<<Legal med-july 8, 2013.

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LEGAL MEDICINE
COVERAGE: Beginning up to sexual dysfunctions!
Monday, July 08, 2013 8:18 PM

STUDY!
1. Definition of legal medicine -LEGAL MEDICINE is a branch of medicine that applies, medical and surgical concepts, scientific knowledge and skills to medicolegal issues, inorder to assist the trier of facts in the proper dispensation of justice. Cut- an injury that is longer than its deep; stab wound- an injury that is deeper than its long Asphyxiation- death from lack of oxygen in the blood. Maybe caused by hanging, accident, suicide or strangulation.

-Medical Jurisprudence is the study of medical law and its applicable jurisprudence, that governs, regulates and defines the practice of medicine. Birth determines personality; but the conceived child shall be considered born for all purposes that are favorable to it, provided, it be born later with the following condition. For civil purposes, the fetus is considered born if it is alive at the time it is completely delivered from the mother's womb. However, if the fetus had an intra-uterine life of less than seven months, it is not deemed born if it dies within 24 hours after its complete delivery from the maternal womb.

Death, Legal presumption of- rule in law that a person is deemed to have died if absent without explanation from his or her usual or last place of residence for a long and continuous period. Presumption of Death: 154 Rules for Purposes of Survivorship: (Rule 131, Sec. 3) 1. If both were under the age of fifteen years, the older is deemed to have survived; 2. If both were above the age of sixty, the younger is deemed to have survived;

3. If one is under fifteen and the other above sixty, the former is deemed to have survived; 4. If both be over fifteen and under sixty, and the sex be different, the male is deemed to have survived; if the sex be the same, the older; 5. If one be under fifteen or over sixty, and the other between those ages, the latter is deemed to have survived.

Death- is the complete cessation of all the vital functions of the body without possibility of resuscitation. The ascertainment of death is medical and not legal problem. Importance of Death Determination: a. The civil personality of a natural person is extinguished by death; b. Succession: The property of a person is transmitted to his heirs at the time of death; c. The death of a partner is one of the causes of dissolution of partnership agreement; d. The death of either the principal or agent is a mode of extinguishment of agency; e. The criminal liability of a person is extinguished by death; f. Extinguishment of Parental authority g. Extinguishment of the Obligation to Support

Brain death- occurs when there is deeply irreversible coma, absence of electrical brain activity Cardiorespiratory death- occurs when there is a continuous and persistent cessation of heart action and respiration. Four Kinds of Death 1. Clinical or Somatic death: occurs when in the judgment of the physician with the use of his clinical eye, the body's vital signs of life, cease to exist continuously and permanently. This is the state of the body in which there is complete, persistent and continuous cessation of the vital functions of the brain, heart and lungs which maintain life and health. 2. Brain Death: follows clinical death, occurs when there is deeply irreversible coma, absence of electrical brain activity 3. Biological Death: all components of the brain are dead. There's a permanent extinction of bodily life.

4. Cellular Death: Irreversible cell injury, cessation of respiration and metabolism of the body tissues which is soon followed by autolysis and decay SIGNS OF DEATH 1. Cessation of heart action and circulation 2. Cessation of respiration 3. Cooling of body (ALGOR MORTIS). No more heat is produced and the body continuous to loss its body temperature. After death the metabolic process inside the body ceases. No more heat is produced but the body loses slowly its temperature by evaporation or by conduction to the surrounding atmosphere. 4. Loss of motor power 5. Loss of sensory power 6. Changes in the skin 7. Changes in and about the eye Changes in the Body following Death 1. Changes in the Muscle a. Stage of primary flaccidity b. CADAVERIC RIGIDITY/ RIGOR MORTIS- the whole body becomes rigid due to muscular contraction which develops 3-6 hours after death and may last for 24-36 hours. c. CADAVERIC SPASM- is the immediate or instantaneous spasm or rigidity of the skeletal muscles occurring at the moment of death due to exhaustion, nervous tension, stress , fear, anger or injury to the motor nerves or injury to the chest. 2. Changes in the Blood a. Coagulation of the Blood b. LIVOR MORTIS-known as postmortem lividity, occurs in most dependent areas of the body bet. 3-6 hours after death. 3. Autolytic/ Auto digestive changes after Death 4. Putrefaction of the body Death Certificate- is a legal document necessary for burial of the dead, as it certifies the occurrence of death. It is a document from the office of the Civil Registrar General, listing the particulars of an individual's death. Death warrant: is a warrant from the proper executive authority, appointing the time and place for the execution of the sentence of death upon a convict judicially condemned to suffer death Immediate cause/Primary cause of Death- the last of a series of events or chain of causes tending to a given result and which, of itself, and without the intervention of any further cause, directly produces the result or event.

