Legal Medicine Notes

Abortion - is the termination of pregnancy by the removal or expulsion from

the uterus of a fetus or embryo before viability.
Algor mortis (Latin: algor - coldness; mortis - death) is the reduction in body
temperature following death.
Rigor mortis (Latin: rigor - stiffness, mortis - death") is one of the
recognizable signs of death, caused by chemical changes in the muscles
after death, causing the limbs of the corpse to become stiff and difficult to
move or manipulate.
Importance Of Rigor Mortis
- Rigor mortis is utilized to approximate the time of death.
muscular contractions occur from 3 to 6 hours until 36 hours.

Generalized

Autopsy - a post-mortem examination to discover the cause of death or the

extent of disease. Autopsy is derived from the Greek word "autos" - oneself
and "opsis" - sight/view.
Who are authorized to perform autopsy
1. Health officers
2. Medical officer of law enforcement agencies
3. Members of the medical staff of accredited hospitals
When Autopsy performed
1. Written request of nearest kin to ascertain cause of death
2. Order of competent court, mayor, prosecutor
3. Written request of a law enforcement officer
4. When required by special law
5. Solgen, prosecutor to determine cause of death
Principal Aim of an Autopsy
1. To determine the cause of death
2. To determine the state of health of the person before he or she died,
3. To determine whether any medical diagnosis and treatment before
death was appropriate.
Types of Autopsies
1. Medico-Legal Autopsy or Forensic or coroner's - autopsies seek to find
the cause and manner of death and to identify the decedent.
2. Clinical or Pathological autopsies are performed to diagnose a
particular disease or for research purposes.
3. Anatomical or Academic Autopsies - are performed by students of
anatomy for study purpose only.

4. Virtual or Medical Imaging Autopsies - are performed utilizing imaging

technology only, primarily magnetic resonance imaging (MRI) and computed
tomography (CT).
Forensic Autopsy - is used to determine the cause and manner of death.
Anatomy - the branch of science concerned with the bodily structure of
humans, animals, and other living organisms, especially as revealed by
dissection and the separation of parts.
Biochemistry - the branch of science concerned with the chemical and
physico-chemical processes and substances which occur within living
organisms.
Cadaveric Spasm - also known as postmortem spasm, instantaneous rigor,
cataleptic rigidity, or instantaneous rigidity, is a rare form of muscular
stiffening that occurs at the moment of death, persists into the period of
rigor mortis and can be mistaken for rigor mortis.
Cadaveric spasm occurs immediately after death and is useful
ascertain the circumstances of death.

to

Cerebral Concussion there is a brief loss of consciousness and sometimes

memory after ahead injury that doesnt cause obvious physical damage.
Cerebral Contusion they are bruises to the brain, usually caused by a
direct, strong blow to the head. They are more serious than concussions.
Circulatory System - also called the cardiovascular system, is an organ
system that permits blood to circulate and transport nutrients (such as
amino acids and electrolytes), oxygen, carbon dioxide, hormones, and blood
cells to and from cells in the body to nourish it and help to fight diseases,
stabilize body temperature and pH, and to maintain homeostasis.
Contempt of Court - any willful disobedience to or disregard of a court order
or any misconduct in the presence of a court action that interferes with a
judge's ability to administer justice or that insults the dignity of the court.
Punishable by fine or imprisonment or both.
Contusion - also called a bruise, is a type of hematoma of tissue in which
capillaries and sometimes venules are damaged by trauma, allowing blood to
seep, hemorrhage, or extravasate into the surrounding interstitial tissues.
Death - Complete cessation of all cardio- pulmonary (heart-lungs) and/or
cessation of brain activity.

