Forensic Study Guide Final Version 2

KING ABDULAZIZ UNIVERSITY
Faculty of Medicine
FORENSIC MEDICINE
&
TOXICOLOGY
Study Guide
2009
TABLE OF CONTENTS
TOPIC
Page
THE OUTCOMES OF THE UNDERGRADUATE CURRICULUM
AIMS & OBJECTIVES
CURRICULUM MAP
INTRODUCTION
TEACHERS CONTACTS
10
ASSESSMENT
11
ICONS
13
TOPIC OUTLINES
14
NO .
LECTURES
(NAMES)
01
Identification & Mass disaster
15
02
Death & Post mortem changes and brain death (I)
17
03
Death & Post mortem changes and brain death (II)
19
04
Medico legal importance of wounds (I)
21
05
Medico legal importance of wounds (II)
23
06
Head Injuries
25
07
Fire Arm Injuries
27
08
Physical injuries
30
09
Asphyxia (I)
33
10
Asphyxia (II)
36
Faculty of Medicine
Pathology-core course-1
11
Sexual Offences
38
12
General Aspects of Forensic Toxicology
42
13
Volatile and Noxious Gases (I)
44
14
Volatile and Noxious Gases (II)
47
15
Plant Poisonous and Drug Dependence (I)
50
16
Plant Poisonous and Drug Dependence (II)
53
17
Animal poins and Insecticides poisonous
56
NO .
PRACTICAL
(Names)
Page
01
Identification
59
02
Ballistics Gross Specimen
60
03
Primary medico legal report and death certificate.
62
04
Blood & Hair and Fibbers
63
Faculty of Medicine
NO .
01
02
03
Pathology-core course-1
STUDENT-DIRECTED LEARNING (SDL)

Medico legal importance of Consent
Medico legal Significance of Car seat belt and Expected

injuries in car accident.
Medico legal evidence collection and reservation methods and
chain of custody.
NO .
TUTORIALS
01
Discussion on Medico legal importance of wounds.

Discussion on Addiction (Drugs and mechanism physiological
02
Page
antidotes.
Page
TRAINING IN FORENSIC MEDICINE

Aims/objectives of the course:
1.
To give the medical students basic knowledge (as a future general

practitioner) about the forensic pathology and forensic medical sciences.
2.
To give the students some basic skills of dealing with forensic cases in
their future careers.
3.
To highlight the major forensic problems in the community which

could face the general practitioners, and the way of dealing with them.
4.
Each lecture would have specific aim(s) (take home message(s)),

which would be insisted upon during and at the end of the lecture. These
aims would be evaluated at the end of each lecture.
Methods of fulfilling the aims:

The course would be delivered as lectures (total 17 hours). The lectures
would include:
Theoretical information
Practical knowledge
Forensic skills
Case studies
Discussions
The lectures will be submitted with a case picture to be looks like a case
scenario.
Multimedia such as power point presentation in would be used to fulfil the
aims.
Phase II
Pathology core course 1
Faculty of Medicine
FORENSIC MEDICINE
Prerequisites:
1.
Anatomy, physiology, histology and biochemistry of the human

body.
2.
General and systemic pathology.
Course Description:
Lectures (17)
PSL (2)
SDL (3)
Tutorials (2)
Practical (4)
Reading:
Book:
1)
2)
Simpson's Forensic Medicine

By: Bernard Knight, eleventh edition.
Hand Book of Forensic Pathology
By: Vincent J.M Di Maio
and Suzanna E. Daua
Phase II
Faculty of Medicine
Undergraduate Program Learning Outcomes

