OSPE LIST – CBME

UNIVERSITY MARK DISTRIBUTION: practical 80 marks + Viva 20 marks

Each station 5 mins 4 marks for each station – total 20 x 4 = 80 marks

Viva 5 marks for each examiner = 4 x 5 = 20 marks

1. Injury certificate – either photograph or description

2. Drunkenness certificate

3. Sex determination from bones with reasons

4. Age determination from X rays with reasons

5. Potency certification in a case of alleged sexual assault

6. Examination of victim in a case of alleged sexual assault

7. Estimation of age of a given fetus

8. Viscera packing and labelling in a case of poisoning

9. Medical leave certificate

10. Fitness from medical leave certificate

11. Interpret autopsy report with reasons

12. Medical certification of cause of death

13. Age certification from physical and dental examination with reasons

14. Appliance

15. Autopsy instrument

16. Weapon Examination

17. Wet specimen

18. Photograph

19. Poisonous Plant/seed

20. Poisonous animal/reptile

1. Injury certificate – either photograph or description of injuries will
be given

Format (table in correct order of columns) – 1 mark

Filling of table – correctness of content – 1 mark

S. No Name of Size Shape Colour Anatomical Simple/

injury position Grievous

1 Laceration 3 cms x 4 - - Front of Simple

cms x anterior

muscle shin

deep

2. Abrasion 8 cm x 6 - Reddish Front of Simple

cm brown thigh

3. Laceration 2 cm x 2 - - Above left Grievous

cm x eyebrow

muscle

deep

Opinion – 2 marks

The injuries 1 and 2 are simple and the injury number 3 is Grievous

-------------------------------------------------------------------------------------------------------
 2. Drunkenness certificate
Opinion on Drunkenness: – 1 mark
a. From above observation, I am of the opinion that the person has not consumed alcohol.
b. From above observation, I am of the opinion that the person has consumed alcohol and
under its influence.
c. From above observation, I am of the opinion that the person has consumed alcohol but
not under its influence.
Reasons for opinion: - 1 mark
a. For opinion a. – because smell of alcohol is not perceived and the person is
able to perform all muscular co-ordination tests
b. For opinion b. – because smell of alcohol is perceived and the person is not able
to perform all muscular co-ordination tests
c. For opinion c. – because smell of alcohol is perceived and but the person is able
to perform all muscular co-ordination tests

Answering for question on consent – 1 mark

Question: Is consent mandatory in this case? Is it a valid consent?

Answer: consent is always mandatory to examine a person for drunkenness, until the
person was arrested and bought by a police officer to examine him (as per section 53 CrPC, a
person arrested and brought for medical examination can be examined without consent)
Question: Is it a valid consent?
Answer: if the person was found not to be in sound mind due to influence of alcohol,
then the doctor can take examine him and wait for the person to come out of influence of
alcohol and then take a consent. Issue the examination results/certificate only if he consented
for the examination. If he denies the consent then he can mention in the request for
examination that the person has not consented for examination which will go against him.
Answering for question on Romberg Sign – 1 mark
Question: what is Romberg Sign?/ How to perform Romberg Test?
Answer:Romberg's test, Romberg's sign, or the Romberg maneuver is a test used in
an exam of neurological function for balance, and also as a test for influence of any
intoxicant. Ask the person to close eyes and stand with feet together, observe if the person is
able to balance himself or if he sways from side to side.
Inference: if he sways side to side – the person is under the influence of alcohol.
----------------------------------------------------------------------------------------------------------------
3. Sex determination from bones with reasons
Format (table in correct order of columns) – 1 mark

Filling of table – correctness of content and at least five features have to be written– 1 mark

S. Anatomical feature Male Female Observation Inference

NO
1 Supra orbital ridge More prominent Less prominent More prominent Male
2 Nasal Aperture Large and opens Small and opens Large and opens at Male
at higher level at lower level higher level
3 Mastoid process Large Small Large Male
4 Styloid process Thick & short Long & Slender Thick & short Male
5 Foramen Magnum Large Small Large Male

Opinion – 1 mark
From above observation, I am of the opinion that the given skull bone belongs
to MALE Sex.

