Forensic Study Guide Final Version 2

KING ABDULAZIZ UNIVERSITY
Faculty of Medicine
FORENSIC MEDICINE
&
TOXICOLOGY
Study Guide
2009
TABLE OF CONTENTS
TOPIC Page
THE OUTCOMES OF THE UNDERGRADUATE CURRICULUM 3

AIMS & OBJECTIVES 5
CURRICULUM MAP 8
INTRODUCTION 9
TEACHERS CONTACTS 10
ASSESSMENT 11
ICONS 13
TOPIC OUTLINES 14
NO . LECTURES (NAMES)
01 Identification & Mass disaster 15
02 Death & Post mortem changes and brain death (I) 17
03 Death & Post mortem changes and brain death (II) 19
04 Medico legal importance of wounds (I) 21
05 Medico legal importance of wounds (II) 23
06 Head Injuries 25
07 Fire Arm Injuries 27
08 Physical injuries 30
09 Asphyxia (I) 33
10 Asphyxia (II) 36
Faculty of Medicine Pathology-core course-1
11 Sexual Offences 38
12 General Aspects of Forensic Toxicology 42
13 Volatile and Noxious Gases (I) 44
14 Volatile and Noxious Gases (II) 47
15 Plant Poisonous and Drug Dependence (I) 50
16 Plant Poisonous and Drug Dependence (II) 53
17 Animal poins and Insecticides poisonous 56
NO . PRACTICAL (Names) Page
01 Identification 59
02 Ballistics –Gross Specimen 60
03 Primary medico legal report and death certificate. 62
04 Blood & Hair and Fibbers 63
3
Faculty of Medicine Pathology-core course-1
NO . STUDENT-DIRECTED LEARNING (SDL) Page
Medico legal importance of Consent

01
Medico legal Significance of Car seat belt and Expected

02
injuries in car accident.
Medico legal evidence collection and reservation methods and
03
chain of custody.
NO . TUTORIALS Page
01 Discussion on Medico legal importance of wounds.

Discussion on Addiction (Drugs and mechanism
02
physiological antidotes.
4
TRAINING IN FORENSIC MEDICINE
Aims/objectives of the course:
1. To give the medical students basic knowledge (as a future general

practitioner) about the forensic pathology and forensic medical sciences.
2. To give the students some basic skills of dealing with forensic cases in
their future careers.
3. To highlight the major forensic problems in the community which

could face the general practitioners, and the way of dealing with them.
4. Each lecture would have specific aim(s) (take home message(s)),

which would be insisted upon during and at the end of the lecture. These
aims would be evaluated at the end of each lecture.
Methods of fulfilling the aims:
The course would be delivered as lectures (total 17 hours). The lectures

would include:
 Theoretical information
 Practical knowledge
 Forensic skills
 Case studies
 Discussions
The lectures will be submitted with a case picture to be looks like a case
scenario.
Multimedia such as power point presentation in would be used to fulfil the
aims.
Phase II Pathology core course 1 Faculty of Medicine
FORENSIC MEDICINE
Prerequisites:
1. Anatomy, physiology, histology and biochemistry of the human

body.
2. General and systemic pathology.
Course Description:
Lectures (17)
PSL (2)
SDL (3)
Tutorials (2)
Practical (4)
Reading:
Book: 1) Simpson's Forensic Medicine

By: Bernard Knight, eleventh edition.
2) Hand Book of Forensic Pathology

By: Vincent J.M Di Maio
and Suzanna E. Daua
6
Undergraduate Program Learning Outcomes

