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PRACTICAL FORENSIC

PATHOLOGY
Dr Udai Bhan Yadav
MBBS,DMCH
SMO & Medical Jurist
General hospital Alwar Rajasthan.
WEIGHT OF HUMAN ORGANS

Brain 12501400gm (1.4% body wt


Spinal cord 2530gm

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
Heart 250300gm
Lung left 325425gm
Lung right 350550gm
Liver 15001800gm
Spleen 120180gm
Kidney each 125150gm
Testes each 2225gm
Prostrate 1530gm
Uterus 100115gm 2
Ovary each 57gm
Stomach 150---200gm
DIMENSIONS OF ORGANS

Liver 1517x15x13cm
Kidney 10.5x5.5x3.5cm

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
Testes 4x3x2cm
Prostrate 4x3x2cm
Uterus (nulliparous) 8x4x2cm
Ovary 4x2x1cm
Spleen 12x8x6cm
Heart 12x8x6cm
Thickness
Rt atrium 2mm
Lt atrium 3mm 3
Rt ventricle 5mm
Lt ventricle 1015mm
LENGTH OF ORGANS

Spinal cord 45cm


oesophagus 25cm

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
stomach 2530cm
Duodenum 25cm
Small intestine 550650cm
Large intestine 150170cm
Trachea 12cm
Ureter 25cm
Male urethra 20cm
Female urethra 4cm

4
CAPACITES

Stomach 1500ml
Urinary bladder 225ml

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
Heart chamber 70ml
Csf 100150ml
Circulating blood 5 litre
Gall bladder 3050ml

5
CIRCOMFERENCE

Mitral valve 10cm(810.5cm)


Aortic valve 7.5cm(67.5cm)

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
Pulmonary valve 8.5cm(79cm)
Tricuspod valve 12cm(1012.5)cm
Pulmonary artery 8.0cm
Aorta (thoracic &abdominal) 5cm

6
NEW BORN FULL TERM MEASUREMENTS

Length 4550cm
Weight of body 33.5kg

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
Brain 350-400gm
Thymus 1215gm
Heart 2225gm
Liver 125140gm
Spleen 1015gm
Stomach
Weight 2030gm
Capacity 30ml
Both lungs 6070ml
Both kidneys 2025gm 7

Both testes 1gm


FOETUS AGE DETERMINATION

Weeks Length in cm weight


12wks 9cm 20gm

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
16wks 16cm 100gm
20wks 25cm 300gm
24wks 30cm 600gm
28wks 35cm 1000gm
32wks 40cm 1800gm
36wks 45cm 2200gm
40wks 50cm 3500gm
Length is more
important
8
DURATION OF GASTATION
1st five months of gastation the square root of
length,for example foetus of 25cm is five month
old

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
After 1st five months of gestation the length in cm
divided by five gives age in months for example
40cm is eight month old.
Length and weight indicate intrauterine age.at
which child is born.Twice the number of
intrauterine months is length of foetus in
inches(Hesss formula)
.It is usually around 20 inch or 50cm at ful term,wt
9
is 2.5--3.5kg avarage.
APPROXIMATE ANTROPOMETERIC VALUES
IN RELATION TO AGE IN CHILDRENS

Age Weight kg Length/height Head


cm cicunferance

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
Birth 3kg 50cm 34cm
6month 6kg double in 65 cm 42cm
5months
1yr 9kg triple 75 m 45cm
2yr 12kg quadruple 85cm 47cm
3yr 14kg 95cm 49cm
4yr 16kg 100cm 50cm

10
POST MORTEM FINDINS IN TYPICAL
HANGING FOR EXAMPLE

A male/female age about..moderately built,


nourished,wt.length.body is cold stiff.post
mortem lividity seen on both

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
forearms,hands,both legs,feets,face
congested,eyes congested,sub conjunctival
haemorrhage present,blood stained froth at
nostrills,tongue protruded out,bitten and
dry.vertical salavary trickle mark on left/right
side of face and front of chest and abdomen,lips
and nailbeds cynosed,seminal and faecal
discharge present body natural orifices intact and
healthy. 11
LIGATURE MARK
E.g size of ligature mark 26x2cm ,running obliquely
above the thyroid cartilage ,upward and
backward,patterned,grooved dark,chocolate

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
colour/dark brown,dry and parchmentized and with
bruswd edges.
E.g ligature mark of size 18x1.5 to 1cm dark brown
hard over neck region start from left side of neck
region 3cm from left side ear lobule passed anterior
in front of neck,above thyroid prominance than back
ward with a distance of 8cm from chin 9cm from
sternal notch and 5cm from right ear lobule.there is a
gap of 8cm in between two noose of ligatue mark,on
dissection underlying of ligatue mark tissue is
pale,hard ,parchmet like in consistency with no
12
hematoma.no cartilage bone fracture..on further there
is depression of posterior aspect of laryngeal wall to
wards posterio side
INTERNAL EXAMINATION IN HANGING.
Brain congested,oedematous with multiple
haemorragic spots in substance of brain.
Walls,ribs cartilage healthy

