Legal Medicine – February 18, 2018
pole or bridge support at a high speed.
In automotive crash:
 First collision – the impact of the
moving vehicle with another vehicle or a
fixed object. The moving vehicle rapidly
decelerates and stops after the impact
 Second collision – the impact of the
unrestrained occupants inside the vehicle
immediately after the first collision, the
occupants move in the same direction
and at the same velocity towards the
point of impact.
Front impact crash
 The driver may strike the steering wheel,
the hub of the steering column,
windshield, rear view mirror, the column
between windshield and side window or
the dashboard
 Fast running vehicle front portion of
care may be accordioned (?) and steering
wheel driven back to passenger
compartment.
Side impact crash
 When a vehicle strikes on the side of
another vehicle (as in street intersection)
or when a vehicle skids sideways into a
fixed object.
Rear impact crash
 As in change of lane in express way or
crash at the rear of a parked vehicle
 Acceleration-deceleration injury or
whiplash injury: with the impact the
head moves backward then moves
forward until the chin strikes the front of
chest.
Suicidal crash
 Usually a single vehicle and single
occupant crash
 Head on collision with roadside object,
 No evidence of effort to apply brake or
foot still on accelerator pedal.
Roll over crash (turn-turtle impact)
 While rolling, the occupants may be
pinned, crushed or may be thrown away
and fall on the ground.
Ejection of the occupant
 The primary impact of the vehicle may
forcibly open the unlocked door.
Pedestrian-vehicle collision:
 Primary impact – is the first violent
contact between the pedestrian and the
motor vehicle.
 The severity depends on:
1. Position of the victim upon
impact
2. Speed of the moving vehicle
3. Amount of bodily support
 If the contact is below the center of
gravity, the body moves backwards to
hit the hood, windshield or top of the
car. The average height of the bumper is
40 to 60 cm from the ground. The most
common site of the impact is the upper
portion of the leg (bumper fracture)
 If the driver had effectively applied the
break before impact, contact will be at
the lower level due to downward dive of
the front end of the vehicle immediately
after application of the brake.
 The leg carrying the body has more
tendency to be fracture. If the victim is
standing, both legs may be fractured.
 If the primary impact is above the center
of gravity of the pedestrian, the tendency
of the body is to move away from the
vehicle and fall on the ground
 If the brake was applied during or
immediately after the crash, the car
slows down faster than the movement of
 the pedestrian who continues moving Physical abuse – may include the act of physical
forward and lands on the road. or emotional persuasion that places the child in a
 If no brake was applied during the potentially dangerous situation where subsequent
accident and at a high speed, the and significant physical injuries are severe
pedestrian passes over the top of the requiring medical treatment
hood, windshield and windshield frame.
Physical neglect – includes the failure to
 Secondary impact – is the subsequent
provide the child with the necessities of life –
impact of the pedestrian to the ground
medical care, nourishment, clothing, supervision,
after the first impact. Injuries depend on
housing. The failure to provide must be willful.
the force of the ground impact, nature of
the road and part of the body involved. Causes of child abuse or neglect
Types of injuries 1. Unwanted child
 Husband disputing the paternity of
1. Hit and run injuries – usually happens
the child
when driver is drunk or high, at night
 Illegitimacy, such as when the child
time, in an isolated road with no
is born of unmarried woman, when
eyewitness. Tire thread marks, abrasion
the wife committed adultery, or
prints or parts of the vehicle in contact
when child born as a consequence
with the victim or in crime scene may be
of rape.
submitted to laboratory.
 Congenital or acquired deformity
2. Run over injuries – pedestrian, usually a
of the child
child, receives the impact above the
2. Abusive parent
center of gravity falling on the ground
 Uncontrollable abuse by psychotic,
with the car wheel passing over the
pervasively angry or temperamental
body. Crash fracture, skid or tire marks,
parent
rupture of organs and internal
 Controllable abuse by compulsive
hemorrhage may result.
disciplinarian or impulsive but
Drunk driving lol inadequate parent
3. Child as center of emotional triangle
Field sobriety tests – refer to standardized tests
to initially assess and determine intoxication Classification of child abuser
such as the horizontal gaze nystagmus, the walk-
Intermittent child abuser – parent who does
and-turn, the one-leg stand.
not intend to hurt the child, but driven by panic
Alcoholic drunkenness – a person with at least or compulsion into abusive behavior
0.15% alcohol in the blood is considered drunk.
One-time child abuser – manhandles child once
Some countries consider it a crime driving with
and never repeats the act. There is more
only 0.05% blood alcohol.
likelihood to repeat the act.
Child abuse
Constant child abuser – parent who hates the
It is the physical and mental injury or child and deliberately beats/miscares for the
maltreatment of a child by a person who is child. May have personality disorder.
responsible for the child’s welfare under
Ignorant abuser – most tragic because the
circumstances which will indicate that the
parent means well, but attempts at rearing the
child’s health or welfare is harmed or threatened.
child results in permanent injury or death.
The infliction must be willful and not accidental.

