Autopsy and Exhumation

 In Greek Auto mean self and opios means view

 Systematic examination of a dead body after death for medical, legal or scientific purpose.
 Involve scrutiny of external surface and three internal cavities (
 Also called necropsy and postmortem examination
Classification
Type of Autopsy Description
In cases of suspicious or unnatural deaths
Forensic/Medicolegal To determine the cause and manner of death
Autopsy To rule out foul play i-e criminal assault, poisoning and industrial accidents
Carried under law of state to protect civilian rights
Clinical/Pathological/ Carried out by anatomy students and pathologist
Academic/ Medical Autopsy To make or confirm diagnose of death.
Examination of external body surfaces only without opening internal cavities
Postmortem Examination To collect specimens of body i-e, blood, bile, urine
Incomplete scrutiny and should be discouraged
Involves investigating mental health history and circumstances
To determine psychological causes of death (e.g., suicide)
Psychological Autopsy
Information is gathered from personal documents, friends, families, police and
medical record
Non-invasive autopsy using imaging technology (e.g., MRI, CT scans)
Virtual Autopsy (Virtopsy)
To examine body without dissection.
Medical Vs Forensic Autopsy
Aspect Medical Autopsy Forensic Autopsy
Study disease, confirm diagnosis, medical Determine cause and manner of death in
Purpose
research or education suspicious cases.
Mandated by law, no consent needed in
Consent Requires family consent.
criminal cases.
Setting Done in hospitals or clinical settings. Conducted in morgues or forensic labs.
Internal examination for disease or medical External and internal for signs of trauma or
Focus
conditions. foul play.
Autopsy Report Given to clinician Given to police/magistrate
Another name Pathological, Hospital, or Academic Autopsy Forensic Autopsy, Postmortem Examination

Objectives
1. Determine cause of death
2. Identify manner of death (natural, accidental, suicidal, homicidal)
3. Estimate time since death
4. Identify the deceased when not known
5. Collection of evidence of crime
6. Document injuries and wounds
7. Identify disease or health conditions before death
8. Collection of toxicological samples (for alcohol, drugs, poison)
9. Aid in legal proceedings with documented findings
 10.Determine issue of live birth and viability (in case of newborn infants
autopsy)
Authorization
 Forensic autopsy requires an official authorization from police or a
magistrate.
 Only allopathic physicians with an MBBS degree working in authorized
autopsy centers can conduct forensic autopsies.
Prerequisites
 A requisition must be submitted by investigating officer, including:
1. Two copies of autopsy request letter
2. Two copies of case history
3. Two copies of inquest report (contains details of body, injuries, and
preliminary conclusions)
4. One copy of the First Information Report (FIR)
5. Other documents of dead body (hospital reports, death certificate
etc.)

Procedure of Medicolegal Autopsy

1. Pre-Examination Formalities
a) Recording Details
 Authorized mortician records arrival details in two registers under
supervision of Forensic Medical Examiner:
 General Register  Contains details like
1) Biodata of deceased
2) Date and time of corpse arrival
3) Name, number and police station of accompanying police officer
4) Date and time of corpse return
 Autopsy Register  Contain details like
1) Biodata of deceased
2) Autopsy number
3) Date and time of autopsy
4) Specimen details collected from dead body
 5) Date and time of dispatch of specimens
6) Name of laboratory where samples are sent
7) Provisional cause of death
b) Corpse Transfer & Identification
 Body is transferred from freezer to autopsy table.
 Identification of corpse by police officer and two relatives and cross
matching names recorded in autopsy certificate.
2. Forensic Autopsy Investigations

Physical Physical
Opening Body
Examination of Examination of
Cavities
Clothes Body Surface

