MEDICO- LEGAL ASPECT OF PHYSICAL INJURIES

Physical Injury
-is the effect of some forms of stimulus on the body.

CAUSES F PHYSICAL INJURIES

A. Physical Injury
B. Heat or Cold
C. Electricity Energy
D. Chemical Energy
E. Radiation by Radio-Actives Substance
F. Change of Atmospheric Pressure
G. Infection

PHYSICAL INJURIES BROUGHT ABOUT BY

PHYSICAL VIOLENCE

WOUND
-is the solution of the natural continuity of any tissue of the living body.

CLASSIFICATION OF WOUNDS

1.As to severity:
a. Mortal Wound
-Wound which is caused immediately after infliction or shortly
thereafter that is capable of causing death.

Parts of the body where the wounds inflicted are considered mortal:
a. Heart and big blood vessels.
b. Brain and upper portion of the spinal cord.
c. Lungs
d. Stomach, liver spleen and intestine.

b. Non-mortal
-Wound which is not capable of producing death immediately after
infliction or shortly thereafter.

2. As to the Kind of Instrument Used:

a. Wound brought about by blunt instrument (contusion, hematoma, lacerated
wound)
b. Wound brought about by sharp instrument:
1. Sharp-edged instrument ( incised wound ).
2. Sharp-pointed instrument ( punctured wound ).
3.Sharp- edge and sharp pointed instrument ( stab wound ).
c. Wound brought about by tearing force ( lacerated wound )
d. Wound brought about by change of atmospheric pressure ( barotraumas ).
e. Wound brought about by heat or cold ( frostbite, burns or scald )
f. Wound brought about by chemical explosion ( gunshot or shrapnel wound )
g. Wound brought about by infection.
3. As to the Manner of infection:
 a. Hit- by means of bolo, blunt instrument, axe.
b. Thrust or stab – bayonet dagger.
c. Gunpowder explosion- projectiles or shrapnel wound.
d. Sliding or rubbing or abrasion.

4.As regards to the Depth of Wound:

Superficial
-When the wound involves only the layers of the skin.
Deep
-When the wound involves the inner structure beyond the layers of the
skin.
1. Penetrating
- one in which the wounding agent inters the body but did not came out or
the mere piercing of a solid organ or tissue
of the body.
2. Perforating
-When the wounding agent produces communication between the inner
and outer portion of the hallow organs.

5.As regards to the Relation of the Site of the Application of Force and the
Location of the Injury:

Coup Injury – Physical injury which located at the site of the application of the
force.
Contre-coup Injury - Physical injury found opposite the site of the application
force.
Coup Contre-Coup Injury – Physical injury located at the site and also opposite
the site of the application of force.
Locus Minoris Resistance - Physical injury located not at the site nor opposite
the site of the application of force but in some areas offering the least
resistance to the force applied.
Extensive Injury - Physical injury involving a greater area of the body beyond
the site of the application of force.

6. As to the Regions or Organs of the Body Involved:

The wounds of the different organs and regions of the body will be
discussed separately under “Injuries in various Part of the Body”.

7.Special Types of Wounds:

Defense Wound
– Wound which is the result of the person‘s instinctive reaction of
self protection.
Patterned Wound
- Wound in the nature and shape of an object or instrument causing it.
Self-Inflicted wound
- Self-inflicted wound is a wound produced on oneself.

Motive of Producing Self-Inflicted Wound:

1. To create or deliberately magnify an existing injury or disease for penson or
workman’s compensation;
2. To escape certain obligations or punishment.
3. To create a new identity or destroy the existing one.
4. To gain attention or sympathy.
5. Psychotic behavior

TYPES OF WOUNDS (MEDICAL CLASSIFICATION)

1.ClOSED WOUND
a. SUPERFICIAL
1. petechiae - this is a circumscribed extravasations of blood in the subcutaneous
tissue or underneath the mucous membrane
2. Contusion – is the effusion of blood into the tissues underneath the skin on
account of the rupture of the blood vessels as a result of the application of
blunt force or violence.
3. Hematoma – is the extravasation or effusion of blood in a newly form cavity
underneath the skin
b. DEEP
1. Musculos- Skeletal Injuries.
a .Sprain
b. Dislocation
c. Fracture
d. Strain
e. Subluxation
2. Internal Hemorrhage
Rupture of blood vessel which may cause hemorrhage ma due to the ff.
a. Traumatic intracranial hemorrhage.
b. Rupture of parenchymatous organs.
c. Laceration of other body
3. Cerebral Concussion
- is the jarring or stunning of the brain characterized by more or less
complete suspension of its functions, as a result of injury to the head ,
which leads to some commotion of the cerebral substance.