Answer to Question: 1 mark

Cephalic Index: it is the index calculated by dividing maximum width of head

by maximum length (anterior - posterior diameter) of head. It is used to
establish the race of the person
------------------------------------------------------------------------------------------------
4. Age determination from X rays with reasons

Format (table in correct order of columns) – 1 mark

Filling of table – correctness of content and all ossification center has to be written– 1 mark

S. Ossification center Appearance Fusion Observation Inference

NO
1 Lower end of femur 9th month of 20-21 years Appeared & fused >20 years
intra uterine life
2 Upper end of tibia At birth 20-21 years Appeared & fused >20 years
3 Upper end of fibula 4th year 20-21 years Appeared & fused >20 years

Opinion – 1 mark
From above observation, I am of the opinion that the age of the person is above
20 years as all the ossification centers around knee joint has appeared and fused
Answer to Question: 1 mark - Medico legal importance of Age:

• Three months of intra uterine life – 12 weeks

According to MTP, for termination of pregnancy up to this age opinion of one doctor is sufficient,
above this age opinion of two doctors is required.
• Six months of intra uterine life – 24 weeks
This is the maximum age of foetus up to which termination of pregnancy is allowed as per MTP.
• Seven months – 28 weeks
A foetus which has completed seven months is considered to be viable.
• 1 year of age
Up to one year child is called infant and killing of an infant amount to infanticide
• 7 years of age
Below this age, a child cannot be held responsible for his or her criminal act
• 7 to 12 years of age
A child may or may not be held responsible for his or her crimes and will be a juvenile offender,
depending up on the mental maturity
• 10 years of age
To kidnap any child less than 10 years of age for the purpose taking any movable asset is an
punishable offence
• 12 years of age
Below this age one cannot give a valid consent
Above this age and up to 18 years if a child commits a crime, then he is called juvenile offender
• 14 years of age
Below this age, a child cannot be employed in any factory for work
Between 14 to 15 years, a person can be engaged in non-hazardous jobs in a factory for limited
period of time in day hours only.
• 15 years of age
Above this age can be employed in a factory
• 16 years of age
To kidnap any boy less than 16 years or female of age less than 18 years from the legal
guardianship for the purpose of begging is punishable offence.
• 18 years of age
Statutory rape – sexual intercourse with a girl below 18 years even with consent is rape
Above this age can give valid consent
Above this age can make valid will
Above this age has right to vote
Minimum legal age for a female to get married
• 21 years of age
Minimum legal age for a male to get married
Maximum age up to which a juvenile offender can be kept in borstal school
• 25 years of age
Minimum age for contesting for membership of parliament and legislative bodies
• 35 years of age
Minimum age for appointment as President, Vice President of India and as Governor of a state

----------------------------------------------------------------------------------------------------------------------
5. Potency certification in a case of alleged sexual assault
Opinion: 2 marks
a. From above observations, I am of the opinion that there is nothing to suggest that the
person is not capable of performing sexual intercourse
b. From above observations, I am of the opinion that there are evidences to suggest that
the person is not capable of performing sexual intercourse

Reasons: 1 mark
For Opinion a: On physical examination, there are no evidences of any congenital abnormality,
local diseases or general diseases, however psychological causes of impotency can’t be ruled out.
For Opinion b: On physical examination, there are evidences of congenital
abnormality(hypospadias)/ local diseases (hydrocele)and/ or general diseases(tuberculosis). [write
as according to your case findings]
Answer to Question 1 mark:What are the materials/samples are preserved from accused?
1. Blood samples for blood grouping and typing
2. Blood samples for testing for presence of any venereal diseases
3. Blood samples for presence of alcohol or any other drugs
4. Loose pubic hair
5. Free hair strands or cloth fibres found on body or clothing
6. Fingernail scrapings
7. Penile swaps for detecting vaginal epithelium
----------------------------------------------------------------------------------------------------------------------
6. Examination of victim in a case of alleged sexual assault
Opinion: 1 mark
a. There are signs suggestive of recent forceful vaginal intercourse
b. There are signs suggestive of vaginal intercourse
c. There are no signs suggestive of penetration of vagina
d. There are no signs suggestive of vaginal intercourse but there is evidence of physical and
genital assault

