Legal medicine

Branch of medicine which deals with the application of medical knowledge to

the purpose of law and in the administration of justice.

Legal Medicine Synonymous;

concept is under
Forensic Medicine Anglo-American
influence
Medical Jurisprudence
Famous personalities in the history of Legal
Medicine
• Imhotep- (2980 B.C) – earliest medico-legal expert. Chief physician and
architect of King Zoser.
• Antistius – first police surgeon or forensic pathologist and performed the
autopsy in the body of Julius Ceasar, (23 wounds and 1 penetrated the chest
cavity between first and second ribs).
• Paulus Zachias – Italian physician regarded as the father of forensic
medicine.
• Orfila- Founder of modern technology. In his traite’ de Poison, he
mentioned mineral, vegetable and animal poison in relation with
physiology, pathology and legal medicine.
• Dr. Rafael Genard y Mas- 1858, the first medical textbook including
instruction related to medico-legal practice, Spanish physician.
AUTOPSY VS. POST MORTEM EXAMINATION
AUTOPSY.- comprehensive study of a dead body, employing
recognized dissection procedure and techniques, to know
the cause of death.
2 TYPES OF AUTOPSY:
1. Hospital or non-official
2. Medico-legal or official

POST MORTEM EXAMINATION

Refers to the external examination of a dead body with out
incision being made although blood and other body fluids
may be collected.
 DEATH
Termination of life. It is the complete cessation of all the vital functions with
out possibility of resuscitation.
SIGNS OF DEATH:
POST MORTEM CALORICITY- the rise of
1. Algor mortis; cooling of the body- temperature of the body after death due
>it is rapid during two (2) hours. to rapid and early putrefactive changes. 2
> a fall of 15-20 degrees Fahrenheit hours after death.

2. Rigor mortis- the stiffening of the body, due to the POST MORTEM RIGIDITY ( cadaveric
dis appearance of adenosine triphosphate (ATP) from rigidity, death stiffening, death struggle
muscle of muscles.
>may last for 24-36 hours
> starts from 2-3 hours and fully developed in 6
– 12 hours
POST MORTEM LIVIDITY ( cadaveric
2. Livor mortis – reddish purple coloration in
lividity or post mortem suggillation or
dependent areas of the body due to accumulation of post mortem hypostasis.
blood in the small vessels of the dependent areas
secondary to gravity.
EXAMPLES OF RIGOR MORTIS
 STAGES OF DECOMPOSITION

• Fresh (1-2 days)

• Bloated (2-6 days
• Decay (5-11 days)
• Post- decay ( 10-24 days)
• Dry stage (24+ days)
 Physical Injury
The effect of some forms of stimulus on the body.
CLASSIFICATION OF PHYSICAL INJURY:

CONTUSION ( BRUISE) – The effusion of blood into the

tissues underneath the skin as result of blunt force or
violence.

Noticeable colors of the injury in relation to number of

hours or days after infliction:
• Red- fresh
• Blue- few hours – 3 days
• Bluish black/brown- 4rth day
• Green- 5- 7 days
• Yellow – 7- 12 days
• normal – 2 weeks
CLASSIFICATION OF PHYSICAL INJURY:

HEMATOMA ( BLOOD CYST, BLOOD TUMOR) – The

effusion of blood into newly formed cavity.

Location of injury in relation to the site of application of

force.

• Coup Injury – located at the site of the application of force.

• Contre-Coup- opposite the site of the application of force.

• Coup Contre-Injury- located at the site and also opposite

the site of application

• Locus Minoris Resistancia-. Physical injury not located at

the site or opposite the site of the application of force but
in some areas offering the least resistance to the force
applied.
• Example: Blow in the forehead—contusion on the region of
the eyeball
 • The solution of natural continuity of the
WOUND living body.
• Disruption of the anatomic integrity of a
tissue of body.
CLASSIFICATION OF WOUNDS
AS TO KIND OF INSTRUMENT USED
AS TO SEVERITY a. Blunt instrument – contusion, hematoma, lacerated
a. Mortal wound – caused wound.
immediately after infliction that b. Sharp instrument
is capable of death.  Sharp-edge instrument (incised wound)
Parts of the body that are mortal  Sharp pointed (punctured wound)
- heart and big blood vessel  Sharp edge and sharp-pointed (stab wound)
- brain and spinal cord c. Wounds brought about by tearing force – lacerated
- Lungs wound
- stomach, liver, spleen, and d. By change in atmospheric pressure – barotraumas.
intestine e. Wounds brought about by heat or cold – frostbite, scald,
b. Non-mortal wound - Not burns.
capable of producing death after f. Wounds brought about by chemical explosion – Gunshot
infliction wound; shrapnel wound
. g. Wounds brought about by infection
 AS TO THE MANNER OF INFLICTION
TYPES OF WOUNDS.
a. HIT – means of bolo, blunt instrument, an
ax.
1. CLOSED WOUND – no breach of continuity of
b. TRUST or STAB – bayonet dagger
the skin or mucous membrane.
c. GUN POWDER EXPLOSION – Projectile or
a. Superficial – When the wound is just
shrapnel wound.
underneath the layers of the skin
d. SLIDING or RUBBING or ABRASION
or mucous membrane.
a. Petechiae – is a circumscribed extravasation of
AS REGARDS TO THE DEPTH OF THE blood in the subcutaneous tissue or underneath
WOUND the mucous membrane.
a. Superficial – wound involves only the b. Contusion –is the effusion of blood into the
layers of the skin. tissues underneath the skin on account of the
b. Deep – inner layers of the skin. rupture of the blood vessels as a result of the
application of blunt force or violence.
PENETRATING WOUND - Wounding agent c. Hematoma
did not come out or piercing a solid organ.
PERFORATING WOUND – Wounding agent
produces communication between the inner
and outer portion of the hollow organs.
2. OPEN WOUNDS

a. Abrasion (Scratch, graze, impression mark, friction mark)

It is an injury characterized by the removal of the superficial epithelial layer of the
skin caused by a rub or friction against a hard-rough object.

b. Incised wound (cut, slash, slice) produced by a sharp-edged (cutting) or sharp-linear edge of
the instrument like a knife, razor, bolo, glass, etc.

3.STAB WOUNDS – is produced by the penetration of a sharp and a sharp-edged instrument like
a knife, scissors. If the sharp edge is the one that comes in contact with the skin, then it is an
incised wound. If the sharp-pointed portion first comes in contact, it is a stab
wound.

4. PUNCTURED WOUND - is the result of the thrust of a sharp-pointed instrument.

5.LACERATED WOUNDS ( tear, rupture, stretch)

• a tear of the skin and the underlying tissues due to forcible contact with a blunt
instrument.
• produced by a hit with a piece of wood, iron bar, fist, stone, butt.
Diameter of the wound of entrance may approximate caliber of
firearm
 Characteristic of Gunshot Wounds
• Smoke – (soot, smudging, fouling, smoke blackening)- by
product of complete combustion of the gun powder
• Powder grains- (tattooing) consist of unburned, burning and
partially burned powder. Penetrate the dermal and epidermal
layer.
• Abrasion Collar- pressure of bullet on the skin will cause the
skin to be depressed and as the bullet lacerate the skin.
• Shored GSW of exit- pressed on the hard objects, the exit
tends to be circular or nearly circular with the abrasion at its
border.