Learning Outcomes
Code
Knowledge
By the end of the program the graduate will be able to:
A1 Describe normal human development across the life-span and how these
affect normal structure and function.
A2 Describe normal structure and function of the major systems and how they
interrelate.
A3 Describe the molecular, biochemical and cellular basis essential for
maintaining homoestasis.
A4 Demonstrate knowledge of the basic medical sciences that explain causes
and mechanisms of disease.
A5 Describe the alterations in structure and function of major body systems as
a result of illness or injury.
A6 Demonstrate knowledge and understanding of the pharmacological
principles of treatment using drugs, their efficacy in the management and
symptomatic relief of diseases, as well as their side effects.
A7 Discuss the implications of basic ethical principles, including
confidentiality, informed consent, truth telling, and justice, for the care of
patients.
A8 recognize the legal background of medical practice
A9 Explain the causes and mechanisms of intoxication.
A10 Describe the role of family, community, and culture as factors influencing
patient presentations, interpretations of illness episodes and adherence to
treatment episodes.
A11 Demonstrate knowledge and understanding of the natural history of disease
and relationships with risk factors and disease prevention.
A12 Recognize and discuss the principles of disease surveillance and screening,
disease prevention, communicable disease control, health promotion, and
health needs assessment.
A13 Describe strategies to support life-long learning via print and electronic
sources to assist in making diagnostic and treatment decisions and to remain
current with advances in medical knowledge and practice.
A14 Demonstrate knowledge of how to use the basic medical sciences and
clinical skills for clinical decision making and problem solving in the care
of patients.
A15 Recognize the scientific basis of health, disease, and medicine in the
management of common and high impact conditions in the society.
A16 Demonstrate knowledge of the functional approach to managing chronic
conditions, including knowledge of the impact of chronic illness on
function.
A17 demonstrate basic knowledge of the global health care delivery system in
the community including physicians, hospitals, outpatient centres, health
agencies and the role of community agencies in that system.
A18 Recognize the management of common emergencies and the initial and the
7
life saving management steps for other emergencies.
A19 Identify the "Red flags" indicating seriousness in the different clinical
presentations.
Cognitive Skills
B1 Recognize, define and prioritize problems.
B2 Demonstrate the ability to acquire new information and data.
B3 Critically appraise validity and applicability of acquired information to
one’s professional decisions.
B4 Organize, record, research, present, critique, and manage clinical
information.
B5 Recognize the limitations of knowledge in medicine and the importance of
triangulation of evidence before reaching a decision.
B6 Evaluate the patient’s medical problems.
B7 Formulate accurate hypotheses to serve as the basis for making diagnostic
and treatment decisions.
B8 Reflect on one’s thinking process and decisions and apply rational
processes.
B9 Use appropriate intellectual strategies to deal with uncertainties when they
arise.
B10 Demonstrate an understanding of research methodology.
B11 Formulate research questions.
B12 Draw research hypotheses.
B13 Choose appropriate research methodologies and designs.
B14 Select appropriate methods of data collection.
B15 Analyse and interpret collected data.
Interpersonal Skills & Responsibility
C1 Display the personal attributes of compassion, honesty, and integrity in
relationships with patients, families, communities and the medical
profession.
C2 Exhibit appropriate value for the sensitive nature of the doctor/patient
relationship and the importance of active listening, with attention to the
patient’s familial, cultural, and spiritual circumstances.
C3 Demonstrate professionalism and high ethical standards in all aspects of
medical practice, specifically competence, honesty, integrity, respect for
others, professional responsibility and social responsibility.
C4 Exhibit a capacity for self-evaluation, moral reflection and ethical reasoning
to form the basis for a self-directed, lifelong engagement in the responsible,
committed, compassionate practice of medicine.
C5 Apply the four principles of ethical and legal knowledge, namely respect for
autonomy, beneficience, non-maleficience and justice.
C6 Demonstrate awareness and understanding of the legal and professional
responsibilities; and report inappropriate medical practice.
Communication, Information Technology & Numerical Skills
D1 work effectively as part of a health care team
D2 communicate effectively with patients, their families and colleagues, both
verbally and in writing
8
D3 retrieve information by all means including electronically
D4 present information clearly in written, electronic and oral forms
D5 work within a changing, multi-task environment
Psychomotor Skills
E1 Elicit accurate comprehensive and focused medical history by employing
techniques that facilitate the patient’s sharing of information.
E2 Conduct a both effective and accurate comprehensive and focused physical
examination.
E3 Formulate a differential diagnosis.
E4 Select the appropriate laboratory tests and radiographic studies and interpret
their results and use them in making diagnostic and treatment decisions.
E5 Formulate and implement a plan of care for both the prevention and
treatment of disease.
E6 Educate patients about their health problems and to motivate them to adopt
health promoting behaviors.
E7 Use pharmacotherapeutic agents and other therapeutic modalities
effectively.
E8 Demonstrate appropriate technique for performing Basic Life Support and
Advanced Life Support.
E9 Undertake tasks to initiate and be involved in the care of acutely ill patients.
9
CURRICULUM MAP
STRUCTURE OF THE MODULE
Module Units (Hours)

Credit
Practical
Module Code/No
Theoretical
Tutorials
Hours
SDL
PSL
Forensic Medicine and PATM

Toxicology 413
17 4 2 2 3 2
TEACHING DEARTMENTS:
Pathology Department
 introduction
10
WELCOME to the forensic and toxicology course..

In this course , our goal to gain a broad understanding of basic
knowledge as a future general practitioner about the forensic pathology,
different forensic medical sciences in addition to the basic knowledge of
forensic toxicology which include some clinical knowledge of some poisonous
substance. To highlight the major forensic problems in the community which
could face the general practitioners, and the way of dealing with them. To give
the medical students basic knowledge as a future general practitioner- about
the forensic pathology and forensic medical sciences.
 Student needs:
In order to establish this foundation, you will need to
 learn a number of specific facts and the precise terminology used to
describe them.
 as well as some key concepts about the mechanism of death, of wounds,
and of the poisonous. And to learn some about the role of laboratories
in forensic pathology, forensic medicine and forensic toxicology.
 Learn the most recent technology in this field and how to collect the
samples, preserve it, to whom it should be sent, what is the chain of
custody. This is whatever your specialty in future.
 Also you should learn a lot about the forensic system and the legal
roles, especially in your country, that regulate your medical job, as a
doctor.
 Likewise, you will need to solve conceptual problems throughout your
training and career, in order to continue to build on your knowledge
about forensic cases and to evaluate the significance of new findings
that will be reported in future.
 Study skills:
Introduce the students to university life and how to utilize lecture, study,
and utilize library and how to deal with examinations.
Teachers Contacts
11
Name Department
Dr. Ayman Nagy (AN) Pathology Ext#21106
ASSESSMENT
1. Formative:
This form of assessment is designed to give you feedback to help you to
identify areas for improvement. It includes a mixture of MCQs, short
answer-questions (SAQs), extended matching questions (EMQs), problems-
solving exercises and independent learning activities in all subjects. These
will be given during tutorial sessions. The Answers are presented and
discussed immediately with you after the assessment. The results will be
made available to you.
2. Summative:
This type of assessment is used for judgment or decisions to be made about

your performance. It serves as:
a. Verification of achievement for the student satisfying requirement
b. Motivation of the student to maintain or improve performance
c. Certification of performance
d. Grades
12
A:-Written Exams :
 They will include multiple choice questions (MCQs).