Evidence tending to show injuries due to
abuse:
 skin imprints from forcefully striking
objects – hand, cord, chain
 Multiple bruises, and/or scars,
particularly on trunk, head and face
 Multiple small burns or emersion burn
levels – cigarette, iron, boiling water
 Multiple fresh healing fractures
 Trauma to the mouth, nose ears and eyes
 In sexual abuse, injuries to the genitalia,
perirectal and perivaginal areas present
 In child neglect: signs of malnutrition,
poor hygiene, infection, poor growth and
development.
Facts to be considered to suspect that a child
is a victim of abuse:
 Child is emotional, fearful and with a
vague history of injury
 Parents present a vague and defensive
detail of the child’s “illness” or “injury”
 Many previous unexplained signs of
injuries or previous illnesses
 Parents have extended delay in seeking
medical care
SEX CRIMES
1. Virginity – condition of a female who
has not experienced sexual intercourse
and whose genital organs have not been
altered by carnal connection.
The presumption of a woman’s virginity
arise when it is shown that she is single
and continuous until overthrown by
proof to the contrary.
KINDS OF VIRGINITY
1. Moral virginity – the state of not
knowing the nature of sexual life
and not having experienced sexual
relation.
2. Physical virginity – the state of
knowing the nature of sexual life but
not having experienced sexual
intercourse.
a. True physical virginity –
when the hymen is intact
with the edges distinct and
regular and opening barely
admitting the tip of small
finger of examiner.
b. False physical virginity –
when the hymen is
unruptured by the orifice is
wide and elastic admitting 2
or more fingers of the
examiner.
3. Demi-virginity – when the woman
permits any form of sexual liberties
abstaining from rupturing the hymen
by sexual act
4. Virgo intacta – literally refers to a
truly virgin woman without
structural changes in her
reproductive organs to infer previous
sexual intercourse.
Physicians give much attention in the
examination of the hymen in the determination
of virginity.
Hymenal opening can be oval, circular, infantile,
semilunar, linear cribiform, stellate septate,
imperforate.
Hymen can be firm, thick or membranous.
Virginity is NOT synonymous with chastity.
Defloration – is the laceration or rupture of
hymen as a result of sexual intercourse. All other
lacerations not caused by the sexual act are not
considered as defloration.
The fact that the hymen is intact does not prove
absence of previous sexual intercourse and the
presence of laceration does not prove
defloration.
[something of the victim]
 1. Written consent from subject or guardian
2. History of the alleged rape
3. Date, time and place of alleged
commission of rape
4. Date, time and place of the examination:
material to the determination of the
possible findings of the physician on the
victim
5. Condition of the clothing – for
laboratory examination
6. Pertinent physical examination: gait,
facial expression and bodily and mental
attitude, genitalia and breasts
7. Mental state of the victim: mental shock,
under the influence of depressants,
alcohol or sex stimulants
8. Bodily signs of violence to include
determination of the probable age of the
physical injuries
9. Examination of the breasts and genitalia
for swelling, tenderness, contusion,
abrasion, laceration, blood, semen, louse
and other foreign bodies.
10. Viscid fluid with faint grayish-yellow
color, with fishy odor and containing
spermatozoa, epithelial cells, lecithin
bodies and other substances
Spermatozoon
 Living organism in the seminal fluid
consisting of a head, neck and tail
 50-55 microns in length; ovoid and flat
frontally and pear-shaped on profile
 head is 5 microns, tail is long with
ciliary movement responsible for the
forward movement.
 2.5 to 5 cc of semen per ejaculation
 60 million spermatozoa/cc
 80% motile after 45 minutes. 20% or
less become abnormal in form after 3
hours.
 May be found in: clothes of the victim
and the alleged accused, vaginal smear
from the victim, stains on the body of
the victim and the accused, stains at the
site of the commission of the crime.
Examination
1. Cross examination
a. Inspection with the naked eye or
hand lens.
 Stain is grayish-white to
faint yellow. Map-like
contour with silvery
appearance of the
surface. Hardened with
shiny borders.
 Inspection by means of
ultraviolet light.
Seminal discharge
shows bluish
fluorescence.
2. Micro-chemical examination
a. Berberio’s test – picric acid
b. Puramen reaction –sulfonic
acide and flavianic acid
c. Acid phosphate test
3. Microscopic examination
a. Ganguli’s method – stain with
erythrocin and malachite green
4. Biological examination
 Seminal grouping – specific
agglutinable substances A and
B as in blood. Value: A
positive result does not
definitely imply that the person
is the owner of the semen in
question. A negative result will
totally exclude the alleged
accused as the possible owner
of the semen.
 The mere presence of
spermatozoa on the stain shows
the presence of spermatic fluid,
but the absence of spermatozoa
does not prove that the stain is
not seminal.
 Sperm can live for only a few
hours inside the vagina and
even less than that outside the
human body, exposed to the
open air. If the sperm survives
to enter the less hostile
environment of the female
 reproductive tract beyond the Overt sex
cervix, they can survive for up
to five days a. Satyriasis – excessive sexual desire of
 The egg, however, has a men to intercourse
lifespan of only about a single b. Nymphomania – excessive desire of
day from the time it leaves the women to intercourse. Expression of
ovary. compulsive neurosis
 In short, fertilization can occur Under-sex (sexual frigidity)
whenever a live sperm meets
up with a live egg, which can a. Sexual anesthesia
happen even fi the sperms are b. Dyspareunia
deposited up to five days in c. Vaginismus
advance of ovulation. d. Old age

