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MEDICO-LEGAL ASPECTS OF DEATH f) Winslow’s test – no movement in the image formed by reflecting

artificial light on the water in a saucer and placed in the chest if

Importance of Death determination: respiration is taking place.
1, The civil personality of a natural person is extinguished
by death. 3. Cooling of the body ( ALGOR MORTIS)
2.The property of a person is transmitted to his heirs at the - After death the metabolic process inside the body ceases.
time of death. - The progressive fall of the body temp. is one of the most prominent
3. The death of a partner is one of the causes of dissolution signs.
of partnership - First two hours after death the cooling is rapid.
agreement. - Fall of temp. of 15 to 20 degrees Fahrenheit is considered as a
4. The death of either the principal or agent is a mode of certain sign of death.
extinguishment of
agency. POST-MORTEM CALORICITY – is the rise of temp. of the body after
5. The criminal liability is extinguish by death. death due to rapid and early putrefactive changes. Usually in the
6. The civil case for claims which does not survive is first 2 hours.
dismissed upon death of the = seen in cholera, liver abscess, tetanus, RF,Strynine poisoning,
defendant. Peritonitis

Death – is the termination of life. A. Conditions connected with the body:

Kinds of death:
1. Somatic or clinical death – persistence of vital Factors delaying the rate of cooling of the body:
functions 1. Acute pyrexial disease
2. Molecular or cellular death – 3 to six hours after 2. Sudden death in good health
cessation of life 3. Obesity of person
3. Apparent death or State of suspended animation – 4. Death from asphyxia
transient loss of consciousness in hysteria, 5. Death of the middle age
uremia, electric shock
Factors accelerating cooling:
Signs of death: 1. Leaness of the body
2. Extreme age
1. Cessation of heart action and circulation., Usually the 3. Long-standing illness
auricle contract after 4. Chronic pyrexial disease with wasting
somatic death fro a longer period than the ventricle, last
to stop so called B. Conditions that are connected with the surroundings
Factors delaying cooling:
Methods of detecting the cessation of heart action and 1. Clothings
circulation: 2. Want of access of air to the body
a) Examination of the heart- pulse, aucultation, flouro, 3. Small room
ECG 4. Warm surroundings

b) Examination of peripheral circulation Factors accelerating cooling:

= Magnus test – application of ligature around the 1. Unclothed body
base of the finger 2. Conditions allowing the access of air
- bloodless area at site of 3. Large room permitting the dissipation of heat
application 4. Cooling more rapid in water than in air
- dead man – no change
Methods of estimating how long a person has been dead from the
= Opening of small artery- spurting cooling of the body:

= Icards test – injection of flourescein SQ 1. If body temp. is normal at the time of death:
- greenish yellow discoloration in the = the average rate of fall of the temp. during the first 2 ½ hours is ½ of
whole skin the
- dead man only in the area of difference of the body temperature and that of the air.
injection = the body attains the temp. of the surrounding air from 12 to 15 hours
= Pressure on fingernails after
= Diaphanous test – fingers are spread wide death in tropical countries.
through a strong light- Red
= Application of heat on the skin - blister 2. Chemical Method ( Schourup’s formula for the determination of the
= Palpation of Radial pulse time of death of any cadaver whose CSF is examined for the
= Dropping of melted wax concentrations of L.A., NPN, A.A.
= L.A> 15 mg to 200 mg/100cc rapid in 1st 5 hours.
2. Cessation of respiration – more than 3 ½ minutes = NPN inc. from 15 to 40 mg/100 cc in 1st 15 hours
= A.A. inc. from 1 mg to 12 mg% 1st 15 hours.
Methods of detecting cessation of respiration:
a) Observance of movement of chest and abdomen
c) Examination with a mirror = may be seen in the living with- apoplexy, epilepsy , trance, catalepsy,
d) Examination with a feather or cotton fibers hysteria
e) Examination with a glass of water
5. CHANGES IN THE SKIN – opacity, flattening, loss of
elasticity b) Age
= early onset – aged and newborn
6. CHANGES IN AND ABOUT THE EYE = delayed – good health, good muscular development
a) Loss of corneal reflex – seen I n live pts: G.A.,
uremia, narcotic poisoning c) Integrity of nerves
b) Clouding of cornea = section of the nerve will delay onset, paralyzed muscle
c) Flaccidity of the eyeball
d) Pupil in the position of rest.
the sclera after death.

7. ACTION OF HEAT ON THE SKIN (2) External factors

= Heat applied while alive – produced blister with serum a) Temperature
and redness around the area. = Hastened by high temperature
= > 75 degrees will produce heat stiffening
= Following combinations of signs show death has b) Moisture
occurred: = rapidly but with short duration in moist air
a) Loss of animal heat to a point not
compatible with life Conditions simulating RIGOR MORTIS:
b) Absence of response of muscle stimulus 1. Heat stiffening - > 75 degrees coagulates muscle proteins resulting to
c) Onset of rigor mortis. rigidity.
= “ Pugilistic attitude” flexed upper and lower limb
CHANGES IN THE BODY FOLLOWING DEATH = hands clenched, flexor stronger than extensors, burned to
1. CHANGES IN THE MUSCLE – complete relaxation of
the whole 2. Cold stiffening
muscular system. = due to solidification of fats when exposed to cold temp.
Three Stages After Death:
a) Stage of primary flaccidity ( POST-MORTEM 3. Cadaveric spasm or Instantaneous Rigor
IRRITABILITY) = instantaneous rigidity due to extreme nervous tension,
= muscle relax, may contract, dilated pupil, exhaustion,
sphincters are relaxed injury to the nervous system.
= presence of molecular life = weapon in hand, weeds
= warm place: 1 hour and 51 minutes
= chemical reaction of muscle is alkaline RIGOR MORTIS CADAVERIC
b) Stage of post-mortem rigidity ( CADAVERIC 1. Time of appearance 3-6H after death Immediately after
RIGIDITY , death
DEATH STRUGGLE OF MUSCLES OR RIGOR 2. Muscles involved All muscles Certain group
MORTIS) 3. Occurrence Natural phenomena May or may not
= whole body is rigid due to contraction of the appear
muscles 4. Medico-legal signif. Approximates time of death Determine nature
= starts at muscle of neck, lower jaw of death
= Reaction is acidic due to inc. of lactic acid
= develops 3 to 6 hours after death in temperate, RIGOR MORTIS MUSCLE
earlier in warm CONTRACTION
= last from 2 to 3 days in temperate, warm: 24-48H 1. Contracted muscle Losses transparency More or less
cold weather transparent
18-36H 2. Elasticity Loss elasticity Very elastic
summer 3. Litmus reaction Acidic Neutral or sl.
c) Stage of Secondary flaccidity or 4. Contraction Absolute flaccidity Possess inherent
Commencement of putrefaction contraction
= muscle are flaccid, not respond to stimuli, a) Coagulation of blood
reaction is alkaline = blood may remains fluid inside the blood vessels 6-8H after
= due to dissolution of muscle proteins death.