 They will cover material presented in lecture, readings, and discussion.
 All exams must be taken on the date scheduled.
B:- Practical Exam :
 It will be in an OSPE (Objective Structured Practical Exam) format,

 You will pass through 5 stations.
C :- Continuous Assessment:
The degree of continuous assessment will be divided to:
 40% to PSL.
 40% to SDL.
 20% to Log book
In this Course your performance will be assessed according to the

following:
 Continuous assessment quizzes (30%)

 Final written Exams (50%)
 Practical Exam (OSPE) (20%)
Total = 100 Marks
13
The most characteristic of the fire arm injury is:
1. Presence of inlet and exit.

2. Loss of substance
3. Presence of associated projectile.
4. Presence of the missile.
5. The circular shape of wound.
Icons (standards)
The following icons have been used to help you identify the various
experiences you will be exposed to.
Learning objectives
Content of the lecture
Independent learning from textbooks
Independent learning from the CD-ROM.

The computer cluster is in the 2nd floor of the medical library,
building No. 7.
14
Independent learning from the Internet
Problem-Based Learning
Self- Assessment (the answer to self-assessment exercises will

be discussed in tutorial sessions)
The main concepts
Topic Outlines
15
Lecture 1: Identification & Mass disaster

Student Notes: .
Department: Pathology
Lecturer: DR. Ayman Abdel Hamid Nagy
At the end of the lecture you should be able

to:
1. Appreciate the concept of DNA

fingerprints.
2. Modern technology used in
identification.
3. Understand the role of the forensic
pathologists in the identification process
4. Describe the major avenues requires
human identification services such as
mass disasters.
1. DNA fingerprints and its role in human

identification.
2. The dating of skeletal remains.
3. Role of X- ray in identification.
Photosuperimposition techniques for
identifications. Reconstruction of the
facial appearance from skull.
4. The role of GP & the forensic
pathologists in the identification process.
(Insert here handouts and additional

pages for notes if needed)
16
Continue … 1: Identification & Mass disaster

Student Notes: .
5. Role of the pathologist in mass disaster
(a-Forward planning-b- Outline of
necessities in mass disaster planning
include the provision of pathologists and
other staff, and Provision of mortuary
facilities. C-Retrieval of bodies).
Remember, However, That, Finger prints still the

most important human prints in the scene of the
crime.
Simpson's Forensic Medicine BY

Bernard Knight, eleventh edition.
To be announced in lecture

17
Lecture 2: DEATH & POSTMORTEM CHANGES AND

BRAIN DEATH (I)
Student Notes: .
Lecturer: DR. Ayman Abdel Hamid

Nagy

to:
1. Define death and its types and their
medicolegal significat
2. Differentiate between physical death and
brain death
3. Medicolegal aspects of brain death.
4. Indications of death.
5. Postmortem Changes of forensic
importance…..Hypostasis…Rigor mortis.
1. Definition of death
2. Definition and criteria of brain death
3. Changes after death. The medicolegal
importance of temperature changes,
factors affecting the cooling rate,and
methods of measuring.

18
Continue … 3: DEATH & POSTMORTEM CHANGES AND

BRAIN DEATH (I)
Student Notes: .
4. Definition and colors of hypostasis and
hypostasis timing, and differentiation
between it and contusion and medicolegal
aspects of hypostasis.
5. Definition, mechanisms and factors
affecting its timminig and cadaveric
spasm and medicolegal aspects of Rigor
Mortis.

Remember, However, That, The early

diagnosis of death is so important in
endemics and organ transplantation but
should be in accurate way.

Lecture 3: : DEATH & POSTMORTEM CHANGES AND

19
BRAIN DEATH (II)
Student Notes: .

Nagy

to:
1. Putrefaction as a late Post mortem

changes.
2. Define Adipocere formation and describe
its medicolegal significance
3. Define Mummification and describe its
medicolegal significance
4. Define Maceration and describe its
5. Timing the postmortem interval
1. Putrefaction Sequance, Putrefaction in

immmersied, in buried bodies and its

Continue … Lecture 4: :
20
DEATH & POSTMORTEM CHANGES AND BRAIN DEATH (II)
Student Notes: .
2. Adipocere formation and its medicolegal
significance
3. Mummification and its medicolegal
significance
4. Maceration and its medicolegal
significance.
5. Post mortem damage by predators.
6. Identifying the time after death.
Remember, However, That insects is so

important in diagnosis of death, cause of death
and time passed since death. Do not miss
Predator injuries as postmortem injuries.

to be announced in lectures

Lecture 4: Medico legal Importance OF THE WOUNDS I

21
Student Notes: .

Nagy

to:
1. Wounds, definition and type
2. Mechanism of wounds
3. Classifications of wounds
4. Forensic anatomy of the skin.
5. Role of forensic pathologist, Emergency
Room (ER) physician, and surgeon in
evaluation of wounds
6. Abrasions.
7. Contusions or Bruises.
8. Lacerations.
1. Definition of wound
2. Classification of wounds and
mechanisms of wouds.
3. Medico-legal aspect of wounds, and the
role of physician in evaluation of wound
for medico-legal point of view.
4. Definition, mechanism, age, medico legal

aspects of Abrasion, bruises, and
laceration.
5. The duty of General practitioner GP, ER pages for notes if needed)
physician in evaluation of wounds from
medico-legal point of view.
Continue …
Lecture 4: Medico legal Importance OF THE WOUNDS I
22
Student Notes: .
To be listed in the lecture.

