Closed Wounds - when there is no breach of continuity of skin or mucous membrane.
Superficial Closed Wounds
Epithelia - extraversion of blood in the subcutaneous tissue or mucous membrane
Contusion or bruise - wound not on the surface of the skin but in the substance of the true skin and the substance of cellular tissue-color is red and sometimes purple soon after the injury.
Change in the Color of Contusion 4-5 days color changed to green
7-10 days it becomes yellow & gradually disappear on the
14th or 15th day - Note: The ultimate disappearance of color varies from 1 to 4 weeks depending upon the severity and constitution of the body.
Hecatomb (blood tumor) - extravasations of blood in a newly formed cavity
Ecchymosis - a form of hematoma only that the extent of extravasations of blood is wider but thinner.
Deep Closed Wounds Simple fracture
Sprain - subcutaneous separation or tearing of the articular tendons, ligaments or muscles.
Strained – tearing or rupture of muscle fibers
Dislocation – displacement from each other of the articular surfaces of bones entering into the formation of a joint.
Cerebral or brain concussion – the jarring or of the brain leading to some commotion of the cerebral substance.
Internal Hemorrhage – Intracranial, Rupture of organs, Laceration of organs
Open Wounds – when there is communication with the outside or break in the skin or mucous membrane.
1. A
brasion – characterize by the removal of the superficial layer of the skin brought about by friction against a hard rough surface.
Forms of Abrasion Linear Multi-linear
Confluent – almost indistinguishable due to severity of friction and roughness of the object.
Multiple - several abrasion noted on the body surface of a person.
Types of Abrasion Scratches
Impact or imprint abrasion Grazes
Pressure or friction abrasion
2. In
cised wound - produced by forcible contact
3. L
acerated Wound - produced by forcible contact of the body with a blunt instrument.
4. St
ab Wound - produced by a sharp-pointed and sharp edge instrument.
5. P
unctured Wound - produced by a sharp-pointed instruments
6. W
ound produced by powder explosion - Firearm, Grenade, dynamite, etc.
7. M
utilation
8. A
vulsion
Medico-Legal Aspect of Wounds:
The following rules must be always observed:
1. All injuries must always be described however small for it may be important later.
The description of wounds must be comprehensive. 2. General Investigation of Surroundings
a. Place where crime was committed
b. Examination of clothing, stains, cuts, hairs and other foreign bodies that may be found in the scene of the crime.
c. Investigation of those persons who may be witnesses to the incident or which could give light to the case.
d. Examination of the wounding instrument.
e. Photography, sketching, or accurate description of the scene of the crime for purposes of preservation.
3. Examination of the Wounded Body - examination applicable to the living and dead victim:
a. Age of the wound from the degree of healing
b. Determination of the weapon used in the commission of the offense.
c. Determination whether the injury is accidental, suicidal or homicidal.
d. Reason for the multiplicity of wounds in cases where there are more than one wound.
4. Examination of the Wound a. Characteristic of the wound b. Location of the wound c. Direction of the wound d. Number of the Wound e. Extent of the Wound
f. Condition of the surrounding of the wounds g. Condition of the locality
h. Degree of hemorrhage i. Evidence of struggle
j. Information as to the position of the body k. Presence of letter or suicide note l. Condition of the weapon
5. Determination whether the wounds were inflicted during life or after death
a. Hemorrhage - more profuse when wound was inflicted during lifetime of the victim
b. Signs of inflammation - there may be swelling of the area surrounding the wound. Other vital reaction maybe present whenever the wound was inflicted during life.
c. Signs of repair - fibrin formation, scab or scar formation conclusively show that wound was inflicted during life. d. Retraction of the edge of the wound - Owing to the vital
reaction of the skin and contractility of the muscular fibers, the edges of the wound inflicted during life retract and cause gaping.
6. Points to consider in the determination whether the wound is homicidal, suicidal or accidental
a. External signs and circumstances related to the position and attitude of the body when found.
b. Location of the weapon or the manner in which it is held. c. The motive underlying the commission of the crime or the
like.
d. The personal character of the deceased.
e. The possibility of the offender to have purposely changed the truth of the condition and other information such as a) Signs of struggle b) Number and directions of wounds c) Nature and extent of the wound d) State of the clothing
7. Length of time of survival of the victim after infliction of wound a. Degree of healing
b. Changes in the body in relation to the time of death c. Age of the blood stain
d. Testimony of witnesses when the wound was inflicted. 8. Possible instrument used by the assailant in inflicting the injuries
a. Contusion - by blunt instrument
b. Incised wound - by sharp-edged instrument c. Lacerated wound - produced by blunt instrument d. Punctuated wound - by sharp pointed instrument e. Stab - by sharp-edged and pointed instrument
f. Gunshot wound - the diameter of the wound entrance may approximate the caliber of the wounding firearm.