Death is the termination of all biological functions that sustain a living

organism.
Kinds of Death
1. Somatic or Clinical Death - permanent cessation of all vital bodily
functions.
2. Molecular or Cellular Death - refers to the death of cells. 3 to 6 hours
after cessation of life.
3. Apparent death or State of Suspended Animation - a state in which the
processes of the body (such as blood circulation)stop or become very slow
for a period of time while a person or animal is unconscious.
Leading Causes of Death In The World
1. Ischaemic heart disease
2. Stroke (cerebrovascular diseases)
3. Lower respiratory infections
4. Chronic Obstructive Lung Disease
Signs Of Death
1. Cessation of heart action and circulation
2. Cessation of respiration
3. Cooling of the body (Algor Mortis) - The temperature of 1520 degrees
Fahrenheit is considered as ascertain sign of death.
4. Loss of motor power
5. Loss of sensory power
6. Changes in the skin
7. Changes in and about the eye - There is loss of corneal reflex
Declaration of Tokyo - is a set of international guidelines for physicians
concerning torture and other cruel, inhuman or degrading treatment or
punishment in relation to detention and imprisonment, which was adopted in
October 1975 during the 29th General assembly of the World Medical
Association.
Defloration - is the laceration or rupture of the hymen as a result of sexual
intercourse.
Dermis - the thick layer of living tissue below the epidermis which forms the
true skin, containing blood capillaries, nerve endings, sweat glands, hair
follicles, and other structures.
Digestive System - digestive system is a group of organs working together to
convert food into energy and basic nutrients to feed the entire body.
Dr. Pedro P. Solis - Philippines father of Legal Medicine.

Ecchymosis - a discoloration of the skin resulting from bleeding underneath,

typically caused by bruising.
Endocrine System - refers to the collection of glands of an organism that
secrete hormones directly into the circulatory system to be carried towards a
distant target organ.
Epidermis - the outermost layer of the skin of a human or other vertebrate
animal.
Euthanasia - Meaning good death (well or good ), Refers to the practice of
ending life in a painless manner. Deliberate intervention undertaken with the
express intention of ending life, to relieve intractable suffering.
Excretory System - is a passive biological system that removes excess,
unnecessary materials from an organism, so as to help maintain homeostasis
within the organism and prevent damage to the body.
Homeostasis -means remaining stable or remaining the same.
Firearm identification - used to determine whether the gun that is subject of
the investigation has the same gun used or fired.
Forensic Medicine - application of medical science to elucidate legal
problems.
Forensic Science - involves the application of the sciences to answer
questions of interest to the legal system.
Four 4 Signs of Inflammation
1. Rubor - redness
2. Calor - heat
3. Tumor - swelling
4. Dulor - pain
Fracture - comes from the Latin word fractura which means a break in the
continuity of the bone. It is also a combination of a break in the bone and
soft tissue injury.
Frostbite - injury to body tissues caused by exposure to extreme cold,
typically affecting the nose, fingers, or toes and often resulting in gangrene.
Frostnip - the initial stages of frostbite.

Gynecology - the branch of physiology and medicine which deals with the
functions and diseases specific to women and girls, especially those affecting
the reproductive system.
Hematoma - is a collection of blood outside of a blood vessel.
Incision - a surgical cut made in skin or flesh.
Injury - is the damage to a biological organism caused by physical harm.
Coup Injury - injury at the site of application of force.
Contre-Coup Injury - injury opposite the site of application of force.
Coup-Conre-Coup Injury - injury at the site and opposite the site of
application of force.
Locus Minoris Resistentiae - injury not at the site and not opposite the
site of application of force but at the site offering least resistance.
Extensive Injury - injury on greater area more than the site of application
of force.
Integumentary system - is the organ system that protects the body from
various kinds of damage, such as loss of water or abrasion from outside. The
system comprises the skin and its appendages, including
hair, scales, feathers, hooves, and nails.
Laceration - a deep cut or tear in skin or flesh. A wound that is produced by
the tearing of soft body tissue. This type of wound is often irregular and
jagged.
Lazarus Syndrome - is also called Lazarus Phenomenon, is the spontaneous
return of circulation after failed attempts at resuscitation.
Lazarus Sign - or Lazarus reflex is a reflex movement in brain dead patients,
which causes them to briefly raise their arms and drop them crossed on their
chests.
Legal Medicine - Branch of medicine which deals with the application of
medical knowledge to the purpose of law and in the administration of justice.
Application of medicine to legal cases.
Livor Mortis - is a settling of the blood in the lower (dependent) portion of the
body, causing a purplish red discoloration of the skin.

