, such as melted candle.
-When all the external identifying marks have disappeared.
2. Patent or visible prints- impression of unknown origins
-Complete lay-out of the bones on a table in their exact which are obvious to the human eye and care caused by a
locations in the human body is necessary to determine: transfer material on the finger onto a surface.

1. Whether the remains are of human origin or 3. Latent prints- not easily visible, chemicals are used.
not
Lifting and preserving fingerprints:
2. Whether the remains belong to a single
person or not Dusting begins by dipping a soft brush into very fine
powder and spread over the prints
II. FINGER PRINT ANALYSIS
Different patters: arches, loops, and whorls
The oldest discipline of forensic science.
ACE-V
The most valuable method and universally used: there are
no two identical fingerprint and fingerprints are not Analysis: small details of friction ridges which serve as vital
changeable. identification markers are studied.

Comparison: fingerprints collected at the crime scene are


matched or compared with those belonging to a person

Automated latent print system- database that searches


latent prints

The assumption that each person has a unique fingerpritns


which is different for others.

Principle of immutability- fingerprints remains the same


until they dies.

COMPILED AND ENCODED: Macky Gallego and Shem Viloro


FORENSIC MEDICINE NOTES 2015

III. DENTAL IDENTIFICATION: Reliability of bite marks: skin is elastic, it slips and moves,
compressed and stretches. Bite marks change even in
Enamel is the strongest bone or the hardest substance in dead flesh.
the body. It does not easily distroyed. The possibility of 2
person having the same is remote. Although they are considered admissible evidence and
have identified suspects who are eventually convicted, the
PD 1575- requires dental practitioner to turnover dental advent of DNA analysis question the reliability. It is said
records to NBI that it must only be used in elimination rather than
identification.
Teeth, not unique, teeth can grow and wear out. Grow an
average of micrometers Aural test: long-term memory, the listener is familiar with
the perceptual characteristics of a given voices
Carries personal, occupational, and cultural traits
Short term memory method-experts, compair two tapes of
voices for identification.

Spectograph methods and display the similarities and


dissimilarities between patterns of similar words from
known and unknown voices. Speech waives.

Aural and visual records may be combined for assucrate


results. Voices can be changed according to age, emotion..

Handwriting: under rules of court.... May be proved by


person who has suficient familiarity of the handwriting of
the person. Maybe analyzed by experts.

Basic: the slants of the handwriting. It is done by


Age: 9 years (12 permanent teeth)
comparing documents. Ways of comparing: 1. Collected
11- 20 (procured) standard - sufficient and clear and most
appropriate standard. 2. Requested standard- procured by
13-28 (no temporary teeth) request.

25 (root ends of third molars completely calcified) Handwriting can be disguised. There is the disguised or
deliberate attempt of the writer of his handwriting with a
new styles. Irregular and inconsistent in slants and letter
formation.
Sex: Barr bodies from palatal scraping or inner lining of the
cheek.

Comparing dental records of a person is common method


is common in US

Dental profile- estimate the shape of the mandible and


other parts.

Bite marks:

First step is to determine if bite is self-inflicted and caused


by a human. Each mark is measured and photographed
because appearance of bite changes. In case the person is
dead the bite mark is cut out from the skin, preserved and
cast in silicone.