Self-assessment
Briefly answer the following short question:

1- What is the medicolegal importance of
wounds?

Lecture 5: Medico legal Importance OF THE WOUNDS II

Student Notes: .
23

Nagy
At the end of the lecture you should be

able to:
1. Incised wounds, cut or slashes.
2. Stab Wounds and penetrating
injuries
3. Injuries by weapons other than
knives.
4. Defence and fabricated wounds.
5. Dating of wounds.
6. Causes of death from wounds and
Investigation of wounds.
1. Definition, mechanism, age, medico

legal aspects of Incised, stab and
penetrating wounds.
2. Medicolegal aspects of defence and
fabricated wounds.
3. Histological and histochemical
changes in wounds and its
medicolegal importance in dating of
wounds.
4. Investigations and differentiation
between suicidal, accidental and
homicidal wounds. (Insert here handouts and additional pages for
notes if needed)
Continue …
Lecture 6: Medico legal Importance OF THE WOUNDS II
24
Student Notes: .
Remember, However, That How to differentiate

between P.M and A.M. wounds? D.D. between
cut and contused wounds in skin stretched over
the bone?
3.

.
In the computer cluster also you have the

opportunity to see some useful web site.
www.google.com
Self-assessment

List the differences between contused and
incised wound

Lecture 6: Head Injuries
25
Student Notes: .
Department: Pathology………

Nagy
At the end of the lecture you should be

able to:
1. Describe skull fractures.

2. Describe the brain membranes
hemorrhage.
3. Describe the different injuries
affecting the cerebral tissues.
4. Describe the medico legal
significance, complications of
head injuries.
5. The ability to talk and walk after
different injuries.
2. Forensic anatomy of brain

membranes.
3. Description of different types of
brain membranes hemorrhages and
their medicolegal significance.
4. cerebral injuries, its mechanism, its
fatalities, and their medicolegal
importance.
5. Describe the complications and
(Insert here handouts and additional pages for
causes of deaths from head injuries.
notes if needed)
Continue …
Lecture 6: Head Injuries
26
Student Notes: .
Remember, However, That, All Head injuries

should be hospitalised for observation of post
concussion symptoms and signs?

You have the opportunity to watch the CD-ROM

You can access the CD-ROM during your spare
time.

opportunity to see some useful web site :
www. forensic pathology for student.com
www.studentconsult.com
Self-assessment
Briefly answer the following short question: (Insert here handouts and additional
What is the lucid interval?
Lecture 7: FIRE ARM INJURIES
27
Student Notes: .

Nagy

to:
1. Know the types of firearm weapons

including rifled weapons and non
rifled weapons.
2. Know the mechanics of missile

injury.
3. Identify characters of wounds from

smooth bore guns and rifled weapons
including; contact wounds,
intermediate and far distance wounds.
4. Differentiate and identify the entrance

and the exit of wounds.
5. Estimating the range of discharge.
6. Know the doctors duty in firearm

injuries and deaths.
1. Types of firearm weapons including

rifled weapons and non rifled weapons.
2. The mechanics of missile injuries.
3. Types and characters of firearms injuries
from rifled and non rifled weapons.
Continue …
28
Student Notes: .
4. Factors affecting the shape of Firearm
injuries.
5. The differences between entrance and the
exit of fire arm injuries.
6. Estimating the range of discharge.
a. The medicolegal significant of firearm
injuries and doctor's duty in firearms
injuries.free radicals
Remember, However, That rifling marks are

primary and secondary and the secondary one
can be intentionally interrupted.


about the. You can access the CD-ROM during
your spare time.

Continue …
29
Student Notes: .

opportunity to see some useful web site about the
inflammatory process:
www.Fleshandbones.com
www.webpath.com
Self-assessment

Enumerate the factors affecting FAI shape.

Lecture 8: - Physical injury
30
Student Notes: .

Nagy
At the end of the lecture

you should be able to:
1. Physical injury, definition and types

2. Burning, classification, and causes of
death in burning.
3. Gross appearance at autopsy.
4. Ante mortem versus postmortem burns.
5. Fumes and fires, Inhalation of soot.
6. Electrical injury, the difference between
point of entrance and exit.
7. Causes of death in electrical injury
8. Causes of death from lighting
1. Definition and classification of physical

injury
2. Value of evaluation of physical injury in
forensic medicine
3. Burning either dry or moist heat
4. Definition, classification of severity, causes
of death
5. Gross appearance at autopsy. Ante mortem
versus postmortem burns.
(Insert here handouts and additional pages for

notes if needed)
Continue … 8
Student Notes: .
31
6. Fumes and fires, Inhalation of soot.