(1) Internal Factors 1. Consistency Firm Soft
a) State of the muscles 2. Surface of blood vessels Raw after clots are removed Smooth,
= healthy – appears late health after
= Onset is hastened in: 3. Clots Homogenous Can be
a.1 hunted animal stripped
a.2 prolonged convulsion/lingering illness can’t be stripped off in
a.3 death from- TY, Cholera, Phthisis, layers
b) Post-mortem Lividity or Cadaveric Lividity , or Post- 2. Mucous membrane Dull,lusterless Not in congestion
3. Inflammatory exudate Not seen Not seen
mortem Suggilation or Post-mortem Hypostasis or Livor
= Stoppage of heart action and loss of tone of b.v. Other changes in the blood
accumulates in dependent areas except in bony 1. Hydrogen ion concentration – acid pH CO2, L.A., After 24H alkaline
areas. ammonia.
= capillaries coalesce > purplish in color called Post- 2. Breakdown of liver glycogen leads to accumulation of dextrose in the
mortem lividity. IVC and
= Hasten by death due to cholera, uremia, Typhus the right side of the heart.
fever 3. Rise in NPN and Free A.A.
= appears 3 – 6 H after death and fully developed 12 4. Chemical:
H after death. = chloride in the plasma/RBC decrease due to extravascular
diffusion, in
Physical characteristics of Post-mortem Cadaveric 72 H only ½ of its content.
Lividity = Mg – increases due to diffusion from without.
1. Occurs in the most dependent areas. = K – increases due to diffusion from the vascular endothelium.
2. Involves the superficial layer of the skin
3. Does not appear elevated from the rest of the skin.
5. No injury of the skin - After death, proteolytic, glycolytic and lipolytic ferments of the
Kinds of Post-mortem Cadaveric Lividity tissues continue to act which lead to the autodigestion of organs.
1. Hypostatic lividity
2. Diffusion lividity
Importance of Cadaveric lividity: - Is the breaking down of complex proteins into simpler components
1. One of the signs of death. associated
2. Determines the position of the body has been with the evolution of foul smelling gasses and accompanied by the
changed after it’s appearance in the body. change of
3. Color of lividity may indicate the cause of death. color of the body.
a) asphyxia – lividity is dark
b) CO poisoning – pink
c) Hemorrhage – less marked
d) Hydrocyanic acid – bright red Tissue changes in putrefaction:
e) Phosphorus – dark brown
f) Potassium chlorate – coffee brown 1. Changes in the color of the tissue
4. Determines how long the person has been dead Hemolysis of blood within blood vessels > Hgb diffuses through the
5. Gives us an idea as to the time of death. walls
Reddish-brown in color
In the tissues > Hgb undergo chemical change
Points to be considered which may infer the position of Greenish-yellow 1st seen at R Iliac
the body at the time of death: fossa
1. Posture of the body when found.
2. Post-mortem hypostasis or lividity MARBOLIZATION – prominence of the superficial veins with reddish
3. Cadaveric spasm discoloration which develops on both flanks of
abdomen, neck, and shoulder
= look like “marbled” reticule of branching veins.
1. Small bruises – Below epidermis in true skin In the epidermis or cutis
larger ones - below this

2. Cuticle Abraded by the same violence Unabraded 2. Evolution of gasses in the tissues
that produce the bruise.
CO2, ammonia, H2, Suphurated hydrogen, methane.= offensive odor
3. Bruise Appears at the seat or surrounding Always dependent
may or may not be dependent
Effects of pressure of gasses of putrefaction:
4. Elevated, inflammatory condition Not elevated, blood in b.v. a) displacement of the blood – bleeding in open wounds
5. Incision shows blood outside the b.v. Blood inside the vessels
c) fluid coming out from nostrils, mouth
= most certain test of difference d) extrusion of the fetus in a gravid uterus
6. Color variegated Uniform color
e) floating of the body

