LEGAL MEDICINE (2011)

Antonio Rebosa, Ll.B, M.D

LEGAL MEDICINE

7.

Branch of medicine which deals withthe

application of medicalknowledge to the
purpose of law andin the administration of
justice.

The application of basic and clinical,medical

and paramedical sciences toelucidate legal
matters.

8.

TYPES and NATURES of INJURY

1.

2.

3.

4.

5.
6.

Lacerated wound / tear (putok) open

wound caused by a blunt objector
instrument. These wounds are torn,
rather than cut. They have ragged,
irregular edges and masses of torn
tissue underneath. These wounds are
usually made by blunt, rather than
sharp objects. Eg: Fist blow in the face,
bump of the car, bamboo, lead pipe
Punctured wound (tusok) caused by
a sharp pointed instrument or object.
Punctures are caused by objects that
penetrate into the tissues while leaving
a small surface opening. Wounds made
by nails, needles, wire, and bullets are
usually punctures. As a rule small
puncture wounds do not bleed freely.
Eg.: Syringe, needle, pen, ice pick, nail
(.5cm.)
Incised wound (hiwa/ cut/ slash)
caused by a sharp edged instrument.
Incisions, commonly called CUTS are
wounds caused by sharp cutting
instruments such as knives, razors, and
broken glass. Incisions tend to bleed
freely because the blood vessels are
cut cleanly and without ragged edges.
Eg.: Knife, blade, scalpel.
Stab wound (saksak) caused by an
instrument sharp point with a sharp
edge. A small surgical incision caused
by a thrust with a sharp instrument.
(single/ double bladed).
Hacking wound (taga) [bolo/axe]
large incise wounds.
Contusion (pasa) tapture of blood
vessels due to forceful contact due to a
blunt object or instrument. Another
name for a bruise. A bruise or
contusion is caused when blood vessels
are damaged or broken as the result of

a blow to the skin. (be it bumping

against something or hitting yourself
with a hammer.)
Hematoma (bukol) blood cyst or
tumor extra vassation of blood that
newly formed cavity, also cause by a
blunt object. An abnormal localized
collection of blood in which the blood
is usually clotted or partially clotted
and is usually situated within an organ
or soft tissue space, such as within a
muscle. A hematoma is caused by a
break in the wall of a blood vessel.
Abrasion (gasgas) contact with a
rough surface / friction or scratching.
Made when the skin is rubbed or
scraped off. Rope burns, flood burns,
and skinned knees or elbows are
common examples of abrasions. This
kind of wound can become infected
quite easily because dirt and germs are
usually embedded in the tissues.

Types of Abrasions
1. Linear
2. Multi-linear
3. Confluent (tapyas)
Special Types of Wounds
1. Patterned wound
2. Defense wound- A wound sustained
when a victim places a hand, arm or other
body part to prevent or minimize a blow or
slashing by a sharp weapon.
3. Self-inflicted wound
4. Suicidal wound
Gun Shot Wounds - A person with a
gunshot wound has an injury from a bullet
that was fired from a gun.
Classification of Firearms
1.
2.

Short (revolver, pistol)

Long (rifle, AK47, M16, Machine Gun
etc.)

Major parts of Firearm

1.
2.
3.
4.
5.
6.

Barre
Handle
Trigger
Percussion cap
Firing Pin
Muzzle

Kinds of Ballistics

1.

1.

2.
3.

2.
3.
4.

1.
2.
3.
4.

Internal / Interior - from the time you

pull the trigger
External - from the time it leaves the
barrel of the gun
Terminal - effect of the bullet on an
object when hit
Medical - when a bullet hits human
body. Firearm identification used to
determine whether the gun that is
subject of the investigation has the
same gun used or fired.
Parts of Ammunition (bala)
Shell / cartridge
Gun powder - inside the shell
Primer - made up of lead, antimony,
barium
Projectile (tingga)

Products of Combustion
1.
2.
3.
4.