9. Which of the injuries sustained by the victim caused death?
This can be ascertained by examining by examining individually the wounds and noting which of them involved injury to some vital organs or large vessels or led to secondary result causing death.
10. Which of the wounds was inflicted first?
a. Relative position of the assailant and the victim when the first injury was inflicted on the latter
b. Trajectory or course of the wound inside the body of the victim.
c. Organs involved degree of injury sustained by victim. d. Testimony of witness.
e. Presence of defense wounds on the body of the victim if the victim tried to make defense act during the initial attack, then the defense wounds must have been inflicted first.
11. Relative Position of Victim and Assailant when Injury was inflicted
a. Location of the wound in the body of the victim b. Direction of the wound
c. Nature of the instrument used in inflicting the injury d. Testimony of witnesses
Death or Physical Injuries Brought About by Powder Propelled Substances:
1. Production of Combustions a. Bullet - Gunshot wound b. Flame - Singeing c. Smoke -smudging
d. Gun powder residue - tattooing e. Grime - tattooing
2. Firearm Wounds
a. Gunshot Wound
Difference between Entrance and Exit of gunshot wound ENTRANCE
1. Appears to be smaller than missile owing to elasticity of tissue except contact fire.
1. Always bigger than missile
2. Edges inverted 2. Edges averted
3. Usually ovaloid or rounded 3. Variable shape
4. Contusion collar present 4. Contusion collar absent
5. Other product of combustions when firing is near 5. Always absent 6. Paraffin test may be positive 6. Always negative 3. Determination of Relative Position of Victim &
Assailant
a. Contusion Collar - the wider side points to the source of the missile.
b. Smudging & Tattooing - the side with more or intense deposit points to the source of the missile.
4. Determination of the probable caliber of the firearm used in the infliction - measure in centimeter of the cross diameter of the gunshot wound fro collar to collar - the shortest is the probable caliber.
5. Determination of the distance of fire
a. Contact fire - intense laceration & undermining of the point entrance. Normal bigger than exit.
b. Distance of six (6) inches presence of smudging, singeing and tattooing.
c. Beyond six (6(inches but within thirty six (36) inches - presence of the tattooing.
d. Beyond thirty six(36) inches only the gunshot wound will be present
1. Unchoked bore or Straight bore
2. Choked bore
a. Improved cylinder - narrowing of the bore from rear to the muzzle is 3-5 thousandth of an inch.
b. Half Chock - narrowing of the barrel is 15-20 thousandth of an inch.
c. Full Chock - narrowing of the barrel is 35-50 thousandth of an inch.
Characteristics of Shotgun Wounds
Contact fire - entrance of wound is irregular with severe destruction of the underlying tissue. There is singeing and smudging.
1. Near shot up to six (6) inches. 2. Mark laceration of skin.
3. Gunpowder maybe driven into the deeper area of the wound. 4. Mark smudging of the skin & deeper portion of the wound of
entrance. 5. Mark tattooing. 6. Hair is singe.
7. Wad may be found inside the wound of entrance. Distance of about one (1) yard
a. Pellets enter as one mass thus making entrance wound with irregular edges.
b. Surrounding skin may be blackened with light burning & tattooing. Distance of 2 to 3 yards
a. The wound of entrance has big central hole with rugged edges with few stray wound of entrance wound.
b. Smudging & tattooing – no longer evident
Distance of 4 yards – pellets may enter skin area of about 6 to 8 inches diameter although there may be a central care where a group might have entered.
Death by Asphyxia
All forms of violent death which results primarily from the interference with the process of respiration or to condition in which the supply of oxygen to the blood or tissue or both has been reduced below normal level. 1. Hanging
2. Strangulation a. by ligature b. manual or throttling c. special forms of strangulation c.1. palmer
c.2. garroting c.3. mugging or yoking
c.4. compression of neck with stick 3. Suffocation
a. smothering – closing mouth and nostrils by solid objects b. choking
4. Asphyxia by submersion in water (drowning) 5. Asphyxia by pressure on the chest
6. Asphyxia by irrespirable gases
Death or Physical Injuries Due to Vehicular Accidents
1. Kinds of injuries in vehicular accident cases Sustained by the pedestrian
Impact injuries - primary impact injuries, subsequent impact injuries, Secondary injuries, Run over injuries
Sustained by driver & passengers - Impact injuries and turn-turtle injuries
2. Medical Evidence in Vehicular Accident Cases
Evidence from the victim Crash injury Tire thread marks Abrasion prints
Blood, hair or clothing of victim may be found sticking on the part of the vehicle which hit the victim.