Internal hypostasis in Visceral organs: 3. Liquefaction of the soft tissues

1. Lungs Putrefy rapidly : Eyeball, lining of trachea, larynx , brain,
2. Loops of intestine stomach, intestine, liver, spleen
3. Brain Putrefy late : Highly muscular organs and tissues, Esophagus,
diaphragm, heart, lungs, kidneys, U.B., uterus, P.G.
1. Post-mortem
staining in organs Irregular, most dependent parts Uniform, all organs
Factors modifying the RATE of putrefaction:
a) age : healthy adults, NB not
yet fed, later than infants FIRST 4 OR 5 DAYS Cold water little change, in rigor mortis
b) condition of body : full grown/obese – FROM 5 – 7 DAYS Skin on hands, feet is bleached, face faded
rapid , Stillborn- late white
c) cause of death : infection - rapid 1 – 2 WEEKS Face swollen and red, skin of hands and
feet wrinkled
2. EXTERNAL FACTORS 4 WEEKS Skin wrinkled, nail intact
a) Free air 6 – 8 WEEKS Abdomen distended, skin of hands/ feet
a.1 air : free air hastens decomposition come off with nails
a.2 moderate moisture - accelerates
a.3 loaded with septic bacteria – early aerobes, Factors influencing the floating of the body in water:
later anaerobic 1. age – fully developed, well nourished - rapid
- Clostridium welchii= 2. sex – females floats sooner
decomposition 3. conditions of the body – obese float quicker
b) Earth 4. season of the year – moist hot air – putrefaction – floats due to
b.1 dry absorbent soil - retards gas
b.2 moist fertile soil - accelerates 5. water- shallow and stagnant water of creeks, higher specific
c) Running water- more rapid than still water - sea water floats sooner than fresh water, higher specific
d) Clothings – early it hastens but delays in the gravity
later stage. 6. external influence – heavy-wearing apparel - slower
- tight clothings - delay
Only teeth, bones and hair remain for an indefinite time.
Flat bones disintegrates faster than round bones.
Factors influencing the changes in the body after
1. state of the body before death – thin slower, 1. Mummification
mummify = is the dehydration of the whole body which results in the
2. time elapsed between death and burial and shivering and preservation of the body.
environment of the body = usually occurs when buries in a hot, dry with free access of
3. effect of coffin – later hot air
4. clothings and other coverings on the body when
buried – pressure, insects 2. Saponification or Adipocere fromation
5. depth at which the body was buried - greater the = a condition where the fatty tissues of the body are
later transformed to soft brownish-white substance known as
6. condition and type of soil ADIPOCERE at SQ level.
7. inclusion of something in the grave which will
hasten decomposition-food 3. Maceration
8. access of air to the body after burial = softening of the tissues when in fluid medium in the absence of
9. mass grave – rapid putrefactive mircro-org, seen in death in utero
10. trauma to the body – violent death - slow – reddish or greenish color, skin peeling off and arms flaccid and


1. Presence of rigor mortis : 2-3 hours after death
12 H fully developed
1-3 DAYS AFTER DEATH - greenish discoloration over 18-36 H disappears concomitant with putrefaction
2. Presence of Post-mortem lividity
iliac fossa, soft eyeballs 3-6 H after death
3-5 DAYS - frothy blood from mouth, appears as small petechia-like red spots
3. Onset of decomposition
nostrils 24-48 H after death
8-10 DAYS - abdominal distention, nails manifested watery. foul smelling froth, mouth, nostrils
4. Stage of decomposition
14-20 DAYS - blisters all over the body, 5. Entomology of the cadaver – 24 H before eggs are hatched, maggots

maggots 6. Stage of digestion - 3-4 H gastric empty

2-5 MONTHS - skull exposed, orbits empty 6-8 distal ileum, cecum

7. Presence of live flies in the clothing in the drowning victim – less than 24H
IN TROPICAL REGION 8. State of clothings - pajama , night
9. Changes in CSF
12 HOURS Rigor mortis all over, hypostasis, greenish- 10. Blood clots inside the b.v. in 6 –8 H after death.
11. Soft tissues of the body may disappear 1 to 2 years after burial.
discoloration caecum
24 HOURS Rigor mortis absent all over, abdominal Post-mortem conditions simulating disease, poisoning or injury:
distention 1. post mortem hypostasis – contusion, inflammation , poisoning
48 H Ova of flies, trunk bloated, face discolored 2. blisters of the cuticle – scald and burns
72 H Whole body grossly swollen, hairs and nails 3. swelling, detachment or splitting - injury
ONE WEEK Soft viscera putrefied
TWO WEEKS Soft tissues largely gone PRESUMPTION OF DEATH
ONE MONTH Body skeletonized Disputable presumption - not heard in 7 years

Absence of 7 years except succession 10 years 1. Requirement Consent of next of kin Law that gives the consent
Vessel for 4 years 2. Confirmation Clinical findings of research Correlate tissue changes to
criminal act
Armed forces 4 years 3. Emphasis Notation at all abnormal findings Effect of wrongful act
In danger of death 4 years 4. Conclusion Summation of all abnormal findings Specific to the purpose
5. Minor Need not be mentioned Included if useful

1. under 15 y.o. – older survives
2. above 60 y.o.- younger
3. under 15, above 60 - former The following manner of death should be autopsied:
4. over 15 and under 60 y.o. – male, older 1. Death by violence
5. under 15, or over 60 y.o. and the other in between - latter 2. Accidental deaths
3. Suicides
MEDICO-LEGAL INVESTIGATION OF DEATH 4. Sudden death of persons who are in good health
5. Death unattended by physician
Inquest Officer – is an official of the state charged with the 6. D.O.A. with no clinical diagnosis
duty of inquiring into certain matters. 7. Death occurring in an unnatural manner
- in medico-legal examination: manner and
cause of death
Mistakes in autopsy:
1. Error or omission in the collection of evidence for identification
The following officials of the government are 2. Errors or omission in the collection of evidence required fro
authorized to make death investigations: establishing the time of death
1. Provincial and City Prosecutors 3. Errors or omission in the collection of evidence required fro the
2. Judges of the RTC, MTC medico-legal examination.
3. Director of NBI 4. Errors or omission result in the production of undesirable
4. SolGen artifacts or in the destruction of valid evidence.
Stages of MEDICO-LEGAL INVESTIGATION: Negative autopsies
1.Crime Scene Investigation – investigation of place of - if after all efforts including gross and microscopic studies and
commission of the toxicological analysis fail to reveal a cause of death.
2.Autopsy - investigation of the body of Negligent autopsy
the victim No cause of death is found due to imprudence, negligence, lack of skill,
lack of foresight.
1. Crime Scene Investigation
- place where the essential ingredients of the crime took
- Person composed the Search Team:
a) Physician MLI trained a. Natural death – cause by natural disease condition in the body.
b) Photographer
c) Assistant, evidence collector, note taker b. Violent death
1. Accidental death
2. Autopsy 2. Negligent death
- comprehensive study of a dead body, in addition to the 3. Infanticidal death
external examination . Post-mortem examination- 4. Parricidal death
external exam without incision being made. 5. Murder
6. Homicidal death
Purpose of autopsy:
1. Determine cause of death If signs of violence are associated with the natural cause of death:
2. Correlate clinical diagnosis and symptoms
3. Determine effectiveness of treatment The following are deaths due to natural causes:
4. Study the natural course of the disease 1. Affection of the CNS
5. Educate students and physicians a. Cerebral apoplexy – sudden loss of consciousness followed by
paralysis or
MEDICO-LEGAL OR OFFICIAL AUTOPSY: death due to Hemorrhage from thrombosis
1. Determine cause, manner, time of death or
2. Recovering, identifying, preserving evidentiary embolism in the cerebral vessels.
material b. Abscess of the brain
3. Provide interpretation and correlation of facts c. Meningitis of the fulminant type
related to death
4. Provide factual, objective medical report 2. Affection of the circulatory system
5. Separating death due to disease from external a. Occlusion of the coronary vessels :
causes. =most common cause of Sudden death due to natural
Dead body belongs to the state for cases that requires b. Fatty or myocardial degeneration of the heart.
medico-legal autopsy. c. Rupture of the aneurysm of the aorta
d. Valvular heart disease
e. Rupture of the heart imprudence

