Forensic Medicine- Introduction, Injuries, evaluation of injuries, abrasions, incised wounds, laceration, antemortem and post mortem injuries.

3.  deceased is the most valuable piece
of potential evidence at any death
scene.
 systematic and thorough examination
of the deceased
 death-scene investigator should
document in writing, by sketch, and
by photography all information about
the body that can be gathered at the
scene.
 focus on the physical condition of a
body at a scene

4.  initially notified, should determine as much information as possible
from the caller
 ascertain if there is any evidence of foul play
 if any instruments are available that might have played a role in the
subject's death
 Helps to anticipate additional information that may be needed upon
arrival at a scene

5.  Ensure scene is safe and secure
 not contaminate or disturb the scene
 should wear disposable examination gloves and it is also advisable to
wear shoe covers and hair nets
 full body covering is desirable
 not to sit on furniture or lean against or brush against walls or
furniture.

6.  is trace evidence at the scene consistent with the death having
occurred at this location?
 Does the body contain any trace evidence that is unusual for this
location, for example, mud on soles of shoes, grass, or seed material
embedded in or found on the clothing when the deceased was located
inside a building?
 Is the death one that can be attributed to natural causes?
 Are there any external signs of violence?
 Is there anything amiss or out of the ordinary regarding the scene?

7.  photographically and diagrammatically
 note taking, videography, photography, and sketching
 none is an adequate substitute for another

8.  Notification information.
 Arrival information.
 Scene description.
 Crime scene team.

9.  to provide a true and accurate
pictorial record of the death scene
and physical evidence present
 permanent record for legal
concerns.
 done immediately following the
videography
 Treat the body with respect.
 should follow the scene survey
 remain objective in recording the
death scene
 allows clear perception

10.  the assignment of units of measurement
 correct perspective to the overall scene
 relevant physical evidence identified within the scene
 The deceased's location relative to other objects and structures within
the scene
 The position of the deceased is plotted
 Accurate measurements should be noted

11.  gather information that relates to cause and manner of death
 an investigational guide for each specific type of death can be very
useful
 searched for a medical history in nearly all death investigations.
 Only interviewing witnesses and searching the scene will reveal this
information

13.  medical expert has jurisdiction over the body
 is invited to the scene as a guest
 whose function is to collect trace evidence?
 restrict his or her physical contact to the body and items immediately
touching the body
 Where no such backup is available, the forensic medicine expert must
try to collect trace evidence himself, but he should remain within the
limits of his own expertise

14.  any items that are in danger of being removed or destroyed by wind, rain,
vehicles, animals, tides, and the movement of individuals at the scene
 the collection of any evidence which will enable access to the deceased or
any critical area of the death scene, such as along entry and exit paths
 those critical areas of the crime scene which may render the most evidence,
or once processed, enable the removal of a body, or the remainder of the
examination to be carried out
 areas which may give a quick indication as to the identity of any suspect(s)
 areas which when processed will permit the release of scene guards and
other resources
 the general examination of the remainder of the death scene for potential
evidence.

15.  Blood - Dried particles should be scraped into a dry container. Some dried areas
may be sampled with a wet swab. A specimen should be dried before sealing it in a
container. Articles of clothing or other objects containing blood may be submitted
to a laboratory for sample removal by a technician.
 Semen - An article of clothing containing semen should be collected or the
specimen on the clothing can be lifted with water or saline.
 Fingerprints - Soft objects that leave an impression may be collected in their
entirety. Prints on hard objects like glass or furniture should be lifted at the scene.
 Firearms and other weapons - These should be submitted to a lab without special
treatment at a scene. A technician must ensure proper handling so that
fingerprints are not smudged or ruined.
 Bullets and cartridges - These should not be grasped with metal forceps because
points of comparison may be damaged.

16.  Hairs and fibers - These should be placed in separate containers and should not be
crushed with hard objects such as metal tweezers.
 Suspicious foods and pills - Each item should be placed in separate containers or
bags to prevent contamination.
 Footprints and tire marks - At the scene, casts should be made and close-up
photographs should be taken.
 Tool marks - There should be close-up photographs of the marks made by tools
and, if possible, the damaged material should be removed for analysis by a lab
technician.
 Blood spatters - These should be photographed and described for analysis as to
distance and angle of spatter. Samples may be removed for testing and
preservation.
 Other - Glass, soil, documents, cigarette butts, tobacco, and all items thought to be
involved in arson should be collected and submitted to a lab.