COMPILED AND ENCODED: Macky Gallego and Shem Viloro


FORENSIC MEDICINE NOTES 2015

IX. CAR CRASH o Position of the victim

• First collision- the impact of the moving vehicle with • If the contact is center of gravity the body moves
another vehicle or a fixed object. This pertains to the backward to hit the hood wind shield or top of the car. The
moving vehicle average height of the bumper is 40 to 60 cms from the
ground. The most common site of impact is the upper
• Second collision – pertains to the occupants, particularly portion of the leg (bumper fracture)
the unrestrained occupants.
• The impact also depends also to the speed of the vehicle.
a. Front impact crash If the driver fails to step on the break, the pedestrian may
be thrown of the vehicle, to the roof, and run over by the
•The driver may strike the steering wheel, the hub of the
car.
steering column, windshield, rear view mirror, column
between • The driver is aware whether he hits the person or not. A
drunk driver usually do not stops because he is not aware
b. Side impact
that he has hit a person.
• Vehicle hits the side of another vehicle
• If the driver had effectively applied the break
c. Rear impact
• The leg carrying the body has the more tendencies to be
fractured. If the victim is standing, both legs will be
• As in change of ane in express way or crash at the rear of
fractured.
a parked vehicle
• The primary impact is above the center of gravity of the
• Results to whip-lash injury
pedestrian, the tendency is to move away from the vehicle
• Acceleration-deceleration injury with the impact the and fall to the ground. If the break is applied, the car stops
head moves backward and forward until chin strikes the while the body continues movement and lands to the
front of chest. road. If no break was applied, the pedestrian passes to the
hood, to the top, and the vehicle passes through the
d. Roll over crash (turn-turtle impact) victim.

• While rolling, the occupants may be pinned , crushed or • Secondary impact – involves not the vehicle but the
may be thrown away and fall to the ground pedestrian subsequent to the impact.

e. Ejection • Run over injuries – receive the impact above the center
of the gravity and the victim falls to the ground and the
• The occupant is thrown outside of the vehicle. vehicle passes over him.

f. Suicidal crash • Hit – and – run – usually the driver is high or drunk at
night time.
• Usually a single vehicle and single occupant crash.
• Sobriety test – refers to standardized test initially
• Head on collision with roadside object.
assessed and determine intoxication, such the horizontal
gaze nystagmus, walk – and – turn, and the one – leg
stand.
Pedestrian-Vehicle collision
• Alcoholic drunkenness – a person with at least 0.15
• Primary impact - is the first violent contact between the alcohol in the blood is considered drunk. Some countries,
pedestrian and motor vehicle it is considered a crime driving with only 0.5 alcohol level.

• Severity depends on:

o Weight of the person

COMPILED AND ENCODED: Macky Gallego and Shem Viloro


FORENSIC MEDICINE NOTES 2015

X. CHILD ABUSE O Multiple fresh healing fractures

• The physical and mental injury of a child by a person who O Trauma to the mouth, nose, ears, and eyes
is responsible for the child’s welfare under the
circumstances which will indicate that the child’s health O Sexual abuse, injuries to the genetalia

O Physical abuse – may include the act of O Child neglect – poor nutrition or hygiene,
physical or emotional persuasion that places the child in a
• Things to be considered to suspect that a child is a
potentially dangerous situation where subsequent and
victim:
significant physical injuries requiring medical treatment.
O Child is emotional, fearful and with a vague
O Physical neglect – includes the failure to
history of injury
provide the child with the necessities of life – medical,
nourishment, clothing, supervision, and nursing. It is
O Parents present a vague and defensive detail
considered physical neglect when it is intentional
of the child’s illness or injury
• Causes:
O Tiny unexplained signs of injuries
o Unwanted child
XI. ASPHYXIA
o Illegitimacy
o Unwanted child that has congenital or deformity
Definition of Asphyxia
• Abusive parent:
Asphyxia is the general term applied to all forms of violent
O Uncontrollable abuse by psychotic, death which results primarily from the interference with
pervasively angry, temperamental the process of respiration or the condition in which the
parent. supply of -oxygen to the-blood or to the tissue or both has
been reduced below normal level.
O Controllable abuse by compulsive
discipline. Phases of Asphyxial Death

• Classification of child abuser The following are the phases of asphyxial death:

O Intermittent child abuser – parent who 1. Dyspneic Phase


with no intent to hurt the child by driven by
panic or impulsive and abusive behavior The symptoms are due to lack of oxygen and the retention
of carbon dioxide in the body tissue. The breathing
O One- time child abuser – man handles becomes rapid and deep, the pulse rate I increases, and
child once over repeats the act. there is a rise in the blood pressure. The face, hands and
fingernails become bluish especially in the case of the
O Constant child abuser - parent who hates the
newly born infants.
child and arbitrarily beats or miscares the child.
2. Convulsive Phase
o Df
This is due to the stimulation of the central nervous
• Injuries
system by carbon dioxide. The cyanosis becomes more
pronounced and the eyes become staring and the pupils
O Multiple bruises and scars, particularly trunk,
are dilated. Examination of the visceral. Organs shows
head, and face
small petechial hemorrhages, commonly known as Tardieu
O Imprints from forcefully striking object Spot.