Sexual abnormalities As to ???

As to the choice of sexual partner: Oralism – use of mouth as a way of sexual

Heterosexual – sexual desire towards the
opposite sex; normal sexual behavior, socially
and medically acceptable
Homosexual – sexual desire towards the same
sex.
a. Overt – conscious of homosexual
cravings and makes no attempts to
disguise intention
b. Latent
Infantosexual – sexual desire towards an
immature person
a. Pedophilia – compulsive desire to have
sexual intercourse with child of either
sex.
Bestiality (zoophilia) – sexual gratification is
attained by sexual intercourse with animals
Autosexual – self-gratification or masturbation
Gerontophilia – sexual desire for elder person
Necrophilia – erotic desire or sexual intercourse
with a corpse
Incest – sexual relation between persons who, by
reason of blood relationship, cannot legally
marry.
As to sexual urge:
gratification
a. Fellatio
b. Cunnilingus
c. Anilism
Sado-masochism (algolagnia) – pain or cruel act
as factor for gratification
a. Sadism (active algolagnia) – infliction of
pain on another is necessary for sexual
enjoyment
b. Masochism (passive algolagnia) – pain
is the primary factor for sexual
gratification
Festishim – sexual perversion where the real or
fantasied presence of an object or bodily part is
necessary for sexual stimulation and/or
gratification.
a. Anatomic – where parts of the body are
the target of interest for sexual
gratification
b. Clothing – interest on shoes,
handkerchief, undergarments either on
sexual partner or stolen
c. Necrophilic – desire to be near a dead
body and may or may not violate the
dead person for sexual gratification.
d. Odor – stimulus is pleasant or foul odor.
 urolagnia
 coprolagnia
 e. Narcissim – extreme admiration and
love one’s self.
As to the parts of the body:
Sodomy – sexual act through the anus of another
person
Uranism – sexual gratification is attained by
fingering, fondling, licking body parts
Frottage – compulsive desire of a person to rub
his sexual organ against some part of the body of
another
Partialism – sexual deviation wherein a person
has special affinity to certain parts of the female
body.
As to number:
Troilism (ménage a trois) sexual perversion
where three persons are participating in sexual
orgies
Pluralism – sexual deviation in which a group of
persons participate in sexual orgies.
Sexual reversal
Transvestism – deviation where a male
individual derives pleasure from wearing female
apparel
Transexualism – extreme desire to identify with
the opposite sex as completely as possible and to
discard their anatomical sex
Intersexuality – genetic defect with
intermingling of the characteristics of both sexes
including physical form, reproductive organs,
and sexual behavior.
a. Gonadal agenesis – sex organs have
never developed
b. Gonadal dysgenesis – external
reproductive organs are present but
testes or ovaries fail to develop
 Klinefelter’s syndrome – XXY
chromosome
 Turner’s syndrome – XO
chromosome
c. True hermaphroditism – state of
bisexuality, having both ovaries and
testicles; nuclear sex usually female
d. Pseudohermaphroditism – sex
organ is anatomically of one sex but
the sex characteristics are that of the
opposite sex.
BIRTH
It is the entire deliver of a child with or without
its separation from the body of the mother. It is
not necessary that the cord should be cut or the
placenta expelled.
Legal importance of birth:
 Birth determines personality
 Proof of live birth must first be shown
before death of the child by the
prosecution in the case of infanticide
 To have the child acquire personality
distinct from that of the mother, there
must be proof of life after complete
separation from the mother’s womb.
Still birth – when the child does not show any
signs of life after being completely born causes:
 Immaturity
 congenital diseases or malformation
 general debilitating disease
 local disease of the generative organ –
placental hemorrhage
 Accidents in the delivery: abnormal
presentation, prolonged labor, prolapsed
cord
 Violence – deliberate or accidental
Live birth – when the child after delivery
exhibits signs of vitality and viability is not
necessary
Presumption – every newborn child found dead
was born dead.
Signs of live birth
 Presence of heart action and circulation
  Movement and cry of the child examination of the spermatozoa in the
 Presence of respiration seminal fluid
5. Proof of access
Hydrostatic test – determines whether respiration
took place in a newborn child before death. Non-medical evidences
Based on the principles that the specific gravity
1. Birth record in the civil registrar or by
of the lungs becomes less as a result of the
an authentic document or a final
introduction of air in the air passages and air
judgment
sacs.
2. Continuous possession of the status of a
Changes in the umbilical cord legitimate child