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
Larynx ,trachea congested.
Both lungs congested.oedematous with blood stained
frothy oozing on cut section.
Pericardium heart large vessels healthy.both
coronaries with patent luman.
Walls,peritonium healthy.mouth pharynx oesophagus
healthy,congested.stomach healthy.empty,small
intestin and large intestine healthy but distended
with gages.liver,spleen kidneys healthy congested.
bladder empty .organ of generation healthy.
OPINION ---- post mortem appearance are suggestive
of death due to asphaxia resulting from hanging 13
LIGATURE STRANGULATION FOR
EXAMPLE

A male/female age about well built and


nourished .wt.lengthcm.body
cold,stiff/rigor mortis present at...... ,post

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
mortem lividity seen on back and fixed.face
livid,eyes congested and sub conjunctival
haemorrhages.blood stained fluid flowing out
through ears and nostrills.lips and nails bluish.A
jute rope material used for strangulation
measuring 1.6 mts was found round the neck of
victim with double reef knot on front of neck over
Adams apple.body orifices intact and healthy.
Brain congested oedematous ,with multiple 14
peticheal heamorrhagic spots in brain substance
.
Thorax -Walls,ribs cartilages,pleurae healthy.
Larynx trachea ,healthy,but contain blood
stained froth.

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
Rt ,lt lungs congested oedematous with blood
stained froth oozing on cut section.
Pericardium,heart healthy,both coronarries with
patent luman.large vessels intact healthy.
Abdomen walls,peritonium healthy .mouth
pharynx oesophagus healthy ,congested.stomach
healthy empty.small intestin,large intestine
healthy and distended with gas. Liver ,spleen,
kidneys healthy congested.bladder healthy and
full. ext and int genital healthy. 15
.
Muscles bones joints-
1 injuries bloodless dissection dissection of neck revealed
ecchymosis of muscles of neck underneath ligature mark.

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
Disease deformity nil.
Fracture- the thyroid cartilage in neck is fractured in
midline
Ligatue mark was a pressure abrasion measuring
28x1.5cm continuous and running horizontally encirclin
the neck at the level of adams apple.mark was grooved
discoloured with with bruses at edges.
Abrasion 3x2cm outer aspect back of rt fore arms.
Abrasion 4x2 on outer aspect tr knee.
Opinion post mortem appearance are suggestive of death
due to asphaxia resulting from ligatue strngulation. 16
PM FINDINGS IN DRAWNING FOR EXAMPLE
Body cold ,wet,rigor mortis well established.
PM lividity on face chest abdomen front of thigh and fixed.
Fine whitish lathery froth seen at mouth and nostrils.
Lips and nails bluish.Hands clenched.
Both palms and soles were soddened bleached.groose skin (cutis anserina) appearance present.

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical

Brain intact healthy but congested,edematous with multiple petecheal haemorrhagic spots in
brain substances.
Larynx trachea intact healthy but containing fine whitish leathery froth
Lungs voluminnous ,congested,edematous with fine whitish lathery froth on cut section.
or Lungs are water logged bulge out pit on pressure,moderately congested and feel doughy.
Mouth pharynx oesophagus intact ,healthy congested.
Liver,spleen kidneys congested
OPINION POST MORTEM APPEARANCE ARE CONSISTENT WITH DEATH DUE TO
DRAWING.
Case of death asphaxia,ventriculr fibrillation,laryngeal spasm ,vagal inhibition,injuries etc

17
PM FINDINGS IN POISONINGS FOR
EXAMPLE
Cold, stiff, pm lividity on back and fixed ,face bluish,pinkish
frothy fluid flowing out of nose.
Brain congested edematous,multiple petecheal hemorrhagic
spots in brain substance.
Larynx trachea intact healthy congested.

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical

Lungs congested edematous with pinkish fine oozing on cut
section.
Mouth pharynx oesophagus intact healthy.congested
Stomach mucosa congested and showed submucosal
erosion.liver intact healthy congested.spleen intact healthy
congested.and pulpy.kidneys congested.
Visceras are collected and sealed in glass jar glass Jar A
contains whole stomach and its contents,glass Jar B contains
piece of liver,kidney,spleen .lungs. Vial C contain blood.Glass
jar A,B ARE preserved in saturated sol of common salt. In
Vial C no preservative used
18
PM FINDINGS IN HEAT STROKE FOR
EXAMPLE
No characteristic findings .
Eyes open drying of cornea and pitting.and sinking of
eye balls.(appearance of avulsion of eyes.)