From the latin word "livor" - bluish color and "mortis" - of death. Also known
as post-mortem lividity.
Mayhem - intentional maiming of another person.
Mechanical Trauma - is an injury to any portion of the body from a blow,
crush, cut, or penetrating wound.
Medical Evidence - is the means sanctioned by the rules of court of
ascertaining in a judicial proceeding the truth respecting a matter of fact.
Types of Evidence
1. Real Evidence/Autoptic - made known to the senses
2. Testimonial Evidence - oral testimony under oath
3. Experimental Evidence
4. Documentary Evidence
Medical Jurisprudence - knowledge of law in relation to the practice of
medicine.
Medico-Legal officer - (medical examiner) a physician who determines the
cause of injury/death/disease by examining the patient/cadaver and testify in
court to aid in the administration of justice.
Mental Deficiency or mental retardation, is sub average intellectual ability
present from birth or early infancy. Intelligence is both determined by
heredity and environment. In most cases of mental deficiency, the cause is
unknown.
Classification of Mental Deficiency
1. Idiot The idiots intelligence never exceeds that of a normal child
over 2years old. The IQ is between 0 20. This is usually congenital.
2. Imbecile the imbeciles intelligence is compared to a normal child
from 2 7 years old and the IQ is 20 40.
3. Feeble Minded his mentality is similar to that of a normal child
between 7 12 years old and an IQ of 40 70.
The Legal Importance of determining the persons state of mind are the
following:
1. In Criminal law, insanity exempts a person from criminal liability.
2. In Civil law, Insanity is a restriction of the capacity of a natural person
to act as provided in Article 38 of the Civil Code.
3. Insanity modifies or limits the capacity of a natural person to act as
provided in Article 39 of the Civil Code.
4. Insanity at the time of marriage of any or both parties is a ground for
the annulment of marriage.

Mental Health Disorders include disturbances in thinking, emotion, and

behavior. There is a complex interaction between the physical, psychological,
social, cultural and hereditary influences.
Factors that Contribute to the Development of Mental Disorders
1. Heredity the most frequent factor that contributes to insanity and a
good history will reveal the ascendants afflicted with the same.
2. Incestuous Marriage The mental illness is accentuated when they are
blood relative.
3. Impaired Vitality Stress, tension, worry, grief may predispose to
insanity.
4. Poor Moral Training and Breeding Corrupt moral upbringing in the
family due to immorality of the parents.
5. Psychic Factors Factors like love, hate, rage, anger, passion
disappointments.
6. Physical Factors
a. Non toxic factors exhaustion resulting from severe physical and
mental strain and traumatic injuries to the head.
b. Toxic factors drug addiction, infections of the brain.
Kinds of Mental Health Disorders
1. Psychosomatic disorders physical disorders caused by psychological
factors.
2. Somatiform disorders encompasses several psychiatric disorders in
which people report physical symptoms but deny having psychiatric
problems.
3. Generalized Anxiety Disorders
4. Panic Attacks and Panic Disorder
5. Phobic Disorders
a. Agoraphobia
b. Specific phobias
c. Social phobia
6. Obsessive Compulsive Disorder
7. Post Traumatic Stress Disorder
8. Depression and Mania
9. Bipolar Disorder
10.Suicidal Behavior
11.Eating Disorders
a. Anorexia nervosa
b. Bulimia nervosa
c. Binge eating disorder
12.Personality Disorders
a. Paranoid
b. Schizoid
c. Histrionic

d. Narcissistic
e. Antisocial
f. Borderline
g. Avoidant
h. Dependent
i. Obsessive Compulsive
j. Passive Aggressive
k. Dissociative
13.Schizophrenia a serious mental disorder characterized by loss of
contact with reality(psychosis), hallucinations, delusions (false beliefs),
abnormal thinking, disrupted work and social functioning.
Types of Schizophrenia
a. Paranoid - is a mental disorder characterized by paranoia and a
pervasive, long-standing
suspiciousness and generalized mistrust
of others.
b. Hebephrenic - it is characterized by disorganized behavior and
speech, as well as disturbances inemotional expression.
c. Catatonic - does not respond to external stimuli. Characterized
by a marked lack of movement, activity, or expression.
14.Delusional Disorder
15.Psychological Incapacity a waste basket diagnosis because it is so
broad a term, that it covers all possible Mental Disorders.
Some Manifestations of Mental Disorders
1. Disorders of Cognition (Knowing)
a. Illusion
b. Hallucination
2. Disorders of Memory
a. Dementia
3. Disorders in the Content of Thought
A. Delusion
a. Delusion of grandeur
b. Delusion of persecution
c. Delusion of reference
d. Delusion of Self Accusation
e. Delusion of infidelity
f. Nihilistic delusion
g. Delusion of poverty
h. Delusion of control
i. Delusion of depression
B. Obsession
4. Disorders in the trend of thought
Types a. Mania
b. Melancholia