O Multiple burns or emersion burn eg. Cigarette, The Tardieu Spots are caused by the hemorrhage
iron, boiling water produced "by the rupture of the capillaries" on. account of
the increase of intra-capillary pressure. It usually appears

COMPILED AND ENCODED: Macky Gallego and Shem Viloro


FORENSIC MEDICINE NOTES 2015

in place where the tissue ‗is soft rand the capillaries are Use of ligature by force other than the weight of the body.
not well supported by the surroundings, as in visceral By single folds or several.
organs, skin, conjunctivae, and capsules of glands.
BY HANGING: BY STRANGULATION
3. Apneic Phase
 Hyoid bone  hyoid bone
The apnea is due -to.-paralysis of the respiratory center of injured spared
the brain. The breathing becomes shallow and gasping and
the rate becomes slower till death. The hearth later fails.  Ligature mark  ligature mark
Recovery at this stage is almost nil due to the permanent inverted V horizontal with
damage inside the brain on account of prolonged cerebral with apex at know on same
anoxia. site of the horizontal
knot plane
KINDS OF ASPHYXIA:
 Ligature at  ligature below
1. Asphyxia by Hanging
level of hyoid the larynx
Asphyxia by hanging is a form of violent death brought bone
about by the suspension of the body by a ligature which  groove
encircles the neck and the constricting force is the weight  Groove is uniform in
of the _body. It is not necessary that the whole body will deepest depth
be left suspended. The victim may be sitting or lying with. opposite knot
the face downward provided that the pressure is present  vertebral injury
in front or the side of the neck.  Vertebral not observed
injury is
2. Asphyxia by Strangulation. frequent

DEATH BY LIGATURE: By hanging or suspension of the


body
Manual strangulation or throttling -The constriction force
Finding that shows that the hanging is ante-mortem: applied is by use of the hand

1. Vital reaction: redness, ecchymosis or red spots Manner of death in strangulation


on the pharynx and epiglottis, rapture of the intima of the
carotid aretery, and subplueral, subepicardial puncture - Air passage is block due to asphyxia
haemorrhage.
- Blood supply to the brain is blocked by compression of
2. Evidence in support of homicidal hanging: the blood vessel
disturbance in the surroundings, signs of struggles,
presence of bodily injury in the body of the victim and - Compression of nerve of the neck producing shock.
presence of wounds in the body
Other forms of strangulation:
3. Evidence of suicidal: findings susceptible with
1. Palmar strangulation: the palm of the hand if the
self-suspension, clenching of hand and absence of signs of
offender is pressed in front of the neck without using
struggle, history of suicidal attempts, suicidal notes, easily
other finger
accessible materials, presence of spasms.
2. Garrotting: a ligature. A metal coffer or a bowstring is
Asphyxia by strangulation
placed around the neck and tightened at the back.
Strangulation by ligature - produced by compression of the
3. Mugging: with the assailant standing behind the victim,
neck other than the weight of the body. The attacker may
the forearm is applied in front of the neck.
be behind or in front of the victim.