3. Affections of the Respiratory system 3. Suicidal death , destruction of one’s self

a. Acute edema of the larynx - not punished, unfortunate being.
b. Tumor of the larynx - Art 253 RPC Giving assistance to suicide. Punishable because
c. Diptheria he has no right to destroy or assist in the destruction of life of another.
d. Edema of the lungs
e. Pulmonary embolism 4. Parricidal deaths
f. Lobar pneumonia Art. 246 father, mother, child, (leg/illeg) ascendant, descendant,
g. Pulmonary hemorrhage spouse (leg.)

4. Affections of the GIT 5. Infanticidal deaths – Art. 255 killing of a child less than 3 days
a. Ruptured PUD
b. Acute intestinal obstruction 6. Murder Art. 248
- treachery, consideration, means of inundation, occasion of
5. Affections of the GUT calamities,
a. Acute strangulated hernia - evident pre-meditation, cruelty
b. Ruptured tubal pregnancy
c. Ovarian cyst with twisted pedicle 7. Homicidal deaths Art 249


a. Status thymico-lymphaticus 1. Death caused in a tumultuous affray Art 251.
b. Acute hemorrhagic pancreatitis 2. Deaths or physical injuries inflicted under exceptional
circumstances. Art 247
7. Sudden death in young children
b. Congestions of the lungs a. Death due to syncope – fatal and sudden cessation of the
c. Acute broncho-pneumonia action of the heart.
d. Acute gastroenteritis
e. Convulsion b. Death from asphyxia – a condition in which the supply of
f. Spasm of the larynx oxygen to the blood or to the tissues or to both has been
reduced below normal working level.
Stage of increasing dyspnea 1 min
B. Violent death Stage of Expiratory convulsion
- are due to injuries inflicted in the body by some forms Stage of exhaustion 3 min
of outside force.
The physical injury must be the proximate cause of c. Death from coma
= That the victim at the time the physical injuries were
inflicted was in normal health. SPECIAL DEATHS
= That the death may be expected from the physical
injuries inflicted. 1. Judicial deaths – Art. III Sec.1 Par. 19 Phil. Const.
= That the death ensued within a reasonable time. “cruel and unusual punishment shall not be inflicted. ;
electrocution, hanging, musketry, gas chamber.
2. Euthanasia or mercy killing
Automatism - due to drug may be considered
1. Physical injury – trauma sustained through as accidental rather than suicidal.
the use of physical force.
2. Thermal injury – injury by heat or cold
3. Electrical injury – electrical energy. Evidences that will infer death is suicidal:
4. Atmospheric injury – due to change of
atmospheric pressure. 1. History of depression, mental disease.
5. Chemical injury – chemicals 2. Previous attempt
6. Radiation injury – radiation 3. Injuries are located in areas accessible to hand.
7. Infection – microbic invasion 4. Effects of the act of self-destruction may be found in the victim;,
empty bottle
5. Presence of suicidal note.
PENAL CLASSIFICATION OF VIOLENT DEATHS 6. Secluded, not in public view.
1. Accidental deaths – due to misadventure or accident. 7. Evidences which rule out H,M, P
Art. 12 no. 4 RPC
Any person who while performing a lawful act with due
care, causes an injury by mere accident without fault or 4. Death from starvation :
intention of causing it.
Ex. Patient died of ATS injection after proper skin test. Cause may be due to suicidal, homicidal or accidental.
2. Negligent death – felonies may be committed when the The human body without food losses 1/24th of its weight daily.
wrongful act is due to reckless imprudence, negligence, And 40% loss>death
lack of skill or foresight.
Ex. Surgeon left a pack – Homicide through reckless Factors that influence the length of survival: age, condition of the body,
sex, environment. tissue to lacerate.


Physical injury : is the effect of some of stimulus on the = It is the sum total of all reactions of tissue or organ to trauma, either
body. observed micro or macroscopically.
Stab wound the effect is immediate but a
blunt object is delayed production on the
contusion. a. RUBOR – redness or congestion of the area due to an increase of
blood supply as a part of the reparative mechanism.
Causes of Physical Injuries
b. CALOR – Sensation of heat or increase in temperature.
1. Physical violence
2. Heat or cold c. DOLOR - pain due to involvement of the sensory nerve.
3. Electrical energy
4. Chemical energy d. LOSS OF FUNCTION- due to trauma, the tissue may not
5. Radiation by radioactive substances function.
6. Change of atmospheric pressure
7. Infection The presence of vital reaction differentiates an ante-mortem from a post-
mortem injury.
EXCEPT: vital reactions not seen even if injury inflicted during life:
= The effect of the application of physical injury on 1. During agonal state of a living person were cells don’t
person is the production of wound. react to the trauma.
= A disruption of the anatomic integrity of the tissues 2. Sudden death as in sudden coronary occlusion.
of the body.
= However, not all physical violence will result in the CLASSIFICATION OF WOUNDS:
production of wound.
Physics of wound production: a. Mortal wound – caused immediately after infliction that
MV2 is capable of death.
a. Kinetic energy = __________ Parts of body that are mortal – heart, vessels, CNS,
2 lungs, other organs.