Reasons: 1 mark
For opinion a:- On examination, there are signs of physical and genital injuries and FSL report of
vaginal washings is positive for spermatozoa
For opinion b:- On examination, there are no signs of physical and genital injuries,but FSL
report of vaginal washings is positive for spermatozoa
For opinion c:- On examination, there are no signs of physical and genital injuries and FSL
report of vaginal washings is negative for spermatozoa
For opinion d:- On examination, there are signs of physical and genital injuries, but FSL report
of vaginal washings is negative for spermatozoa
Answer to Question 1 mark:What are the materials/samples are preserved from victim?
1. Blood samples for blood grouping and typing
2. Blood samples for testing for presence of any venereal diseases
3. Blood samples for presence of alcohol or any other drugs
4. Loose pubic hair
5. Free hair strands or cloth fibres or any blood/seminal stains found on body or clothing
6. Fingernail scrapings
7. Two vaginal swabs and vaginal washings for detecting spermatozoa
----------------------------------------------------------------------------------------------------------------------
7. Estimation of age of a given fetus – Fetus examination
Answer to question 1: 1 mark – Estimate the age of the fetus
Age of the Fetus is Calculated by Rule of Hasse, which states that,
Age of Fetus in months = Square root of Crown Heel length of Fetus, if it is less than 25 cm
Age of Fetus in months = Crown Heel length of Fetus divided by 5, if it is more than 25 cm
In the given case crown heel length is 30 cm so,
Age of Fetus in months = 30/5 = 6 months.
Answer to question 2: 1 mark – what is viability of fetus? Is the fetus viable
Viability of fetus means he physical ability of a fetus to lead a separate existence after birth apart from
its mother, by virtue of certain degree of development. A fetus is viable after 210 days or 7 months of
intrauterine life, so this fetus being 6 months of age is non-viable fetus.
Answer to question 3: 2 mark – what the features that will be present consistent with
the age calculation.
At 6 months of intrauterine life following features will be seen in fetus.
• Weight – around 700 gms
• Eyelids adherent, eyelashes appear
• Vernix caseosa will be present
• Meconium will be present in upper part of large intestine
• Testis will be seen closer to kidneys
• Ossification centre of Manubrium sternum and 1st segment of sternum will appear

Months Weight Nails & eyes Gonads Lanugo hair & Scalp Meconium
of IUL caseosa hair &
Ossification
centre
3 month 30 gms Nails Sex Lanugo hairs absent Scalp hair
membranousEyes indistinguishable absent
seen as spots

4 month 120 gms Sex Lanugo hairs starts Meconium

distinguishable to appear present in
upper part of
small intestine
5 month 400 gms Nails thin Testis above Lanugo hairs Scalp hair Meconium
membranous kidneys covers face and appears present in
body, Vernix starts to appear
caseosa appears in large
intestine
7 month 1 kg Eyelids non adherent, Lt Testis closer Lanugo hairs Scalp hair Meconium
nails Thicker but does to ext inguinal covers entire body – 1 cm present in
not reach tip of ring, whole large
fingers Rt testis closer intestine
to int inguinal
ring
8 month 1.5 kg Nails reach tip of Lt testis at Lanugo hairs Scalp hair Ossification
fingers eyes, eyelids scrotum disappears from – 1.5 cm centres of
and eyelashes well Rt testis atext face Talus, 2nd& 3rd
formed inguinal ring segment of
sternum
appears
9 month 2 – 2.25 Nials over grows Both testis at Lanugo hairs Scalp hair Ossification
kg beyond finger tips scrotum present only at – 2 cm centre of lower
shoulders. end of femur
Caseosa present appears.
only at Flexures of Meconium at
neck and joints rectum
---------------------------------------------------------------------------------------------------------------------------
8. Viscera packing and labelling in a case of poisoning
For Organophosphorus poisoning (example)
Answer to Question 1: 2 marks - what are the viscera you will collect in this case?
Routine Viscera collected in this case
Bottle 1: Stomach and its contents
Bottle 2: proximal 20 cm of small intestine
Bottle 3: 500gms of Liver and half of each kidney
Bottle 4: 20 ml of blood
Bottle 5: Sample preservative – saturated solution of Sodium chloride
Bottle 6: Special Viscera – Muscle/ fat

Poison Special Viscera to be collected

Organophosphorus Muscle 3 cm x 3 cm fat 10 gms
Carbon Monoxide Whole lung tied at the level of trachea and kept in a nylon bag and heat sealed, blood in air tight
container
Methyl Alcohol Vitreous Humour, CSF
Ethyl Alcohol Vitreous Humour, CSF
Potassium Cyanide Whole lung tied at the level of trachea and kept in a nylon bag and heat sealed, blood in air tight
container
Arsenic Hair – 20 to 30 with roots, all nails, Femur bone – 10 cm
Cerebra thevetia Whole heart
Barbiturate Brain – 100 gms
Answer to Question 2: 1 mark –what is the Preservative?
In this case
preservative for solid organs – Saturated Solution of Sodium Chloride
Preservative for blood and fluids - Sodium fluoride & potassium oxalate
Poison Preservative for solid organs Preservative for blood and fluids
Organophosphorus Saturated Solution of Sodium chloride Sodium fluoride & potassium oxalate
Carbon Monoxide Saturated Solution of Sodium chloride Sodium fluoride & potassium oxalate
Methyl Alcohol Saturated Solution of Sodium chloride Sodium fluoride & potassium oxalate
Sulphuric Acid Rectified Sprit Sodium fluoride & potassium oxalate
Barbiturate Saturated Solution of Sodium chloride Sodium fluoride & potassium oxalate
Potassium Cyanide Saturated Solution of Sodium chloride Sodium fluoride & potassium oxalate
Copper sulphate Saturated Solution of Sodium chloride Sodium fluoride & potassium oxalate
Cerebra thevetia Saturated Solution of Sodium chloride Sodium fluoride & potassium oxalate
Carbolic acid Saturated Solution of Sodium chloride Sodium fluoride & potassium oxalate
Ethyl Alcohol Saturated Solution of Sodium chloride Sodium fluoride & potassium oxalate
Arsenic Saturated Solution of Sodium chloride Sodium fluoride & potassium oxalate
Sulphuric Acid Rectified Sprit Sodium fluoride & potassium oxalate
Hydrochloric acid Rectified Sprit Sodium fluoride & potassium oxalate
Nitric acid Rectified Sprit Sodium fluoride & potassium oxalate