5. Disorders of Emotions or Feelings a disorder in the state of mind,

fervor, or sensibility, not in accord with reality.
6. Disorders of volition or conation (doing)
Conation - the mental faculty of purpose, desire, or will to perform an
action; volition.
Kinds of Conation
A. Impulsion or Impulse (Compulsion) a sudden and irresistible force
compelling a person to the conscious performance of some action without
motive or forethought.
Types of Compulsion
a. Pyromania - from the Greek word "pyr" - fire, is an impulse
control disorder in which individuals repeatedly fail to resist impulses to
deliberately start fires in order to relieve tension or for
instant
gratification.
b. Kleptomania - is the inability to refrain from the urge to steal
items and is done for reasons other than personal use or financial gain.
c. Dipsomania - an uncontrollable craving for alcoholic liquors.
d. Homicidal impulse - occurs when one person kills another
suddenly and without premeditation or planning.
e. Sex impulse - a sudden strong and unreflective urge or desire to
have sex..
f. Suicidal impulse - recurring thoughts of or preoccupation with
suicide.
Mortal Wound - capable of causing death.
Muscular System - is an organ system consisting of skeletal, smooth and
cardiac muscles. It permits movement of the body, maintains posture, and
circulates blood throughout the body.
Mutilation - or maiming is an act of physical injury that degrades the
appearance or function of any living body.
Nervous System - consists of the brain, spinal cord, sensory organs, and all of
the nerves that connect these organs with the rest of the body.
Obstetrics - branch of medecine that deals with pregnancy, childbirth, and
postpartum period, including care of the newborn.
Paraffin test or Dermal Nitrate test present on the skin of the hand or site of
the wound of entrance. This test is not conclusive because fertilizers,
cosmetics, cigarettes, urine and other nitrogenous compounds with nitrates
will give a positive reaction.

A negative test is also not conclusive . The test usually gives a positive result
even after a lapse of 3days or even if the hands are subjected to ordinary
washing.
Pathology - the science of the causes and effects of diseases, especially the
branch of medicine that deals with the laboratory examination of samples of
body tissue for diagnostic or forensic purposes.
Paulus Zacchias - (15841659) is the Father of Forensic Medicine.
Petechiae a circumscribe extravasation of blood in the subcutaneous tissue.
Physical Injury - is the effect of some stimulus on the body.
Physical injuries - include those caused by mechanical trauma, heat and cold,
electrical discharges, changes in pressure, and radiation.
Mechanical trauma is an injury to any portion of the body from a blow, crush,
cut, or penetrating wound.
Physics - The subject matter of physics includes mechanics, heat, light and
other radiation, sound, electricity, magnetism, and the structure of atoms.
Physiology - the branch of biology that deals with the normal functions of
living organisms and their parts.
Post-Mortem - (meaning after death) internal examination of the dead to
determine the cause of death.
Ante-Mortem - before death.
Post-Mortem Caloricity - is the rise of temperature of the body after death
due to rapid and early putrefactive changes, usually in the first two hours.
Post Mortem Lividity - it occurs in most extensive areas of the most
dependent portions of the body.
Puncture Wound - is usually caused by a sharp pointy object such as a nail,
animal teeth, or a tack. This type of wound usually does not bleed
excessively and can appear to close up.
Putrefaction - or decomposition is the final stage following death, produced
mainly by the action of bacterial enzymes, mostly anaerobic organisms
derived from the vowel. Other enzymes are derived from fungi and
sometimes from insects.