`Velocity component is the important factor: b. Non-mortal wound - Not capable of producing death
M16 rifle with a velocity of 3200 ft/ sec causes after infliction.
damage more than a heavier .38

b. Time a. Blunt instrument – contusion, hematoma, lacerated

= The shorter the period of time needed for wound.
the transfer of energy, the greater the likelihood of
producing damage. b. Sharp instrument
= If a person is hit on the body and the body = Sharp-edge instrument> incised wound
moves towards the direction of the force applied, the injury = Sharp pointed > punctured wound
is less as when the body is stationary. = Sharp edge and sharp-pointed > stab
= The longer the time of contact between the
object or instrument causing the injury, the greater will be c. Wounds brought about by tearing force – lacerated
the dissipation of energy. wound
d. By change in atmospheric pressure – barotraumas.
c. Area of transfer e. Wounds brought about by heat or cold – frostbite,
= The larger the area of contact between the scald, burns.
force applied on the body, the lesser the damage to the
body. f. Wounds brought about by chemical explosion – GSW,
= By applying an equal force, the damage shrapnel wound
caused by stabbing is greater compared to a blunt g. Wounds brought about by infection.
= The less elastic and plastic the tissue > the a) HIT – means of bolo, blunt instrument, axe.
greater that a laceration will result. b) TRUST or STAB – bayonet dagger
c) GUN POWDER EXPLOSION – Projectile or shrapnel
Elasticity : wound.
Ability of the tissue to return to its normal d) SLIDING or RUBBING or ABRASION
sizes and shape after being deformed by a pressure.
= A force transmitted through a tissue a) Superficial – wound involves only the layers of the
containing fluid will force the fluid away from the area of skin.
contact in all directions equally, frequently causing the b) Deep – inner structures beyond the layers of the
skin. a.1 –PETECHIAE – is a circumscribed extravasation of
blood in the subcutaneous tissue
PENETRATING WOUND - Wounding agent did not or underneath the mucous
come out or Piercing a solid membrane.
organ. Example : mosquito bite, blood disease, hanging

PERFORATING WOUND – Wounding agent produces a.2 – CONTUSSION – is the effusion of blood into the
communication between the inner and outer portion of the tissues underneath the skin on
hollow organs. account of the rupture of the
blood vessels as a result of the application
OR piercing or traversing completely a particular part of the of blunt force or violence.
body causing communication between the points of entry = size of contusion greater than the size of
and exit of the instrument or substance producing it. the object.
= Location of the contusion is not always
5. AS REGARDS TO THE RELATION OF THE SITE OF the site of application of the force.
Medico-legal point of view:
A contusion as indicated by its external pattern may
a. Coup Injury – Physical injury which is located at the site correspond to the
of the > shape of the object or weapon used.
application of force. Extent > the possible degree of violence
b. Contre-coup injury – opposite the site of the application applied.
of force. Distribution> indicates the character and manner of
injury as in manual strangulation around the neck.
c. Coup contre-coup injury – site and also opposite of
application of force. Age of Contusion: appreciated from its color change

d. Locus minoris resistencia – Physical injury not located at The size tends to become smaller from the periphery to the
the site nor opposite the site of center and passes through a series of color changes as a result of the
the application of force but in > Disintegration of the RBC and liberation of
some areas offering the least hemoglobin.
resistance to the force applied.
The contusion is red, purple soon after its complete
Example: Blow in fore head > contusion on the development.
region of the eyeball. 4 to 5 days > green
7 to 10 days > yellow and gradually disappears on the
e.Extensive injury – Physical injury involving a greater 14th or 15th day.
area of the body
beyond the site of the application The ultimate disappearance of color varies from 1 to 4 weeks
of force. depending upon the severity and constitution of the body.
Example : Fall or MVA
The color changes starts at the periphery.
Injuries in various parts of the body CONTUSION VS. POST-MORTEM HYPOSTASIS


a) DEFENSE WOUNDS – Instinctive reaction of Below the epidermis in the true skin in small bruises or
self- preservation. > extravasations, below this in larger ones and often much deeper still.
hands/fractures The epidermis has no blood vessels to be ruptured.

b)PATTERNED WOUND – Wound in the nature Post mortem Hypostasis

and shape of the instrument. In the epidermis or in the cutis as a simple stain or a showing
> Wheels,abrasions from through the epidermis of the underlying engorged capillaries.
c)SELF-INFLICTED WOUNDS - Wound produced on Cuticle was probably abraded by the same violence that produced
oneself but no intention to end the bruise. In small punctures such as fleas bites, this is not observed.
his life.
Post-mortem hypostasis
TYPES OF WOUNDS ( MEDICAL CLASSIFICATION) Cuticle unabraded, because the hypostasis is a mere sinking of the
blood, there is no trauma.
1. CLOSED WOUND – no breach of continuity of the skin
or mucous membrane. Contusion
A bruise appears at the seat of and surrounding the injury. This
a. Superficial – When the wound is just underneath may or may not be a dependent part.
the layers of the skin or mucous
membrane. Post-mortem hypostasis
Always in a part which for the time of information is dependent.
Contusion - is the extravasation or effusion of blood in a newly formed cavity
Often elevated because elevated blood and underneath the skin. When the blunt instrument hit a hard part
subsequent inflammation swell the tissues. of the body like a bony part which is superficially located.
- Force causes the subcutaneous tissue to rupture on account of
Post-mortem hypostasis the presence of a hard structure underneath..
Not elevated, because either the blood is still in the
vessels or at most has simply soaked into and stained the

Contusion 1. In contusion- the effused blood are accumulated in the

Incision shows blood outside the vessels. This is the interstices of the tissues underneath the skin
most certain test of difference and can be observed even in In hematoma blood accumulates in a newly formed cavity
very small bruises. underneath the skin.

