Reviewer inFORENSIC MEDICINE By

MELCON S. LAPINA, MSCrim Q1 The scope of forensic medicine can be summed in two words. Absolute and complicated Broad and encompassing Definite and wide-ranging Specific and delimiting Q2 It is the inner framework of the body. It gives form and rigidity to the body, and serves to protect many vital organs. Digestive system Integumentary system Muscular system Skeletal system Q3 An effect of injury that takes place when the stimulus applied is insufficient to cause injury and the body resistance is great. Apparent Real Immediate Delayed Q4 Under the physics of wound production, this factor explains why an M-16 will do more damage than .38 caliber bullet. Area of Transfer Elasticity and plasticity of tissue Kinetic energy Time Q5 Sensation of heat or increase in temperature. Rubor Calor Dolor Loss of function Q6 Wound brought about by blunt instrument could be any of the following, EXCEPT Contusion Hematoma Laceration Incision Q7 X, a doctor, wanted to kill his wife by poisoning. During dinner time, he put poison on the food of his wife. Moments after, his wife suffered excruciating pain in the stomach. Seeing his wife in agony, he pitied his wife and administered an antidote. Thus, his wife did not die. What is the crime committed by X? Frustrated parricide Attempted parricide Serious physical injuries Murder Q8

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Q1 The scope of forensic medicine can be summed in two words. Absolute and complicated Broad and encompassing Definite and wide-ranging Specific and delimiting Legal Medicine definition Branch of medicine Application of medical knowledge to law & admin of justice Application of basic & clinical, medical & paramedical sciences to elucidate legal matters Scope of Legal Medicine Broad & encompassing Applies medical & paramedical sciences Wounds: surgery Abortion: gynecology Sudden death & effects of trauma: pathology Basic medical sciences: Anatomy Physiology Biochemisty, Physics Other allied sciences Nature of Study Knowledge in Pathology Surgery Gynecology Toxicology Other branches of medicine Q2 It is the inner framework of the body. It gives form and rigidity to the body, and serves to protect many vital organs. Digestive system Integumentary system Muscular system Skeletal system Systems of Human Body Integumentary System Outer covering of body Function: protection, regulation of temperature, sensation & excretion Skeletal System Inner framework of body Gives form & rigidity to body Protects vital organs

Systems of Human Body Muscular System Changes energy from food to mechanical energy Enables parts of body to move & perform work Digestive System Changes food to soluble form: absorbed by blood & utilized by body Systems of Human Body Circulatory System Brings food & oxygen to cells of body Removes waste materials Helps maintain even temperature of body Provides defenses against disease Respiratory System Supplies oxygen to cells: used for production of energy Systems of Human Body Excretory System: Anim. 1 & Anim. 2 Collects & eliminates metabolic wastes of body Reproductive System: Male & Female Ensures perpetuation of species Nervous & Endocrine Systems Coordinate all other systems of body Make other systems work together harmoniously & efficiently Q3 An effect of injury that takes place when the stimulus applied is insufficient to cause injury and the body resistance is great. Apparent Real Immediate Delayed Concept of Physical Injury

Effect of some forms of stimulus on body Effect: Apparent: stimulus applied insufficient to cause injury & body resistance great Real : effect visible Immediate: sharp pointed & sharp edged instrument immediate production of stab wound Delayed: blund object delayed production of contusion Causes of Physical Injuries Physical violence Heat or cold Electrical energy Chemical energy Radiation by radio-active substances Change of atmospheric pressure (barotrauma) Infection Q4 Under the physics of wound production, this factor explains why an M-16 will do more damage than .38 caliber bullet. Area of Transfer Elasticity and plasticity of tissue Kinetic energy Time Effect of Physical Violence Production of wound Wound: Solution of natural continuity of any tissue of living body Disruption of anatomic integrity of tissue of body Interchangeably used w/ wound NOTE: physical violence not always resulting to wound but wound always result of physical violence Physics of Wound Production Wound = kinetic energy X time X area X other factors Kinetic Energy = MV2/2 Kinetic Energy: Explains why M-16 bullet (speed: 3,200 ft/sec) will do more damage than .38 caliber bullet (heavier but has much slower velocity) Time: Shorter time of transfer of energy, greater production of damage

Physics of Wound Production Area of transfer Larger area of contact, lesser damage to body Instrument for stabbing greater than blunt instrument Other factors Less elastic & plastic tissue, greater laceration Movement of parts of body resulting from force applied & local stretching of tissue cause internal injuries