COMPILED AND ENCODED: Macky Gallego and Shem Viloro


FORENSIC MEDICINE NOTES 2015

Asphyxia by Suffocation Causes of death:

Asphyxia by suffocation is exclusion of air from the lungs 1. Typical cause/ Primary cause: water interfering with
by closure of air openings or obstruction of the -air respiration
passageway from the. External openings to the air sucks.
There are two kinds: 2. Atypical drowning

a. Smothering: a. Vagal stimulation causing cardiac inhibition

– by closing if the external respiratory orifice by the use of b. Laryngeal spasms from inhaled water
hand or by some means as blocking of foreign object.
c. Unconsciousness at time of submersion
Suicidal smothering cannot occur but may occur by
The average time= 2-5 min. Some can hold it to 10 min.
accident under influence of alcohol, drugs
Length of survival is equivalent to the froth in the lungs.
1. Overlaying- in children from pressure of bedding or The more froth, the lesser chances of survival
pressure of unconscious parent
Post-mortem findings:
2. Gagging- application of materials to prevent access of
1. External findings
air through the mouth and nostrils
a. Wet clothing, face pale, foreign bodies
3. Plastic bag suffocation - children covered with plastic
on skin
bag
b. Cutis anserine or gooseflesh due to
b. Choking
contraction of erector pili muscle
- is suffocation from impaction of foreign body in the
c. Washerwoman’s hands and feet proves only
respiratory passage:
that the body has remained in the water for
1. Vomitus some time
2. Regurgitated food
3. Bolus of food (café coronary) d. Penis and scrotum may be contracted. Eyes
4. False set of teeth half opened or closed conjuctivae, red pupils,
5. Blood in oral surgery dilated mouth half-open or closed with tongue
6. Bleeding from the lungs protruding.

e. Post-mortem lividity marked in head, neck and


*Usually accidental
chest

3. Asphyxia by Drowning
f. Cadaveric spasm

This is a form of asphyxia wherein the nostrils and the


g. Other physical injuries
mouth has been submerged in nay watery, viscid or
pultaceous fluid for a time to prevent the free entrance of 2. Internal findings:
air into the air passage and lungs. It is not necessary that
the whole body to be submerged in fluid. It is sufficient for a. Emphysema aquosum - lungs are distended
the nostrils and mouth to be under fluid. Children may be overlapping the hearth with rib markings on the
drowned in an ornamental pool or fish pond, and an surface due to irritation by the inhaled water
epileptic or drunk person may found -drowned in a stimulating mucus secretion. Lungs progressively
shallow creek. distended and air driven by the fluid in the lungs
surface
Asphyxia by submersion
b. Edema aquosum – entrance of water into the
– nostrils and mouth are submerge in any fluids for period air sacs makes the lungs doughy pits pressure
of time preventing the free entrance of air unto the lungs and exudes water and froth when cut.

COMPILED AND ENCODED: Macky Gallego and Shem Viloro


FORENSIC MEDICINE NOTES 2015

c. Champignon d’ ocume – whitish foam in the - Combines with haemoglobin to form carboxyhemoglobin
nostrils and mouth. This is due to the abundant which is more stable than oxyhemoglobin
mucus secretion of the respiratory passage
which by respiratory movement whips into a - Limits oxygen carrying capacity of blood and prevents
foam. release of oxygen from oxyhemoglobin