The Antecedent Cause- events or conditions that substantially contribute to the Immediate Cause of death.

-Evidence is the means, sanctioned by the Rules of Court, of ascertaining in a judicial proceeding the truth respecting a matter of fact (Sec. 1, Rule 128, Rules of Court). -Types of Medical Evidence: 1. 2. 3. 4. 5. Autoptic or Real Evidence . Testimonial Evidence Experimental Evidence Documentary Evidence Physical Evidence

TRAUMA- injury; the leading cause of death in the first four decades of life and the third leading cause of death in all age groups today. Injury SPECIFIC INJURIES 1. Head 2. Spine and Spinal Cord Injuries 3. Chest 4. Abdomen 5. Fractures and Dislocations Fractures-comes from the Latin word "fractura" which means break in the bone continuity. It is also a combination of a break in the bone and soft tissue injury. Sprain- partial or complete disruption in the continuity of a ligamentous support of a joint Dislocation- complete displacement of a joint Subluxation- partial dislocation of joint Strain- Overstretching of muscle
6. Urologic

CLASSIFICATION OF WOUNDS
1. As to legal Classification -Parricide Death or physical injuries Murder Homicide Physical Injuries in Tumultuous Affray -Discharge of firearms

Giving assistance to suicide -Infanticide Intentional Abortion -unintentional abortion -abortion practiced bya physician or midwife and dispensing of abortives Physical Injuries (serious, light, less serious, mutilation) Rape

2. As to the Depth of the Wound a. Superficial: when the wound involves only the layers of the skin b. Deep: when the wound involves the structures of beyond the layers of the skin -penetrating: wound enters the body but does not come out -perforating: there is a communication between the outside, inner and the outside. 3. As to Mortality a. Deadly Wound 4. As to the Wounding Instruments a. Sharp instruments

B. Non-deadly wound

B. Blunt instruments

5. As to the Consequential Injury after application of Force a. Coup injury b. Coup centre Coup injury; Minoris Resistencia e. Extensive Injury

c. Conter Coup Injury

d. Locus

6. As to the Integrity of the Skin a. Closed Wounds: presents no break in the integrity or continuity of the skin. There may be only outward manifestations of injury internally b. Open Wounds: there is a break in the continuity of the skin

SPECIAL TYPES OF WOUNDS

1. Assailant's Wound: these wounds are sustained by the assailant from the victim, while the former is in the process of attacking, wounding, assaulting, beating or killing his victim 2. Defense' wounds: In the process of defending himself from the attacks, assaults, wounding or beating of the assailant, the victim sustains defensive wounds usually in the upper extremities. 3. Victim's wounds: these wounds are sustained by the victim, from the assailant, the former not having the chance or opportunity to defend himself. 4. Self-Inflicted Wounds: self inflicted by the person on himself. 5. Homicidal wounds: these are the serious wounds sustained by the victim, resulting to his death from the criminal assailant. 6. Accidental wounds: these wounds are sustained by the victim, without any fault or intention whatsoever on the part of the accused to inflict the wounds on the victim.

7. Suicidal wounds: wounds self- inflicted by the victim on himself, usually seen on the temple or fatal areas of the body, accessible to the hand of the victim

Indication that the victim is shot close range a. Entrance wound shows inverted edges. b. If within the flame reach, which is less than 3 inches in ordinary handguns, there is an area of burning c. Smudging is present due to smoke. d. Powder tattooing is present. e. Presence of an abrasion ring or collar. DISTINCTIONS BETWEEN GUNSHOT WOUNDS OF ENTRANCE AND EXIT 1. Smaller than the missile due to elasticity of tissues- always bigger than missile. 2. Edges are inverted- everted edges 3. Oval/round depending upon angle of approach of bullet- no definite shape 4. Contusion collar or contact ring is present due to invagination of the skin - absent 5. Tattooing or smudging maybe present when firing is near- always absent 6. Underlying tissues do not protrude beyond the skin- potrusion may be seen.