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
Rigor mortis appears early and disappear early.
Putrifaction rapid.lividity is mark.
Degeneration of neurones in cerebral cortex
cerebellum and basal ganglion is common
Visceral congestion well mark.Peticheal haemorrhage
found in skin ,visceras and in walls of third and
fourth ventricle and aquaduct.
Pulmonary oedema is some time found.
Face is flushed and skin is hot and dry.
Brain and membranes congested.peticheal
haemorrhage are seen in white matter. 19
.
Respiratory system trachea bronchi contains
frothy haemorrhagic fluid.lungs edematous
congested,haemorrhage.

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
Heart dilatation of right auricle.

Liver kidney congested

General peticheal and confluent haemorrhage in


most organs.

20
PM FINDINGS INSUFFOCATION FOR
EXAMPLE
Ext closure of mouth and nostrils.pressure on chest.
Int clsure of glottis or luman of air tube.,decrease O2 in
atmosphere.,inhalation of irritant gases.

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
PM examinaton signs of asphaxia well pronounced such
as cynosed face, open eyes,prominent eye balls,dilated
pupils,deeply injucted conjuctiva,livid lips,protruded
tongue,blood stain froth per mouth and nostrils.etc.
Mark of violance-bruses and abrasions round about
lips.cheeks, scratches near about nose and mouth,injuries
on inner surfaces of lips ,bruses of gums.signs of strugles
on other part of body.
Compression of chest injury on chest,# of
ribs,extravasation of blood in subcutaneous tissues.
In overlaying of nose is flattened deviated to one side.
# of cervical vertebrae seen if neck is forcibly wrenched or
twisted. 21
.
INTERNAL
Forign body detected in mouth ,throat.

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
Larynx and trachea red congested,blood stained
froth in luman.
Death by pressure on chest -#of ribs some
times,lungs congested contused or lacerated even
without #ribs,superficial air vesicles ruptured,int
organs congested,tradieus spots on
pleurae,meninges,pericardium.

22
TIME SINCE DEATH
These are avarage time.in cold wheather they may be
doubled or trebled.in hills they are quite inapplicable.
Less than 1 hour-body is warm

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical

3 hours patchy post mortem lividity.


6 to 8 hours lividity fully developed and fixed.
12 hours rigor mortis all over ,green patch showing
over the caecum.
24 to 36 hours rigor mortis receding/absent, green
discolouration over whole abdomen and spreading to
chest,abdomen distended with gases ,ova of flies seen.
48 hours trunk bloated,face discoloured and swollen
blisters present.moving maggots seen. 23
.
72 hours whole body grossly swollen and
disfigured.hairs and nails loose.tissue soft and
discoloured.

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
One week soft viscera putrefied.

Two weeks only the more resistant viscera


distiguishable ,soft tissues largely gone.
One to three month body skeletonised.

24
STANDARD OPINIONS IN DEATH BY
SNAKE BITE (PM)
SNAKE BITE-cobra &similar snake which have
neurotic venum. on perusal of the pm report
case sheet and circumstantial evidence I am of

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
the opinion that the death is due to respiratory
failure consequent upon snake bite.
In case of vipar and other similar snake which
have hemolytic venom. (a) If bleed to death
Death is due to shock and haemorrhage as a
result of snake bite. (b) If there is haemorrhage
in brain stem Death is due to coma as a result of
brain stem haemorrhage secondary to snake bite,
; 25
ESTIMATION OF AGE
Below 20 years x rays advised-
wrist,elbow,pelvis.

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
21 years Abve x ray + X ray clavicle

25 years - above + xray strnum ,skull ap lat


view.
FOLLOWING X RAY OF RIGHT SIDE ARE
TAKEN-
RT side of jaw oblique view.

RT shoulder ap view.

RT elbow ap and lat view.

RT wrist with hand ap view. 26

Pelvis with upper third of femur ap view.


FOETUS AGE DETERMINATION
Week length in cm weight
12 wk 9cm 20gm

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
16wk 16cm 100gm
20wk 25cm 300gm
24wk 30cm 600gm
28wk 35cm 1000gm
32wk 40cm 1800gm
36wk 45cm 2200gm
40wk 50cm 3500gm
Length is more important.
27
DURATION OF GASTATION
1st five months of gestation the square root of
length, for example foetus of 25cm is five month
old.

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
After 1st five months of gestation the length in cm
divided by five gives age in months for example
40cm is eight month old.
Length and weight indicate intrauterine age.at
which child is born.Twice the number of
intrauterine months is length of foetus in
inches(Hesss formula)
.It is usually around 20 inch or 50cm at ful
28
term,wt is 2.5--3.5kg avarage.
ENUMERATION THE SIGN OF
RESIPIRATION
CHARACTERSTIC BEFORE AFTER
Shape of chest Flat Arched
Diaphragm at 4-5 Ribs 6-7 Ribs
level

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
Lungs size Small voluminous
Foderes test 500qraim 1000qraim
Ploquets test 1:70 1:35
Edge sharp round
Colour reddish brown mottled pinkish red
Consistency Liver like spongy and crepitant
Section Dark blood Red blood
Hydrostatic test Sinks Floats
Stomach Bowel test Sinks Floats.