Code
Learning Outcomes
Knowledge
By the end of the program the graduate will be able to:
A1
A2
A3
A4
A5
A6
A7
A8
A9
A10
A11
A12
A13
A14
A15
A16
A17
A18
Describe normal human development across the life-span and how these
affect normal structure and function.
Describe normal structure and function of the major systems and how they
interrelate.
Describe the molecular, biochemical and cellular basis essential for
maintaining homoestasis.
Demonstrate knowledge of the basic medical sciences that explain causes
and mechanisms of disease.
Describe the alterations in structure and function of major body systems as
a result of illness or injury.
Demonstrate knowledge and understanding of the pharmacological
principles of treatment using drugs, their efficacy in the management and
symptomatic relief of diseases, as well as their side effects.
Discuss the implications of basic ethical principles, including
confidentiality, informed consent, truth telling, and justice, for the care of
patients.
recognize the legal background of medical practice
Explain the causes and mechanisms of intoxication.
Describe the role of family, community, and culture as factors influencing
patient presentations, interpretations of illness episodes and adherence to
treatment episodes.
Demonstrate knowledge and understanding of the natural history of disease
and relationships with risk factors and disease prevention.
Recognize and discuss the principles of disease surveillance and screening,
disease prevention, communicable disease control, health promotion, and
health needs assessment.
Describe strategies to support life-long learning via print and electronic
sources to assist in making diagnostic and treatment decisions and to remain
current with advances in medical knowledge and practice.
Demonstrate knowledge of how to use the basic medical sciences and
clinical skills for clinical decision making and problem solving in the care
of patients.
Recognize the scientific basis of health, disease, and medicine in the
management of common and high impact conditions in the society.
Demonstrate knowledge of the functional approach to managing chronic
conditions, including knowledge of the impact of chronic illness on
function.
demonstrate basic knowledge of the global health care delivery system in
the community including physicians, hospitals, outpatient centres, health
agencies and the role of community agencies in that system.
Recognize the management of common emergencies and the initial and the
life saving management steps for other emergencies.
7
Phase II
A19
Faculty of Medicine
Identify the "Red flags" indicating seriousness in the different clinical

presentations.
Cognitive Skills
B1
B2
B3
B4
B5
B6
B7
B8
B9
B10
B11
B12
B13
B14
B15
C1
C2
C3
C4
C5
C6
D1
D2
D3
Recognize, define and prioritize problems.

Demonstrate the ability to acquire new information and data.
Critically appraise validity and applicability of acquired information to
ones professional decisions.
Organize, record, research, present, critique, and manage clinical
information.
Recognize the limitations of knowledge in medicine and the importance of
triangulation of evidence before reaching a decision.
Evaluate the patients medical problems.
Formulate accurate hypotheses to serve as the basis for making diagnostic
and treatment decisions.
Reflect on ones thinking process and decisions and apply rational
processes.
Use appropriate intellectual strategies to deal with uncertainties when they
arise.
Demonstrate an understanding of research methodology.
Formulate research questions.
Draw research hypotheses.
Choose appropriate research methodologies and designs.
Select appropriate methods of data collection.
Analyse and interpret collected data.
Interpersonal Skills & Responsibility
Display the personal attributes of compassion, honesty, and integrity in
relationships with patients, families, communities and the medical
profession.
Exhibit appropriate value for the sensitive nature of the doctor/patient
relationship and the importance of active listening, with attention to the
patients familial, cultural, and spiritual circumstances.
Demonstrate professionalism and high ethical standards in all aspects of
medical practice, specifically competence, honesty, integrity, respect for
others, professional responsibility and social responsibility.
Exhibit a capacity for self-evaluation, moral reflection and ethical reasoning
to form the basis for a self-directed, lifelong engagement in the responsible,
committed, compassionate practice of medicine.
Apply the four principles of ethical and legal knowledge, namely respect for
autonomy, beneficience, non-maleficience and justice.
Demonstrate awareness and understanding of the legal and professional
responsibilities; and report inappropriate medical practice.
Communication, Information Technology & Numerical Skills
work effectively as part of a health care team
communicate effectively with patients, their families and colleagues, both
verbally and in writing
retrieve information by all means including electronically
8
Phase II
Faculty of Medicine
D4
D5
present information clearly in written, electronic and oral forms

work within a changing, multi-task environment
Psychomotor Skills
E1
Elicit accurate comprehensive and focused medical history by employing

techniques that facilitate the patients sharing of information.
Conduct a both effective and accurate comprehensive and focused physical
examination.
Formulate a differential diagnosis.
Select the appropriate laboratory tests and radiographic studies and interpret
their results and use them in making diagnostic and treatment decisions.
Formulate and implement a plan of care for both the prevention and
treatment of disease.
Educate patients about their health problems and to motivate them to adopt
health promoting behaviors.
Use pharmacotherapeutic agents and other therapeutic modalities
effectively.
Demonstrate appropriate technique for performing Basic Life Support and
Advanced Life Support.
Undertake tasks to initiate and be involved in the care of acutely ill patients.
E2
E3
E4
E5
E6
E7
E8
E9
Phase II
Faculty of Medicine
CURRICULUM MAP
STRUCTURE OF THE MODULE
Toxicology
413
17
TEACHING DEARTMENTS:
Pathology Department
10
SDL
PATM
Tutorials
Forensic Medicine and
PSL
Code/No
Practical
Module
Theoretical
Module Units (Hours)

Hours
Credit
Phase II
Faculty of Medicine
introduction
WELCOME to the forensic and toxicology course..