- If the drowning took place in salt water the blood - Accidental and suicidal death: enclosing in a room or
chloride is greater in the left side of the heath than in the garage with motor engine running
right.
- Carbon dioxide. Hydrogen sulphide. Cyanide
- Floating of the body occurs within 24 hours from
XII. GUNS/ GUNSHOT WOUNDS
drowning. Decomposition of the body causes
accumulation of gas in the body causing the body to float.
Forensic Ballistic and firearms:
- “tete de negri” bronze color of the head and neck when
Firearm- includes rifles, musckettes, carbine, pistol and
drowned body is decomposed
others for which bullet or ball may be discharged. Includes
air rifle exception to those to small calibre which are
Compression asphyxia or crush asphyxia
considered as toys.
- Respiration is prevented by the immobility of the chest
The barrel of the firearm is considered for all intent and
and abdomen due to external pressure
purposes are considered as firearm.
- Assailant may kneel on chest of victim. Victim in
Ammunition
wresting, body pinned under collapsing building.
- means the loaded shell for which the ball is fired by
Asphyxia by breathing irrespirable gases:
means of gun powder
This death is due to carbon monoxide or carbonic oxide
- is a complete fire unit consisting of shell, powder, bullet.
the silent killer. Carbon monoxide is formed from the
incomplete combustion of carbon fuel. The fatal carbon
- A slog is an empty shell.
monoxide poisoning usually involves burning of wood oil,
coal, kerosene and charcoal used in heating or cooking, or 3 basic types of gun:
gasoline engines in cars.
1. Machine gun
The occurrence of symptoms is carbon monoxide 2. Rifle
poisoning depends on the rapidly or intoxication, ability of a. A long barrel with a butt.
the individual -to tolerate the lack of oxygen and-presence b. It has a faster velocity.
of other depressant drugs, usually alcohol. The main action 3. Shot gun
a. There are several pellets inside a shell
of carbon monoxide is oxygen deprivation and not its toxic
b. Mean to destroy the tissues of a person.
manifestation, so the oxygen deprivation of the tissue is 4. Handgun
the degree of saturation of hemoglobin with the gas. a. Revolver
b. Pistol
Accidental and suicidal death by carbon monoxide is i. Automatic
common. Victims may be accidentally imprisoned or 1. A self-loading fire arm
deliberately enclosed themselves in a room or garage with ii. Semi-automatic
motor engine running or slow burning is present. Judicial
A revolver is used when the hammer is cocked and the
'death' execution by gas chamber carbon monoxide is
bullets are positioned.
utilized in some foreign countries that cause almost
painless death.

- Carbon monoxide (silent killer)

- Colorless gas

COMPILED AND ENCODED: Macky Gallego and Shem Viloro


FORENSIC MEDICINE NOTES 2015

Ballistics is the science of the projectile 3. It could tell if the position of the person or the
trajectory inside the body.
4 parts of ballistics
4. Forensic ballistics
1. Interior ballistics
a. Involves investigation of the
a. While the bullet is in the gun, before the bullet
leaves the gun Identification of bullets:

b. The rifling of the bullet in the rifle is called - No marks in the bullet are the same
rotation.
- No two bullets are identical because no barrel
c. The path of the bullet to the barrel is called are identical, as the surfaces of their bores are
trajectory. different from the other .

d. As the bullets passes to the grooves of the - Every barrel leaves its mark to every bullet that
barrel, it creates marks to the bullet which are leaves through it.
not similar to any other gun.
If the firearm is recovered and the gun is used in a
2. Exterior ballistics recovery box filled with water or cotton, 6 feet deep, and
bullets are compared.
a. Involves the exit of the bullet of the gun and
its projectile. Forensic crime nabbing is employed to recover to
determine the identity of bullet and which bullet hit the
b. Trajectory of the bullet is the pathway of the victim
bullet from the gun to the target
Gunshot Wounds
i. In determining the trajectory of the bullet, there are
many factors to consider. - Powder burns or the blackening of the entrance
wounds due to the smoke, smudging of the
ii. Determines the eye dominance bullet to the tissue.

1. A shooter closes one eye when firing. Typically - Not all bullets that enters has exit wounds.
in opposite to the hand the shoots the gun.
- Abrasion collar when the bullet presses to the
2. A cross-eye dominance may results to skin causes it to depressed portion rubs the
difficulty of the target and missing the target. rougher portion of the bullet.

3. Terminal ballistics Factors to consider:

a. Effects of the impact of the projectile to the O Speed of the bullet


target
-The faster the speed, the more injurious the
b. Trajectory of gunshot wound is the pathway of bullet is.
the bullet inside the target or organ.
O Size and shape
i. It is different when it hits an organ, bone, or others
-Pellets are not so dangerous than bullet to
ii. Determines the culpability of the gunshot wound humans.

1. Intent to kill, the person would hit the vital O Character of the bullet in flight
organ
-The more rotation, the more damage the bullet
2. If to disable, hit a bone or hollow organ. creates.