17.  Each item submitted to a lab should be referenced by either a
photograph or written description as to its location in the scene.
 All containers with items submitted to the lab must be labeled on the
lid and side of the container, with a case number, date, time, type of
specimen, and name of the person who collected the specimen.
 A "chain of custody" begins at this point and continues until a
disposition of the specimen is completed.

18.  Any weapon or other item possibly related to the death and found at a
scene should be brought to the morgue for analysis by a forensic
medicine expert.
 All medication and alcoholic beverage containers should be
confiscated as these will be invaluable to the toxicologists. Note the
location where each item was found.
 Studies have shown that a fatal intoxicant is likely to be found in the
same location as a decedent.
 Any drugs, notes, or any unusual item that might have been used by
the subject should be confiscated.

20.  under Section 44 of IPC, denotes any harm whatever illegally caused to
any person, on body, mind, reputation or property. It will include any
tortuous act also.
 The characters of an injury caused by some mechanical force are
dependent upon:
 The nature and shape of the weapon.
 The amount of energy in the weapon or instrument when it strikes the body.
 Whether inflicted on a moving or a fixed body.
 The nature of the tissues involved.
 The area over which the force acts.

21.  the injuries involving superficial layer of the skin (the epidermis or
mucous membrane) due to impact against some hard, blunt and rough
object/weapon.
 abrasions do not ordinarily bleed
 abrasions may penetrate the full thickness of skin
 large areas of abrasions may bleed

22.  Scratches or Linear Abrasions
 horizontal or tangential friction by the pointed end of some object like thorn,
nail, needle or tip of any weapon
 Grazes (Sliding/Tangential/Brush Abrasions)
 caused due to horizontal or tangential friction between the broader area of the
skin and the object/weapon or hard rough surface of the ground
 The epidermis will get heaped up at the opposite end
 the pattern of heaping will indicate the direction of movement of the
object/weapon against the skin
 most commonly encountered in traffic accidents

23.  Pressure Abrasions (Crushing Abrasions/ Imprint Abrasions)
 impact is vertical to the skin surface
 the epidermis gets crushed and pressure type of abrasions result
 the imprint of the impacting object may be produced
 manual strangulation, hanging
 Patterned Abrasions
 force is applied at or around right angle to the surface of the skin
 weapon with patterned surface strikes the body
 body falls upon a patterned rough hard surface

24.  Atypical Abrasions
 short straight or curved marks depending upon the circumstances
 pattern may often be fragmentary

25.  usually heal rapidly without any scar formation
Fresh The area will appear reddish due to oozing out of serum and little blood. The dermis will
be congested and painful.
12–24 hours: The exudation dries up to form a reddish scab, comprising dried blood, lymph and
injured epithelial cells.
depigmented area underneath. The depigmented area gets gradually pigmented in due
course of time.
2–3 days: The scab is reddish-brown, less tender and adhering over the abraded area.
4–5 days: The scab is dark brown in appearance.
5–7 days: Scab is brownish black in appearance and starts falling off from the margins.
7–10 days: The scab shrinks and falls off, leaving some

26.  In the living
 detection of abrasions does not pose much problem
 victim is aware of their situation since these are painful and moist.
 In the dead
 circulation of blood has ceased
 no exudation of serum
 the surface gets dried up and becomes hard acquiring the consistency of
parchment and also appears brownish.

27.  Postmortem abrasions may be caused during transportation of the
dead body.
 These abrasions may also leave hard yellow areas that can be
differentiated if examined with care.
 Abrasions sustained at or about the time of death cannot be
distinguished with certainty.
 Any associated bruising or vital reaction can be shown either by naked
eye or by microscopy, then differentiation can be established.
 The presence of fair amount of bleeding, of course, favours
antemortem production.

28.  infiltration of extravasated blood into the subcutaneous and/or
subepithelial tissues resulting from rupture of small blood vessels due
to application of blunt force.
 the integrity of the skin or of the architecture of the organ is not
disturbed
 abraded contusion’- overlying epidermis may be abraded
 superficial contusion - ‘bruise’
 bluish-purple discolouration and, in some instances, swelling of the
involved area

29.  https://www.youtube.com/watch?v=cLEdznnTT8s
 https://www.youtube.com/watch?v=X31bHKS0mM0

30.  AMOUNT OF FORCE
 the greater the force of violence, the more extensive will be the bruise
 tissue involved is loose - relatively large bruise
 If the tissues are strongly supported containing firm fibrous tissues -
comparatively small bruise
 PECULIARITIES OF THE VICTIM
 Children bruise more rapidly
 Old persons too bruise easily
 Boxers and athletes show comparatively less bruising

31.  DEEP/DELAYED/MIGRATORY BRUISES
 others may lie deeper
 may not appear against the actual point of impact
 Example : black eye
 PATTERNED BRUISING
 ‘tramline’ or ‘railway line’ bruise.
 the tissue on each side of this impact gets stretched.