Collection and
Closure and Scrutiny of Internal
Presevation of
resorting of body Organs
Specimens

a) Physical Examination of Clothes

 Remove clothes from deceased body  Air dry them on hangers 
Examine them for specimens like
 Blood
 Semen
 Vomit
 Hair or fiber
 Dirt, soil or debris
 Gunshot residues
b) Physical Examination of Body Surface
 Observe postmortem changes like
 Hypostasis
 Rigor mortis
 Cadaveric spasm
 Document any injury, surgical and therapy marks
 Collect evidence of forensic importance
 Defense wound
 Hesitation marks
c) Opening Body Cavities
 Head
 Make coronal incision for examining skull and brain
 Coronal incision starts just behind ear  extend from both side  meet
coronally on center of head
 Chest & Abdomen
 Make anyone (out of three) incisions to open chest and abdomen
 Type Definition Advantages Disadvantages
Common
Straight vertical incision Inadequate exposure to
I-shaped Easy
From below chin to pubis axillary and neck regions
Fast
More time-consuming
Begins from mastoid area 
Faster than I-shaped Tedious
Y-shaped extends to suprasternal notch 
Better exposure of neck Inadequate exposure to
continues straight to pubis
axillary region
From acromial end of clavicle  More cosmetic
Modified Y- Time-consuming
above/below nipples  Better exposure to neck and
shaped Tedious
above/below axillary regions.

Diagram

 Spinal Cord
 Not routinely opened
 Spinal cord is opened in case of
 Injury
 Disease affecting spinal cord
 Strychnine poisoning
 Opened by two approaches:
Aspect Anterior Approach Posterior Approach
Incision Midline incision on front of body i-e over Midline incision on back i-e over spinous
Location abdomen process of vertebrae
Involves cutting of abdominal wall to access Involves making an incision over back
Procedure
spinal cord. followed by bilateral laminectomies
Easier for examining spinal cord and spinal
Advantages Direct access to certain spinal structures.
column.
Cutting through muscle and abdominal
Disadvantages More invasive
structures
d) Scrutiny of Internal Organs
 Cranial Cavity
 Reflect scalp after coronal incision
 Saw skull bones to remove skullcap by cutting skull bones from center
of head to base of mastoid process on both sides to external
occipital protuberance
 Examine structures of forensic importance
 Skull vault  for fracture or hematoma
 Superior sagittal sinus  for thrombosis
 Dura matter  for any injury or collection of blood
 Ventricular system after brain dissection  vascular malformation,
aneurysm
  Thoracic and Abdominal Cavities
 Inspect thoracic and abdominal cavities for
 Injuries
 Pathological lesions
 Blood or fluid
 Examine organs to note any change in
 Shape
 Size
 Weight
 Color
 Surface
 Consistency
e) Collection & Preservation of Specimens
Preservative Use
10% formalin Histopathological examination
Rectified spirit (99% alcohol)
Suspected acid poisoning except carbolic acid, acetic acid, alcohol,
Methylated Spirit (90% ethanol +
phenol, paraldehyde and phosphorus poisoning + Urine preservation
10% methanol)
Saturated solution of NaCl (150-
Non-acid poisoning + Carbolic acid poisoning + Urine preservation
200ml)
Thymol (5 grains)
Concentrated HCl (5mg) Urine preservation
Sodium benzoate (1gm)
Samples Collection
Specific Cases Sample to be collected
Digitalis poisoning Heart
Strychnine poisoning Spinal Cord + Heart
Alcohol poisoning CSF+ Vitreous humor + Lungs
Chloroform poisoning Vitreous humor+ Lung
Gaseous Poisons Lungs
HCN Lungs + Brain
Injected poisons (Insulin, Morphine, Heroin, Cocaine) Skin
Heavy metals (Arsenic, Thallium) Bone + Hair + Nails
Pesticides & Insecticides Fatty tissue
Chemical Abortion Uterus and its appendages
Decomposition Muscle
Neurotics & Volatile Organic Poisons Brain
Rabies Negri bodies
Contents of Bottles
Bottle Content
Bottle No. 1 Stomach and its contents
60-ounce liver (right lobe with gallbladder)
Bottle No. 2 Half spleen
One Kidney (Both kidneys in children)
Bottle No. 3 3 feet of upper portion of small intestine and its contents
Bottle No. 4 Preservative used
Blood  Take in ampoule of 5-10 ml
Others
100-200ml Urine  Taken in small bottles
Negative Autopsy
Causes of Negative Autopsy Examples
Autopsy without adequate history Anaphylactic shock, Pneumothorax, Vagal inhibition, Epilepsy
Ischemic heart disease, Coronary spasm, Distal coronary artery
Lack of training of medical examiner
occlusion
Concussion, Fat and air embolism, Delirium tremens, Polyarteritis
Insignificant Trauma
nodosa, Myocarditis, Pathology of SA/AV node and bundle of His
Firearm injury in nostrils, ear, palate
Trauma at concealed sites
Atlantooccipital and atlantoaxial dislocation with spinal cord injury
Lapses in examination
Electrocution, Intracardiac injection, Drug addiction, Poisonous bites
External
(snake, spider, wasp, and scorpion)
Air embolism, Pneumothorax, Coronary spasm, Distal coronary artery
Internal
occlusion
Histological and Toxicological Faulty or negative results (with no contribution for determination of
Laboratories cause of death)