Answer to Question 3: 1 mark – write a sample label

Viscera label
PONDICHERRY INSTITUTE OF MEDICAL SCIENCES
DEPARTMENT OF FORENSIC MEDICINE & TOXICOLOGY
PMNO: 123/22 CR NO: 345/22 U/S 174 CRPC
Police station: Kottakuppam Police stationDate of collection; 12.12.2022
NAME: Mr ABCDEF AGE: 45 YEARS SEX:MALE
Viscera collected: Stomach and its contents
Preservative: Saturated solution of Sodium chloride
Name &Signature of Medical Officer:
---------------------------------------------------------------------------------------------------------------------------
9. Medical leave certificate
Format given in the record should be written as it is without any changes including signature
of medical officer along with details of patient – 2 marks
Date of leave should commence from the day of examination – 1 mark
Appropriate number of days of leave – 1 mark
Illness like Acute Gastroenteritis number of leave is 3 days
For Enteric fever – 14 days
----------------------------------------------------------------------------------------------------------------

10. Fitness from medical leave certificate

Format given in the record should be written as it is without any changes including signature
of medical officer along with details of patient – 3 marks
Date of joining should commence from the next day of examination – 1 mark
----------------------------------------------------------------------------------------------------------------

11. Interpret autopsy report with reasons

Opinion to Cause of Death: 2 marks
The deceased would appear to have died of Cranio-cerebral injuries sustained to head (RTA Case)
The deceased would appear to have died of Asphyxia due to antemortem hanging (hanging case)
The deceased would appear to have died of Asphyxia due to antemortem Drowning (Drowning case)
The deceased would appear to have died of Neurogenic Shock due to 99% thermal injuries (Burns
Case)
Reason; 1 mark
Injuries or features given in history of case (in question) have to written here

Other questions: 1 mark

Ques:What is cadaveric spasm and its medico legal importance?(Drowning case)
Ans:Cadaveric spasm is a condition in which group of voluntary muscles which were active
and contracted during life will become stiff and rigid immediately after death without passing
in to the stage of primary relaxation. As such the change preserves exact attitude of the
person at the time of death for several hours after death and helps in identifying the manner
of death in such cases.

Ques:what are confirmatory tests that can be done in this case? (Drowning case)
Ans:Diatom Test: to differentiate antemortem drowning from postmortem drowning
Gettler’s test; to differentiate fresh water drowning from salt water drowning

Ques:what is Pugilistic attitude? (Thermal burns case)

Ans: the position of body which is exposed to great heat is often characteristic due to
contraction of muscles and it will be in an attitude commonly adopted by boxers while
defending. This stiffening is due to coagulation of protein and dehydration which causes the
contraction. It occurs irrespective of whether the person was alive or dead at the time of body
burning.
---------------------------------------------------------------------------------------------------------------
 12. Medical certification of cause of death
Format of medical certificate of cause of death with details of patient – 1 mark
All three causes of death written – 1 mark
Correctness of content – 2 marks
Name of deceased:
sex Age at death
If 1 year or more If less than 1 If less than 1 month If less than 1 day
Age in years year Age in days Age in hours
Age in months

CAUSE OF DEATH Interval between onset of disease and death

I. Immediate cause Acute Myocardial infarction 24 hours
Antecedent cause Hyper lipidaemia 10 years
Hypertension 10 years
II. Contributory cause Bronchial Asthma 5 years
If deceased was a female, was pregnancy the death associated with? No
Name & signature of doctor:Registration Number:

I. Immediate cause Air embolism

Antecedent cause Rupture of uterus following D&C
II. Contributory cause Diabetes Mellitus

I. Immediate cause Hypostatic Pneumonia

Antecedent cause Extensive bed sores
Fracture of neck of femur
II. Contributory cause -