In this course , our goal to gain a broad understanding of basic
knowledge as a future general practitioner about the forensic pathology,
different forensic medical sciences in addition to the basic knowledge of
forensic toxicology which include some clinical knowledge of some poisonous
substance. To highlight the major forensic problems in the community which
could face the general practitioners, and the way of dealing with them. To give
the medical students basic knowledge as a future general practitioner- about
the forensic pathology and forensic medical sciences.
Student needs:
In order to establish this foundation, you will need to

learn a number of specific facts and the precise terminology used to
describe them.
as well as some key concepts about the mechanism of death, of wounds,
and of the poisonous. And to learn some about the role of laboratories in
forensic pathology, forensic medicine and forensic toxicology.
Learn the most recent technology in this field and how to collect the
samples, preserve it, to whom it should be sent, what is the chain of
custody. This is whatever your specialty in future.
Also you should learn a lot about the forensic system and the legal
roles, especially in your country, that regulate your medical job, as a
doctor.
Likewise, you will need to solve conceptual problems throughout your
training and career, in order to continue to build on your knowledge
about forensic cases and to evaluate the significance of new findings
that will be reported in future.
Study skills:
Introduce the students to university life and how to utilize lecture, study,
and utilize library and how to deal with examinations.
11
Phase II
Faculty of Medicine
TEACHERS CONTACTS
Name
Dr. Ayman
Department
Nagy (AN)
Pathology Ext#21106
ASSESSMENT
1. Formative:
This form of assessment is designed to give you feedback to help you to
identify areas for improvement. It includes a mixture of MCQs, short
answer-questions (SAQs), extended matching questions (EMQs), problemssolving exercises and independent learning activities in all subjects. These
will be given during tutorial sessions. The Answers are presented and
discussed immediately with you after the assessment. The results will be
made available to you.
2. Summative:
This type of assessment is used for judgment or decisions to be made about
your performance. It serves as:
a. Verification of achievement for the student satisfying requirement
b. Motivation of the student to maintain or improve performance
c. Certification of performance
d. Grades
12
Phase II
Faculty of Medicine
A:-Written Exams :
They will include multiple choice questions (MCQs).
They will cover material presented in lecture, readings, and discussion.
All exams must be taken on the date scheduled.
B:- Practical Exam :
It will be in an OSPE (Objective Structured Practical Exam) format,
You will pass through 5 stations.
C :- Continuous Assessment:
The degree of continuous assessment will be divided to:
40% to PSL.
40% to SDL.
20% to Log book
13
Phase II
Faculty of Medicine
In this Course your performance will be assessed according to the

following:
Continuous assessment quizzes
(30%)
Final written Exams
(50%)
Practical Exam (OSPE)
(20%)
Total = 100 Marks
The most characteristic of the fire arm injury is:

1. Presence of inlet and exit.
2. Loss of substance
3. Presence of associated projectile.
4. Presence of the missile.
5. The circular shape of wound.
Icons (standards)
The following icons have been used to help you identify the various
experiences you will be exposed to.
Learning objectives
14
Phase II
Faculty of Medicine
Content of the lecture
Independent learning from textbooks
Independent learning from the CD-ROM.

The computer cluster is in the 2nd floor of the medical library,
building No. 7.
Independent learning from the Internet
Problem-Based Learning
Self- Assessment (the answer to self-assessment exercises will

be discussed in tutorial sessions)
The main concepts
15
Phase II
Faculty of Medicine
Topic Outlines
16
Phase II
Faculty of Medicine
Lecture 1: Identification & Mass disaster

Student Notes:
Department: Pathology
Lecturer: DR. Ayman Abdel Hamid Nagy
At the end of the lecture you should be able

to:
1. Appreciate the concept of DNA
fingerprints.
2. Modern technology used in
identification.
3.
Understand the role of the forensic

pathologists in the identification process
4. Describe the major avenues requires

human identification services such as
mass disasters.
1.
DNA fingerprints and its role in human

identification.
2. The dating of skeletal remains.