Hazards in Autopsy Room

Type of Hazard Description
Fracture of limb from fall on wet/slippery floor
Needle prick
Mechanical Injury Cuts, burns from sharp/hot instruments
Back strain from lifting heavy corpse
Eye injury from sawing dust
Bacterial infections (septicemic bodies, abscesses, typhoid, tuberculosis, anthrax)
Biological Viral infections (hepatitis, AIDS)
Fungal infections from contaminated bodies
Exposure to antiseptics (iodine, phenols, Dettol)
Chemical
Exposure to fixatives (formalin) causing skin, eye irritation or toxicity.
Electrical Electric burns due to faulty electrical appliances, wet floors, or metallic autopsy tables.
Exposure to electromagnetic radiation from equipment
Radiation
Ionizing radiation from therapeutic radioactive isotopes.

Autopsy Rate Vs Autopsy Index

Criteria Autopsy Rate Autopsy Index
Proportion of autopsies (of any type) carried on Proportion of autopsies (medicolegal type only)
Definition
death and notified to authorities carried on death and notified to authorities
Purpose Measures frequency of autopsies. Measures diagnostic value of autopsies.
Focus Quantity of autopsies Quality of autopsy findings
Calculation (No. of Autopsies / Total deaths) × 100 (Significant findings/ Total autopsies) × 100
Use Tracks autopsy practices Assesses autopsy impact on diagnosis accuracy

Artifact Class Artifact Misinterpretation

During Terminal Dying Period
Regurgitation and aspiration of gastric contents Choking
Bruising of chest wall and heart Violence
Agonal
Fracture of ribs and sternum Violence
Injection marks on limbs, chest, and neck Addiction or Violence
 Postmortem Period (Situational)
Situational Pseudo groove on neck by tight collar Ligature mark
False bruising in occipital region Head injury
Fracture of cervical spine Violence
Handling
Dislocation of shoulder and hip joints Violence
Breaking of rigor mortis Non-appearance
Bloatment Obesity
Hypostatic discoloration of tissue Decomposition
Decomposition
Bloody fluid in mouth and nose Poisoning or violence
Artifactual hemorrhages in tissues and cavities Violence
Nibbling by rats and rodents Violence
Animal Ravage by fish or crabs Violence
Ripping apart by vultures Violence
Gas bubbles in right heart and vessels Air embolism
Stomach rupture due to acid digestion Poisoning
Separation of skull sutures in infants Violence
Autolytic Changes Shrinkage of facial skin Burning
Rigor of Heart muscles Concentric hypertrophy
Flattening of cerebral gyri Cerebral edema
Shrinkage of facial skin Hiar growth
Heat ruptures of skin and scalp Open wound
Flaking fractures of long bones and skull Antemortem fractures
Thermal
Burning hematoma inside skull Intracranial hemorrhage
Fat droplets in pulmonary vessels Fat embolism
During Autopsy
Air bubbles in blood vessels of brain and neck Air embolism
Faulty techniques Pseudo-bruising in subcutaneous neck tissues Throttling
Introduction or extension of skull fractures Antemortem fractures