Within 12-24 hours – begins to shrink and dry
36-48 hours – inflammatory redness of the base
of the umbilical cord
2nd or 3rd day – shrivels and falls on the 5th or 6th
day
10th -12th day –healed cicatrix of the umbilical
cord
Paternity and filiation
Paternity – is the civil status of the father with
respect to the child begotten by him.
Filiation – is the civil status of the child in
relation to its mother or father.
Artificial insemination – the medical procedure
by which the semen is introduced into the vagina
by means other than copulation for the purpose
of procreation.
Classification according to the source of the
semen:
1. Artificial insemination homologous AIH
– when the sperm comes from the
husband
2. Artificial insemination donor AID –
when the sperm comes from a donor
other than the husband
3. Artificial insemination husband donor
AIDH – when the semen comes from the
husband and a third party donor

Medical evidences Steps:

1. Parental likeness – general feature, 1. Gonadotropin is injected into the ovary

gesture, personal peculiarities, gait 2. Superovulation
speech, movement, color and texture of 3. Laparascopy to remove oocytes or ova
hair, eyes and general built and size 4. To Petri dish or test tube with growth
2. Blood grouping test – positive result is medium
not conclusive, but a negative result is 5. Sperm fertilizes ovum
conclusive 6. Conceptus kept in moist environment at
3. Evidences from the mother room temperature
 proofs of the previous delivery – should 7. Divides to blastocyst state
be compatible with the age of the child 8. Zygote is implanted to the uterus via
 proof of physical potency and fertility vagina and cervix
 proof of capacity to have access with the 9. Carried to term
husband.
4. Evidences from the father *The physician selects the appropriate donor of
 Proof of physical potency and fertility: semen
whether the husband is capable of Obligations of the physician:
erection; quantitative and qualitative
 1. Proper screening of the door including
chromosomes for genetic defects
2. Ensure that the donor must have blood
type compatible with ABO and Rh
genotype of the wife
3. Ensure that the identity of the donor is
not known to the parents and vice versa
4. Conduct complete examination with
tests for AIDS, syphilis and gonorrhea
not more than 1week before the seminal
fluid is collected.

Cloning

Type of sexual reproduction where the nucleus

of the female egg is removed (enucleation)
which contains three genetic material and
replace with the nucleus of a somatic cell of
same or another woman (renucleation). It is then
placed in a uterus for gestation and normal
development.