I. Immediate cause Pneumonitis

Antecedent cause Measles
II. Contributory cause -

I. Immediate cause Peritonitis

Antecedent cause Perforation of chronic duodenal ulcer
II. Contributory cause Bronchial Asthma

I. Immediate cause Pneumonia

Antecedent cause Fracture of shaft of femur, calcaneum, shaft of
humerus
Sepsis at implant site
II. Contributory cause -

I. Immediate cause Haemoptysis

Antecedent cause Secondaries cancer deposit in lungs and vertebrae
Prostate Cancer
II. Contributory cause -

I. Immediate cause Hematemesis

Antecedent cause Hepatic encephalopathy
Alcoholic liver cirrhosis
II. Contributory cause -

I. Immediate cause Pancreatitis

Antecedent cause Alcoholic liver cirrhosis
II. Contributory cause -
---------------------------------------------------------------------------------------------------------------------------
13. Age certification from physical and dental examination
Exercise 1:Ms Reena, D/O Mr Shiva was rescued from a house where she was working as a
domestic help by the Child Welfare Committee workers. The owners of the house claimed
that she was 16 years old.
Opinion to age: 1 mark
From above the physical, dental and radiological examination, I am of the opinion that the age
is above 14 years but less than 15 years
Reasons: 3 marks
Dental examination:
All permanent teeth appeared except for 3rdmolar- more than 12 less than 25 years
Radiological examination:
Triradiate cartilage not fused- less than 15
Iliac crest appeared not fused- more than 14 less than 17
All carpal bones appeared- more than 10 years
Lower end of radius and ulna appeared not fused- more than 6 less than 18 years

Exercise 2: Ashok, S/o Ajay was caught for throwing stones at passing trains and breaking
the Windows. A case was registered in the Railway Police station, Pondicherry Crime no.
226/2017.
Opinion to age:
From above the physical, dental and radiological examination, I am of the opinion that the age
is above 6 years but less than 7 years
Reasons:
Dental examination:
Permanent 1 molar have appeared but central incisor is temporary- 6-8 years
Radiological examination:
Only head of radius and capitulum has appeared- more than5 and less than-7 years
All carpal bones appeared except for pisiform- more than6, less than 12 years
Lower end of radius and ulna appeared and not fused- more than 6 less than 18 years

Exercise 3:Meera D/O Dheeran was sexually assaulted by one of their neighbours. A case
was registered in the Marakkanam Police Station.
Opinion to age:
From above the physical, dental and radiological examination, I am of the opinion that the age
is above 16 years but less than 17 years
Reasons:
Dental examination:
All permanent teeth appeared except for 3 molar- more than 12 less than 25
yearsRadiological examination:
All ossification centre in the lower end of humerus appeared- more than 11 years
Conjoint epiphysis formed but not fused- more than 14 less than 17 years
Upper end of radius and ulna appeared not fused- more than 9 less than 17 years
Triradiate cartilage fused- more than 13 years
iliac crest appeared not fused- more than 14 less than 20
Ischial tuberosity appeared not fused- more than 16 years less than 21 years

Exercise 4:Mayur, S/O Senthilvanan was caught on camera while he was trying to shoplift.
A case was registered in the Kiliyanur Police Station
Opinion to age:
From above the physical, dental and radiological examination, I am of the opinion that the age
is above 11 years but less than 12 years
Reasons:
Dental examination:
Permanent canines have appeared- more than 11 years less than 14 years
Radiological examination:
All ossification centres in the lower end of humerus have appeared- more than 11 years
Upper end of radius and ulna appeared not fused- more than 9 less than 17 years
All carpal bones appeared except for pisiform- more than 6 years less than 12 years
Lower end of radius and ulna appeared and not fused- more than 6 less than 18 years

Exercise 5:Ajay, S/O Ashok was caught for throwing stones at passing trains and breaking
the windows.
Opinion to age:
From above the physical, dental and radiological examination, I am of the opinion that the age
is above 7 years but less than 9 years
Reasons:
Dental examination:
Permanent central incisors present- more than 7 less than 9 years
Radiological examination:
All ossification centres appeared in the upper end of humerus.- more than 5 years
Conjoint epiphysis formed not fused- more than 5 less than 19 years
All ossification centres in the lower end of humerus have appeared except for trochlea and
lateral epicondyle- more than 5 years less than 9 years
Centres for upper end of radius has appeared and not fused- more than 5 less than 17 years
Upper end of ulna has not appeared- less than 9 years