29
Dr Udai Bhan Yadav SMO & Medical
Jurist GH Alwar Rajasthan
30
VARIOUS CHANGES IN FOETUS
FEATURES HELPING IN ESTIMATING
FOETAL AGE
Length measure crown heal (vertex to heal) length
by flexible tape.
Weight

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
Midpoint ofbody in relation to sternom and umbilicus.
Skin wrinkle or presence of fat,presence of
fat,presence and amount of vernix.
Nail appeared or not ,extent of growth.
Scalp hairs appeared or not
Eyelashes and eye brows appeared or not.
Eyelids adherent or open.
Testicles in male ,ascertain the position by incising
the scrotum and inguinal canal.if necessary.
31
Ossification centre.
EXAMINATION OF MALE IN SEXUAL
OFFENCE FOR IMPOTENCY

Name . s/o cast.. Sex.. Age R/o


R/o ..

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
Sent by

MI.

In presense of ..

General development . Ht..Wt


Teeth..
Hairs scalp
eyebrows.upperlip.axillary.pubic.
Breast.
32
Injury on body
.
BP. PULSE 80 per minut. HEART,LUNG
nad.. UROGENITAL TRACT nadH/O
DIABETTES,HTnil

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
STAINS OVER EXTERNAL GENITALS.. absent
INJURY nilSUPERFICIAL VEINS OVER
PENIS-prominent on stimuls of
penisDEVELOPMENTAL ABNORMALITY IF
ANYno .SORTAL REFLAXpresent.
ON STIMULUS PENIS BECOMES STIFF
HARD AND ELONGATED AND ERECTILE.
SEALEAD ENVELOP CONTAINS
FOLLOWINGS FOR GROUPING AND CROSS
MATCHING IF NEEDED. 33
.
A Blood staned dried gauze
B-- Saliva staned dried gauze

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
OPINION- I am the opinion that there is nothing
to suggest that the persion is incapable of
performing sexual intercourse.

34
RAPE CASE SAMPLES TAKEN AND SEALED

Sealed envelop contains following for


spermatozoa and chemical examination to detect
out human seminal stain blood stain and cross

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
matching if needed.
A blood soaked dried gause

B - saliva soaked dried gause

C vulvovaginal swab smear 2

D vulvovaginal swab stic .

Opinion regarding recent sexual act kept


reserved till receiving FSL report.
35
PM FINDINGS IN BURN(SAMPLE
CASE)
e.g.-body cold and stiff. Face is totally
burnt,blackened,swollen,with scalp hairs burnt in
patchy area on the front and on the sides of the

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
head,have been trimmed short up to neck level.
Eyes brows &eyelashes are also burnt completely.
Rest body showed infected deep skin burn injuries
with greenish black sloughing except a thin strip of
intact skin around the waist line 1x30 cm,perineum
and inner aspect of both feet(total skin area
burnt90%).Suturing venesection wound measuring
1.5x0.25cm were seen one each on the inner aspect of
both ankles.
36
Superficial to deep burn,peeling of skin present,skin
black.red line present
Brain congested,edematous
Pleurae intact healthy.but with an effusion of straw
. yellow fluid measuring 400ml on rt side
and200mlon lt side.
Larynx and trachea intact healthy and showed
blakish shoot particals .

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
Lungs congested,edematous
Mouth,pharynx,oesophagus intact
healthy,congested
Stomach mucosa congested and showed submucosal
erosion at duodenal end.
Liver,kidney,congested.spleen congested and pulpy
0PINION-DECEASED DIED DUE
TOCOMPLICATION OF BURN INJURIES
SUSTAINED.
37
DURATION OF BURN
Rednss immediate
Vesication about 2-3 hours

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
Pus,Slough about 36-72 hours

Fall of superficial slough about 1 week.

Fall of deep slough about 2 weeks.

38
CAUSE OF DEATH IN BURN
Shock within 2 days
Toxaemia -2 to 4 days

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
Septecemia if infection

Rarely MI,and Fat embolism

39
LUNG TUBERCULOSES
Congested,edematous multiplegray white
nodules ranging from pin point size up to 1 cm
were diffusely distributed through out the lung

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
parenchyma
Or bluish discoloration over left side lower chest
on dissection pleurae adhere to cavity wall and
lungs multiple nodular lesion over both upper
lobes on cut fibrocaseous lesion filled with blood
mixed pale column fluid with foul smell ,bridging
of tissues inside cavetious lesion.