Exhumation
 Lawful digging of a buried body for postmortem examination

Reasons
1. Criminal Cases
 Suspected Homicide  To confirm cause/manner of death

 Criminal Abortion & Negligence

 Evidence Retrieval  Like bullets from the body in firearm cases
2. Civil Cases
 Identification of deceased for claims related to:

 Accidental death
 Insurance and compensation (e.g., workmen’s compensation)
 Professional liability for negligence
 Inheritance and survivorship disputes
  Correcting identity issues (e.g., burial of the wrong body).

Authorization
 Requires written order from:
 First Class Magistrate
 District Magistrate
 Sub-Divisional Magistrate
 Executive Magistrate

Procedure
 Make necessary preparations along with graveyard authorities.
 Identify the grave with the help of the caretaker, grave digger, and
relatives.
 Remove the body from the grave and confirm identification.
 Collect earth samples in suspected poisoning cases (above the body and
from a distant area).
 Conduct an autopsy examination

Precautions
 Conduct in daylight with adequate ventilation.
 Use face masks (impregnated with KMnO₄) and gloves.
 Apply disinfectant around the body, avoiding direct contact with the body.
 Ensure witnesses are present for identification of grave, coffin, and body.
 Immediately wash and disinfect hands after handling necropsy wounds.
Limitations of Exhumation
 Time lapse causes decomposition, affecting soft tissue examination.
 Postmortem artifacts may lead to misdiagnosis.
 Environmental Conditions can impact the condition of the body.
 Loss of volatile/synthetic toxins with time.
 Misinterpretation by untrained personnel during exhumation.
Idiosyncrasy:
 An unusual or abnormal reaction to a substance that differs from the typical
response experienced by most people.
 Often genetically determined, leading to unpredictable effects when exposed
to certain drugs or chemicals.
Automatism:
 In toxicology, refers to involuntary actions or behaviors resulting from drug or
substance effects, where the individual has little or no control over their
actions.
 Can occur in cases of overdose or drug reactions, leading to unintentional or
unintended actions.
Tolerance:
 A condition in which repeated exposure to a substance results in a reduced
effect, requiring higher doses to achieve the same effect.
 Often seen in long-term use of drugs, where the body adapts to the
substance over time.
Synergism:
 When two or more substances interact to produce an effect greater than the
sum of their individual effects.
 Commonly occurs with drugs or chemicals, where combined exposure
intensifies the overall impact on the body.
Chronic Poisoning:
 Poisoning that occurs due to long-term, repeated exposure to a toxin or
poison, typically at low doses.
 Leads to cumulative damage over time, often affecting specific organs or
systems and resulting in long-lasting or permanent health effects.
Forensic Sexology
Basic Definitions
Term Definition
Impotence Inability of either sex to perform a sexual act.
Sterility Inability on the part of the male to procreate or on the part of the female to conceive children.
Fertility Ability to procreate or conceive children, opposite of sterility.
Frigidity Inability to respond warmly to sexual arousal stimuli.
Causes of Sterility

Particulars Male Female

Age Before puberty, no upper limit Before menarche and after cessation of
menstruation

Physical Hypospadias & epispadias (abnormal urethral Conical cervix, absence of uterus,
Abnormalities opening site) ovaries, or fallopian tubes

Diseases Testicular atrophy, diseases of testes & Chronic salpingitis, rectovaginal fistula,
epididymis, mumps menstrual disorders, leucorrhoea

Injuries & Injuries to testes, fear of inability to complete Exposure to F-rays, chronic alcoholism,
Addiction the act, emotional disturbance, dislike for narcotics
partner

Operations Vasectomy, lithotomy operation Ligature of both fallopian tubes,

hysterectomy

Table: Causes of Impotence (Male and Female)

Category Male Causes Female Causes

Age Before puberty No limit of age

At vey old age

Physical Absence or underdevelopment of penis Absence or rudimentary vagina, firm or

