Contents
Identification
5
X-ray
15
wounds
21
asphyxia
25
firearm injuries
27
head injuries
31
abortion
47
ballistics
49
Hairs and Fibers
63
Tests for blood
65
tests for semen
67
general toxicology
69
Antidotes
73
house hold poisons
77
Reinsch test
81
Toxic seeds
85
5
Identification 1- Left humerus aged below 14 years (if male) due to: -Trochlea and capitalum are not united (unites at 14 years in males).
2- Left humerus aged more than 20 years (if male) due to: -The head is united with the shaft (epiphysis unites at 20 years in males)
3- (A): Right ulna aged less than 16 years (if male) due to -The upper end of ulna is not united with the shaft (epiphysis unites at 16 years in males). 3- (B): Left radius aged less than 17 years (if male) due to: -The head of radius is not united with the shaft (epiphysis unites at 17 years in males).
14
15
X-Ray 1- X ray, antero-posterior view of shoulder joint. The age is more than 20 years (if male) due to: The epiphysis of head of humerus is united with the shaft (unites at 20 years in males).
2- X ray, antero-posterior and lateral views of elbow joint. The age is less than 14 years (if male) due to: -The epiphysis between trochlea and capitulum is not united (unites at 14years in males).
Wounds 3- Stab penetrating wound of the heart & overlying skin Specimen: Opened heart and overlying skin Lesions: Stab penetrating wound in the heart & overlying skin with 2 acute angles
Causative instrument: Sharp pointed bi-bladed instrument “elliptical wound�
Possible cause of death: May be shock, hemorrhage or cardiac tamponade
4- Stab penetrating wound of the left ventricle of the heart & overlying chest wall Specimen: Heart & overlying chest wall Lesions: Stab penetrating wound in the left ventricle & overlying chest wall, regular edges and acute angles. Causative instrument: Sharp pointed instrument Possible cause of death: May be shock, hemorrhage or cardiac tamponade
22
25
Asphyxia 1- A piece of skin of the neck with a ligature mark (most probably of hanging). Specimen: A piece of the skin of the neck. Lesions: A ligature mark high up in the neck (notice hair line), and it is incomplete. -The mark is in the form of a depression with abrasions and contusions at the edges. Mechanism of death: Cerebral anoxia, congestion, asphyxia or reflex vagal inhibition.
26
Firearm Injuries
27
1- A piece of anterior chest wall showing two firearm inlets. Specimen: A piece of the skin of the anterior chest wall
Lesions:
- Two injuries with loss of substance (firearm injury) - One is circular (Perpendicular firing) & the other is oval or slit like (oblique firing) Causative instrument: Rifled weapon
Possible cause of death:
may be shock, hemorrahage or injury to vital organs
2- Inlet &exit of firearm wound in the heart. Specimen: Heart
Lesions: - 2 injuries with loss of substance (firearm injury) - 1st one in the right ventricle with regular inverted edges (Inlet) - the other one is in the left ventricle which is rounded with irregular everted edges (exit) Causative instrument: Rifled weapon
Possible cause of death:
may be shock or hemorrahage
30
31
HEAD INJURIES
1-A transverse section in the brain and skull showing localized depressed comminuted fracture with nibbling and subdural hematoma. Specimen: A transverse section in the brain and skull. Lesion: 1-Localized depressed comminuted fracture in the right parieto- occipital bone with nibbling. 2-A big hematoma under dura matter (subdural hemorrhage) is present in left parieto-temporal bone. Causative instrument: Heavy blunt instrument with localized striking surface area and high momentum. Possible cause of death: May be brain compression.
Abortion 1-The specimen is a fetus aged more than 4 months and less than 5 months gestatioan. Aged more than 4 months gestation due to: • Fetal length is 16 cm. • Sex is differentiated.
Aged less than 5 months gestation due to:
• No ossified center in calcaneum (appears at 5th month).
2-The specimen is a fetus aged more than 7 months and less than 8 months gestation. Aged more than 7 months gestation due to:
• It is about 35 cm in length • Skin is still wrinkled. • Ossific centers appear in calcaneum (at 5th month gestation) and in talus (at 7th month gestation).
Aged less than 8 months gestation due to:
• No ossific center in the lower epiphysis of femur.
46
49
Ballistics 1- the specimen is a Complete, non fired cartridge of sporting gun (non-rifled weapon) - It’s a complete, non fired cartridge (No DIMPLE on the Percussion cap) - It’s long, made of plastic with brass base - Inside the Cartridge there is Inner wad, outer wad and small rounded shots in between. - Powder: is Smookless or Black
2- the specimen is an empty, fired cartridge of sporting gun (non-rifled weapon) It is an empty cartridge and fired (dimple in the percussion cap). It is long, made of plastic with brass base. The complete cartridge contains internal wad, external wad and small rounded shots in between. Powder: is smookless or black
Hairs & Fibers 1- Silk fiber Description: -Translucent cylinders. -Clear margin. -Refracting light. -No Surface markings. -No twists, No swellings. DD: From hair and other types of fibers
2- Linen fiber Description: -Bamboo Like. -Segmented (may be swollen at Joints of segments with projections). DD: From hair and other types of fibers.
