FORENSIC

MEDICINE AND
TOXICOLOGY
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FORENSIC MEDICINE AND TOXICOLOGY

GENERAL FORENSIC MEDICINE

CONTENTS
GENERAL FORENSIC MEDICINE ..................................................................................................................................... 5
IDENTIFICATION ........................................................................................................................................................ 5
PRIMARY TEETH ........................................................................................................................................................ 5
SECONDARY TEETH ................................................................................................................................................... 6
DENTITION ................................................................................................................................................................ 6
ESTIMATION OF AGE ................................................................................................................................................. 7
ESTIMATION OF SEX .................................................................................................................................................. 7
ESTIMATION OF RACE ............................................................................................................................................... 8
ESTIMATION OF STATURE ......................................................................................................................................... 9
DEATH AND POSTMORTEM .......................................................................................................................................... 9
DEATH AND CHANGES AFTER DEATH ....................................................................................................................... 9
AUTOPSY ................................................................................................................................................................. 10
POSTMORTEM TEMPERATURE CHANGES ............................................................................................................... 11
POSTMORTEM STAINING/POSTMORTEM LIVIDITY ................................................................................................ 12
RIGOR MORTIS AND CADAVERIC SPASM ................................................................................................................ 12
MUMMIFICATION ................................................................................................................................................... 13
ADIPOCERE .............................................................................................................................................................. 13
PUTREFACTION ....................................................................................................................................................... 13
MAGGOTS ............................................................................................................................................................... 14
ANTEMORTEM AND POSTMORTEM BURNS ........................................................................................................... 14
ASPHYXIA .................................................................................................................................................................... 14
CAF CORONARY ..................................................................................................................................................... 14
HANGING ................................................................................................................................................................ 14
DIFFERENT FORMS OF ASPHYXIA ............................................................................................................................ 15
DROWNING ................................................................................................................................................................. 16
FIREARM INJURIES ...................................................................................................................................................... 17
TYPES OF FIREARM .................................................................................................................................................. 17
TYPES OF BULLET .................................................................................................................................................... 17
TYPES OF FIREARM INJURIES .................................................................................................................................. 18
WOUND AND INJURY .................................................................................................................................................. 19
GRIVEOUS INJURY ................................................................................................................................................... 19
INJURIES .................................................................................................................................................................. 19

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GENERAL FORENSIC MEDICINE

FRACTURES ............................................................................................................................................................. 19
WOUND................................................................................................................................................................... 20
LAW IN RELATION TO MAN ......................................................................................................................................... 21
COURTS ................................................................................................................................................................... 21
EVIDENCE ................................................................................................................................................................ 21
OFFENCE ................................................................................................................................................................. 22
IPC, CrPC AND IEA ................................................................................................................................................... 22
INQUEST .................................................................................................................................................................. 23
EXHUMATION ......................................................................................................................................................... 23
TORTURE ................................................................................................................................................................. 23
CRIMINAL RESPONSIBILITY...................................................................................................................................... 23
CONSENT ................................................................................................................................................................. 24
MEDICAL LAW ......................................................................................................................................................... 24
MEDICAL NEGLIGENCE ............................................................................................................................................ 24
TESTS AND RULES........................................................................................................................................................ 25
SEXUAL OFFENCES ...................................................................................................................................................... 26
RAPE ........................................................................................................................................................................ 26
OTHER SEXUAL OFFENCES ...................................................................................................................................... 27
INFANTICIDE AND FETAL DEATH ................................................................................................................................. 28
FETAL DEATH ........................................................................................................................................................... 28
BATTERED BABY SYNDROME .................................................................................................................................. 28
TOXICOLOGY ............................................................................................................................................................... 29
GENERAL FEATURES OF POISONING ....................................................................................................................... 29
POISONING BASED ON PHYSIOLOGICAL STATE ...................................................................................................... 30
HYDROGEN SULPHIDE ............................................................................................................................................. 30
ARSENIC .................................................................................................................................................................. 30
LEAD ........................................................................................................................................................................ 31
PHOSPHORUS .......................................................................................................................................................... 32
MERCURY ................................................................................................................................................................ 32
COPPER ................................................................................................................................................................... 33
ZINC ......................................................................................................................................................................... 33
CADMIUM ............................................................................................................................................................... 33
ALUMINIUM PHOSPHIDE ........................................................................................................................................ 34
CYANIDE .................................................................................................................................................................. 34
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PARACETAMOL POISONING .................................................................................................................................... 34