Q5 Sensation of heat or increase in temperature. Rubor Calor Dolor Loss of function Vital Reaction Sum total of all reactions of tissue or organ to trauma Reaction observable macroscopically & microscopically Reactions of living to tissue to trauma: Rubor: redness or congestion of area due to increase of blood supply as part of reparative mechanism Vital Reaction Reactions of living to tissue to trauma: Calor: sensation of heat or increase in temperature Dolor: pain on account of involvement of sensory nerve Loss of function: tissue losing ability to function normally Vital Reaction Importance: differentiates ante-mortem injury vs post-mortem injury Vital reactions not observable: Physical injuries inflicted during agonal state Sudden death, ex: sudden coronary occlusion Q6 Wound brought about by blunt instrument could be any of the following, EXCEPT Contusion Hematoma Laceration Incision Classification of Wounds As to Severity Mortal wound: capable of causing death Heart & big blood vessels Brain & upper portion of spinal cord Lungs Stomach, liver, spleen & intestine Non-Mortal Wound: not capable of producing death Classification of Wounds Instrument Used Blunt instrument: contusion, hematoma, lacerated wound Sharp instrument: (1) incised wound sharp-edged instrument; (2) punctured wound sharp-pointed instrument; (3) stab wound: sharp-edged & sharp pointed instrument Tearing force: lacerated wound Change of atmospheric pressure: barotrauma Classification of Wounds Instrument Used Heat/Cold: frostbite, burns or scald Chemical explosion: gunshot/shrapnel wound Infection Classification of Wounds Manner of Infliction Hit: bolo, blunt instrument, axe Thrust/Stab: bayonet dagger Gunpowder explosion: projectile/shrapnel wound Sliding/rubbing or abrasion Classification of Wounds Depth of Wound Superficial: only layers of skin Deep: inner structure beyond layers of skin Penetrating no exit: punctured, stab & gunshot wounds Perforating w/ exit Classification of Wounds Relation of Site of Application of Force & Location of Injury Coup Injury: injury @ site of application of force Contre-Coup Injury: injury opposite site of application of force Coup Contre-Coup Injury: injury @ site & opposite site of application of force Classification of Wounds Relation of Site of Application of Force & Location of Injury Locus Minoris Resistencia: injury not @ site & opposite but areas offering least resistance. Ex: blow on forehead, contusion @ eyeball Extensive injury: injury on greater area more than site of application of force. Ex: fall from height, run-over victim of vehicular accident Classification of Wounds Special Types of Wounds Defense wound: result of instinct of self-protection Patterned wound: w/ nature & shape of object/instrument Self-inflicted wound: produced on oneself but no intention to end life Classification of Wounds Self-Inflicted Wounds: Motive Pension/workmans compensation Escape obligations/punishment New identity/destroy existing one Attention/sympathy Psychotic behavior Q7 X, a doctor, wanted to kill his wife by poisoning. During dinner time, he put poison on the food of his wife. Moments after, his wife suffered excruciating pain in the stomach. Seeing his wife in agony, he pitied his wife and administered an antidote. Thus, his wife did not die. What is the crime committed by X? Frustrated parricide Attempted parricide Serious physical injuries Murder Legal Classification of Physical Injuries Mutilation (Art. 262) Elements Penalty Important Points to Remembers Serious Physical Injuries (Art. 263) Element & Penalty Important Points to Remember Legal Classification of Physical Injuries Administering Injurious Substances/Beverages (Art. 264) Elements Penalty Important Points to Remembers Less Serious Physical Injuries (Art. 265) Elements Penalty Important Points to Remembers Integumentary System Animation Skin: true integument covering surface of body Largest organ of vertebrate body 15-16% of total body weight of adult human 17.5 sq ft for ave. woman; 20 sq ft for ave. man 1-2 mm thick

Integumentary System Layers Epidermis (thinner; 10-30 cells thick) Dermis (thicker) Melanocytes Scattered at juncture between deep layers of epidermis & dermis Cells producing dark pigment melanin Integumentary System Melanin Absorbs UV rays Tanning: increase in melanin production by much exposure of UVR Light vs Dark: Production of melanin Dermis Contains: Muscle fibers Glands Pigment cells Blood vessels Sensory nerves 15-40 times thicker than epidermis Subcutaneous layer Beneath dermis fat-rich cells of adipose tissue: acts as (1) shock absorbers & (2) insulation to conserve body heat The Skin Animation Skeletal System Animation Skeleton: framework of animal body, composed of Cartilage Bone Combination of both 2 Parts Axial Skeleton Appendicular Axial Skeleton Skull Vertebral Column Ribs Sternum Appendicular Skeleton Upper pectoral appendages (arms) & girdle (scapula: shoulder blade& clavicle: collarbone) Lower pelvic appendages (legs) & girdle (ilium, ischium, & pubis, collectively called as hips) Appendicular Skeleton Appendicular Skeleton Distribution of Bones: (1) adult human: 206 bones; (2) Infants: over 270 bones Muscular System Tissues w/ ability to contract Myofibril: basic unit of all muscles; minute, thread-like structure Muscle fiber: each muscle cell; contains several myofibrils: myofilaments of 2 types, thick & thin. Thick myofilament: several hundred molecules of protein myosin Thin myofilament: 2 strands of protein actin Muscular System Animation Human body has 3 types of muscles: Skeletal muscles Smooth muscles & Cardiac muscles Digestive System Chain of organs: Mouth Oral cavity Pharynx Esophagus Stomach Small intestine Large intestine Anus Digestive System Animation Circulatory System Animation After process of digestion, digested food delivered to all parts of body by blood stream Blood picks up nutrients @ small intestine, & transports to approx. 17 billion cells; transports oxygen to cells; collects waste materials for elimination Heart: pumping station of blood system; cone, muscular organ size of fist; middle of chest cavity; lower end pointed to left Circulatory System Animation Heart: 4 chambers Atria (upper 2) Ventricles (lower 2)