Smudging smoke or soop

Singeing (kulot pag natamaan)
Tatooing, peppering, stippling
Contusion or collar -would help
determine the relative position
between the assailant or the victim and
or the trajectory of the bullet.

Point of Entry
Smaller and oval in
shape unless it is a
close contact fire.

Point of Exit
Usually bigger and
irregular or stellate
in shape.

The edges are

inverted.
Depending upon a
distance, may be
positive for the
products of
combustion and
paraffin.
Have a contusion or
abrasion collar

Everted, and tissued

are protruding.
Always negative.

Absent

Perrafim test
- used to determine whether
the subject has recently fired a gun or not.
-not used to determine whether
the subject is the killer or shooter.
-the value of the test is only
presumptive, not conclusive,
because of false positive and
false negative results.
FALSE POSITIVE

Subject recently fired a gun-totally not

related to the incident inquestion
Subject is a smoker
Subject is a farmer who deals with
fertilizer.

FALSE NEGATIVE
1.
2.
3.

Subject is a professional
Incessant rushing with water and soap
(suka)
Paraffim test was done beyond 3days
from the time of incident.

WITNESS -A person who by perceiving and

made known his perception toothers.
-Person who testifies under oath in a trial with
first hand or expert evidence useful in a
lawsuit.
-A person who sees an event.
Who cannot be a witness?
-Those who cannot made known his perception
to others
* Children
* Senile / Insane
*Those who have previously been convicted of
perjury
Two Types of Witnesses:
1.
2.

Ordinary - goes to court and specify

what he has perceived.
Expert - goes to court to enlighten the
court to render his expert opinion on
matters.
-He has authority on that particular
field.

Subpoena - order issued by the court to a

person to appear in court.
A subpoena ad testificandum is a court
summons to appear and give oral testimony for
use at a hearing or trial.
CONTEMPT OF COURT
-any willfull disobedience to or disregard of a
court order or any misconduct in the presence
of a court action that interferes with a judges
ability to administer justice or that insults the
dignity of the court. Punishable by fine or
imprisonment or both.
2 kinds:

Direct - inside the court room or anywhere in

the court room
Indirect - outside the court room, defied the
order of the court.

-the woman allows sexual intercourse but only

inter-femora or even inter-labia but not to
the extent of rupturing the hymen.
-hymen is still intact

VIRGINITY - A condition of a female who has

not experience sexual intercourse and whose
genital organs have not been altered by carnal
connection and whose hymen is still intact.

4. VIRGO INTACTA - literally the term refers to

a truly virgin woman; that there are structural
changes in her organ to infer previous sexual
intercourse and that she is a virtuous woman.

Virtuous Female -If her body is pure and if she

has never had any sexual intercourse with
another though her mind and heart is impure.

- inasmuch as there are no conclusive evidence

to prove the existence of such condition, liberal
authorities extend the connotation of the term
to include women who have had previous
sexual act or even habitually but had not given
birth.

Kinds of Virginity:
1. MORAL - the state of not knowing the nature
of sexual life and not having experienced
sexual relation.

Defloration - is the laceration or rupture of the

hymen as a result of sexual intercourse.

-Applies to children below the age of puberty

and whose sex organs and secondary sex
characters are not yet developed.

-All other lacerations of the hymen which are

not caused by sexual act are not considered as
defloration.

2. PHYSICAL - condition whereby a woman is

conscious of the nature of the sexual life but
has not experienced sexual intercourse.

Other causes of Hymenal Laceration:

The term applies to women who have reached

sexual maturity but have not experienced
sexual intercourse.
Distinction between True and False
PhysicalVirginity.
a) True Physical Virginity - a condition wherein
hymen is intact with edges distinct and regular
and the opening small to barely admit the tip
of the smallest finger of the examiners even if
the thighs are separated.
b) False Physical Virginity a condition wherein
the hymen is unruptured but the orifice is wide
and elastic to admit two or more fingers of the
examiner with a lesser degree of resistance.
-the hymen may be laxed and distensible and
may have previous sexual relation. In this
particular instance the physician may not be
able to make a convincing conclusion that the
subject is virgin.
3. DEMI-VIRGIN -this term refers to a condition
who permits any form of sexual liberties as
long as they abstain from rupturing the hymen
by sexual act.
-the woman may be embraced, kissed, may
allow her breasts to be fondled, her private
organ to be held and other lascivious acts.