3. Role of X- ray in identification.
Photosuperimposition techniques for
identifications. Reconstruction of the
facial appearance from skull.
4. The role of GP & the forensic
pathologists in the identification process.
(Insert here handouts and additional

pages for notes if needed)
17
Phase II
Faculty of Medicine
Continue 1: Identification & Mass disaster

Student Notes:
5. Role of the pathologist in mass disaster
(a-Forward planning-b- Outline of
necessities in mass disaster planning
include the provision of pathologists and
other staff, and Provision of mortuary
facilities. C-Retrieval of bodies).
Remember, However, That, Finger prints still the

most important human prints in the scene of the
crime.
Simpson's Forensic Medicine BY

Bernard Knight, eleventh edition.
To be announced in lecture

18
Phase II
Faculty of Medicine
Lecture 2: DEATH & POSTMORTEM CHANGES AND

BRAIN DEATH (I)
Student Notes:
Lecturer:
DR. Ayman Abdel Hamid
Nagy

to:
1. Define death and its types and their
medicolegal significat
2. Differentiate between physical death and
brain death
3. Medicolegal aspects of brain death.
4. Indications of death.
5. Postmortem Changes of forensic
importance..HypostasisRigor mortis.
1. Definition of death
2. Definition and criteria of brain death
3. Changes after death. The medicolegal
importance of temperature changes,
factors affecting the cooling rate,and
methods of measuring.

19
Phase II
Faculty of Medicine
Continue 3: DEATH & POSTMORTEM CHANGES AND

BRAIN DEATH (I)
Student Notes:
4. Definition and colors of hypostasis and
hypostasis timing, and differentiation
between it and contusion and medicolegal
aspects of hypostasis.
5. Definition, mechanisms and factors
affecting its timminig and cadaveric
spasm and medicolegal aspects of Rigor
Mortis.

Remember, However, That, The early

diagnosis of death is so important in
endemics and organ transplantation but
should be in accurate way.

Lecture 3: : DEATH & POSTMORTEM CHANGES AND

20
Phase II
Faculty of Medicine
BRAIN DEATH (II)

Student Notes:
Lecturer:
Nagy

to:
1. Putrefaction as a late Post mortem
changes.
2. Define Adipocere formation and describe
its medicolegal significance
3. Define Mummification and describe its
medicolegal significance
4. Define Maceration and describe its
5. Timing the postmortem interval
1.
Putrefaction Sequance, Putrefaction in

immmersied, in buried bodies and its

Continue Lecture 4: :
21
Phase II
Faculty of Medicine
DEATH & POSTMORTEM CHANGES AND BRAIN DEATH (II)

Student Notes:
2. Adipocere formation and its medicolegal
significance
3. Mummification and its medicolegal
significance
4. Maceration and its medicolegal
significance.
5. Post mortem damage by predators.
6. Identifying the time after death.
Remember, However, That insects is so

important in diagnosis of death, cause of death
and time passed since death. Do not miss
Predator injuries as postmortem injuries.

to be announced in lectures

Lecture 4: Medico legal Importance OF THE WOUNDS I

22
Phase II
Faculty of Medicine
Student Notes:
Lecturer:
Nagy

to:
1. Wounds, definition and type
2. Mechanism of wounds
3. Classifications of wounds
4. Forensic anatomy of the skin.
5. Role of forensic pathologist, Emergency
Room (ER) physician, and surgeon in
evaluation of wounds
6. Abrasions.
7. Contusions or Bruises.
8. Lacerations.
1. Definition of wound
2. Classification of wounds and
mechanisms of wouds.
3. Medico-legal aspect of wounds, and the
role of physician in evaluation of wound
for medico-legal point of view.
4. Definition, mechanism, age, medico legal
aspects of Abrasion, bruises, and
laceration.
5. The duty of General practitioner GP, ER
physician in evaluation of wounds from
medico-legal point of view.

Continue
Lecture 4: Medico legal Importance OF THE WOUNDS I
23
Phase II
Faculty of Medicine
Student Notes:
To be listed in the lecture.

Self-assessment
Briefly answer the following short question:
1- What is the medicolegal importance of
wounds?