Physical defects of the victim like poor eyesight
Inebriation of the victim – like under the influence of alcohol
Evidence from the driver
Physical defect like poor eyesight
Under the influence of alcohol or drugs by drive History of grudge between the driver and the victim. Medico-Legal Aspects of Sexual Crimes
What is Virginity? It is a condition of a female who not experienced sexual intercourse.
Kinds
1. Moral virginity 2. Demi-virginity 3. Virgo-Inacta
4. Physical virginity - True physical virginity, False physical virginity Determination of the condition of virginity
1. Breast 2. Vaginal canal 3. Labia majora minora 4. Fourshette & perineum 5. Hymen
6. Rougosites
What is Defloration? It is the laceration or rupture of the hymen as a result of sexual intercourse.
Classification
1. Incomplete Laceration – Superficial or Deep 2. Complete
3. Complicated
Healing Time of Hymenal Laceration 1. superficial – 2 to 3 days 2. extensive tear – 7 to 10 days
3. complicated – if with intervening infection will require longer to heal
Duration of Laceration of the Hymen
1. fresh bleeding laceration – rupture quite recent 2. healing – after 24 to 7 days
3. recently healed – 7 days to 3 months 4. old healed – 3 mos to years
Medical Evidence to Consider in Sexual Crimes 1. Evidence from the victim
2. Alleged time and place of the commission of the crime. 3. Date, time and place of the examination.
4. Condition of clothing.
5. Physical and mental development of victim. 6. Gait, facial expression etc.
7. Examination of body for sign of violence 8. Examination of genetalia a. hymen b. hymental orifice c. vaginal canal d. rougosites e. fourshette f. pubic hair g. labias h. presence of spermatozoa
Medico—Legal Aspects of Pregnancy
Pregnancy – is a state of a woman who has within her body the going product of conception.
Legal importance of the study of pregnancy
1. Pregnancy ground for the suspension of the execution of the death sentence in women
2. A conceived child is capable of receiving donation.
3. Duration of pregnancy – 270-280 days from onset of last menstruation.
4. Abnormally prolonged gestation – beyond 300 days.
5. Minimum period of gestation – compatible with viability of the child born at 180 days may live.
6. Super fecundation – fertilization made by separate intercourse of two ova which have escaped at the same act of ovulation. 7. Pseudocysis or spurious pregnancy – imaginary pregnancy Medico-Legal Aspects of Delivery
1. Delivery is the process by which in a woman gives birth to her offspring.
2. Puerperium – is the interval between the termination of labor (delivery) to the complete return of the reproductive organ its normal pregnant state-last from 6 to 8 weeks.
3. The study of delivery is important because proof delivery is necessary in judicial action on the following:
a. Legitimacy b. Abortion c. Infanticide d. Concealment of birth e. In slander or libel 4. Methods of delivery
a. Natural Route – the normal passages- Spontaneous, Surgical intervention, Instrumentation
b. Surgical Route – Abdominal caesarian section, vaginal caesarian section, Post-mortem caesarian section
Medico-Legal Aspect of Abortion
Willful killing of the fetus in the uterus, or violent expulsion of the fetus from the natural womb and which results to the death of the fetus Principal elements of crime
1. That the expulsion of the product of conception is induced. 2. That the fetus dies either as an effect of the violence used, drug
administered or fetus was excelled before the term of its viability. Provision of the Revised Penal Code on Abortion
Intentional Abortion
1. That the woman is pregnant
2. Violence was applied on such pregnant woman without the intention of abortioning her.
3. The woman aborted as result of the violence. Unintentional Abortion
1. The woman must be pregnant
2. Violence was applied on such pregnant woman without the intention of abortioning:
3. The woman aborted as aborted as result of the violence. Abortion Practiced by the woman herself or by her parents
1. The woman is pregnant
2. Abortion is intended to be committed 3. Abortion is induced by
4. The pregnant woman
5. Other person with consent of the pregnant woman
6. The presents of the woman, or either of them for the purpose of concealing her dishonor and with the consent of the woman herself Abortion practiced by a physician or midwife and dispensing of abortions
1. The woman is pregnant
2. The physician induced or assisted in causing the abortion 3. The acts done by the physician or midwife intended to cause an
abortion
4. There must be intention of the physician to produce abortion and the absence of intention will not make the physician criminally liable.