Abnormalities imperforate hymen, adherent labia
Intersexuality (Ambiguous genetilia)

Hormonal Hypopituitarism, lack of sex hormones Hypopituitarism, lack of sex hormones

Dysfunction

Local & General Gonorrhea, syphilis, large hernia, diabetes, Gonorrhea, syphilis, large hernia, diabetes,
Diseases tuberculosis, vaginismus (painful vaginal tuberculosis, vaginismus (painful vaginal
muscle spasms during intercourse) muscle spasms during intercourse)

CNS Diseases Syringomyelia, hemiplegia, paraplegia Syringomyelia, hemiplegia, paraplegia

Drugs Opium, alcohol, cocaine Opium, alcohol, cocaine

Psychological Fear of impotence or inability to complete Fear of impotence or inability to complete

 Causes the act, emotional disturbances, perversions, the act, emotional disturbances,
aversion to sexual activity perversions, aversion to sexual activity

Sexual Offence
 Any form of sexual intercourse which
 Deviates the normal heterosexual (penile-vaginal) intercourse between legitimate husband
and wife
 Violates rule & law of country

Classification

Sexual Offences

Sex-linked
Natural Unanatural Perversions
Offences

Natural Sexual Offences

 Sexual intercourse that is considered normal and natural but are committed
 Without consent of one of the parties
 Outside of lawful marriage
 Examples include zina, rape, adultery and incest

Zina & Rape

Aspect Zina Rape
Involves mutual consent between both Lacks consent and involves coercion, force, or
Consent
parties. threat.
Punishment According to Hadood Ordinance 1979 According to Section 375 PPC
Victim No victim, both parties willingly engage. Person who is unwilling forced into act.
Guilty Can be committed by both man and woman Committed by man only

Hadood Ordinance 1979

 Law introduced in Pakistan in 1979 by General Muhammad Zia-ul-Haq
 Was part of the "Islamization of Pakistan" program

Sections Related to Sexual Offences

Section 2 (Definitions)
Adult
 A person who has attained puberty (18 years for males, 16 years for females)

Hadd
 Fixed punishment for a specific offense
  Laid down in the Holy Quran and Sunnah
 Cannot be altered or varied by any court or authority

Tazir
 Punishment other than Hadd
 Can be altered or varied by a court based on circumstances

Marriage (Nikah)
 A valid and legal union between a man and a woman
 Recognized by Islamic law
 Not against personal laws of both parties

Muhsan
 A married person who has
 Normal mental status
 Has had sexual intercourse with his/her spouse
 Liable to Hadd punishment for certain offenses (eg, adultery)

Section 4 (Zina)
 A man is said to have committed zina if he willfully has sexual intercourse with a woman who is:
 Not his wife
 Not a concubine (enslaved in a war and has a valid Islamic relationship)

Section 5 (Zina Liable to Hadd)

 Whoever commits Zina (as defined in Section 4) shall be liable to Hadd punishment i-e

 Death by stoning (Rajm) if the offender is a Muhsan (married and has had sexual
intercourse with his/her spouse)
 One hundred lashes if the offender is not a Muhsan

Section 6 (Zina Bil Jabr)

 A person is said to commit zina-bil-jabr if he or she has sexual intercourse a man or woman to
whom he/she is not married

 Against the will of victim

 Without the consent of victim
 With consent, when consent is being taken after putting fear of death on victim
 With consent, when offender knows that victim has given consent considering him/her
to be his/her spouse
 With consent, when victim is not in senses i-e intoxicated by victim himself or by the
offender
 With her consent, when victim is at pre-puberty age

Rape
 According to section PPC 375 rape is same as Zina-bil-Jabr (as stated in section 6 of Hadood
Ordinance of 1979) with some additional clauses i-e
 Penetration should be sufficient to constitute sexual intercourse to offence of rape
  Sexual intercourse by a man with his own wife who is not under 15 years of age is not a
rape