40
AGE OF ABRASION
Bright red-Fresh
Red scab-12-24 hr

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
Redish brown scab 2-3days

New growth of epithelium 4-7days

Scab dried shrink and falls off -7days.some time


may take 10-15 days

41
AGE OF CONTUSION
Red-Fresh
Blue-After few hours to three days

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
Bluish black/brown- 4th day

Green 5-7days

Yellow 7-12 days

Normal 2 weeks

42
DETEMINATION OF AGE OF INJURY
Scab over abrasion and superficial cut-12-24hr
In case of bruse change of color commence from

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
the circumferance by 12-24hr and passes through
usual changes
In ordinary wound inflamation sat in within48
hr. If it is not rendered properly aseptic pus also
forms by this time
Skin wounds or contused wound on the head will
generally heal within a week.if margins is
considerably brused,it may take a
fortnight.Healing of wound depend much on the
43
constitution of pt and treatment
In fracture ,inflamation and exudate of blood in soft
. tissue around the fracture site are noticed from 1st
to 3rd days.callus begins to form the third day
onwards.If inflamation subsides callus begins to
ossify from 2nd to 3rd week on wards.it is fully
absorbed by about 6-8 weeks

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
Granulation tissues appears about 1 week

When tooth knocked out.bleeding stops in24 hrs


cavity fills in 7-10days time.smooth after 14 days
Dution estimated by color change in bruse if
present

44
CHARACTERS OF INCISED AND LACERATED
WOUNDS

Incised wound edges are regular, clean


cut,retracted,everted,except in neck&scrotum
where edges are inverted,spindle shaped ,length

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
is greaterin three dimensions,haemorrage
isexcessive,Edge of wound may be irregular in
care skin is loose eg neck &scrotum.
Lacerated wound-margins are irregular ragged
and inverted.tissues are torn and not cot.bleeding
may not be marked due tocrushing of tissues.

45
PM FINDING IN ELECTRIC
BURN(ELECTROCUTION) FOR
EXAMPLE

e.g-multiple burn injuries present over an area


6cmx5cm.and contact electric burn of 5cmx3cmon
palmar aspect of left hand.

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
e.g-an oval crater like electric burn mark
measuring 2cmx0.4cm with a pale flattened floor
and a ridge of elevated skin and blackening
around.
e.g-split laceration skin wound 0.75x0.3cm with
elevated ridge,seen on middle of the sole of left
foot.
Face is pale,eyes congested
46
Brain congested,oedimatous,multiple petichial
haemorrhagic spots in brain substance.
Larynx and trachea congested
, Rt&Lt Lungs congested,oedimatous.

Mouth,pharynx,oesophagus,stomach
mucosa.liver,spleen,kidneys all are congested.
OPINION Post mortem findings are consistent

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
with death due to electrocution.

47
Dr Udai Bhan Yadav SMO & Medical
Jurist GH Alwar Rajasthan
48
AGE INCISED AND STAB WOUND
MORPHOLOGICAL CHANGES IN
MYOCARDIAL INFARCTION
---4hr none
4---12hr occasional dark mottling.
12---24hr dark mottling.

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
1---3days mottling with yellow tan infarct centre.
3---7days hyperemic border,cental yellow tan
softening.
7---10days maximally yellow tan and soft with
depressed red tan margins.
10---14days red gray depressed infarct border
2---8weeks gray white scar progressing from border to
ward core of infarct.
>2months scarring complete.
e,g-pericardium and heart adhere to lower anterior
surface of heart,pale glistering waxy lesion of size 49
0.5x0.3 cm over lower part of anteror ventricula
region left side.
POST MORTEM OF BURN ABOUT 9095%
FOR EXAMPLE

Post mortem hypostases can not be determined


due to burnt body surface area .pupil B/L fixed
and dilated.

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
Brain membrane congested brain oedematous
cordnil (not examined)
Walls,ribs,cartilage,pleura congested.

Larynx,trachea mucus membrane congested,


contain mucoid secretion with black shot
particles over lower ends rt and lt both lungs
congested
Pericardium healthy,heart rt side chambers
50
contains blood and left side chambers empty.
Large vessels healthy
.
Mouth ,pharynx ,oesophagus healthy.
Stomach and its contents mucous membrane

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
congested contains 250ml dark brownish gluid
Small intestine and their conents distended with
gas ,large intestine contain foecal matter and
gases.liver,spleen,kidneys congested,urinary
bladder empty.
Superficial to deep burn with sringing of hairs
peeling and slough formation granulation tissye
formation pus foci at places present over
following parts of body.
51
.
1 Head and neck as a whole
2 Anterior aspect of chest and abdominal wall as a whole
3 Posterior aspect of trunk(Back)as a whole .

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
4 Right side upper limb as a whole
5 Left side upper limb as a whole.
6 Genitals including both buttock as a whole.
7Right side lower limb as a whole.except some places over
1/3 of leg sole region.
8 Left side lower limbs as a whole except 1/3 of leg and sole
region.
Total burnt body surface area 90--95%
Opinion cause of death is shock brought about as a result
of above mentioned antimortem dry heat flame. Burn with
total burnt body surface are 90-95%sufficent to cause death
in ordinary course of nature. 52
ELECTRIC BURN 3035% FOR EXAMLE
Superficial to deep wounds with blackening of skin
singing of hairs crater formatoin and charing of skin
muscle with soft tissue and bones over following parts
of body.