Post-mortem hypostasis 1. in contusion, theskin shows no elevation and is ever elevated,

Incision shows the blood is still in its vessels and if any the elevation is slight and is on account of inflammatory
oozing occurs drops can be seen issuing from the cut changes
mouths of the vessels. In hematoma – the skin is always eelevated.

Contusion 2. In contusion, puncture or aspiration with syringe of the lesion,

Color variegated. This is only true of bruises that are no blood can be obtained.
the same days old due to the changes in the hemoglobin In hematoma – shows presence of blood and subsequent
produced during life. depression of the elevated lesion.

Post-mortem hypostasis Abscess, gangrene, hypertrophy, fibroid thickening and

Color is uniform. The well known change in color even malignancy are potential complications of
produced in blood Extravasated Into living tissues does not hematoma.
occur in dead tissues with the same regularity.


If the body happens to be constricted at or supported
on a bruised place, the actual surface of contact may be a 1. Sprain - partial or complete disruption in the continuity os a
little lighter than the rest of the bruise but will not be white. muscular or ligamentous support of a joint, due to a blow, kick
or torsion force.
Post-mortem hypostasis 2. Dislocation – displacement of the articular surface of bones
In a place which would otherwise be the seat of entering into the formation of a joint.
hypostasis pressure of any kind even simple support is 3. Fracture – solution of continuity of bone resulting from violence
sufficient to obliterate the lumen of the venules and or some existing pathology.
capillaries and so to prevent their filling with blood.
a. Close or Simple Fx – no break in continuity of the
White lines or patches of pressure bordered by the overlying skin.
dark color of hypostasis are produced and marks of b. Open or Compound Fx – Fx is complicated by an
floggings, strangulation, etc. are thus sometimes simulated. open wound caused by the
broken bone which protruded
with other tissues of the
OF CONTUSSION c. Comminuted Fx – Fractured bone is fragmented into
several pieces.
1. General condition of the patient. d. Greenstick Fx – Fx wherein only one side of the bone
2. Part of the body affected. Fatty tissues, bloody is broken while the other is merely
parts > contused easily bent.
Fibrous areas, muscle > less e. Linear Fx – when the Fx forms a crack usually in flat
3. Amount of force applied –The greater the force, the bones.
more effusion of blood. f. Spiral Fx – break in the bones forms a spiral manner
4. Disease – Contusion may develop with or without as seen in long bones.
application of force. g. Pathologic Fx – Fx caused by weakness of the bone
Example: Aplastic anemia, whooping cough due to disease.
5. Age – Children and old age tend to bruise easily.
6. Sex – women, obese easily develops unlike boxers. 4. Strain – the over-stretching instead of an actual tearing or the
7. Application of heat and cold rupture of a muscle or ligament which may not be associated
with the joint.
The distinction between ante-mortem and post-mortem
contusions in an undecomposed body is that in ; 5. Sublaxation – Incomplete or partial dislocation.

1. Ante-mortem bruising: there is swelling, damage to INTERNAL HEMORRHAGE

epithelium, extravasation, coagulation and - rupture of blood vessels which may cause hemorrhage due to
infiltration of the tissues with blood the following:
2. Post-mortem bruising there are no such findings. a. Traumatic intracranial hemorrhage.
b. Rupture of parenchymatous organs.
c. Laceration of other part of the body. pressure, nature of the rubbing object and the
direction of movement.

5. Abrasion heals in a short time and leaves no scar

unless if not infected or if the whole thickness of the
skin is involved.


SUSPENSION OF ITS FUNCTIONS AS A RESULT OF 1. Linear abrasion – appears as a single line, straight
COMMOTION OF THE CEREBRAL SUBSTANCE. = pinching with fingernails = curve
- is more severe when the moving or mobile head = sliding the point of a needle =
struck a fixed hard object as compared when the head is straight linear ab.
fixed and struck by a hard moving object.
2. Multi-linear – develops when the skin is rubbed on
Signs and Symptoms a hard rough object producing
1. unconsciousness which is more or less complete. several linear marks parallel to one
2. muscles are relax and flaccid. another.
3. eyelids are closed and the conjunctivae are Example: MVA
4. surface of the body is pale, cold and clammy. 3. Confluent – linear marks in the skin are almost
5. respiration is slow and sighing. indistinguishable on account of the
6. pulse is rapid, weak, faltering and scarcely severity of friction and roughness of the
perceptible to the fingers. object.
7. temperature is subnormal.
8. sphincters are relaxed with unconscious 4. Multiple – several abrasions of varying sizes and
evacuation of the bowel and bladder. shapes may be found in different parts
9. reflexes are present but sluggish and in severe of the body.
cases may be absent.
Types of abrasion
Loss of memory for events just before the injury is a 1. Scratch – caused by sharp pointed object which slides across
constant effect of cerebral concussion and is of medico- the skin, like pin, thorn or fingernail.
legal importance. - Injury usually parallel to the direction of slide.
= Fingernail scratch > broad at point of commencement
2. OPEN WOUNDS with tailing at the end.