1. Passage of clotted blood during

menstruation
2. Ulceration due to disease like diphtheria
3. Jumping or Running
4. Falling on hard sharp object
5. Medical instrumentation
6. Self-scratching or irritation
7. Masturbation
8. Insertion of foreign bodies
9. Previous operation
10. Horseback riding
11. Aerobics / biking
12. Throma to the genitalia
Degree of Laceration:
a) Incomplete Laceration -Rupture or laceration
of the hymen is considered incomplete when it
does not involve the whole width or height of
hymen.
Superficial - the laceration does not go beyond
one-half of the whole width of the hymen

Deep - the laceration involves more than onehalf of the width of the hymen but not reaching
the base.

2. Stage of Post Mortem Rigidity:

b) Complete Laceration -The hymenal

laceration involves the whole width but not
beyond the base of the hymen

-The whole body becomes rigid due to the

contraction of the muscles.

c) Compound or Complicated -The laceration

involves the hymen and also the surrounding
tissues.
-It may involve the hymen also the surrounding
tissues.
-It may involve the perineum, vaginal canal,
urethra or rectum.
DEATH - Complete cessation of all cardiopulmonary (heart-lungs) and/or cessation of
brain activity.
3 Kinds of Death
1. Somatic Death / Clinical Death

Dead for less than 3 hours.

Dead, but cells are still alive

2. Molecular /Cellular Death

Dead for 3-6 hours

Death also of the cells3.

Apparent Death or State of Suspended

Animation

Transient loss of consciousness or

Temporary cessation of the vital
functions of the body

-AKA Rigor Mortis

- Six (6) - twenty four(24) hours

3. Stage of Secondary Flaccidity/Onset of
Decomposition:
-AKA commencement of putrefaction
-Relaxed and soft but with foul odor
- 24-36 hours ++
Forensic Entomology - involves the insects that
are eating up the body.
POST MORTEM LIVIDITY
-it occurs in most extensive areas of the most
dependent portions of the body.
Importance: to determine the position of the
body when the person died.

2 KINDS:
1. HYPOSTATIC LIVIDITY - blood still fluid on
form.
2. DIFFUSION LIVIDITY - blood has already
coagulated, blood already clotted.
POST MORTEM EXAMINATION
-Internal examination of the dead
Importance: to determine the cause of death.
AUTOPSY:

It is important to determine the

condition of suspended animation to
prevent premature burial.

MUSCULAR CHANGES in the BODY following

DEATH
Importance: help us determine the
approximate time of death.
1. Stage of Primary Flaccidity:
-AKA post-mortem irritability. -The muscles
are relaxed and capable of contracting when
stimulated.
-Died less than six (6) hours.

-Both the internal and external examination of

the dead.
NEGATIVE AUTOPSY - after the autopsy, cause
of death is still unknown.
NEGLIGENT AUTOPSY - cause of death is still
unknown because of so many errors committed
during the autopsy.
An autopsy may be official and non-official, the
differences are as follows:
OFFICIAL
medico legal or

NON-OFFICIAL /
NONMEDICO LEGAL
hospital based or

mandatory autopsy
done on those who
died on non-natural
causes
NO NEED for consent
of the next of kin

always a TOTAL
autopsy
Only those authorized
by law may perform
this kind of autopsy

elective autopsy
done to those who died
from natural causes
consent from next of
kin is needed, they will
decide whether it will
be a TOTAL or PARTIAL
autopsy
by the pathologist of
the hospital

PERSONS ALLOWED BY LAW TO PERFORM

OFFICIAL AUTOPSY:
-Medico legal of PNP
-Medico legal of NBI
-Municipal/ Health Officers who are considered
ex-officio medical officers
-Those authorized by an ordinance or thru
request from chief of police, mayor, prosecutor.