Exercise 6:Mayur, S/o Senthilvanan was caught on camera while he was trying to shoplift.
A case was registered in the Kiliyanur Police station.
Opinion to age:
From above the physical, dental and radiological examination, I am of the opinion that the age
is above 10 years but less than 11 years
Reasons:
Dental examination:
All teeth are permanent except canine- more than 10 less than 12 years.
Radiological examination:
All carpal bones appeared - more than 10 years
Lower end of radius and ulna appeared and not fused- more than 6 less than 18 years
All ossification centres in the lower end of humerus appeared except for lateral epicondyle-
more than 9 years less than 11 years
Upper end of radius & ulna appeared & not fused- more than 9 less than 17 years

Exercise 7:Basheer, S/O Bawa was caught with illegal explosive material travelling from
Pondicherry to Chennai. He pleaded to be tried as juvenile and he stated his age to be 16
years and he was just a school dropout.
Opinion to age:
From above the physical, dental and radiological examination, I am of the opinion that the age
is above 20 years
Reasons:
Dental examination:
All permanent teeth have appeared- more than 17 years
Radiological examination:
All ossification centres of elbow joint appeared and fused- more than 16 years
All ossification centres of pelvis appeared and fused- more than 20 years.
---------------------------------------------------------------------------------------------------------------------------
14. Appliance
Identification of appliance: 1 mark
Draw a neatly labelled diagram: 1 mark
Mention the uses and contra indication: 2 marks

Stomach wash tube

• Indication
– Gastric lavage in case of poisoning
• Contraindication
Absolute
– Corrosive poison except carbolic acid
Relative
– Convulsant poison
– Comatose patients
– Volatile poisons
– Oesophageal varices

Naso gastric tube

• Indication
– Aspiration of gastric
contents for analysis
– Gastric lavage in case of
poisoning
– feeding
• Contraindication
– Mid face trauma
– Recent nasal surgery
– coagulopathy
– Oesophageal varices
Endo tracheal tube

• Indication
– General anaesthesia
– Coma patients
– Respiratory failure – for
ventilatory support
• Contraindication
– Foreign body in phayrnx
– Face trauma
– Tracheal/oesophageal fistula
– Ca in upper GI or respiratory tract
– Severe bronchospasm

Foley’s Urinary catheter

• Indication
– Collecting urine
– Critical I&O chart
– Retention of urine
– Comatose patient
– Paralysed patient
– Neurogenic bladder
– Pre op preparation
• Contraindication
• Absolute
– Urethral injury
– Trauma to pelvis with suspected urethral
injury
• Relative:
– Use cautiously in patients with urethral stricture

-----------------------------------------------------------------------------------------------
15. Autopsy instrument
Identification of autopsy instrument – 2 marks
Uses/ indication – 2 marks

1. Councilman’s saw
To cut open cranial vault
To cut open bone marrow

2. Enteretome Scissors
To open hollow viscera like small intestine, Large intestine, Rectum

3. Scissors
To eviscerate
To cut structures like rectus sheath, large vessls, trachea

4. Blunt forceps
To hold structures like blood vessels, Dura, Nerves
etc
5. Toothed forceps
To hold Skin, Soft tissue without slippage

6. Chisel and hammer

To break open the cranial vault after sawing

7. Brain knife
To dissect brain
To cut solid organs like liver, kidney, lungs etc

8. Scalpel
To make skin incisions
To cut soft tissues.

9. Dissection knife
To dissect organs
To separate ribs at costro-chondral junctions

10. Rib shears

To cut ribs in order to open chest cavity

11. Inch tape

To measure head circumference, chest circumference
To measure size of injuries

12. Magnifying Lens

To magnify and observe wound margins in doubtful cases
16. Weapon Examination

Identification of weapon and its type – 2 marks

What are the injuries produced by them – 1 mark
Or
Draw a neatly labelled diagram of the weapon – 1 mark
Or
Answering to the relevant question – 2 marks

Questions
Ectopic bruise: when the place of impact and appearance of bruise are at two different
locations due to gravitational shift of accumulated blood, then the bruise is called as
ectopic bruise. Example – black eye – accumulation of blood surrounding the eye, in
cases of blunt impact in anterior half of scalp.

Tram line contusion: Tram line contusions are caused by - canes, wires, batons, rubber
hoses, PVC pipes, whips, due to compression force on striking with the above objects the
bruising will be prominent along the margins of the weapons causing two parallel lines of
contusion which will mimic like a tram line and hence the name.

Rat Hole entry wound – entry wound of shot gun, when fired from a near range (45 cms
to 90 cms) will have scalloped margins due to spread of pellets and will look like a rat
hole and hence the name.

Tandem cartridge: these are cartridges which are struck at the barrel of a rifled firearm
and on second subsequent firing both the cartridges will exit the muzzle end.