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
1 left side upper limb from shoulder region to hand as
a whole.
2 anterior aspect of chest wall region
3Anterior abdominal wall up to pubic region
4right side lower limb from middle third of thigh to
lower third of leg,anterior aspect as a whole
5 left side lower limb from lower third of thigh to
middle third of leg ant erior aspect as a whole with
distal of foot including great toe 1 and 2nd.total body
surface area 30-35%
OPINION Post mortem findings are consistent with 53
death due to electrocution.
STARVATION
30-48 hr feeling for hunger.
Followed by pain epigastrium relived by pressure
45days general

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
emaciation
Absorption of subcutaneous fat
Eyes sunken &glistening
Pupil dilated
Cheek sinks
Bony prominence become visible
Bichats buccal pad of fatis among the last subcutaneous
adipose tissue which disappears
Lips dry and cracked
Tongue coats and dirty
Thirst intolerable.
Saliva thick and scanty,voice is week&whispering.skin dry 54
rough thin inelastic wrinkled&pigmented,emaciation may be
extreme
Abdomen concave limbs become thin flaccid with loss
of muscular power muscular weakness is progresive
and may be severe

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
Cardiovascular changes are those of progresive
insufficency.pulse is slow at rest but on exertion
paroximal tachycardia supervens.
Temperature sub normal.constipation is usual but
towards death diarrhoea and disentry common.
Urine scanty ,turbid concentrates and evedance of
acidoses.
Loss of wt is most marked &constent, in last stage
body is reduced extreme state of emaciation
Ribs are proment with concavity in intercostal spaces
sunken superaclavicular fossa
55
Before death has offensive odour.
Death usually occur when 40%of original weight.

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
Intellect remain clear till death though in some
cases delusion and hallucination of sight
&hearing occur.
Cause of death exahausion circulatory failur
dehydration ,hypothermia
Loss of weight acidoses with ketone bodies in
urine are criteria to advise forced feeding.

56
SODOMY FINDINGS IN HABITUAL PASSIVE
AGENT.

Shaving of anal and perianal hairs


Loss of normal puckering around anus.

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
Funnel shaped depression between buttocks
around anus
Skin around anus thickened and smooth due to
frequent friction
On per rectal Prexamination

1 Loss of muscle tone(no radial constriction of


anus on pinching the skin around.)
2 Presence of scars of old tear or fissure

3 Presence of lubricant/seman/venerial 57

discharges.
SODOMY FORCIBLY VICTIMISED (NON
HABITUAL)PASSIVE AGENT.

Anus may appear to be swollen with temporary


loss of tonicity of anal sphinctor
Contusion/laceration of posterior &

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
mucocutaneous tissues
Seminal or seman mixed with faecal matter or
blood stain may be seen
If the victm is child penetration is usually
forceful,resulting in tears and times prolapse of
portion of anal canal seen.
On per rectal examination---If one finger enters
no intercourse may be opined.but if two finger
can be inserted eliciting pain ,it is suggestive of
anal intercourse. 58
SODOMY EXAMINATION OF ACTIVE AGENT
Peculior smell of anal gland secretion
Traces of faecal matter & lubricant used are

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
often detected on the coronal
sulcus,frenulam,prepause etc,
Abrasion bruses laceration of
prepause,frenulam,glans penis etc.
Presence of STD lesion/discharge

Note the shape of glans penis may be found to


be paping,elongated&constricted in habitual
sodomist (active agent)
59
SIGN OF VIRGINITY
Labia majora firm,elastic,rounded,lies in close contact
with each other even in full abduction.
Labia minora soft,elastic,small,rose coloured,lie in

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
close contact ,not visible being hidden under labia
majora.clitoris not enlarged.vestibule narrow.
Posterior commissure and the fourchette are intact
and crescent shaped(they are lacerated by sexual
intercourse on children and rarely on adults.
Vaginna narrow,tight with rugosed pinkish wall
orifice is slit like due to opposition of wall and due to
presence of hymen
Perinium entire no sign of delivary hymen most imp
sign of virginity.
Extra genital BREAST-
Hemispherical,firm,plumps,elastic. NIPPLE Small 60
pointed surrounded by pink areola.
SIGN OF DEFLORATION
Labia majora relaxed,not touching each other,
Labia minora little elongated,protruted between

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
labia minora.
Clitoris enlarged

Posterior commissure rupture

Breast enlarged flabby,especially after child birth

Nipple large

Dilatation of vaginal canal and loss of corugation


of its mucous membrane.