Signs and Symptoms:

a. Unconsciousness which is more or less complete.
b. Muscles are relaxed and flaccid.
c. Eyelids are closed and the conjunctivae are insensitive.
d. Surface of the body is pale, cold and clammy.
e. Respiration is slow, shallow and sighing.
f. Pulse is rapid, weak, faltering and scarcely perceptible to the fingers.
g. Temperature is subnormal.
h. Sphincters are relaxed perhaps with unconscious evacuation of the bowel and
bladder.
i. Reflexes are present but sluggish and in severe cases may be absent.

2. OPEN WOUND
. Abrasion- It is an injury characterized by the removal of the superficial
epithelial layer of the skin caused by a rub or friction against a hard rough
surface.

Forms of Abrasion:
a. Linear
b. Multi-Linear
c. Confluent
d. Multiple

Types of Abrasion:
Scratch - this cause by a sharp-pointed object which slides across the skin, a pain,
thorn or fingernail.
Graze – These are usually cause by forcible contact with rough, hard objects
resulting to irregular removal of the skin surface.
Impact or Imprint Abrasion – Those whose pattern and location provides
objective evidence to show cause, nature of the wounding material or instrument
in the manner of assault or death.

1. Marks of the grid of the radiator may be imprinted on the skin.

2. Tire thread marks may be seen on the skin in vehicular accidents.
3. Muzzle imprint in contact fire gun shot wound of entrance.
4. Teeth impression mark in the skin bites.

Pressure or Friction Abrasion – abrasion cause by pressure accompanied by

movement usually observes in hanging or strangulation.

2. Incised wound
-this is produce by a sharp edge (cutting) or sharp linear edge of the
instrument.

Changes that occur in an incised wound:

After 12 Hours - Edges are swollen; adherent with blood and with leucocyte
infiltration.
After 24 Hours - Proliferation of the vascular endothelium and connective-
tissue cells.
After 36-48 hours -Capillary network complete; fibrolasts running at right angles
to the vessels.
After 3-5 days - Vessels show thickening and obliteration.

Incised wounds may be:

a. Suicidal
b. Homicidal
c. Accidental

3. Stab wound
-is produced by the penetration of a sharp-pointed and sharp edged
instrument, like knife, saber, dagger, scissors.
4.Punctured wound
 -is the result of a thrust of a sharp pointed instrument.
5.Lacererated wound
-is a tear of the skin and the underlying tissues due to forcible contact with
a blunt instrument. It may be produced by a hit with a piece of wood, iron bar,
fist blow, stone , butt of firearm, or other objects without sharp objects.

Classification of lacerated wound:

a. Splitting caused by crushing of the skin between two hard objects.
b. Overstretching of the skin.
c. Grinding compression
d. Tearing

GAPING OF WOUNDS:

1. Mechanical stretching or dilatation- the presence of a mechanical device

on the edges to prevent coaptation will cause separation.
2. Loss of tissue- Separation of the edges of the wound may b on account of
loss of tissue bridging them. The loss of tissue may be due to:

a. Destruction by pressure, infection, cell lysis, burning or chemical

reaction.
b. Avulsion or physical or mechanical stretching resulting to
separation of a portion of the tissue.
c. Trimming of the edges.Debridment of the skin which com in
contact with the bullet at the gunshot wound of entrance and the
removal of necrotic material in an infected wound may cause
separation of the edges.
3. Retraction of the edges- Underneath the skin are dense networks of
fibrous and elastic connective tissue fibers running on the same direction
and forming a pattern more or less present in all persons.

LEGAL CLASSICIFICATION OF PHYSICAL INJURIES:

Article 262, Revised Penal Code
MUTILATION
-is the act of loping or cutting off any part or parts of the living body.

Kinds of Mutilation

1.Intentionally depriving a person totally of some of the essential organs for

reproduction.
2.Intentionally depriving a person of any part or parts of the body other than the
organs for reproduction.

Serious Physical Injuries:

Article 263, Revised Penal Code
- any person who shall wound , beat, or assault another, shall be guilty of
the crime of serious physical injuries.
The crime of serious physical injuries may be due to:
1. wounding
2. beating
3. assaulting
4. administering injurious substances
Administering Injurious Substances or Beverages
Article 264, Revised Penal Code
- any person who without intent to kill , shall inflict upon another any serious
physical injury, by knowingly administering to him any injurious substances or
beverages or by taking advantages of his weakness of mind or credulity.
Elements of the crime:
a. The offender inflicted upon another person any serious physical injury.
b. The infliction of physical injury was done knowing that the substance or
beverages administered is injurious or took advantage of the victim’s
weakness or credulity;and
c. There was no intent to kill on the part of the offender.

Less Serious Physical Injuries:

Article 265, Revised Penal Code
- any person who shall inflict upon another physical injuries not described
in the preceding article, but which shall incapacitate the offended party for
labor 10 days or more or shall require medical attendance for the same
period , shall be guilty
of less serious physical injuries.