Lecture 5: Medico legal Importance OF THE WOUNDS II

Student Notes:
24
Phase II
Faculty of Medicine
Lecturer: DR. Ayman Abdel Hamid
Nagy
At the end of the lecture you should be

able to:
1. Incised wounds, cut or slashes.
2. Stab Wounds and penetrating
injuries
3. Injuries by weapons other than
knives.
4. Defence and fabricated wounds.
5. Dating of wounds.
6. Causes of death from wounds and
Investigation of wounds.
1. Definition, mechanism, age, medico

legal aspects of Incised, stab and
penetrating wounds.
2. Medicolegal aspects of defence and
fabricated wounds.
3. Histological and histochemical
changes in wounds and its
medicolegal importance in dating of
wounds.
4. Investigations and differentiation
between suicidal, accidental and
homicidal wounds.
(Insert here handouts and additional pages for
notes if needed)
Continue
Lecture 6: Medico legal Importance OF THE WOUNDS II
Student Notes:
25
Phase II
Faculty of Medicine
Remember, However, That How to differentiate

between P.M and A.M. wounds? D.D. between
cut and contused wounds in skin stretched over
the bone?
3.

.
In the computer cluster also you have the

opportunity to see some useful web site.
www.google.com
Self-assessment
List the differences between contused and
incised wound

Lecture 6: Head Injuries

Student Notes:
26
Phase II
Faculty of Medicine
Lecturer:
Nagy
At the end of the lecture you should be

able to:
1. Describe skull fractures.
2. Describe the brain membranes
hemorrhage.
3. Describe the different injuries
affecting the cerebral tissues.
4. Describe the medico legal
significance, complications of
head injuries.
5. The ability to talk and walk after
different injuries.
2. Forensic anatomy of brain

membranes.
3. Description of different types of
brain membranes hemorrhages and
their medicolegal significance.
4. cerebral injuries, its mechanism, its
fatalities, and their medicolegal
importance.
5. Describe the complications and
causes of deaths from head injuries.
notes if needed)
Continue
Lecture 6: Head Injuries
27
Phase II
Faculty of Medicine
Student Notes:
Remember, However, That, All Head injuries

should be hospitalised for observation of post
concussion symptoms and signs?

You have the opportunity to watch the CD-ROM

You can access the CD-ROM during your spare
time.

opportunity to see some useful web site :
www. forensic pathology for student.com
www.studentconsult.com
Self-assessment
What is the lucid interval?

Lecture 7: FIRE ARM INJURIES

Student Notes:
28
Phase II
Faculty of Medicine
Lecturer:
Nagy

to:
1. Know the types of firearm weapons
including rifled weapons and non
rifled weapons.
2. Know the mechanics of missile
injury.
3. Identify characters of wounds from
smooth bore guns and rifled weapons
including; contact wounds,
intermediate and far distance wounds.
4. Differentiate and identify the entrance
and the exit of wounds.
5. Estimating the range of discharge.
6. Know the doctors duty in firearm
injuries and deaths.
1. Types of firearm weapons including

rifled weapons and non rifled weapons.
2. The mechanics of missile injuries.
3. Types and characters of firearms injuries
from rifled and non rifled weapons.
Continue
29
Phase II
Faculty of Medicine
Student Notes:
4. Factors affecting the shape of Firearm
injuries.
5. The differences between entrance and the
exit of fire arm injuries.
6. Estimating the range of discharge.
a. The medicolegal significant of firearm
injuries and doctor's duty in firearms
injuries.free radicals
Remember, However, That rifling marks are

primary and secondary and the secondary one
can be intentionally interrupted.


about the. You can access the CD-ROM during
your spare time.

Continue
30
Phase II
Faculty of Medicine
Student Notes:

opportunity to see some useful web site about the
inflammatory process:
www.Fleshandbones.com
www.webpath.com
Self-assessment
Enumerate the factors affecting FAI shape.

Lecture 8: - Physical injury

Student Notes:
31
Phase II
Faculty of Medicine
Lecturer:
Nagy
At the end of the lecture
you should be able to:
1. Physical injury, definition and types
2. Burning, classification, and causes of
death in burning.
3. Gross appearance at autopsy.
4. Ante mortem versus postmortem burns.
5.
Fumes and fires, Inhalation of soot.
6. Electrical injury, the difference between

point of entrance and exit.
7. Causes of death in electrical injury

8. Causes of death from lighting
1. Definition and classification of physical

injury
2. Value of evaluation of physical injury in
forensic medicine
3. Burning either dry or moist heat
4. Definition, classification of severity, causes
of death
5. Gross appearance at autopsy. Ante mortem
versus postmortem burns.

notes if needed)
Continue 8
Student Notes:
32
Phase II
Faculty of Medicine
6. Fumes and fires, Inhalation of soot.