a. Abrasion ( Scratch, graze, impression mark, 2. Graze – usually caused by forcible contact with rough, hard
friction mark ) objects resulting to irregular removal of the skin
- it is an injury characterized by the removal of the surface.
superficial epithelial layer of the skin caused by a = course indicated by a clean commencement and tags
rub r friction against a hard rough object. on the end.
- Contussion with abrasion = forcible contact before 3. Impact or imprint abrasion ( patterned abrasion, stamping
friction occurs. abrasion, abrasion a la signature)
- the shape varies and the raw surface exudes blood - those whose pattern and location provides objective
and lymph which later dries and forms a protective evidence to show cause, nature of the wounding instrument
covering as SCAB or CRUST. and the manner of assault or death.
= marks of grid of radiator, thread marks of wheel, teeth
Characteristics of abrasion: marks.
1. It develops at the precise point of the 4. Pressure or friction abrasion – caused by pressure
force causing it. accompanied by movement usually observed in hanging
2. Grossly or with the aid of a hand lens or strangulation.
the injury consists of parallel linear = spiral strands of the rope as seen in the skin in
injuries which are in line with the hanging.
direction of rub or friction causing it.
3. It may exhibit the pattern of the
wounding material. Differential diagnosis:
4. Usually ignored by attending physician. 1. Dermal erosion - gradual breakdown or very shallow
Medico-legal viewpoint ulceration of the skin which involves only the
= abrasions caused by fingernails may epidermis and heals without scarring.
indicate struggle or assault
and are usually located in the face, neck, 2. Marks of insects and fishes bites – skin injury is irregular with no vital
forearms and hands. reaction and usually found on angles of the mouth, margins of nose,
= abrasions resulting from friction on rough eyelids and forehead.
surfaces are located in bony
parts and are usually associated with 3. Excoriation of the skin by excreta – found in infants and the skin
contusion or laceration. lesions heals when the cause is removed. No apparent history of rubbing
= nature of the abrasion may infer degree of trauma on the affected area.
4. Pressure sore – usually found at the back at the region Accidental wounds – multiple incised wounds observed on the
of bony prominence. History of longstanding illness, bed passenger and driver of MVA due to broken windshields.
ridden. - kitchen knives in the preparation of food.


COLOR reddish-bronze due to slight yellowish and transparent
exudation of blood
DIRECTION Oblique from below left ear, Usually horizontal below
downwards across front neck the adams apple
LOCATION any area over bony prominence
just above Adams apple
Rough handling of the cadaver
SEVERITY Usually not so deep and Usually deep and may cause
VITAL with intravital reaction shows not vital reaction and
may only involve trachea, involvement of the cartilage
REACTION may show remains of damaged is characterized by a separation
carotid and esophagus and bones.
Epithelium of the epidermis from
Complete loss of the former.
SUPERF’L Usually present before the Practically absent but may
CUT commencement of deeper rarely be present when the
wound. victim struggled when attacked
b. Incised wound ( cut, slash, slice)
– produced by a sharp-edged ( cutting)
POSIT’N OF May be sitting or facing a Usually victim lying on bed
THE BODY mirror or standing or in other place.
– or sharp-linear edge of the instrument like a knife, razor, bolo,
WOUNDING Firmly grasp (cadaveric spasm) Weapon is absent
glass etc.
WEAPON or found lying beside the
= Impact cut > when there is forcible contact of the cutting instrument
with the body surface.
BLOOD Bld found in front part of body Bld found at the back of neck.
= Slice cut > when cutting injury is due to the pressure accompanied
DISTRIBUTION Hand smeared with blood. Hands are clean.
with movement of the instrument
= Chopped or Hacked wound > when the wounding instrument is a
MOTIVE History of mental depression, Absence of such history
heavy cutting instrument like saber
Financial, social problems, alcoholism
> injury is severe

PREVIOUS Hx May be present Always absent

Characteristics of incised wound:
1. Edges are clean cut.
2. The wound is straight
3. Usually the wound is shallow near the extremities 3. STAB WOUNDS – is produced by the penetration of a sharp and a
and deep at the middle portion. sharp edged instrument like a knife, scissors.
4. Profuse hemorrhage because of the clean cut on - if the sharp edge is the one that comes in contact with the skin
the vessels. then it is an incised wound.
5. Gaping is usually present due to the retraction of - If the sharp pointed portion first come in contact, it is a stab
the edges. wound.
6. Clothes will also show a clean cut if cut by the
instrument. = surface length may reflect the width of the wounding
7. Faster healing if without complications. instrument.
8. Incised wound made by broken glasses maybe
irregular, needs to be removed. = smaller when the wound is not so deep.
Changes that occur in an incised wound: = wider if upon withdrawal is not in the same direction as
1. After 12 hours – edges are swollen, adherent with seen in slashing movement. The presence of an abrasion
blood and with leukocyte infiltration. from the extremity of the skin defect is in line with direction of
2. After 24 hours – proliferation of the vascular the slashing movement.
endothelium and connective tissue cells.
3. After 36 to 48 hours –capillary network complete, The extremities of stab wound may show the nature of the instrument
fibroblasts running at right angles to the vessels. used.
4. After 3 to 5 days – vessels show thickening and - a doubled bladed weapon shows both extremities to be sharp.
obliteration. - A single bladed weapon – one of its extremities as rounded and
contused, not seen if instrument is quite thin.
Why a person suffers from incised wound:
1. As a therapeutic procedure. The direction of the surface defect may be useful in the determination of
2. As a consequence of self-defense the possible relative position of the offender and the victim when the
3. Masochist may self-inflict incised wounds for self- wound was inflicted.
4. Addicts and mental patients. As to whether the wound is slit-like or gaping depends on the direction of
the wound to the Langers line.
Suicidal wounds – usually located in peculiar parts of the
body, accessible to the hand. The depth of the wound may be influence by:
- the most common site is the wrist, radial artery 1. size and sharpness of the instrument.
and the neck. 2. area of the body involved
3. the degree of force applied
Homicidal wounds – usually deep, multiple and involves
both accessible and non-accessible parts. Hemorrhage is always the most serious consequence of stab wound
- clothing are usually involved due to the severance of blood vessels or involvement of bloody
- Defense and other forms of wounds are present. organs.
kill the victim:
1. there are more than one stab wounds
2. stab wounds located in different parts of the body
3. stab wounds are deep
4. serrated stab wounds means thrust and withdrawal of the
wounding weapon to increase internal damages.
5. irregular or stellate shape skin defects> due to changing
How to describe stab wound: direction of the weapon with the portion of the instrument at the
level of the skin as the lever.
1. length of the skin defect – edges must be coaptated
Tailing – the direction of withdrawal of the
wounding weapon.
2. condition of the extremities
= sharp extremity > sharpness of the instrument 4. PUNCTURED WOUND - is the result of a thrust of a sharp
used. pointed instrument.
= If Both extremity are sharp > double bladed
weapon is used. = External injury is quite small but the depth is to a certain degree.; ice-
3. condition of the edges. pick, nail
= edges are regular and clean cut> due to one
stabbing act. - Nature of the external injury depends on the sharpness of the end of
= serrated or zigzag in appearance > several the wounding instrument:
stabbing wounds ( series of thrust and withdrawal.) = contusion of the edges> if end is not sharp
4. linear direction of the wound – it may be running = opening may be> round, elliptical, diamond shaped or
vertically, horizontally, or upward medially or cruciate.
5. location of the stab wound – to include exact - External hemorrhage is limited although internal injuries may be
measurement from anatomical landmarks. severe.> blood vessels and bloody organs is fatal if no intervention
6. direction of the penetration – must be tridimentional applied.
7. depth of the penetration
8. tissue and organs involved - Site of external wound can be easily sealed by dried bld, serum, or
clotted bld.
- Punctured wounds are usually accidental