Examination of Victim of Rape

Pre-examination
Steps Protocols /Procedure
Documentation Proper Authority Letter from Police is required
Person Identification Police constable must identify victim (accompanies) & record two identification marks
Consent In expressed written form, from adult victim or from parents of victim <18 years of age
Biodata Victim Name, Father Name, Age, Address, Social Status, Marital Status
Examination Records Date, Time and Place of Examination
Third Party Record Female doctor/ Female nurse/ Female relative
Settings Proper light, stage and other examination instruments
Position of Examination Vaginal Exam in Lithotomic Position & Anal exam in Knee-Elbow Position
Medical Examination
1. Make a general impression about the victim by noting
 Behavior & Character
 Age (to access development of secondary sex characters)
 Gait (Broad base & short in rape)
 Make up (disturbed)
 Mental status (frightened & depressed)
 Speech (confuse, shy, slurred)
 Struggle evidence marks (present in rape)
2. Take both specific and obstetrics history from the victim
 Specific History include following questions
 What were the time, date and place of the act?
 Who removed the clothes from victim and how?
 Who removed the clothes from accused and how?
 What were the relative positions during the act?
 Was she felt pain during or after the act?
 How many persons were involved in the act?
 Was any violence used by accused(s)?
 Was penile penetration partial or full?
 Has victim changed or washed the clothes after the act?
 Has victim lathed or washed away the body parts after the act?
 Obstetric history include following questions
 Whether ejaculation took place inside or outside?
 Was any contraceptive used during the act?
 Has she used any medication in last 24 hours?
 Do you have any previous sexual experience?
 What is your menstrual status and cycles with dates?
 Are you married or not?
 How many children do you have and what are their date of births (if married)

Clothes Examination
 Make victim stand on plain white cloth free of contamination
  Undressing should be done by the victim herself while standing to avoid loss of any trace
evidence
 Spread the clothes in proper light (day light) and inspect for following:
 Manner and state of clothes
 Damage to clothes due to struggle
 Site and nature of any staining (air dry the wet stains)

Body Examination:

A. GENERAL EXAMINATION

Physical Health: Height, Weight, Built, Vital Signs. Anemin, Strength, Resistance ability Mental Health:
Memory, Concentration, Feeling, Orientation

Injuries:

Hands, forearms, arms (griping exerted by pressure of finger tips) Medial sides of knee and thigh (to
separate them)

Bruises

Hips, Cheeks, Breast (scuffle)

Back of body (friction in rape)

✔Back of elbows and front of knees (friction in sodomy)

Abrasions

✔ Nail scratches on accused body on face and around genitals)

Bite Marks

✔Neck and front of chest of accused (imprint abrasions)

outh, face etc

Mains: Semen, Blood, Saliva, Soil, Vegetation, Oil from hugle areas around genitalia, breast.

Loose Hairs: From either partner

In both victim and accused

B. SYSTEMIC EXAMINATION

Dividec A. IN

B. BIL

C. DIC

Requirements: Lithotomy table. Pedestal lamp, Surgical gloves. Specula, Magnifying le D SP Glister Keen
glass rods (for deployment of hymen edges), Swab applicators, Test tubes, Slidn
To rule out the possibility of false defense plea by the accused on the grounds of physi ability or other
systemic diseases.

C. GENITAL EXAMINATION

Most important and is based on physical disproportion between vaginal and anal canals penis of
accused.

Modified Findings:

Time interval between sexual acts

Previous experiences of sexual intercourse

First aid rendered after the act

Changing of clothes and washing of parts

Containers INSPECTION

Vaginal Exam

Lahia majora, fahia minora, mons pubis and adjacent parts of thigh Langeons, bleeding, discharge,
injuries, stains, loose

mitted/aled pubic hairs

BILATERAL TRACTION OF LABIA

Make hymen visible for examination: For making tears visible

1. Lateral traction of vaginal orifice by placing thumbs at 3 & 9 o'clo

2 Hymen stretched at 6 & 12 o'clock

3. Above step repeated in all around For differentiating old from new scars

1. Use of Glister Keen glass rods Old scars: Translucency

2 of hymen brighter 3 New scars: Translucency of hymen slightly blurred

Digital Teers.