Penetrating and perforating stab wound: Penetrating stab wound are stab wounds
which enter a cavity but will not exit the cavity through an exit wound, whereas a
perforating stab wounds are ones which will enter a cavity and will exit the cavity
through an exit wound.

Lacerated like incised wound: these are incised wounds made with sharp weapon over
the regions with loose skin/ regions with multiple skin folds like, scrotum, axilla etc
where the margins of the wound will be irregular and mimic like a lacerated wound.

Incised like lacerated wound: these are lacerated wounds made with blunt weapon over
the tissues with underlying bone like scalp, elbow etc, where the tissues being
compressed between the blunt object and bony surface, will give away and the margins
will be regular grossly and mimic like a incised wound.

Preservation of ligature material: the ligature material has to be removed by cutting the
ligature away from the knot position. The knot in the ligature material should not be
disturbed/ removed and it has to be packed, sealed and to be send in separate package
with pr oper labelling and seal.
 RIFLED CARTRIDGE SHOT GUN CARTRIDGE

------------------------------------------------------------------------
17. Wet specimen

1. Identify the wet specimen – 2 marks

2. Answer to relevant question – 2 marks

Cut section of larynx and trachea

Shows inflammation of mucosa and deposition of soot particles
due to inhalation of heated air and smoke

A case of antemortem burns

Cut section of larynx and trachea

Shows impaction of foreign body
Café coronary syndrome

specimen is identified as heart

shows stab injury to heart
commotio cardis

specimen is identified as liver

shows extensive laceration of right lobe
types of liver laceration
 specimen is identified as Stomach
the mucosa of stomach is corroded due to ingestion of
corrosive substances
precaution to be taken during treatment of corrosives acid
ingestion
define vitriolage

specimen is identified as skin

shows tattoo mark of tiger
medico legal importance of tattoo marks

Specimen is identified as skull

Shows frature of temporal bone
Types of skull fracture

Specimen is identified as brain

Shows sub-dural haemorrhage
Lucid interval
Causes of death

Specimen is identified as section of brain

Shows sub arachnoid haemorrhage
Lucid interval
Causes of death

----------------------------------------------------------------------------------------------------------------
18. PHOTOGRAPHS OF MEDICOLEGAL IMPORTANCE:

1. Identify the photograph

2. What are the signs of asphyxia (cyanosis, congestion, petechial haemorrhages, increase in fluidity
of blood)
3. Classify asphyxial deaths (Example: due to compression of neck (hanging & strangulation, other
means smothering, gagging, choking, drowning, suffocation deaths etc.., )

1. Identify the injury in the given photograph

2. Write its medicolegal importance (consistent with road traffic accident, direction of force
applied can be assessed)
3. How will you interpret the age of injury from the color change ? (ageing of abrasion)

1. Identify the change which is shown in the photograph (decomposition change (image 1– skin
slippage (destocking in foot and degloving in hands) (image 2: bloating features – swelling of
scrotum)
2. Calculation of time since death from such changes (earliest sign externally – greenish
discoloration – right iliac fossa (18-24 hours)
Three distinct features of decomposition
a) Change in colour of the tissues
b) The evolution of gases in the tissues
c) The liquefaction of tissues
1. Identify the photograph (fresh water drowning)
2. What is the cause of death in such case (asphyxia due to drowning)
3. How will you classify such asphyxia deaths? (dry, wet (salt & fresh water), immersion death)

1. Identify the photograph (thermal burns)

2. Write about the medicolegal importance
3. What are the different methods of classifying such injuries based on the depth (Wilson’s (3),
Dupuytren’s (6))
4. What is rule of 9?

1. Identify the photograph ‘

2. Write its medicolegal importance
3. What are the various inks used in producing it ?
4. Mention about different methods of obliteration
 1. Identify the photograph
2. What is the cause of death in this case (Asphyxia due to hanging )
3. How will you classify such deaths (write about complete / incomplete hanging & typical / atypical
hanging)
4. What is Le facie sympathique? (compression over cervical sympathetic chain on ipsilateral side –
eyes will be open with pupils dilated)

1. Identify the photograph (Joule burn – at the point of contact otherwise an entry wound in
electrocution – endogenous thermal burn)
2. Describe the injury and its medicolegal importance
Description of injury:
Round, oval, shallow craters, one to three cm in diameter and have a ridge of skin of about 1-3mm
high. The floor of the crater is lined by pale flattened skin)

1. Identify the photograph

2. Medicolegal importance
a) Suggests an inflicting instrument or its unique means of its causation
b) Produced when the force is applied at right angles to the surface of skin
1. Identify the photograph
2. Medicolegal importance and ageing of abrasion based on colour change
3. Differences between antemortem and post-mortem wound?