61
RAPE EXAMINATION
Injuries, number,appearanc.extent,probable duration
Around mouth cheeks scratches ,abrasion,slight bruses
Front of neck

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
Thigh-inner side upper part scratches abrasions bruses
Arms scratch,abrasion,bruses.
Breast ecchymoses,bruses ,mark of nail.
Injuries resulting from struggle - Back,buttock,bony
prominence,upper and lower extrmities.
Blood or seminal stain on body of victim.vulva,vaina.thigh
scraped by clean blunt knife and send for examination.
Pubic hairs matted together with seminal fluid or blood.cut
of by scissors and send for chemical examination.
Examination for marks of violence on genitals Vulvared
swollen,tender,abraded, brused. 62
.
Vagina dilated,hot mucous membrane of vagina
red,abraded,even lacerated(sexual intercourse
without rupture of hymen if orifices allow two finger

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
is possible)
Hymen may be ruptured or lacerated edges torn
segments swollen red tender ,usually shows radiate
tears bleed on touching.
Posterior commissure and fourchette ruptured in
violance.
Labia majora may be injured.
Perinium swollen,tender.occasionally lacerated in
children
63
Vaginal discharge thick in gonorrhoea,white in
leucorrhoea.
RAPE CASE EXAMINATION POSITIVE
FINDING MAY BE (SAMLPE CASE)
Findings examined by lady doctor
Gait broad based,short paced
Axillary and pubic hairs curly,dark,busy.

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
Breast developed hemispherical,showed bite marks
around the nipple on rt side.
Back abrasion on both shoulders blades regions each
mearuring 4x3cm.
Finding on genital examination
Vulva labia majora,labia minora both contused
edematous and inflamed.
Hymen lacerated 1.5cmx0.75x0.5cm at 6.0 clock
position
Vagina bruised in posterior region in continuation
with lacerated hymen over an area of 3x0.5cm 64
RAPE CASE SAMPLES TAKEN AND SEALED

Sealed envelop contains following for


examination of spermatozoa and chemical
examination to detect out human seminal stain

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
blood stain and cross matching if needed.
A blood soaked dried gause

B - saliva soaked dried gause

C vulvovaginal swab smear 2

D vulvovaginal swab stic .

Opinion regarding recent sexual act kept


reserved till receiving FSL report.
65
PM FINDINGS IN THROTTLING
Ligature mark if throttling done by rt hand from front ,the impressin
of thumb will be found ovr upper part of rt side of neck.and on lt side
will be found four marks produced by four fingers.
These four marks distributted from above downward and out wards

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
.these marks are really due to bruses or contusions.they are
accompaned by cresentic scratches produced by finger nails.
Some time mark on left side may not be discrete but may be clusterd
to gether.
This may be reversed in case where lt hand or both hands are used.
When both hands are used there will be several marks on each side of
the neck.
SIMPTOMS ATTEMPTED THROTTLING. Brurse on
neck,dysphasia,hoarseness of voice,marks of burse and abrasion on
mouth ,nore cheek,fore head ,lower jaw,other part of body.
Fracture of ribs with extravasation of blood in chest wall may be seen
in some case.

66
PM CHANGES IN EPILEPSY.
H/O Attack and death.
May die of asphaxia in an epileptic attack.
Look for following

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical

1-Bitten tongue.
2Hypertrophied gums if pt is on phenantoin sodium.
3Look for forign body in brain depressed fracture
,scarring of brain which are caused by secondary
epilepsy.
4Relavent hospital record.
5Doctor can send organs and blood.for analyses of
antiepileptic drugs which the pt was taking.this can
be taken as laboratory evidence rule out fowel play
and other cause of death. 67
PM OF BRONCHEAL ASTHMA
Autopsy finding are minimal.
Hypertrophic emphysema of lungs

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
Brown atrophy of heart

Doctor must concentrate on

1 History and relevent hospital records.

2 Record of chronic use of antiasthmatic drugs


,bronchodilators.
3Rule out fowel play and other cause of death.

68
MYOCARDIAL INFARCTION
Hospital record.and laboratory investigation such
as ecg,enzyme studies(sgot,sgpt,cpk etc)

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
Look for atherosclertic changes of aorta,valves
and coronaries.
Look for coronary narrowing ,oclusion thrombus
in coronaries etc.
If pt die within about 6 to12 hr after MI ,no
histopathological changes are
noted.histopathological report normal
Some time coronary may be within normal limit
at autopsy,in such case the death was due to
69
acute coronary spasm.
SCAR (CICATRICS)
Scar is a healed granulation (fibrous) tissue
covered by epithelium formed as a result of
healing of the wounds.

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
It have no hair follicles

No sweat glands.

No elastic tissues.

Slightly vascular by fine capallarries.

It is 1st reddish brown later white or glistening.

Scar of childhood grows in size with age.