fännal Interference: Anterior part mostly

Sexual Intercourse: 5 or 7 o'clock position posterior-laterally

C. DIGITAL EXAMINATION

Gauge size, tone, tenderness or l laxity of vaginal canal

Introduction of gloved index finger into vagina and moving its palmer aspect vaginal epithelium (Note
degree of lateral pressure over index finger and co
roughness on bulb of finger) Differentiae roughness on bulb of finger) Differentiae habituated and non-
habituated vagina Rugosities absent in habituated vagina with proportionate dilatation of vaginal cas

D. SPECULAR EXAMINATION Appropriate size speculum is introduced into vagina to inspeet mucosa,
roughs

Consent: Can be don Biodata Informatio

injuries and bleeding

Vaginal rugosities: Marked in virgin and obliterated till child birth ✔ Vaginal bruises: Mostly on anterior
wall, dark brown in colour

Status

Anal Exam-

Divided into 4 stages:

INSPECTION,

✔Anus and surrounding skin

1 anal intercourse: Redness, bleeding, tear od anal skin, sphincter or anal mucosa

B. BILATERAL TRACTION OF ANAL SPHINCTER

To locate location of tear

C. DIGITAL EXAMINATION

✔ Gauge size, tone, tenderness or laxity of anal canal

Differentiae habituated and non-habituated anal canal

✓ Habituated canal sometimes infected is fax, absence of anal folds and smooth margins, expanded,

D. SPECULAR EXAMINATION

✔ Appropriate size proctoscope is introduced into anal canal to inspect mucosa, roughness, injuries and
bleeding

✓ Anal bruises: Dark brown in cojour

V. Specimen Collection:

Clothes entire lot (bearing stains and soiling)

2. Loose and matted hair

3. Swabs

From the body

Seminal stains (areas other than the vagina)

Salivary stains from the bite marks

From the vagina

From introitus, perineum

o'clo

From lower vagina (separating the labia minora and passing a swab just into

the areas above to hymen border)

From anal margins

From higher vagina

From the posterior fornix

4. Scrapings of assailant from undersurface of nails of non-consenting victims

5. Urine for screening of drugs and venereal disease

6. Control specimens

Blood

Plucked har (2 from head. 2 from pubic region)

Saliva

FEMINATION OF ACCUSED OF RAPE/ZINA BIL-JABAR

1. Pre-examination:

Requisition: Proper Auffustity Letter from Police is required Person Identification: Palice constable must
identify atcused Faceoompanies) & recard 2 ID

marks Consent: Can be done sathout case or even sath force (USPICI

Biodata Information: Vatim Name, Father Name, Ar, Address Social Status, Marital

Status

COMPENDIUM OF FORENSIC MEDICINE & TOXICOLOGY BY ARC

Date, Time and Pince of Examination Other Requirements: Proper light, stage and other examination
instrumenta

II. Physical Examination:

Physical Health: Height, Weight, Boill, Vital Signs, Anemia, Strength, Resistance al

Secondary sex characters

Mental Health: Memory, Concentration, Feeling, Orientation

Scratches

Clothes Examination: Signs of struggle or any stains

Injuries: Struggle injuries, on tace, neck, haud, or private parts

Bruises

ite Marka

LE

re

III. Genital Examination:

INSPECTION

Development of external genitalia ve, penis, scrotum, testes & their abnormalities respect to vaginal or
anal damage of victim

Size of penis with Any biological stains

Pubic hair growth pattern, soiling, matting

Injury, swelling, bleeding or any damage to prepuce and rim of glans pes

uncircumcised penis

10.2

- PALPATION

State of penis, and testis in serotal sac ie. descent, hernia, atrophy or lesions

mear

→Tenderness

Test of reflexes i.e. scrotal, penile, cremesteric reflexes Test for potency (eg, holding of glans penis with
thumb & index finger ot prostate

evection-Pinching the glens penis will cause drop of fluid) Vaginal epithelium stuck onto glens penis
(detected by Lugol's lodine Test)