19. Toxicology spotters

Saw scaledViper

1. Identify the snake and the identification features

2. What is the mode of action ? (mention whether neurotoxic or hemotoxic or Musculo toxic )
3. What are the clinical features in case its envenomation ?

Russel viper

Banded krait Cobra

 Scorpion
1. Identify the specimen ?
2. What is the mode of action in case of sting? (it is an autonomic stimulator- symptoms
due to increase in catecholamines)
3. What is the treatment given in such sting?

PLANTS AND SEEDS:

QUESTIONS: (common for all)

1. Identification (common name & scientific name)

2. Active principle & mechanism of action
3. Clinical features
4. Medicolegal importance
Calotropis gigantea – IRRITANT

Ricinus communis – ORGANIC IRRITANT

1. Active principles – toxalbumin ricin

2. MOA: ricin blocks protein synthesis
through inhibition of RNA polymerase
3. Signs & symptoms : GI symptoms
(nausea, vomiting, severe abdominal
pain, bloody diarrhoea etc..,) uremia,
convulsions, hemolysis , death
 RICINUS SEEDS

Datura Fastuosa– DELIRIANT

Active principles: Hyoscine, Hyoscyamine, atropine

MOA: stimulation of higher center of brain, then the motor

centers and finally causes depression and paralysis of
brainstem

Peripheral effects are from anticholinergic effects

Signs & symptoms: write anticholinergic symptoms

Specific: Differentiate between datura seeds and capsicum seeds

DATURA CAPSICUM
Nerium odorum – CARDIAC POSION

Active principle: oleandrin, nerioside, folinerin, rosagenin

Signs & symptoms: difficulty in swallowing, abdominal

pain, vomiting, salivation & diarrhoea. Bradycardia
followed by pupillary dilatation, AV block, respiratory
paralysis and death

Yellow oleander – CARDIAC POISON

Cerebra thevetia

Active principle: thevetin, thevetoxin, nerifloin, peruvoside,

ruvoside, cerberin

Signs & symptoms: ingestion – burning pain in mouth,

dryness of throat, tingling, vomiting, diarrhoea, headache,
giddiness. Bradycardia, and hypotension, heart block,
collapse and death

Abrus precatorius – IRRITANT

Active principle: abrin, a toxalbumin – similar to

viper snake bite ; abrine ( hemoglutinin) , abralin
(glucoside)

MOA: inhibition of protein synthesis

Signs & symptoms: irritation of upper GI, abdominal

pain, nausea, vomiting, bloody diarrhoea, weakness,
miosis, rectal bleeding
Specific : what is sui ? - the seeds are decorticated, mixed with datura, opium and onion, are
made into a paste with spirit and water =, and small sharp pointed spikes or needles prepared
“suis”
Use for killing cattle

Semecarpus anacardium
Active principles: semecarpol, bhilawanol

Signs & symptoms: external application of juice –

irritation, painful blister contains acrid serum.

Used for producing artificial bruise

Other irritants used for artificial bruise:

Plumbago rosea, seme carpus anacardium, Calotropis

Strychnos nux vomica (strychnine) – NEUROTOXIC

Active principle: two principle alkaloids – strychnine, brucine

MOA: competitively blocks – ventral horn motor neuron postganglionic

receptor sites in the spinal cord and brainstem. Inhibits glycine

Signs & symptoms: CNS symptoms due to increasd excitation – convulsions

– more marked in anti gravity muscles “ Opisthotonus”

Risus sardonicus – contraction of the jaws and facial muscles

Name…………………………… Roll NO…………………………… Batch…………………
Check List for Exam (Forensic Medicine practical)
1 week before Exam:
□ Get acquainted with exam pattern
□ Take care of each part of exam
□ Theory
□ Practical
□ Revise the resources
□ Mental well being- Do the activity you like for 30 minutes everyday like
jogging, music instrument etc.
□ Make a list of queries
□ Clarify doubts
□ Seek help from teachers/colleagues/friends
□ Regular relaxing exercises for half an hour
□ Sleep well
Day before exam:
□ Record Book
□ Log Book
□ Preparation for exam writing
□ Revised through all the exercises (1-hour superfast revision)
□ Go through doubts (1 hour)
□ Stationary
□ Apron
□ ID card
□ Ironed clothes
□ Roll no badge
□ Relaxation by exercise or meditation
□ Sleep for 7-8 hours
□ Don’t eat too much / too less
Morning of exam:
□ Physical activity for 10 to 15 mins
□ Maintain smiling face
□ Come to exam with positive mindset
□ Stay calm.

ALL THE BEST …