SALICYLATE POISONING .......................................................................................................................................... 34
COPPER SULPHATE POISONING .............................................................................................................................. 35
ACID POISONING ..................................................................................................................................................... 35
SULPHURIC ACID ..................................................................................................................................................... 35
NITRIC ACID ............................................................................................................................................................. 35
CARBOLIC ACID ....................................................................................................................................................... 35
OXALIC ACID ............................................................................................................................................................ 36
KEROSENE POISONING............................................................................................................................................ 36
CARBON MONOXIDE ............................................................................................................................................... 36
CHLORAL HYDRATE ................................................................................................................................................. 36
METHYL ALCOHOL ................................................................................................................................................... 37
BARBITURATES ........................................................................................................................................................ 37
ACONITE .................................................................................................................................................................. 37
DHATURA ................................................................................................................................................................ 38
STRYCHNINE ............................................................................................................................................................ 38
OPC ......................................................................................................................................................................... 38
PRESERVATIVES FOR POISONING............................................................................................................................ 39
SNAKES .................................................................................................................................................................... 40
MUSHROOM POISONING........................................................................................................................................ 40
PLANT POISON ........................................................................................................................................................ 41
GENERAL FEATURES OF MANAGEMENT OF POISONING ........................................................................................ 41
HEMODIALYSIS ........................................................................................................................................................ 41
ALKALINE DIURESIS ................................................................................................................................................. 41
SALINE DIURESIS ..................................................................................................................................................... 42
GASTRIC LAVAGE ..................................................................................................................................................... 42
BAL .......................................................................................................................................................................... 42
EDTA ........................................................................................................................................................................ 42
METALLOTHIENES ................................................................................................................................................... 43

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FORENSIC MEDICINE AND TOXICOLOGY

GENERAL FORENSIC MEDICINE

KEY TO THIS DOCUMENT

Text in normal font Must read point.
Asked in any previous medical entrance
examinations
Text in bold font Point from Harrisons
text book of internal medicine 18th
edition
Text in italic font Can be read if
you are thorough with above two.

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GENERAL FORENSIC MEDICINE

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GENERAL FORENSIC MEDICINE

IDENTIFICATION
Superimposition technique is used in
Cheiloscopy is the study of
Palatoprints are taken from
Study of fingerprinting
Dactylography is also known as
Majority of fingerprints in Indians
MC type in Dactylography
Least common type of finger printing
NOT a type of fingerprinting
System of Dactylography first used in
First finger loop bureau established in
Disease permanently altering fingerprints
Identical twins may NOT have
Most sensitive and specific for identification
To make a positive identification with the help of a
partial fingerprint, the points of similarity should be
Most reliable method for identification of person
Tattoo is useful in identifying
Blackening and tattooing of skin and clothing best
demonstrated by
Faint letter mark can be made visible by
Identity in convict established by
Bertillon system is used for
Bertillon system

Skull
Lips
Anterior hard palate
Dactylography
Galton system, dermatoglyphics
Loop
Loop
Composite
Circle
India
Kolkatta
Leprosy
Same fingerprinting
Dactylography
16
Galton method
Decomposed body
Infrared photography
Infrared photography
Anthropometry
Identification
Identification based on body
measurements

PRIMARY TEETH
TEETH
Lower Central Incisor
Upper Central Incisor
Upper Lateral Incisor
Lower Lateral Incisor
First Molar
Canine
Second Molar

ERUPTION
6 months
7 months
8 months
9 months
1 year
1 years
2 years

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SECONDARY TEETH
TEETH

ERUPTION

First Molar
Central Incisor
Lateral Incisor
First Premolar
Second premolar
Canine
Second Molar
Third Molar

6 years
7 years
8 years
9 years
10 years
11 years
12-14 years
17-25 years

DENTITION
Natal teeth

Hardest part of the tooth

Best method to determine age up to 14 years
Charting of left lower canine
Dental numbering is done by
Dental numbering is NOT done by
Stack formula for age estimation from dental pattern in
Gustafson method is used for
Most reliable criteria in Gustafsons method of
identification
Gustafson method

Most reliable criteria in Boydes method

Eruption of tooth
First incisors to erupt in an infant
All milk teeth are erupted by
Eruption of temporary teeth completed at
Number of deciduous teeth
Period of mixed dentition
First permanent tooth to appear
First Permanent tooth
Second molar erupts at
Number of teeth in 3 years
No of tooth at 7 years
No of permanent tooth in 8 year old child

Present at birth, usually 2 incisors of

mandibular teeth, need not be removed in
all cases
Enamel
Dentition
33 in FDI, 43 in modified FDI, -3 in Haderup
FDI two digit system, Anatomic and diaphragmatic
charting, Palmer notion
Acrogram
Infants
Age estimation
Transparency of root
Estimation of age in adults over 21 years,
transparency of root is not seen until 30
years, error in estimation is + 4 to 7 years
Incremental lines
Canine is the second last to appear in primary dentition,
Hypothyroidism delays dentition
Lower central
2 years
2-2 years
20
6-11 years
First molar
Maxillary molar
12 years
20
24
12