7. Spurious " wounds" in burns. Atypical localized
burning and spontaneous combustion.
8. Electrical injury
9. Definition and Physical factors
10. The cutaneous electric marks
11. Cause of death in electrical injury, Internal and
histological appearance, Mood of death by
electricity.
12. Lighting
13. Definition and physical factors. External and
internal appearance.
14. Causes of death.
15. Medicolegal significance of physical injuries.
Remember, however, that Post mortem buns

is so common.

Continue … 8
32
Student Notes: .


your spare time.

opportunity to see some useful web site about the
www.forensic pathology for students.com
Self-assessment

Differentiate scaldes from dry and corrosive
burns
Lecture 9: ASPHYXIA I
33
Student Notes: .

Nagy

to:
1. Define asphyxia and know its

classification ( Gordone's classification).
2. Mechanical Asphyxia.
3. Know the traditional features of
asphyxia.
4. Understand the phases and sequences of
asphyxia.
5. Define different types of mechanical
asphyxia and autopsy findings.
1. Definition, types and traditional features

of asphyxia.
2. Phases and sequences of asphyxia.
3. Definition, different types of mechanical
asphyxia and autopsy findings of each
type.
Continue … 10
Student Notes: .
34
4. Effects and mechanism of fatal pressure

on the neck (Manual strangulation,
strangulation by ligature, mugging and
Arm locks and hanging, hanging, sexual
asphyxia) and autopsy findings.
5. Medico legal importance of each type of
mechanical asphyxia.
Remember, however, that post mortem

hanging…

Continue … 9
Student Notes: .
35

You have the opportunity to watch the CD-

ROM about the. You can access the CD-
ROM during your spare time.

opportunity to see some useful web site
about the
www.forensic pathology.com
Self-assessment
Briefly answer the following short

question:
List differences between hanging and

strangulation
Lecture 10: ASPHYXIA II

36
Student Notes: .
Nagy

to:
1. Know the different autopsy signs of

immersion.
2. Know the difference between
drowning and immersion.
3. Natural causes of death before
entering and whilst in water
4. Understand the sequences of events in
drowning on fresh and sea water.
5. Know the autopsy signs of drowning.
6. Understand the mode of death.
7. Know the laboratory test for
diagnosis drowning (chemical
changes in the blood in drowning and
histological changes and diatoms).
a. The differences between drowning and

immersion.
b. The autopsy signs of immersion.
c. The sequence of events in drowning in fresh
and sea water.
Continue … 10
37
Student Notes: .
d. The autopsy signs of drowning.
e. Natural causes of death before entering
and whilst in water
f. Mode of death and laboratory tests for
drowning.
g. Injuries sustained in or before entering the
water.
h. Estimation of duration of immersion.
Remember, Hower, That Do not miss non

violent cause of asphyxia

Lecture 11: SEXUAL OFFENSES

Student Notes: .
38

Nagy

to:
1. Definitions and know the different types of

sexual offense.
2. Definition of rape, and medicolegal types

of hymen.
3. Consent and its medicolegal types.
4. Examination of living assailant and victim

in cases of rape and homosexual offences.
5. External and internal findings in fatal

sexual assaults.
6. Collection of medicolegal evidences as

semen and its examinations.
1. Medico-legal aspects of
pregnancy.
2. Examination of medico-legal
cases of pregnancy.
3. Know the medico-legal aspects of
abortion including criminal, therapeutic
and spontaneous abortion, methods of
induction and doctor's action in respect to
illegal abortion. Regulations on induced
abortion.
Continue … 11
Student Notes: .
39
7. Deaths associated with abortion and

autopsy in abortion deaths. Infanticide
definition, medicolegal importance and
autopsy findings
1. Definition of each type of sexual

offense.
2. Know in details the doctors duty in
examination, including:
 Informed consent and regulations
in general and in KSA especially
for examination and duties of
doctors in different medicolegal
cases.
 Methods examinations and
manegement of allegad assailant
and victim.
 Medcolegal evidences collections
as seminal collection and available
tests for recent and old stains.
 Making full record for the case.
3. External and internal findings in
fatal sexual assaults.
4. Medico-legal aspects of pregnancy. (Insert here handouts and additional
5. Medicolegal types of abortion and
medicolegal regulations of termination of
pregnancy.
6. Methods of induction of abortion.
Continue … 11
40
Student Notes: .
7. Examination of case pregnancy and its
sure signs.
8. Examination of case recent and old
abortion.
9. Deaths associated with abortion and
autopsy in abortion deaths.
10. Collection of medicolegal evidence of
abortion and laboratory tests.
11. Infanticide definition,
medicolegal importance and
autopsy findings, age of viability,
determination tests for viability.
Remember, However That the Saudi regulation

of examination of all cases of rape and raped
females (especially).
Do not miss the illegal abortion in cases of
induced abortion

Continue … 11
41
Student Notes: .