7. Spurious " wounds" in burns. Atypical localized
burning and spontaneous combustion.
8. Electrical injury
9. Definition and Physical factors
10. The cutaneous electric marks
11. Cause of death in electrical injury, Internal and
histological appearance, Mood of death by
electricity.
12. Lighting
13. Definition and physical factors. External and
internal appearance.
14. Causes of death.
15. Medicolegal significance of physical injuries.
Remember, however, that Post mortem buns

is so common.

Continue 8
33
Phase II
Faculty of Medicine
Student Notes:


your spare time.

opportunity to see some useful web site about the
www.forensic pathology for students.com
Self-assessment
Differentiate scaldes from dry and corrosive
burns
Lecture 9: ASPHYXIA I
34
Phase II
Faculty of Medicine
Student Notes:
Lecturer:
Nagy

to:
1.
Define asphyxia and know its

classification ( Gordone's classification).
2.
Mechanical Asphyxia.
3.
Know the traditional features of

asphyxia.
4.
Understand the phases and sequences of

asphyxia.
5.
Define different types of mechanical

asphyxia and autopsy findings.
1. Definition, types and traditional features

of asphyxia.
2. Phases and sequences of asphyxia.
3. Definition, different types of mechanical
asphyxia and autopsy findings of each
type.
Continue 10
Student Notes:
35
Phase II
Faculty of Medicine
4. Effects and mechanism of fatal pressure

on the neck (Manual strangulation,
strangulation by ligature, mugging and
Arm locks and hanging, hanging, sexual
asphyxia) and autopsy findings.
5. Medico legal importance of each type of
mechanical asphyxia.
Remember, however, that post mortem

hanging

Continue 9
Student Notes:
36
Phase II

You have the opportunity to watch the CDROM about the. You can access the CDROM during your spare time.

opportunity to see some useful web site
about the
www.forensic pathology.com
Self-assessment
Briefly answer the following short
question:
List differences between hanging and
strangulation
Lecture 10: ASPHYXIA II

37
Faculty of Medicine
Phase II
Faculty of Medicine
Student Notes:

to:
1. Know the different autopsy signs of
immersion.
2. Know the difference between
drowning and immersion.
3. Natural causes of death before
entering and whilst in water
4. Understand the sequences of events in
drowning on fresh and sea water.
5. Know the autopsy signs of drowning.
6. Understand the mode of death.
7. Know the laboratory test for
diagnosis drowning (chemical
changes in the blood in drowning and
histological changes and diatoms).
a. The differences between drowning and

immersion.
b. The autopsy signs of immersion.
c. The sequence of events in drowning in fresh
and sea water.

Continue 10
Student Notes:
38
Phase II
Faculty of Medicine
d. The autopsy signs of drowning.

e. Natural causes of death before entering
and whilst in water
f. Mode of death and laboratory tests for
drowning.
g. Injuries sustained in or before entering the
water.
h. Estimation of duration of immersion.
Remember, Hower, That Do not miss non

violent cause of asphyxia

Lecture 11: SEXUAL OFFENSES

Student Notes:
39
Phase II
Faculty of Medicine
Lecturer:
Nagy

to:
1. Definitions and know the different types of
sexual offense.
2. Definition of rape, and medicolegal types
of hymen.
3. Consent and its medicolegal types.
4. Examination of living assailant and victim
in cases of rape and homosexual offences.
5. External and internal findings in fatal
sexual assaults.
6. Collection of medicolegal evidences as
semen and its examinations.
1.
Medico-legal aspects of
pregnancy.
2.
Examination of medico-legal
cases of pregnancy.
3.
Know the medico-legal aspects of

abortion including criminal, therapeutic
and spontaneous abortion, methods of
induction and doctor's action in respect to
illegal abortion. Regulations on induced
abortion.
Continue 11
Student Notes:
40
Phase II
Faculty of Medicine
7. Deaths associated with abortion and