COMPILED AND ENCODED: Macky Gallego and Shem Viloro


FORENSIC MEDICINE NOTES 2015

Nature of the target: The mechanical passage of the bullet through the skin
causes abrasion, and the circular defect is lined by a rim of
- Density of the target: bone vs. heart/ abrasion – the abrasion ‘collar’. This tends to dry out like
all abrasions, and may be easier to discern with the
- The length of the entrance
passage of time (more useful to pathologists).
- Nature of the media traverse. Bullets traveling through
air is less injurious than bullets traveling in water

- The organ involve. (vital organ)

ENTRANCE WOUND vs. EXIT WOUND

ENTRANCE WOUND EXIT WOUND

Entrance wound is Exit wound is larger


smaller than the than the missile
missile

Edges of the entrance Everted wound


wound are inverted

Usually oval when there is no definite


traverse shape
Lead alloy based bullets and ‘dirty’ bullets may also leave a
The contusion collar or contusion collar is greasy rim (‘bullet wipe’) around the entrance defect
the contact ring is absent (Besant-Matthews 2000, DiMaio 1999, Dana and DiMaio
present 2003).

Another feature of entrance wounds, of short to


Tattooing or smudging absent intermediate distance is the presence of powder markings
is usually present or ‘tattooing’. Powder tattooing results from the forceful
when a near fire in driving of powder into the skin, whilst ‘stippling’ is the
term used where the powder causes impact markings only.
Protruding tissues may be present
The abrasion collar can also be of use in approximating
Always present may be absent angle of fire – if the bullet impacts perpendicular to the
skin surface, it will be round, but if the bullet hits at an
Paraffin test may be always absent angle, the abrasion collar will be uneven, and more distinct
present at the point of bullet entry (Spitz 1993).

Higher velocity bullet wounds may exhibit less of an


abrasion collar, but may have minute tears around the
ENTRANCE WOUND: wound entrance. If the wound is made over bone, the
defect may not be circular at all – these wounds tend to be
When a bullet hits the skin surface, it causes indentation stellate in shape with ragged and torn edges caused by the
before perforation. Following perforation, elasticity causes overstretching of skin and tearing under tension (Dana and
the skin to recoil, and the resulting round, circular defect is DiMaio 1999).
of a slightly smaller diameter to that of the bullet. An
accurate estimation of the calibre size cannot therefore be In a review of contact gunshot wounds to the head, from
made from measuring the radius of the wound, unlike in handguns, rifles and shotguns, Faller-Marquardt and Pollak
the movies! (2002) described the presence of 'stretchmark-like skin