www.forensic pathology for student.com
Self-assessment

question:
What is the medicolegal significance of

abortion and pregnancy?
Lecture 12: GENERAL ASPECTS OF FORENSIC

42
TOXICOLOGY
Student Notes: .
Lecturer: DR. Ayman Abdel Hamid Nagy

to:
1. Definition of the poison, classification of
poison and fields of toxicology.
2. Definition of the forensic toxicology
3. The rules of the forensic toxicologist
4. Medicolegal significance of forensic
toxicology.
5. Diagnosis of poisoning.
5. General treatment of poisoning
(emergency and supportive
management.)
1. Definition of the poison, classification of

poison and fields of toxicology.
2. Definition of the forensic toxicology
3. The rules of the forensic toxicologist
4. Medicolegal significance of forensic
toxicology.
5. Diagnosis of poisoning.
6. General treatment of poisoning
exposure

Continue … 12
Student Notes: .
43
Remember, That to safe the life of poisoned

patient the type of poison should be not the first
thing you should to know.


www. forensic pathology for medical
students.com

Lecture 13: VOLATILE POISONS AND NOXIOUS GASES(1)

Student Notes: .
44

Nagy

to:
1. Define the volatile poisons and Noxious

gases
2. Ethyl alcohol (Ethanol) metabolism.
3. Ethyl alcohol actions, toxic dose and fatal
dose.
4. Clinical picture of alcohol acute toxicity,
Its diagnosis, and treatment.
5. Medicologal importance of acute ethyl
alcohol toxicity and autopsy findings.
6. Methyl alcohol Toxicity. and
Medicologal importance of acute Methyl
alcohol toxicity and autopsy findings.
1. Define the volatile poisons and Noxious

gases

Continue … 13
Student Notes: .
45
2. Ethyl alcohol metabolism, action, toxicity

(C/P, Fatal and toxic dose, and
medicolegal significance of ethyl alcohol
toxicity, autopsy finding)
3. Mthyl alcohol metabolism, action,
toxicity (C/P, Fatal and toxic dose, and
medicolegal significance of methyl
alcohol toxicity, autopsy finding).

Continue … 13
46
Student Notes:
listed:
will be announced in lecture


your spare time.

www.google.com
Self-assessment

Discuss autopsy findings in alcohol toxicity

pages for notes if needed) .
Lecture 14: VOLATILE POISONS AND NOXIOUS GASES

(II)
47
Student Notes: .

Nagy

to:
1. Cyanide poisoning, Conditions of

poisoning, management of toxicity.
2. Medicolegal significance of poisoning and
autopsy finding.
3. Carbon monoxide poisoning, Conditions of
poisoning, management of poisoning.
autopsy finding.
5. Carbon monoxide poisoning, Conditions of
poisoning, management of poisoning.
autopsy finding.
1. Cyanide poisoning, sources and

condition of poisoning, fatal and toxic
dose, c/p of toxicity and management,
autopsy findings and medicolegal
significance of cyanide toxicity.
Continue … 14
Student Notes: .
2. Carbon monoxide poisoning, sources and
48
significance of carbon monoxide toxicity.
3. Carbon dionoxide poisoning, sources and
significance of carbon dionoxide toxicity.
4. Diagnostic laboratory tests and role of
physation in collection and preservation
of samples.

Continue … 14
Student Notes: .
Remember, That the CO poisoning is the silent

49
Killer.


about the
. You can access the CD-ROM during your spare
time.

www.google.com
Self-assessment

What is the autopsy findings of cyanide and Co
poising?
Lecture 15: PLANT POISONOUS AND DRUG DEPENDENCE (1)

Student Notes: .

Nagy
50
to:
1. Define the plant toxicology and alkaloids
2. Describe the types and classifications of

plant poisons
3. Opium toxicity, sources and chemistry,

management of toxicity, medicolegal
importance of toxicity
4. Atropine toxicity, sources and chemistry,

importance of toxicity.
5. Strychnine toxicity, sources and chemistry,

importance of toxicity.
1. Definition of plant toxicology and

alkaloids.
2. Opium toxicity, sources and chemistry,
management of toxicity (c/p, antidotes,
D.D), precautions in prescription of
opium, medicolegal importance of
toxicity
Continue … 15
Student Notes: .
3. Atropin toxicity, sources and chemistry,
management of toxicity (c/p, antidotes,
D.D), medicolegal importance of toxicity
4. Strychnine toxicity, sources and

chemistry, management of toxicity (c/p,
51
antidotes, D.D), medicolegal importance
of toxicity.

Continue … 15
Student Notes: .
Remember, however, that not all medicinal

plants are absolutely safe.
52


about the
. You can access the CD-ROM during your spare
time.
On the website you will find

many interactive cases for
discussion, MCQs and images.
Self-assessment

What is the legal precautions of morphine
prescription?

Lecture16: PLANT POISONOUS AND DRUG DEPENDENCE (II)

Student Notes: .