autopsy in abortion deaths. Infanticide
definition, medicolegal importance and
autopsy findings
1.
Definition of each type of sexual

offense.
2. Know in details the doctors duty in

examination, including:
Informed consent and regulations

in general and in KSA especially
for examination and duties of
doctors in different medicolegal
cases.
Methods examinations and

manegement of allegad assailant
and victim.
Medcolegal evidences collections

as seminal collection and available
tests for recent and old stains.
Making full record for the case.
3. External and internal findings in

fatal sexual assaults.
4. Medico-legal aspects of pregnancy.
5. Medicolegal types of abortion and

medicolegal regulations of termination of
pregnancy.
6. Methods of induction of abortion.
Continue 11
Student Notes:
41
Phase II
Faculty of Medicine
7. Examination of case pregnancy and its

sure signs.
8. Examination of case recent and old
abortion.
9. Deaths associated with abortion and
autopsy in abortion deaths.
10. Collection of medicolegal evidence of
abortion and laboratory tests.
11. Infanticide definition,
medicolegal importance and
autopsy findings, age of viability,
determination tests for viability.
Remember, However That the Saudi regulation

of examination of all cases of rape and raped
females (especially).
Do not miss the illegal abortion in cases of
induced abortion

Continue 11
Student Notes:
42
Phase II
Faculty of Medicine


www.forensic pathology for student.com
Self-assessment
question:
What is the medicolegal significance of
abortion and pregnancy?
Lecture 12: GENERAL ASPECTS OF FORENSIC

TOXICOLOGY
43
Phase II
Faculty of Medicine
Student Notes:

to:
1. Definition of the poison, classification of
poison and fields of toxicology.
2. Definition of the forensic toxicology
3. The rules of the forensic toxicologist
4.
Medicolegal significance of forensic

toxicology.
5.
5.
Diagnosis of poisoning.
General treatment of poisoning
(emergency and supportive
management.)
1. Definition of the poison, classification of

poison and fields of toxicology.
2. Definition of the forensic toxicology
3. The rules of the forensic toxicologist
4.
Medicolegal significance of forensic

toxicology.
5.
6.
Diagnosis of poisoning.
General treatment of poisoning
exposure
Continue 12
Student Notes:
44
Phase II
Faculty of Medicine
Remember, That to safe the life of poisoned

patient the type of poison should be not the first
thing you should to know.


www. forensic pathology for medical
students.com

Lecture 13: VOLATILE POISONS AND NOXIOUS GASES(1)

Student Notes:
45
Phase II
Faculty of Medicine
Lecturer:
Nagy

to:
1.
Define the volatile poisons and Noxious

gases
2. Ethyl alcohol (Ethanol) metabolism.

3. Ethyl alcohol actions, toxic dose and fatal
dose.
4. Clinical picture of alcohol acute toxicity,
Its diagnosis, and treatment.
5. Medicologal importance of acute ethyl
alcohol toxicity and autopsy findings.
6. Methyl alcohol Toxicity. and
Medicologal importance of acute Methyl
alcohol toxicity and autopsy findings.
1. Define the volatile poisons and Noxious

gases

Continue 13
Student Notes:
46
Phase II
Faculty of Medicine
2. Ethyl alcohol metabolism, action, toxicity

(C/P, Fatal and toxic dose, and
medicolegal significance of ethyl alcohol
toxicity, autopsy finding)
3. Mthyl alcohol metabolism, action,
toxicity (C/P, Fatal and toxic dose, and
medicolegal significance of methyl
alcohol toxicity, autopsy finding).

Continue 13
47
Phase II
Faculty of Medicine
Student Notes:
listed:
will be announced in lecture


your spare time.

www.google.com
Self-assessment
Discuss autopsy findings in alcohol toxicity

pages for notes if needed) .
Lecture 14: VOLATILE POISONS AND NOXIOUS GASES

(II)
48
Phase II
Faculty of Medicine
Student Notes:
Lecturer:
Nagy

to:
1.
Cyanide poisoning, Conditions of

poisoning, management of toxicity.
2.
Medicolegal significance of poisoning and

autopsy finding.
3.
Carbon monoxide poisoning, Conditions of

poisoning, management of poisoning.
4.

autopsy finding.
5.
Carbon monoxide poisoning, Conditions of

poisoning, management of poisoning.
6.

autopsy finding.
1.
Cyanide poisoning, sources and

condition of poisoning, fatal and toxic
dose, c/p of toxicity and management,
autopsy findings and medicolegal
significance of cyanide toxicity.