62
Tests for blood
65
Screening (Macrochemical tests) 1- PHENOL – PHTHALEIN test Principle: It depends on the presence of peroxidase enzyme. Result: Pink color. Value: The stain may be blood (It is a preliminary test).
2- guaiacum test: Principle: It depends on the presence of peroxidase enzyme. Result; Greenish-blue color. Value: The stain may be blood (It is a preliminary test).
Tests for blood Confirmatory (Microchemical tests) 1-Teichmann test Principle: It depends on the formation of special crystals of hemoglobin derivatives after addition of specific chemicals to the blood (Haemin crystals). Result: Small brown regular crystals with rhombic termination of acid hematin. Value: The stain is blood (It is confirmatory test).
2-Takayama test Principle: It depends on the formation of special crystals of hemoglobin derivatives after addition of specific chemicals to the blood (Hemochromogen crystals). Result: Needle salmon pink, feathery shaped crystals of alkaline hematin arranged in clusters or rosettes. Value: The stain is blood (It is confirmatory test).
66
Tests for semen
67
1- Florence test Principle: The test is based on the formation of brown rhombic crystals of choline periodide Result: Dark brown rhombic crystals of choline periodide arranged in clusters or crossed, (Larger than haemin crystals, disappear after 1/2 hour). Value: The stain may be semen.
2- Barberios test Principle: The test is based on the formation of yellowish green needle crystals of spermine picrate arranged in feathery appearance. Result: Yellowish green needle crystals of spermine picrate arranged in feathery appearance. Value: The stain may be semen.
General Toxicology 2- Activated charcoal Dose: Activated charcoal to poison ratio of 10:1 or 1 gm/kg is mixed with 60 to 90 ml of water.
Contraindications of activated charcoal:
-Corrosives -Hydrocarbons -Intestinal obstruction, perforation or ileus.
3- Oropharyngeal airway device Placed in the mouth to lift the tongue and push it forward in comatosed patient or patient with depressed gag reflex.
70
ANTIDOTES
73
1- Diagnosis: Deferoxamine - Target Poison: Iron - Mechanism: It combines with iron forming deferoxamine-iron complex which is excreted via kidney.
- Dose: 10-15 mg/k/hr up to 6 gm I.V. for serious toxicity. - Route of administration: I.V.
2- Diagnosis: Naloxone - Target Poison: Opiate and Opioid toxicities. - Mechanism: It competes & displaces drugs from Mu, Kappa & Delta opioid receptors. - Dose: 0.4 - 2 mg repeated every 2 minutes up to 20 mg. - Route of Administration: I.V.
House-Hold Poisons 3- Caustic potash Mechanism of action: Tissue injury by liquefactive necrosis. Fat & proteins are saponified resulting in deep tissue destruction; further injury is caused by thrombosis of blood vessels. Specific antidote: No specific antidote
4- Naphthalene Mechanism of action: It’s an oxidative agent causing denaturation of haemoglobin so haemoglobin precipitates inside RBCs leading to haemolysis of RBCs specially in patients with G6PD enzyme deficiency Specific antidote: No specific antidote
78
81
REINSCH TEST 1-Diagnosis: Container contains cupper foils with grey to black deposit indicating that it is arsenic or bismuth (+ve reinsch test). It must be followed by sublimation stage to differentiate both Principle: Some metals precipitate on cupper foils giving certain colors. Value +ve for soluble inorganic metals and negative for insoluble organic metals.
2-Diagnosis: Container contains Cupper foils with mirror-like deposit indicating that it is either mercury or silver (+ve reinsch test). It must be followed by sublimation stage to differentiate both Principle: Some metals precipitate on cupper foils giving certain colors. Value :+ve for soluble inorganic metals and negative for insoluble organic metals.
84
TOXIC SEEDS
85 1- Diagnosis : Nutmeg Seed 2- Description:
About 3-4 cm in length. More or Less like a date. Slightly furrowed surface. Used as a flavouring agen. In medicine: used as gastric stimulant and abortificient.
3- Active principle: Myristicin ( hepatoxic ) 4- Antidote: No specific antidote. 1- Diagnosis : Strychnus nux vomica seed. 2- Description: A hard, rounded, button shaped seed with a compressed concavo-convex center and raised edges. It has central hilum at the middle of the seed. Ash grey in colour, velvet surface. It has intense bitter taste & no odour.
3- Active principle: Strychnus, brucine (alkaloids) and Loganin (glucoside). 4- Antidote: Diazepam.
TOXIC SEEDS
89 1- Diagnosis: Datura stramonium seed. 2- Description:
3-4mm in length. Kideny shaped. Finely mammillated. Black in colour.
3- Active principle: Atropine, Hyocine & Hyoscyamine. 4- Antidote: Physostigmine. 5- D.D: Onion seeds.
Black pepper seeds.
1- Diagnosis: Onion Seed 2- Description:
1-2 mm in length. Irregular shape with elevated protrusions (edible). Black in colour.
3- Antidote: No specific antidote. 4- D.D: Datura stramonium seed.
Black pepper seeds.