Nagy
53
to:
1. Ergot toxicity, sources and chemistry,

2. Cocaine toxicity, sources and chemistry,
3. Define the drug dependence
4. Theories of dependence, and
classifications of dependence
5. Examples of dependence, management
of dependence
6. Describe the medicolegal aspects of the
drug of dependence.
1. Ergot toxicity, sources and chemistry,

management of toxicity (c/p, antidotes, D.D),
medicolegal importance of toxicity
2. Cocain toxicity, sources and chemistry,
management of toxicity (c/p, antidotes, D.D),
medicolegal importance of toxicity
3. Definition of dependence
Continue … 16
Student Notes: .
4. Theories of dependence, and classifications
of dependence
5. Examples of dependence and its
management.
6. Describe the medicolegal aspects of the drug
of dependence.
54

Continue … 16
Student Notes: .
Remember, however, the magnitude of addiction

and increasing the number of addict drugs.
55


your spare time.
On the website you will find many

interactive cases for discussion, MCQs and
images.
Self-assessment

What is the medicolegal significance of drug
depends? (Insert here handouts and additional
Lecture 17: ANIMAL POISONS & INSECTICIDIES POISONOUS

Student Notes: .
56

Nagy

to:
1. Define animal toxicology

2. Poisonous snakes, Classifications,
mechanisms of snake poisoning,
fatal period and fatal dose,
Management of toxicity.
3. Medicolegal importance of snake
poisoning and autopsy findings.
4. Poisonous scorpiones,
Classifications, mechanisms of
scorpion poisoning, fatal period and
fatal dose, Management of toxicity.
6. Medicolegal importance of bee
stings and autopsy findings.
7. Definition and classification of
insecticides.
8. Conditions of poisoning.
9. Medicolegal importance of
organophosphorus poisoning
10. Medicolegal importance of carbamates
poisoning (Insert here handouts and additional
11. Medicolegal importance of paraquat pages for notes if needed)
poisoning
Continue … 17
12. Medicolegal importance of new insecticide Student Notes: .
57
poisoning. Know the most acquired
preneoplastic disorders
1. What is animal toxicology, definition

and classifications
2. Poisonous snakes, Classifications,
mechanisms of snake poisoning, fatal
period and fatal dose, Management of
toxicity.
4. Poisonous scorpiones, Classifications,
mechanisms of scorpion poisoning,
fatal period and fatal dose,
Management of toxicity.
6. Medicolegal importance of bee stings
and autopsy findings.
7. Definition and classification of insecticides.
8. Conditions of poisoning.
9. Medicolegal importance of
organophosphorus poisoning (Diagnosis,
D.D, Treatment, Autopsy findings)
10. Medicolegal importance of Carbamates
poisoning (Diagnosis, D.D, Treatment,
Autopsy findings)
11. Medicolegal importance of paraquat (Insert here handouts and additional
poisoning (Diagnosis, D.D, Treatment,
Autopsy findings). pages for notes if needed)
Continue … 17
Student Notes: .
58
Remember, however, that the insecticide

and organophosphrous poisoning are a
house hold poisoning.

You have the opportunity to watch the CD-

ROM about the. You can access the CD-
ROM during your spare time.
On the website you will find many

interactive cases for discussion, MCQs and
images.
Self-assessment

question:
What are the autopsy findings in snakes
poison and scorpion?
Practical 1:
Identification
59
TUTOR: DR. Ayman Abdel Hamid Nagy

OBJECTIVES:
 Characteristics useful in identifying the living, dead remains.
 Personal identity from skeletal remains.
 General identification of human remains (Biological profile) as role of
individual prints (finger, foot, lip, DNA and others).
 Estimating the subject's age from skeletal structures and role of teeth in
identification.
 .Determination of sex.
 Estimation of stature and race from skeletal remains..
Teaching material of different gross specimens demonstrating the following lesions:

1. Images and X-rays
2. Long bone
3. Skull
4. Pelvis
5. Sternum
6. Jars of foetus
60
Practical 2:
Ballistcs- gross specimens
TUTOR: DR. Ayman Abdel Hamid Nagy Department: Pathology
 Know the types of firearm weapons including rifled weapons and non
rifled weapons.
 Know the mechanics of missile injury.
 Identify characters of wounds from smooth bore guns and rifled

weapons including; contact wounds, intermediate and far distance
wounds.
 Differentiate and identify the entrance and the exit of wounds.
 Estimating the range of discharge.
 Know the doctors duty in firearm injuries and deaths.
 Types of firearm weapons including rifled weapons and non rifled

weapons.
 The mechanics of missile injuries.
 Types and characters of firearms injuries from rifled and non rifled
weapons.
 Factors affecting the shape of Firearm injuries.
 The differences between entrance and the exit of fire arm injuries.
 Estimating the range of discharge.
 The medicolegal significant of firearm injuries and doctor's duty in firearms
injuries.free radicals
61
Teaching material of different gross specimens demonstrating the following lesions:

1. Complete bullet
2. Fired and non fired bullets
3. Empty cartage
4. Different types of powders
5. Images of different shapes of fire arm injuries.
6. Brown atrophy heart
.
Simpson's Forensic Medicine By Bernard Knight, eleventh edition.
62
Practical 3:
Primary medicolegal reports and Death
certificates
TUTOR: DR. Ayman Abdel Hamid Nagy Department: Pathology
OBJECTIVES:
1. Medico-legal aspect of wounds, and the role of physician in evaluation of

wound for medico-legal point of view.
2. Definition, mechanism, age, medico legal aspects of Abrasion, bruises,

and laceration.
3. The duty of General practitioner GP, ER physician in evaluation of
wounds from medico-legal point of view.
4. Medicolegal aspects of defence and fabricated wounds.
5. Histological and histochemical changes in wounds and its medicolegal importance
in dating of wounds.
6. Investigations and differentiation between suicidal, accidental and homicidal
wounds.
7. How to write a primary medicolegal report.
8. Indications of death.
9. Postmortem Changes of forensic importance…..Hypostasis…Rigor mortis.
10. Timing the postmortem interval
11. Death certificate.
63
Practical 4:
Blood & hair and fibbers
TUTOR: DR. Ayman Abdel Hamid Nagy Department: PATHOLOGY
OBJECTIVES:
 Medicolegal importance of evidence in scene of crime in general.