Kinds of Abortion
1. Spontaneous or natural 2. Induced – therapeutic or criminal Medico-Legal Aspects of Birth
Legal importance of the study of birth 1. Birth determines personality
2. Appearance of a child is ground for the revocation of donation. 3. Proof of live birth must first be shown before of the child by the
prosecution in the case of infanticide Medico-Legal Aspects of Infanticide
INFANTICIDE – is the killing of a child less than three (3) days old.
How the crime committed?
1. By omission or neglect
a. Failure to litigate the umbilical cord
b. Failure to protect the child from heat and cold
c. Omission to take the necessary help of a midwife or skilled physician.
d. Omission to supply the child with proper proof food. e. Omission to remove the child from the mother’s discharge
with resulted to suffocation
2. By Commission
a. By inflicting physical injuries b. By suffocation
c. By strangulation d. By drawing e. By poisoning f. By burning
g. By deliberate exposure to heat and cold
3. Other allied causes
a. Abandoning a minor
b. Abandoning a minor by person entrusted with custody indifference of parents.
Medico-Legal Aspects of Paternity and Filiation
PATERNITY – is the civil of the father with respect to the child begotten him.
FILIATION – is the civil status of the child in relation to its mother or father.
Legal importance of determining Paternity & Filiations 1. For succession
2. For enforcement of the naturalization and immigration laws. Kinds of children
1. Legitimate children (proper) –
born in lawful wedlock or within 300 days after the dissolution of marriage.
Presumption of Legitimacy – children born after 180 days following the celebration of marriage, and before 300 days following its dissolutions or the separation of the spouses shall be presumed to be legitimate.
Against their presumption no evidence shall be admitted other than that of the physical impossibility of the husband’s having access to his wife within the 180 days of the 300 which preceded the birth of the child.
This physical impossibility may be caused by:
a. The impotence of the husband; the fact that the husband and wife were living separately in such a ay that access was not possible.
b. By the serious illness of the husband. Requisites of the presumption
a. There is a valid marriage
b. the birth of the child took place after 180 days following the celebration of marriage or within 300 days following its dissolution or separation of spouse;
c. There is no physical impossibility of the husband having access to the wife during the first 120 days of the 300 proceeding the birth of the child.
2. Legitimated Children
Legitimation – is defined as a remedy or process by which a child born out of lawful wedlock and are therefore considered illegitimate are by fiction of law considered by subsequent valid marriage of the parents.
Children that can be legitimated:
a. Natural children (proper) - Natural children are those born outside lawful of parents who, at the time of the conception of the former were not disqualified by any impediment to marry each other.
3. Adopted Children
Adoption – is defined the act or proceeding by which of paternity and filiation are recognized as legally existing between persons not so related by nature.
Persons who may be adopted: a. The natural child by the natural father or mother; b. Other illegitimate children, by the father or mother; c. A step-child, by the step-father or step-mother;
d. Any person, even if age provided adopter is sixteen years older
4. Illegitimate Children
a. Natural Children
Natural Children (proper)
Natural children by legal fiction – natural children by legal fiction are those born of void degree of annulment.
Natural children by presumption - are those natural children acknowledge the father or the mother separately if the acknowledging parent was legally competent to contact marriage at the time of conception.
b. Spurious Children - Illegitimate who are not natural are considered spurious children may be:
Adulterous Children – conceived in an act of adultery or concubinage.
Sacrilegious Children – children born of parents who have been ordained in sacris.
Incestuous Children – children born by parents who are legally incapable of contracting valid marriage because of their blood relations as marriage between brothers and sisters, father and daughter, etc.
Manceres – children conceived by prostitute. It is very difficult to determine the father because of the nature of the work.
Artificial Insemination
It is the introduction of seminal fluid with spermatozoa in the generative of a woman by any means of springe, pipette, irrigator, etc. Status of Children born by artificial Insemination
a. If the donor is the husband, the child must be unquestionable legitimate.
b. If the semen came from a donor than the husband, with the consent of the later, the child may also consider legitimate in as much as it born lawful wedlock and there is consent of the husband.
c. If the semen came from a third party and introduced to the wife without consent or against the will of the husband, the