COMPILED AND ENCODED: Macky Gallego and Shem Viloro


FORENSIC MEDICINE NOTES 2015

tears' of the facial skin around the mouth, forehead, d. Stellate shaped in higher velocity weapons, or hard
submental region, around the eyes, and within the naso- contact over bony parts of the body
labial folds.
e. Slit-like or irregular if bullet deformed or tumbling
Shots in the mouth also gave rise to radial tears in the skin
around the mouth. These stretch marks and tears f. Presence of soot soiling, powder tattooing, stippling etc
appeared to follow the lines of tension (Langer's lines),
g. Shallow angled wounds may ‘graze the surface’
and they postulated that they were caused by
subcutaneous or intra-oral expansion of muzzle gases
EXIT WOUND:
and/or the radial forces of the bullet causing 'ballooning'
of the facial soft tissues. In general, exit wounds are larger than entrance wounds.
They are also more irregular in outline, and their edges are
At the end of a bullets range it begins to lose axial stability
everted. They exhibit no abrasion collar, and they do not
and may tend to yaw and possible tumble end-over-end. If
have any features of secondary muzzle product projectile
this happens, or if the bullet strikes an intermediate target
impact, such as soot soiling, or powder tattooing (Besant-
(including another part of the victims body in a re-entrant
Matthews 2000; Knight 1996).
wound) and becomes deformed, the resultant entry
wound may be very irregular, or even slit-like, and not As the bullet travels through the body it looses kinetic
resemble an entrance wound at all. energy, and looses stability. As it exits, it may do so at an
angle, or the bullet itself may have been deformed in the
Careful examination of the wound edges, however (with a
body, for example after striking bone.
hand lens and good light source if necessary) may reveal
inverted wound edges and a variable abrasion rim, The exit wound in such circumstances may resemble a
revealing it’s true nature. knife wound or a laceration caused by blunt trauma. In
addition to the wound caused by the exiting bullet,
As will be described in the range of fire section, secondary
secondary projectile damage may be caused by fragments
projectiles from the muzzle of the weapon, such as hot
of bone, particularly in headshots.
gases, soot, powder and metal fragments from the barrel
or the bullet casing etc can also give rise to characteristic Muzzle velocity is of vital importance when considering
wound patterns, and their presence can assist in the the characteristics of an exit wound – high velocity rifles
determination of whether or not a wound is an entrance rounds, for example can pass straight through the body
or exit wound. unless they strike bone, and if the round has not been
deformed, the defect can be rounded.
When a bullet impacts bone, it is also possible to infer
whether the overlying tissues have suffered an entrance There exists a particular type of exit wound that often
wound, and to some extent at what angle they were causes problems with interpretation. This is the ‘shored
struck. exit wound’, and arises where the part of the body being
exited by the bullet is supported by tight clothing or a
The outer table of the skull, for example is punched
structure such as a concrete floor etc (DiMaio 1999).
inwards, creating a circular defect (or a ‘keyhole’ defect if
the angle was less than perpendicular), whilst the inner An exit wound that is at the level of a brassier support, or
table exhibits a rough chipped or bevelled defect where a trouser belt for example, may be irregular in outline, and
the amount of bone displaced covers a larger area than have abraded edges. Care must be taken in such
that lost at the outer table. circumstances to examine clothing and obtain details
about the circumstances surrounding the shooting, as well
SUMMARY FEATURES OF ENTRANCE WOUNDS:
as looking for other wounds consistent with an entrance
wound before a shored exit wound is described as
a. Circular defect (unless entrance at an angle – then more
anything else.
tear-drop shaped)
Rifles give rise to the same sorts of entrance and exit
b. Abrasion collar or rim
wounds, but the higher velocities involved inevitably lead
c. Inverted edges to larger wounds.

COMPILED AND ENCODED: Macky Gallego and Shem Viloro


FORENSIC MEDICINE NOTES 2015

When the edges of an entrance wound are brought O It is the nitrate that are determines
together, there is always a central defect, or a missing area
of skin – this is not the case with an exit wound, unless -A positive result is not conclusive whether the
there has been massive tissue destruction, and a piece of assailant fired the gun.
skin has not been located.
-A negative result is not also conclusive as to
SUMMARY FEATURES OF EXIT WOUNDS: whether the assailant did not fire a gun.

a. Usually larger than entrance wounds

b. Irregularly shaped

c. Everted skin edges

d. No powder tattooing, soot soiling or stippling etc

e. May have abraded edges (‘shored exit wounds’)

a. The number of entrance wounds may not determine the


number of fires.

b. The number of entrance wound may not determine the


number of the exit wound.

c. The bullet may hit a solid object before entering the


body creating more entrance wound

What to ask the physician?

-Is the weapon caused the wound?

-At what range was it fired?

-What was the direction of the fire?

-Is the wound self-inflicted?

-Is it possible that the victim returned fire?

Paraffin test

- Test for powder residue on the skin in the


dorsal part of the hand or on the site of the
wound or the clothing of the victim or assailant.

- The metallic residue of the gun

- The gun powder will expelled from the shell


and are expelled to the dorsal part of the hand
of the assailant or the palm of the victim when
trying to ward off the gun.

Dermal nitrate test

COMPILED AND ENCODED: Macky Gallego and Shem Viloro

Вам также может понравиться