32.  When fresh, a bruise is reddish in appearance.
 Within a few hours, it becomes bluish and changes to bluish-purple by the
second day, bluish-black by the third day and continues as such till the
fourth day.
 By the fourth/fifth day, it appears brownish due to presence of
haemosiderin, an iron-containing pigment.
 By the fifth/seventh day, it is greenish due to presence of haematoidin.
 By the seventh/tenth day, the bruise assumes yellow colour due to presence
of bilirubin.
 The yellow colour slowly fades in tint, and the normal colour of the skin is
restored by about 2 weeks.

33.  anterior abdominal wall- though internally rupture of viscera may be
noticed.
 Weapon is flat surface type such as sand bag
 sole of foot and palm of hand
 body surface to be hit is covered with thick rug, blanket, quilt, etc.

34.  Coagulation of the effused blood into the subcutaneous tissues along
with infiltration of blood in the tissues is no longer to be seen in
postmortem bruises
 Sir Robert Christison proved by experiments that it was possible to
produce a bruise within about 2 to 3¼ hours after death which,
 great violence would have to be applied and even then the resulting
bruise might be smaller than what would have been produced
 there would be no internal pressure in the small vessels and bleeding
would be a passive ooze rather than active extravasation

35.  is an evidence of application of blunt force
 importance of bruising lies in the site and the organ involved
 Patterned bruising, as stressed already, may be quite helpful in
providing clue towards the nature of the agent used in the assault
 Healing of a bruise imparts some help in the broad determination of
age.
 Bruising and abrasions of the shoulder blades indicate firm pressure
on the body against the ground or other resisting surface.
 bruising of some particular parts of the body may be indicative of
some peculiar offences

36.  rupture or tear or a split in the skin, mucous membrane, muscle or any
internal organ, involving depth more than the covering epithelium of
the skin or that of an organ that is produced by application of blunt
force
 Passive agents like ground (lacerations due to falls are most frequent),
 Vehicles—it may be of any kind, and it is difficult to name them all in
the present scenario.
 Blunt weapons—it may be any mechanical object/instrument or a part
of the body being used as a weapon

37.  Split Laceration
 soft tissues are ‘sandwiched’ between a hard unyielding deeper structure and
the agent applying the force.
 Stretch Lacerations
 heavy forceful frictional impact by a blunt force exercising localised ‘pressure
with pull’
 Avulsion
 grinding compression
 Tears
 Tearing of the skin and subcutaneous tissue can occur from localised impact by
or against some hard, irregular object like motorcar door handle

38.  The margins are ragged, irregular and uneven and may show tearing of the
 There is usually associated abrasion or bruising.
 The edges of laceration may give an indication of direction, in which the
blow or force was applied.
 Depth of the wound presents bridges of irregularly torn fibrous tissue, blood
vessels and nerves, etc. across the interior of the wound.
 Soiling of the wound by mud, sand, glass, brick particles, vegetation,
machine oils, hair, fibres, etc.
 Lacerations over the hairy areas will show hair bulbs crushed or torn and
the crushed hair bulbs may get thrust into the depth of the wound.

39.  presence or absence of vital reaction
 the extent of bleeding
 bruising of the margins
 Eversion and gaping of the margins is usually seen when it has been
inflicted during life
 Bodies recovered from water may pose even greater difficulties
 Perimortem period, i.e. immediately before or after death, the
distinction may be impossible as no vital reaction is likely to be found.

40.  the absence of external trauma does not preclude the presence of
grave internal injuries
 in blunt force impacts- concealed’ fatal trauma
 Sudden disturbance in the functions of the heart may be the cause.
 Scalp lacerations may classically be confused with incised wounds

41.  On the night of 31st July, 1998, some altercation took place between
two tenants over sharing of the common roof for sleeping. One was at
the ground floor and the other at the first floor. Due to hot-humid
atmosphere, both the tenants desired to use the common roof for
sleeping. Hot exchanges supervened but they were soon brought to
rest by the intervention of the neighbours. On the next day, the tenant
of the first floor along with his brother and others beat up the tenant
of the ground floor. As alleged, one inflicted a lathi blow on the chest,
another dashed his head against the chest and some conveyed blows.
The police, on receiving information, reached the scene and
transported the victim (about 20 years of age) to a hospital where he
was declared ‘brought dead’.