2. inte
a. Mop the glens penis with filter paper

10.3

errati

b. Expose the paper to Lugol's lodine Vapor Brownish discoloration of paper confirms vaginal epithelium
(due

content)

to fe ction c

Absence of smegma (which is normally present)

0.4. L

4.10.1. SODOMY

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4.10. UNNATURAL SEXUAL OFFENSES

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Chamosen It is the anal sex that is sexual connection of a male with other male Jemale (heterosexual
sodomy or Buggery) who may There are two types of agents in sodomy ie. be child or adult, with or w
active agent (one doing anal intercourse

Traumatology
Injury
 Disruption of the anatomical continuity of body tissues.
  As per Section 44 IPC, injury is any harm caused illegally to a person body, mind, reputation, or
property.

Types of Injuries
1. Mechanical Injuries
2. Firearm Injuries
3. Transportation Injuries
4. Thermal Injuries (Includes injuries from chemicals, electricity, lightning, and explosions).

Mechanism of Injury
 Key factors responsible for mechanical injuries:
1. Force  More force causes greater damage (force = 1/2 mv²).
2. Area of Impact  Narrower areas of impact cause more damage.
3. Specific Effect of Force  Type of force determines the injury.
4. Time of Energy Transfer  The longer the time, the lesser the impact.

Examples
 A brick pressed on the scalp vs. falling from height: The fall can cause skull damage.
 Narrow vs. flat edge of a plank: Narrow edges cause more injury.
 Torsion can cause fractures even if external tissue looks unaffected.

Classification of Injuries
Abrasions

Bruises

Lacerations

On basis of
Etiology Fractures

Incised Wounds

Stab Wounds
Classification Of
Injuries
Firearm Injuries

Defense Wounds

Medicolegal Self-Inflicted
Classification Wounds

Injury Patterns
Abrasion
 Injury involving the superficial layers of the skin.
 Caused by friction and/or pressure between the skin and a rough object or surface.
 Heals rapidly, leaves no scar, and bleeds slightly.

Types of Abrasions
1. Scratches
 Linear injuries caused by sharp objects like pins, thorns, or fingernails.
 Direction of injury indicated by sharp edge initially and heaped-up epithelium at the end.

2. Grazes
 Caused by skin scraping against a rough surface.
 Common in traffic accidents; also called brush or friction burns.
 Direction indicated by serrated border initially and heaped-up epithelium at the end.

3. Imprint (Pressure or Contact) Abrasions

 Result from direct impact, reproducing the shape and surface marking of the object.
 Often associated with bruising.
 Examples: Ligature marks, tyre tread marks, whip marks, teeth marks.

Age of Abrasion
 Fresh abrasion is bright red in color
 Formation of scab starts in 12-24 hours.
 Scab color is red initially that turn reddish-brown in 2-3 days.
 Scab falls off in 4-7 days, complete healing in 10 days.

Antemortem & Postmortem Abrasions

 Antemortem  Reddish-brown with blurred margins due to vital reaction.
 Postmortem  Dark brown/black, parchment-like, sharply defined edges, no vital reaction.

Caution
 Abrasions should be distinguished from
a. Postmortem injuries  Caused by insects or marine animals occur in drowned person edges
appear nibbled, no vital reaction.
b. Excoriation of skin  Caused from excreta that is common in infants (nappy rash).
c. Pressure sores  Caused by prolonged pressure

Medico-Legal Aspects
Medico-legal Aspect Description
Site of Impact Helps indicate the location of external impact
Identification of Object Patterned abrasions (e.g. ligature marks) help identify object causing injury.
Cause of Injury Location of abrasion helps determine cause (e.g. face abrasions in rape).
Direction of Injury Visible with a hand lens, showing sharp or serrated edges of the injury.
Time of Injury Estimated from the age of the abrasion based on healing stages.
Possibility of Infection Abrasions can serve as entry points for infections.
Confusion with Burns Abrasions may darken and dry after death and may be mistaken for burn