Kinds of Putrefaction:
1. Mummification - is the preservation of a body.
2. Saponification also called Adipocere Formation.
3. Maceration - Softening of the tissues after death by autolysis.
Reproductive System - or genital system is a system of sex organs within an
organism which work together for the purpose of sexual reproduction. Many
non-living substances such as fluids, hormones, and pheromones are also
important accessories to the reproductive system.
Respiratory System - (or ventilatory system) is a biological system consisting
of specific organs and structures used for the process of respiration in an
organism. The respiratory system is involved
in the intake and exchange of oxygen and carbon dioxide between an
organism and the environment.
Scald - is a type of burn injury caused by hot liquids or gases.
Sex Crimes - generally involve illegal or coerced sexual conduct by one
person towards another.
Chaste An unmarried woman who has had no carnal knowledge with
men or that she never voluntarily had unlawful sexual intercourse. These
also denotes purity of mind and innocence of heart.
Virgin A woman who has had no carnal knowledge of man. Her genital
organs have not been altered by carnal connection.
Kinds of Virginity
1. Moral virginity the state of not knowing the nature of sexual life
and not having experience sexual relation.
2. Physical Virginity A condition whereby a woman is conscious of
the nature of sexual life but has not experienced sexual intercourse.
3. Demivirginity This term refers to a condition of a woman who
permits any form of sexual liberties as long as they abstain from rupturing
the hymen by sexual act. The woman allows sexual intercourse, but only
inter femora or even inter labia, but not to the extent of rupturing the
hymen.
4. Virgo intacta A truly virgin woman. There is no structural change
in her organ, not withstanding the fact of a previous sexual intercourse.
Carnal Knowledge - is the act of a man in having sexual bodily connection
with a woman. There is carnal knowledge if there is the slightest penetration
in the sexual organ of the female by the sexual organ of the male.

Shrapnel - fragments of a bomb, shell, or other object thrown out by an

explosion.
Skeletal System - gives the body its basic framework, providing structure,
protection, and movement.
Subpoena - order issued by the court to a person to appear in court.
Subpoena ad Testificandum- is a court summons to appear and give oral
testimony for use at a hearing or trial.
Surgery - is an ancient medical specialty that uses operative manual and
instrumental techniques on a patient to investigate and/or treat a
pathological condition such as disease or injury, to help improve
bodily function or appearance or to repair unwanted ruptured areas.
Topinard and Rolet - two french anatomist who devised a formula for the
determination of the height for male and female.
Toxicology - the branch of science concerned with the nature, effects, and
detection of poisons.
Trauma - injury, a physical wound to the body caused by an external source.
Virginity - A condition of a female who has not experience sexual intercourse
and whose genital organs have not been altered by carnal connection and
whose hymen is still intact.
Virgo Intacta - literally the term refers to a truly virgin woman; that there are
structural changes in her organ to infer previous sexual intercourse and that
she is a virtuous woman.
Virtuous Female - If her body is pure and if she has never had any sexual
intercourse with another though her mind and heart is impure.
Vital Reaction - the response of living body tissues to injury.
Wound - in legal medicine,it means strictly a solution of continuity. An injury
to living tissue caused by a cut, blow, or other impact, typically one in which
the skin is cut or broken.
Open Wound - there is a break in the continuity of the skin.
1. Abrasion - a wound consisting of superficial damage to the skin.
Scratch, friction mark.
2. Bruise - is a common skin injury that results from the breakage of tiny
blood vessels leaking under the skin. Blood from damaged blood vessels

beneath the skin collects near the surface of the skin to appear as what we
recognize as a black and blue mark. Cause by a blunt injury to the tissues
which damage blood vessels beneath the surface, allowing blood to
extravasate or leak into the surrounding
tissues.
3. Incised Wound - caused by a clean, sharp-edged object such as a knife,
razor, or glass splinter.
4. Stab Wound - is a specific form of penetrating trauma to the skin that
results from a knife or a similar pointed object that is "deeper than it is
wide".
5. Punctured Wound - is a deep wound caused by something sharp and
pointed, like a nail. The opening on the skin is small, and the puncture wound
may not bleed much. Puncture wounds can easily become infected.
6. Perforating Wound - a wound with an entrance and exit opening.
7. Lacerated Wound - that occurs when skin, tissue, and/or muscle is torn
or cut open. Lacerations may be deep or shallow, long or short, and wide or
narrow. Most lacerations are the result of the skin hitting an object, or an
object hitting the skin with force.
8. Bite - is a wound received from the teeth of an animal, including
humans.
9. Gunshot Wound (GSW) - (Ballistic Trauma) is a form of physical trauma
sustained from the discharge of arms or munitions.
Barotrauma - wound/injury caused by a change in atmospheric pressure.
Defense Wound - or self-defense wound is an injury received by the
victim of an attack while trying to defend against the assailant. Often found
on the hands and forearms, where the victim has raised them to protect the
head and face or to fend off an assault, but may also be present on the feet
and legs
where a victim attempts defense while lying down and kicking
out at the assailant. Abortion - is the termination of pregnancy by the
removal or expulsion from the uterus of a fetus or embryo before viability.