42.  Postmortem examination showed presence of a 10 × 3 cm2 reddish
contusion on the front of chest running from a point 3 cm below the
angle of the sternum, going obliquely downwards and to the right,
ending at a point 6 cm medial to the right nipple. Heart showed
rupture (1.0 × 0.75 cm 2) on the anterior surface, 2 cm above and to
the right of the apex, with consequent accumulation of blood in the
pericardial and pleural cavity. On 28th October, 1998, a query from the
police appeared—whether the injury to the heart as mentioned in the
postmortem report was caused by hitting the head or striking a lathi
blow upon the chest?

43.  In this context, it has repeatedly been emphasised that organs may suffer
extensive damage beneath intact surface. Because of their thinner walls, wounds
of the auricles are more dangerous than those of the ventricles; due to the same
reason, right ventricular injuries are more dangerous than those of the left
ventricle. In fact, most common form of ‘concealed’ fatal trauma is usually
encountered in blunt force impacts. Traumatic rupture of heart, though it usually
involves the right ventricle as it exposes its widest area on the front of the chest,
can cause injury to the left ventricle too. Death is usually immediate, but may be
delayed for hours or even days in cases where original rupture being small and
sealed by blood clot in the state of shock but rent getting increased with the
return of blood pressure or with its rise or the other situation may be where the
rupture incompletely involves the wall and the rent getting enhanced by increase
of blood pressure on exertion. Heart can get ruptured even in the intact
pericardium; if the pericardium is also involved, heart may herniate through the
tear and get self-strangulated.

44.  An incised wound is a clean cut through tissues by an object, with
sharp cutting edge
 Shape: Spindle-shaped due to gaping by skin elasticity, zigzag where
skin is lax, e.g. Axilla
 Edges: Clean, well defined and everted
 Bleeding: Minimum if smaller vessels are cut, more if bigger vessels
 are cut
 Length: It is greater than width/depth
 Width: It is greater than edge of weapon

46.  tailing of the wound.
 deeper at point of commencement and shallower at termination.
 The deeper end- head of the wound
 shallower end- tail of the wound

47.  The wound may have to be distinguished from an incised like
laceration (tissue tags/bridges are not seen in incised wound)
 The wound could give clues regarding the motive by noting the
following.
 Hesitation cuts/tentative cuts -suggestive of suicidal motive, seen in the vital
parts of the body such as neck
 Defense cuts are incised wounds suggestive of homicidal motive or assault with
sharp weapon, seen on a victim’s forearms and hands
 could also give clues on weapon causing the wound, time since injury, site of
impact and direction of force.

49.  Stab wounds are wounds produced by sharp pointed objects
penetrating the skin and underlying structures

50.  Site: Anywhere, especially chest/abdomen.
 Size: Depends on size of the weapon used.
 Shape: Usually corresponds to the type of weapon used
 single edged knife – it will be wedge/triangular shape,
 blunt edge of the knife corresponds to base of the triangle
 Length: Usually equal to the breadth of the weapon
 Breadth: More than thickness of the blade—gaping
 Depth: Is either equal to or a little less than the length of the weapon
used for stabbing it
 could be more in yielding areas like abdomen.

51.  Punctured wound
 weapon just enters into the part of the body without entering into any of the
body cavity
 Penetrating wound
 the weapon just enters into the body cavity producing only one wound
 Perforating wound - (through and through punctured wound)
 the weapon after entering into one side of the body will come out through the
other side, producing two wounds
 Wound of entry –It is larger
 Wound of exit –It is usually smaller

54.  injury produced by a blow with the sharp cutting edge of a fairly heavy
weapon like an axe.

57. • The word Exhumation comes from Latin words ex
meaning "out of", and humus, meaning "ground".
Thus the word literally means "out of ground".
• Exhumation means the lawful disinterment or
digging out a body from a grave, which has
already been buried.
• (176 of Criminal Procedure Code (Cr.P.C.)

59.  Exhumation must be differentiated clearly from the
retrieval of a body clandenstinely buried body by the
criminals. In the latter case, the body was never legally
buried (or inhumed) in the first place.
 Retrieval of such a body is NOT exhumation

60.  For the purposes of
identification .
 To determine the cause of
death especially when foul
play is suspected for e.g.
homicide, disputed case of death
or poisoning.
 Re- Autopsy in the case
of foul play.

61. District Magistrate /Sub-
Divisional Magistrate
/Executive Magistrate are
empowered to order for
the exhumation.
Carried out during early
morning hours.
In India ,no time limit is
fixed.
Body is exhumed under the supervision of a
magistrate in the presence of a doctor. The presence
of a police officer is required for providing witness to the
identify the grave, the coffin and the dead body as well as
maintaining law and order.