Heart Beat: Systole: alternate contraction Diastole: relaxation Circulatory System Blood Vessels: circulates thru body by means of tubes that varyin size & function Arteries Veins Capillaries Respiratory System Breathing mechanism operates throughout lifetime: taking in oxygen & giving off carbon dioxide Comparative absence & survival W/out food for 40 days: survives W/out water for 5 days: survives W/out oxygen for only a few minutes: death Respiratory System Animation Respiratory Tract: Nostrils Pharynx (throat) Glottis Larynx (voice box) Trachea (windpipe) Bronchi lungs Respiratory System Animation Skull Framework of head Most complex of all parts of endoskeleton Cartilaginous during embryonic stage Includes: Cranium (primary brain case) 3 pairs of sense capsule for organs of smell, sight & hearing Visceral skeleton for tongue (hyoid apparatus) Ear (incus, malleus, & stapes) for sound conduction Throat Skull Skull Animation Vertebral Column Backbone Main axial support of vertebrates Composition: segmentally arranged vertebrae from base of skull to tip of tail Protects spinal cord Provides rigidity of body Direct or indirect attachment of appendicular skeleton

Vertebral Column Vertebral Column Ribs Series of cartilaginous/elongated bony structures attached to vertebrae Stout, arched structures surrounding thoracic cavity & uniting ventrally w/ sternum Forms thoracic cage 12 pairs of ribs 1st-7th pairs: true ribs, directly attached to sternum; 8th-10th pairs: false ribs, ends unite w/ cartilages of true ribs; 11th-12th pairs: floating ribs, ends terminate freely Ribs Sternum Breatbone Elongated structure lying in central portion of chest Flat & narrow 3 parts: (1) manubrium: upper part; (2) gladiolus: middle/body & largest part; (3) xiphoid: lowest portion Protect heart; holds sternal ends of ribs & some abdominal muscles Sternum Skeletal Muscles Smooth Muscles A.k.a. visceral muscles Found in internal organs (involuntary movement) Involved in automatic process w/out conscious actions: disgestion & blood pressure Cardiac Muscles 3 Types of Muscles Arteries Veins Capillaries Heart: 4 Chambers Heart Beat Melanocytes 7 Cervical Vertebrae 12 Thoracic Vertebrae 5 Lumbar Vertebrae Sacrum & Coccyx Elasticity & Plasticity Ability of tissue to return to its normal size & shape after being deformed by pressue Agonal pertaining to death or extreme suffering.SOURCE: agonal. (2012). Retrieved August 18, 2012, from The Free Dictionary by Farlex: http://medical-dictionary.thefreedictionary.com/agonal Sudden Coronary Occlusion Coronary refers to arteries carry blood containing oxygen and other nutrients essential to the normal functioning of the heart muscle. Occlusion refers to blockageSOURCE: Team, T. N. (2010, January 11). What is coronary occlusion? Retrieved August 18, 2012, from netdoctor: http://www.netdoctor.co.uk/ate/heartandblood/203287.html Contusion Hematoma Lacerated Wound Incised Wound Punctured Wound Stab Wound Barotrauma Frostbite Scald Gunshot Wound Shrapnel Wound Coup Injury Contre-Coup Injury Defense Wound Self-Inflicted Wound Elements of Mutilation Castration (intentional mutilation (totally/partially) of organ for reproduction Castration Intention Mayhem lopping/clipping off any part of body other than organ for reproduction Penalty of Mutilation Castration RT-RP Mayhem PM med & Max Mutilation: Important Points to Remembers Castration: intentional 1 degree higher: victim 12 yrs old Offender has intention to deprive offended party of part of his body Mutilation lopping/clipping off of some part of body Mayhem other intentional mutilation Elements & Penalty of SPI Becomes insane, imbecile, impotent or blind by PI = PM Loses: (a) use of speech/power to hear/smell, eye, hand, foot, arm, leg, (b) use of any such member; becomes incapacitated for work = PC med & max (a) becomes deformed; (b) loses of any member of body; (c) loses use thereof, (d) becomes ill/incapacitated for work for 90 days = PC min & med Becomes ill/incapacitated for labor for days & not 90 days = AM max to PC min Mutilation: Important Points to Remember