SEXUALITY: normal biological urge and an important part of the human experience. Desire
Arousal Orgasm resolution SEXUAL DYSFUNCTIONS As to choice of sexual partners HOMOSEXUAL The sexual desire is toward the same sex. Physicians now consider this not a sexual dysfunction, but merely a sexual orientation that is present from childhood. Two kinds of HOMOs: Overt Homosexual: Persons who are conscious of their homosexual cravings and who makes no attempt to disguise their intention. They make advances towards members if their own sex openly. Latent Homosexual: Persons who may or may not be aware of the Ardent wish to engage in sexual activity The state of sexual excitement The peak or climax of sexual excitement A sense of well-being and general muscular relaxation follows orgasm

tendency in that direction but are nevertheless incline to repress the urge to give way to their homosexual yearning. HETEROSEXUAL Normal persons who desire to have sex with the opposite gender.

INFANTO SEXUAL Sexual desire is towards minors. BESTO SEXUAL AUTO SEXUAL A sexual desire towards animals. A form of sexual self gratification.

Transvestism is a form of sexual deviation characterized by an overwhelming desire to assume the attire and be accepted as a member of the opposite sex.

Hermaphrodism: A state of bisexuality. The gonads of both sexes are present which may be separated or combined as ovotestis.

Pseudohermaphrodite are persons who have the gonadal tissue of one sex and the behavior of the opposite sex.

As to instinctual strength of sexual urge

Oversex Undersex Satyriasis is the excessive sexual desire in men, while Nymphomania is the excessive sexual desire in women who is called a "fighter or hot woman" Sexual anesthesia- absence of sexual desire ; Dyspareunia- painful sexual intercourse in women; Vaginismus- painful spasm of the vagina during coitus Old age- decrease in sexual desire

As to mode of sexual expression 1. Oralism The use of mouth as a way of sexual gratification a. Fellatio- the female partner sucks the penis and initiates ejaculation. b. Cunnilingus- this is sexual gratification by licking the female genitalia. c. Analism- sexual gratification is attain by licking the anus of the sexual partner.

2. Sado-masochism Pain or cruel acts is inflicted on the sexual partner for sexual gratification.

a. sadism- the sexual enjoyment a person receives from inflicting actual physical or psychological suffering on a sex partner. b. Masochism- there is a sexual enjoyment in being physically harmed, threatened or abused, the pain and humiliation from the opposite sex is the primary factor for sexual gratification. 3. Fetishism A sexual perversion wherein the real or fantasied presence of an object or bodily part is necessary for sexual stimulation and or gratification. Kinds of Fetishes are: a. Anatomic - particular portions of anatomy, such as breast, or buttocks are the target of interest for sexual stimulation. b. Clothing - the deviate may have interest centered on shoes, hanky, undergarments, either of a sexual partner or a stolen clothing. c. Necrophilic - the deviate has the desire to have sex with the dead body. d. Odor (ospresiophilia)- a fetishism whose stimulus is pleasant odor or foul odor for sexual stimulation or gratification.

SEXUAL CRIMES: Chaste Virgin Kinds of Virginity An-unmarried woman who has had no carnal knowledge with men or that she never voluntarily had unlawful sexual intercourse. A of woman who has had no carnal knowledge of man. Her genital organs have not been altered by carnal connection. 1. Moral Virginity- the sate of knowing the nature of sexual life and not having experienced sexual relation. 2. Physical Virginity- a condition whereby a woman is conscious of the nature of sexual life but has not experienced sexual intercourse. 3. Demi-Virginity- refers to condition of a woman who permits any form of sexual liberties as long as they abstain from rupturing the hymen by sexual act. 4. Virgo Intacta- a truly virgin woman. There is no structural change in her organ, notwithstanding the fact of her previous sexual intercourse.

SEX CRIMES IN THE RPC -rape -carnal knowledge

-seduction ( act of a man enticing a woman to have unlawful intercourse with him by means of persuasion, solicitation, promises or bribe without employment of force) -acts of lasciviousness (acts which tend to excite lust, or conduct which is wanton, lewd, voluptuous, or lewd emotions by using force or intimidation, depriving her of reason or is otherwise unconscious. -abduction -adultery -concubinage -bigamy -premature marriage -prostitution Provisions of RPC applicable to UNNATURAL SEXUAL OFFENSE -grave scandal -immoral doctrines, obscene publications and exhibitions - vagrants and prostitutes - grave threats - light threats - grave coercions -unjust vexations