 Medicolegal importance of. hair &blood and fibbers.
 How to preserve the forensic evidence?
 What is the chain of custody?
 Is it human?
 Is it related to certain persn?
1.
:
Simpson's Forensic Medicine By Bernard Knight, eleventh edition.
64
Independent learning
“Independent learning is a very essential skill for tomorrow’s doctors. We
will train you to gain this important skill by asking you to read
independently about specific topics in pathology”
List of Course student directed learning:
1- Medico legal importance of Consent
2- Medico legal Significance of Car seat belt and Expected injuries in car accident.
3- Medicolegal evidence collection and reservation methods and chain of custody.
65
Problem Solving Learning PSL
“Problem Solving Learning is a very essential skill for tomorrow’s doctors.

We will train you to gain this important skill by asking you to read
independently about specific topics in pathology”
List of Course Problem Based Learning
66
1- It discuses house hold poisoning, and post mortem findings
in corrosive and heavy metal poisoning.
2- It discuses the house wife abuse, sexual abuse. Weapons
used, injuries findings and post mortem findings in this
case.
Log book requirement:
Students will be divided into groups each group consists of six

students they will work together to inspect and photo six medicolegal cases
( wounds, and/ or Post mortem changes). To write a full Primary
medicolegal report
By the end of the book it will be corrected and discussed according to cases.
Further Reading
Course Text Book:
Simpson's Forensic Medicine
BY
Other Information Resources:

1. Knight's Forensic Pathology by Pekka Saukko. Bernard Knight,
Third Edition ( Reading Text book).
2. Hand Book of Forensic Pathology By: Vincent J.M Di Maio
and Suzanna E. Daua (Reading Text book).
3. Forensic web site on the internet.
www.forensicmedicineformedicalstudent.co.uk
www.internt pathologylaboratory for medical education. co
4. Hand out of lectures.
5. King Abdul Aziz University Library.

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KING ABDULAZIZ UNIVERSITY

THE OUTCOMES OF THE UNDERGRADUATE CURRICULUM 3

01 Identification & Mass disaster 15

02 Death & Post mortem changes and brain death (I) 17

03 Death & Post mortem changes and brain death (II) 19

04 Medico legal importance of wounds (I) 21

05 Medico legal importance of wounds (II) 23

07 Fire Arm Injuries 27

12 General Aspects of Forensic Toxicology 42

13 Volatile and Noxious Gases (I) 44

14 Volatile and Noxious Gases (II) 47

15 Plant Poisonous and Drug Dependence (I) 50

16 Plant Poisonous and Drug Dependence (II) 53

17 Animal poins and Insecticides poisonous 56

NO . PRACTICAL (Names) Page

02 Ballistics –Gross Specimen 60

03 Primary medico legal report and death certificate. 62

04 Blood & Hair and Fibbers 63

NO . STUDENT-DIRECTED LEARNING (SDL) Page

Medico legal importance of Consent

Medico legal Significance of Car seat belt and Expected

01 Discussion on Medico legal importance of wounds.

Aims/objectives of the course:

1. To give the medical students basic knowledge (as a future general

3. To highlight the major forensic problems in the community which

4. Each lecture would have specific aim(s) (take home message(s)),

Methods of fulfilling the aims:

The course would be delivered as lectures (total 17 hours). The lectures

1. Anatomy, physiology, histology and biochemistry of the human

Book: 1) Simpson's Forensic Medicine

2) Hand Book of Forensic Pathology

Undergraduate Program Learning Outcomes

STRUCTURE OF THE MODULE

Module Units (Hours)

Forensic Medicine and PATM

WELCOME to the forensic and toxicology course..

Dr. Ayman Nagy (AN) Pathology Ext#21106

This form of assessment is designed to give you feedback to help you to

identify areas for improvement. It includes a mixture of MCQs, short

answer-questions (SAQs), extended matching questions (EMQs), problems-

solving exercises and independent learning activities in all subjects. These

made available to you.

This type of assessment is used for judgment or decisions to be made about

 They will include multiple choice questions (MCQs).

B:- Practical Exam :

 It will be in an OSPE (Objective Structured Practical Exam) format,

The degree of continuous assessment will be divided to:

In this Course your performance will be assessed according to the

 Continuous assessment quizzes (30%)

Total = 100 Marks

The most characteristic of the fire arm injury is:

1. Presence of inlet and exit.

Content of the lecture

Independent learning from textbooks

Independent learning from the CD-ROM.

Independent learning from the Internet

Self- Assessment (the answer to self-assessment exercises will

The main concepts

Lecture 1: Identification & Mass disaster

Lecturer: DR. Ayman Abdel Hamid Nagy

At the end of the lecture you should be able

1. Appreciate the concept of DNA

1. DNA fingerprints and its role in human