Slight Physical Injuries and Maltreatment:

Article 266, Revised Penal Code

Kinds of slight physical injuries

1. Physical injuries which incapacitate the victim for labor from one to nine days
require medical attendance for the same period.
2. Physiacl injuries which did not prevent the offended party from engaging in his
habitual work or which did not require medical attendance.
3. Ill treatment of another by deed without causing any injury.

Physical Injuries Inflicted in a Tumultuous Affray:

Article 252. Revised Penal Code

Elements of the Crime:

a. There is a tumultuous affray.
b. Participant(s) suffered from serious physical injuries.
c. The person(s) who inflicted such serious physical injuries cannot be
identified: and
d. All those who appear to have used violence upon the person of the
offended party shall be penalized by arresto from 5 to 15 days.

MEDICO-LEGAL INVESTAGATION OF WOUNDS:

The following rules must always be observed by the physician in the examination
of wounds:
1. All injuries must be described, however small for it may be important
later.
 2. The description of the wounds must be comprehensive, and if possible a
sketch or photograph must be taken.
3. The examination must not be influence by any other information obtained
from others in making a report or a conclusion.

Outline of the Medico legal Investigation of Physical Injuries:

1.General investigation of the surroundings:
a. Examination of the place where the crime was committed.
b. Examination of the clothing’s, stains, cuts, hair and other foreign bodies
that can be found in the scene of the crime.
c. Investigation of those persons who may be the witnesses to the incident
or those who could give light to the case.
d. Examination of the wounding instrument.
e. Photography ,sketching, or accurate description of the scene of the crime
for purposes of preservation.

2.Examination of the Wounded Body:

a. Examination that are Applicable to the living and dead victim:

1.Age of the wound from the degr of healing
2.Determination of the weapon used in the commission of the offense.
3.Reasn for the multiplicity of the wound in cases where there are more than one
wound
4.Determination whether the injury is accidental, suicidal homicidal.

b. Examinations that are applicable only to the living:

1. Determination whether the injury is dangerous to life.
2. Determination whether the injury will produced permanent deformity.
3. Determination whether the wound (s) produced shock.
4. Determination whether the injury will produce complication as a consequence.

3. Examination of the Wound

The following must be included in the examination of the wound. The report
made in connection with such examination also included in the detail the
following items:
a. Character of the Wound
b. Location of the Wound
c. Depth of the Wound
d. Condition of the Surroundings
e. Extent of the Wound
f. Direction of the Wound
g. Number of Wounds
h. Condition of the Locality
1.Degree of hemorrhage
2.Evidence for struggle
3.Information as to the position of the body
4.Presence of letter or suicide note
5.Condition of the weapon

Determination whether the wounds were inflicted during life or after death
 In the determination whether the wounds were inflicted during life or after
death, the following factors must be taken into consideration:
1. Hemorrhage
2. Signs of Inflammation
3. Signs of repair
4. Retraction of the Edges of the Wound

Length of Time of Survival of the Victim After Infliction of the

Wound:

In the approximation of the length of survival of the victim after receipt of the
physical injury, the following factors must be taken in consideration:
1. Degree of healing
2. Changes in the body in relation to the time of death
3. Age of the blood stain
4. Testimony of the witness when the wound is inflicted

Possible Instrument Used by the Assailant in Inflicting Injuries:

1.Contusion - produce by blunt instrument.

2.Incised wound - produced by sharp-edge instrument inflicted by hitting.
3.Lacrated wound - produced by blunt instrument.
4.Punctured wound - produced by sharp-pointed instrument.
5.Abrasion – body surface is rubbed on the rough hard surface.
6.Gunshot wound – the diameter of the wound of entrance may approximate the
caliber of the wounding firearm.

Relative Position of the Victim and Assailant when Injury was Inflicted:
1.Location of the wound in the body of the victim.
2.Deriction of the wound .
3.Nature of the instrument used in inflicting the injury.
4.Testimony of the witnesses.

Extrinsic Evidence in Wound:

1. Evidence from the wounding weapon:
a. Position of the weapon
b. Blood on weapon
c. Hair and other substance in weapon
2. Evidence in the clothing of the victim.
3. Evidence derived from the examination of the assailant.
4. Evidence derived from the scene of the crime.

POLYTHECNIC COLLEGE OF LA UNION

CRIMINOLOGY DEPARTMENT
AGOO, LA UNION
A REPORT ON MEDICO- LEGAL ASPECT
OF PHYSICAL INJURIES

IN TH SUBJECT

LEGAL MEDICINE

BY:
NIMUAN, ERNALYN B.
DELIZO, REY
ESTALILIA, MARY ANTONETTE
ESTRADA, JONATHAN
LACHICA, ADORABLE