1. The opening of the skin is very small, wound is much
Stab wounds may be: deeper than it is wide.
A.Suicidal 2. External hemorrhage is limited than internally may be
1. Located over vital parts of the body. severe.
2. Usually solitary 3. Sealing of external opening is favorable for the growth
3. Located over covered parts of the body, the and multiplication of anaerobic organism like bacillus
clothing is not involved tetani.
4. Stab wound is accessible to the hand of the
victim Homicidal -
5. Hand of victim is smeared with blood 1. multiple and usually located in different parts of the body.
6. Wounding weapon is firmly grasp by the hand 2. wound are deep
of the victim. 3. there are defense wounds on the victim.
7. If stabbing is accompanied with slashing 4. signs of struggle in the crime scene.
> the wound tailing abrasion is seen towards Suicidal -
the hand inflict the injury. 1. located in areas of the body where the vital organs are
8. Suicide not may be present located.
9. Presence of a motive for self destruction. 2. usually singular, if multiple located in one area.
10. No disturbance in the death scene with 3. parts of body involved is accessible by the hand of the
wounding instrument found near the victim.
victim. 4. clothing usually not involved.
5. wounding is made while the victim is in sitting or standing
B. Homicidal – stabbing with homicidal intent is the position , bleeding is towards the lower part of the body
most common or clothing.
Characteristics:1. Injuries other than stab wound may 6. no disturbance in the crime scene.
be present . 7. wounding instrument found near the body.
2. Stab wound may be located in any
part of the body. Puncturing wound with puncturing instrument loaded with poison:
3. Usually more than one stab wound 1. poison dart – cyanide or nicotine
4. A motive for stabbing, if none then 2. fish spines
the offender either insane/drugs 3. dog bites with hydrophobia virus
5. Disturbance in the crime scene 4. injection of air and poison as a way of euthanasia.

Medical evidence showing the intent of the offender to 5.LACERATED WOUNDS ( TEAR, RUPTURE, STRETCH “PUTOK”)
- is a tear of the skin and the underlying tissues due
Healing is faster healing is delayed
to forcible contact with a blunt instrument.
- May be produced by a hit with a piece of wood, Caused by sharp edged instrument caused by a blunt instrument
iron bar, fist, stone, butt.
- If the force is applied to a tissue is greater than its
cohesive force and elasticity> the tissue tears and

Characteristic: 1. contusion – blunt

1. shape and size of the injury does not 2. incised wound – sharp-edged instrument
correspond to the wounding instrument 3. lacerated wounds- blunt
2. tear on the skin is rugged with extremities 4. punctured wounds – sharp pointed
irregular, ill-defined. 5. abrasion – body surface is rubbed on a hard surface
3. injury developed where the blunt force is 6. GSW – the diameter of the wound of entrance may approximate
applied. the caliber of the wounding instrument.
4. borders of the wound are contused and
swollen. Could the injury have been inflicted by a special weapon?
5. developed in areas where the bone is A physician cant determine that a specific weapon was used in
superficially scalp. inflicting a wound.
6. examination with the aid of hand lens It is possible that it is caused by a certain instrument presented.
shows bridging tissue joining the edges He must be cautious in giving categoric statements
and hairs bulbs are intact.
7. bleeding is not extensive due to blood Which of the injuries sustained by the victim caused death?
vessels are not severed evenly. If with conspiracy – no need coz the act of one is the act of all.
8. healing process is delayed and has a If none- offenders are only responsible for their individual acts.
tendency to develop a scar.
If multiple injuries: which of the wound injured a vital organ.
Or if same organ which caused the degree of damage.
Classification of lacerated wounds:
1. Splitting caused by crushing of the skin between
two hard objects. Death or physical injuries brought about by powdered propelled
Ex: laceration of scalp hit by a bunt instrument, cut substances:
eyebrow of a boxer. 1. Firearm shot
= the injury is caused by the missile propelled by the
2. Overstretching of the skin explosion of the gunpowder located in the cartridge shell and the
- When pressure is applied on one side of the rear of the missile.
bone> the skin over the area will be stretched up
to a breaking point to cause laceration and 2.detonation of high explosives - grenades
exposure of the fractured bone. = explosion inside the metallic container will cause
- In avulsion: the edges of the remaining tissue is fragmentation of the container.
that of laceration.
3. Grinding compression
- the weight and the grinding movement may cause = Firearm : is an instrument used for the propulsion of a projectile by
separation of the skin with the underlying tissues. the expansive force of gasses coming from the burning of gunpowder.
(technical definition)
4. Tearing
- this may be produced by a semi-sharped edged = includes rifles, muskets, shotguns, revolvers, pistols, other deadly
instrument which causes irregular edges on the weapons which a bullet, ball, shell or other missile may be discharged by
wound like hatchet and choppers. means of gunpowder or other explosives.

Lacerated wounds are rarely suicidal. = includes air rifle except of small calibers and limited range.

= the barrel of any firearm shall be considered as a complete firearm

for all purposes thereof.


Edges are clean cut, regular, well defined edges are roughly cut,
irregular, ill-defined

No contusion or swelling around the swelling and contusion around

Incised wounds lacerated wounds

Extremities of the wound are sharp, may be extremities are ill-defined and
Round, or contused

Examination by means of a hand lens hair bulbs are preserved

Shows that hair bulbs are cut