Scar can be removed by plastic surgery.scar


produced is less pbvious. 70
MEDICOLEGAL IMPORTANCE OF SCAR.
Marks of identification.
Shape of scar may indicate nature of weapon

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
causing injury.
Age of scar is imp in criminal
offence.(circumstantial evedence)
Linea albicantes may indicate pregnancy

71
AGE OF SCAR
Firm union occurs in 5 to7 days . producing a
reddish or bluish,e.g.angry scar.

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
At the end of 14 days scar is pale soft and
sensitive .no further change up to end of second
month.
In about 2 to 6 months scar becomes brown or
copper red but it remains soft and is not
wrinkled.
After 6 months scar become white and glistening
,become tough may wrinkled and after that no
change occur.
72
EXAMINATION OF DELIVERED
FEMALE &ISSUE OF DELIVERY
CERTIFICATE.
A Consent
B Brought by relative/police name
C MI

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
D Date and time of examination
EGeneral particular name agesex.
Adress..
FName and signature of female attendent this is
important when a male doctor is examining
G General sign
1 General appearance (for first one to three days pt is
exahasted with rapid pulse and raised temperatue etc.
2 Breast changes enlarged ,tender,colostrum and milk
come out.,engorged veins present,areola is darker,
montgomerys tubercle present etc. 73
3Abdominal changes-lax,,pendulous,stria gravidorum
present
.
H-Local signs
1-external genitaliavulva swollen,tender,blood
stains may be present,vagina,cervix may be

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
swollen,congested,roomy,may show injuries
dilated cervix etc.
2Lochia last for two to three weeks,these can
be-lochia rubra,lochia serosa lochia alba
3---Uterus uterus takes 2to3 weeks to become
pelvic organ.
OPINION-I am of opinion that the women by
name has local and general finding suggestive of
recent delivery. Sd
74
moi/c
ASSULT PM
Conjunctiva ,lip nail pale
Liver spleen kidneys healthy but pale.

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
Cranium spinal cord brain skull showed fissure
fracture measuring 7cm in lengthcorresponding
to the external injury. No membranesshowed
diffuse extradural ,subdural and subarachnoid
haemorrhage. Brain is congested and oedimatous
.shows laceration of frontal pole.on both side
dissection brain intraventricular haemorrhage
present

75
RTA PM SKULL

Skull showed a 14 cm long fissured fracture on


the vault. Of skull.commencing 2cm above and
right to glabella.membranes intact but showed

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
diffuse subdural and subarachnoid haemorrhage.
Brain congested and oedimatous.

76
CORROSIVE POISONING
Corrosion especially lips,mouth,chin,angle of
mouth hands etc, also clothing.

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
Intestinal findings restricted to upper
gastrointestinal and respiratory tract.
Pharynx,oesophagus oedema,bleeding.

Stomach soft,boggy,black (H2SO4)


,yellow(HNO3) Brownish(HCL)
Surrounding visceras- sloughing (if stomach
perforated) perforation common in H2SO4
Larynx trachea corrosion inflammation
congestion 77

Of respiration common in HNO3 due to fumes.


SULFURIC ACID
Cloth burn
Corrosion of mucous membrane of lips mouth and
throat and skin over the chin angle of mouth and

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
hands seen.
Necrotic area are at first grayish white but soon
become brown or black and leathery.
Internal changes limited to upper digestive tract
and respiratory system.
Upper digestive tract is inflamed and swollen by
oedema and severe interstitial haemorrhage .The
greater part of stomach may be converted in to a
soft boggy black mass which readily
disintegrated when touch 78
Mucosal ridges more damage than the furrows.
In the damaged area the mucosa is brown or

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
black.
Perforation may occur with escape of stomach
contents in to the peritoneal cavity.
Small intestine may show sign of irritation.

Corrosion or severe inflamation of larynx and


trachea may be present.

79
NITRIC ACID
Finding of sulfuric acid but tissue stain yellows.
Perforation of stomach is not common

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
In death from inhalation of fumes the larynx
trachea bronchi are congested and lung oedema

80
HYDROCHLORIC ACID
Finding similar to sulfuric acid
Corrhosion is less severe

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
Perforation of stomach is rare.

Acute inflamation and oedema of respiratory


tract and lungs are common.

81
DEATH BY COLD
1 skin- pale with dark red patches on more
exposed parts post mortem staining is red in
colour.

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
2 muscles-cold stiffening of muscles occur with
delayed appearance and disappearance of rigor
mortis.
3 brain- congested with ventricle filled with
serum.
4 heart- full of blood on both sides

5 other organs- congested sub mucosal


haemorrhages in stomach and
82
duodenum.Gangrenous changes with mucosal
ulcers are seen in intestine.
EFFECT OF HEAT
Rigor mortis well marked come early
passrapidly.

Jurist GH Alwar Rajasthan


Dr Udai Bhan Yadav SMO & Medical
PM lividity well marked due to fluidity of blood.

Brain and its membrane congested and also other


organs pin point haemorrhagic area seen
Rt side of heart filled up with dark liquid
blood.left is empty. Petecheal haemorrhage on
pericordial and endocardial surface of heart.

83

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