62. • Autopsy may have to be done at the spot for which a
tarpaulin screen may be erected around the grave or
the body/skeleton may be shifted to a close-by
mortuary.
• It is advisable to be conversant with the nature of the
geological layout of the cemetery and direction of
any water drainage. If the grave is water-logged,
samples of water should be collected.

63. The identified grave should then be dug
carefully to avoid damage to the coffin and its
contents. Notes should be made about the
condition of the soil, water content and nature of
vegetation.
In suspected case of mineral poisoning about
500 gram of sample of earth in actual contact
with coffin should be collected preserved in a dry
clean glass bottle for chemical analysis.
Control samples at some distance from the
coffin should be taken.

64. If interment has been recent then post mortem is
carried in usual manner
After the dirt has been removed from above and
around the corpse, it needs to be photographed. A
drawing of the grave and body or skeleton should
be made noting all the details.
In case of bodies which has been underground
for a sufficiently long time undergone
putrefaction, an attempt should be made to
determine
- sex
- stature
- marks of identification

65. Disinfectants should not be sprinkled on the body. If
decomposition is not advanced, a plank or a plastic
sheet should be made to spread under the body and
the body be gently shifted onto plank or sheet and
then removed from the grave.

66. If skeletonisation is advanced,
then it may become necessary to
dig down beside and beneath the
body and the skeleton (including
some soil from beneath and
sides) be lifted on some plank or
sheet and transported to a
mortuary.

67.  The soil must be carefully screened for smaller objects like
teeth, bullet(s), hyoid bone, thyroid cartilage, etc. If
necessary, X-ray examination of the body with
surroundings should be undertaken before transporting
the body and the materials surrounding it.
 Eight jars with soil from top, bottom, front, back, left and
right side of the casket. Two jars contain soil from about
25 yards away from the grave

68. Hairs found on body should be preserved in a dry
clean glass bottle for subsequent identification or
chemical analysis.
A search should also be made for recent or old
injuries and fractures.
All the cavities should be examined as many viscera as
can be obtained , should try to be preserved.
In case of suspected mineral poisoning such as
arsenic antimony hairs, nails long bone should be
preserved.
Sample then forwarded duly labeled sealed
to the forensic science laboratory

69.  https://www.youtube.com/watch?v=48xEfjt7fl4

71.  Complete hanging—both feet are not touching the ground
 Partial hanging—both feet or any other parts of the body are touching
the ground. Thus, it may be also induced in sitting, stooping, kneeling,
lying prone or supine positions
 Typical hanging—knot of ligature is on the backside of theneck
 Atypical hanging—knot of the ligature is anywhere other than on the
backside of the neck Occasionally, it may be under the chin

73.  Distribution of the mark-
 non-continuous
 placed high up in the neck, above the level of thyroid cartilage
 runs obliquely, backwards and upwards towards the point of suspension
 may also be non-continuous at the site of knot due to some gap
 Skin at the site
 depressed, pale, dry, and hard
 may be with small abrasions at its edges- rope burns and they are due to
frictional force.

74.  The pattern of the ligature:
 Pressure abrasion
 ligature material used is tough and narrow then the ligature mark is deep and
prominent.
 Postmortem staining:
upper margin of the ligature mark has a line of postmortem staining
 Double ligature mark
 2 folds
 fastened at times at a lower level of the neck may move upwards

75.  Period of suspension
 Degree of suspension
 Weight of the body hanged
 Tightness of the ligature
 Any intervening material

76.  right handed suicide victims, knot is usually seen on the right side of
the neck
 slip knot or granny knot

77.  Rarely, scratch marks may be seen on the neck above or below the
ligature mark of hanging
 where the victim tried to undo the noose.
 These are often referred to as ‘periligature marks/injuries’ and are
always antemortem in nature.

78.  Hands
 are usually clenched
 May have presence of fibres of the ligature material
 bluish discolouration of fingertips and nail beds due to cyanosis
 Postmortem hypostasis
 peculiar distribution of the postmortem staining
 speaks of the fact that body was in a state of suspension in an upright position
for a considerable period after death

79.  Involuntary voiding of urine and /fecal matter
 Stains of which may be seen on the under garments/on the floor below.
 Abrasions or contusions on lateral aspect of shoulder, feet, toes
 friction with a wall or a pillar during suspension, in the last phase of life
 attempt to jump from a support such as a wooden stool or a steel chair or a tree
branch at a height