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GENERAL FORENSIC MEDICINE

FORENSIC MEDICINE AND TOXICOLOGY

No of tooth at 10 years
20 permanent and 8 temporary teeth seen at
No of tooth at 12 years
Precocious dentition in newborn is
associated with
Dentition occurs earlier in
Dentition is delayed in
Delayed eruption if no teeth at age of
Permanent staining of teeth
Teeth typically grown in 20 30 months
Least medicolegal importance given to
Early loss of primary teeth
Commonest morbidity in school
Complication of Xerostomia
MC tooth to be impacted
Impacted wisdom tooth produce referred pain via
On tenth day of a teeth being knocked out, the local
clinical finding will be
Pantomogram is useful in visualization of

16, 8
10 years
24
Ellis van Crevald syndrome, Hallerman
Streiff syndrome
Syphilis
Rickets
13 months
Tetracycline
Second molar
Second bicuspid
Hypophosphatasia
Dental caries
Dental caries
Lower third molar
Branch of auriculotemporal nerve
Tooth socket is filled by tissue
Caries, Dental cyst, Temporomandibular joint

ESTIMATION OF AGE
Age assessment
Number of carpal bones seen in newborn X ray
Number of carpal bones in skiagram of hand at the end
of 1 year
X ray site for age determination of 16 year old female
Attainment of 16 years of age best diagnosed on X-ray
by
X ray site for age determination of 21 year old female
Most successful age estimation in skull
Metopic suture closes at
Coronal, sagittal and lambdoid suture
closes on inner side by
Closure of coronal suture starts by
Xiphoid process fuses with body of sternum at
Best bone to assess age between 20-50 years
If the angle of mandible is obtuse, it means that the
bone belong to
Mental foramen in older age
Two halves of mandible unite at

Clinical examination and Radiological evidence

None
2
Lower end of radius and ulna
Elbow
Iliac crest and clavicle
Sagittal suture (lateral view)
3 years
25 years
30-35 years
40 years
Skull
Young female child, Elderly
Near upper border of mandible
2 years

ESTIMATION OF SEX
Best bone for sex determination
Best criteria in pelvis
Chilotic line

Pelvis
Sciatic notch index
Line on hip bone for sex determination
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Ischiopubic index is more in
Pubic arch in male pelvis
Pubic arch in female pelvis
Female pelvis

Male skull

Skull of male from female

Features of male skull
Preauricular sulcus helps in determination of
Corpobasal index is useful for determination of
Corpobasal index is more in
Corpobasal index of sacrum in females
Sacral index in females
Scapular glenoid height in females
Bicondylar width of femur in females
Knogman table for
Sex differentiation from pelvic bone upto 95% accuracy
from
Best bone for sex determination
Female pelvis

NOT useful for sex determination

Females
70 75*
90 100*
Obtuse and U shaped subpubic angle, Broad greater
sciatic foramen, Broad lesser sciatic foramen, Pre and
post auricular sulcus is prominent, Ischial tuberosity is
everted and obturator foramen small and triangular, C
shaped pelvic cavity
Muscular markings over occiput are more marked,
Capacity greater than 1500 cc, Orbits square, Frontal
eminence small
Capacity > 1500 cc, Square orbit, Frontal eminence
small
U shaped palate, steeper forehead,
prominent zygomatic arch
Sex
Sex
Males
Less than 42
Greater than 114
Less than 36 mm
Less than 72 mm
Sex
Greater sciatic notch, Pre auricular sulcus, Obturator
foramen, Sub pubic arch
Pelvis
Wide sciatic notch, Shallow and wide symphysis pubis,
Obtuse sub pubic angle, Light and graceful structure,
Preauricular sulcus is larger
Clavicle

ESTIMATION OF RACE
Most reliable bones for purpose of medullary index
Craniofacial angle
AP diameter of skull is minimum in
Cephalic index
Cephalic index of Indian population
Cephalic index is used for determination of
Pure Aryans have
Rounded nasal opening, horse shoe shaped palatte,
round orbit cephalic index above 80
Squared orbit and rectangular palate with cephalic
index 75,broad nose
Fragmented medullary hair
Kidney shaped cross section of hair

Humerus, Tibia, Radius

130*
Brachycephaly
Maximum breadth/maximum length * 100
70-75
Race
Dolicocephalic
Mongols
Negroes
Negroes
Negroes

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