Continue 14
Student Notes:
2. Carbon monoxide poisoning, sources and
49
Phase II
Faculty of Medicine

significance of carbon monoxide toxicity.
3. Carbon dionoxide poisoning, sources and
significance of carbon dionoxide toxicity.
4. Diagnostic laboratory tests and role of

physation in collection and preservation
of samples.

Continue 14
Student Notes:
Remember, That the CO poisoning is the silent

50
Phase II
Faculty of Medicine
Killer.


about the
. You can access the CD-ROM during your spare
time.

www.google.com
Self-assessment
What is the autopsy findings of cyanide and Co
poising?
Lecture 15: PLANT POISONOUS AND DRUG DEPENDENCE (1)

Student Notes:
Lecturer:
Nagy
51
Phase II
Faculty of Medicine

to:
1. Define the plant toxicology and alkaloids
2.
Describe the types and classifications of

plant poisons
3. Opium toxicity, sources and chemistry,

management of toxicity, medicolegal
importance of toxicity
4. Atropine toxicity, sources and chemistry,
importance of toxicity.
5. Strychnine toxicity, sources and chemistry,
importance of toxicity.
1. Definition of plant toxicology and

alkaloids.
2. Opium toxicity, sources and chemistry,
management of toxicity (c/p, antidotes,
D.D), precautions in prescription of
opium, medicolegal importance of
toxicity
Continue 15
Student Notes:
3. Atropin toxicity, sources and chemistry,
management of toxicity (c/p, antidotes,
D.D), medicolegal importance of toxicity
4. Strychnine toxicity, sources and
chemistry, management of toxicity (c/p,
antidotes, D.D), medicolegal importance
52
Phase II
Faculty of Medicine
of toxicity.

Continue 15
Student Notes:
Remember, however, that not all medicinal

plants are absolutely safe.
53
Phase II
Faculty of Medicine


about the
. You can access the CD-ROM during your spare
time.
On the website you will find

many interactive cases for
discussion, MCQs and images.
Self-assessment
What is the legal precautions of morphine
prescription?

Lecture16: PLANT POISONOUS AND DRUG DEPENDENCE (II)

Student Notes:
Lecturer:
Nagy

54
Phase II
Faculty of Medicine
to:
1. Ergot toxicity, sources and chemistry,
2. Cocaine toxicity, sources and chemistry,
3. Define the drug dependence
4. Theories of dependence, and
classifications of dependence
5.
Examples of dependence, management

of dependence
6. Describe the medicolegal aspects of the

drug of dependence.
1. Ergot toxicity, sources and chemistry,

management of toxicity (c/p, antidotes, D.D),
medicolegal importance of toxicity
2. Cocain toxicity, sources and chemistry,
management of toxicity (c/p, antidotes, D.D),
medicolegal importance of toxicity

3. Definition of dependence
Continue 16
Student Notes:
4. Theories of dependence, and classifications
of dependence
5. Examples of dependence and its
management.
6. Describe the medicolegal aspects of the drug
of dependence.
55
Phase II
Faculty of Medicine

Continue 16
Student Notes:
Remember, however, the magnitude of addiction

and increasing the number of addict drugs.
56
Phase II
Faculty of Medicine


your spare time.
On the website you will find many

interactive cases for discussion, MCQs and
images.
Self-assessment
What is the medicolegal significance of drug
depends?

Lecture 17: ANIMAL POISONS & INSECTICIDIES POISONOUS

Student Notes:
57
Phase II
Faculty of Medicine
Lecturer:
Nagy

to:
1. Define animal toxicology
2. Poisonous snakes, Classifications,
mechanisms of snake poisoning,
fatal period and fatal dose,
Management of toxicity.
3. Medicolegal importance of snake
poisoning and autopsy findings.
4. Poisonous scorpiones,
Classifications, mechanisms of
scorpion poisoning, fatal period and
fatal dose, Management of toxicity.
6. Medicolegal importance of bee
stings and autopsy findings.
7. Definition and classification of
insecticides.
8. Conditions of poisoning.
9. Medicolegal importance of
organophosphorus poisoning
10. Medicolegal importance of carbamates
poisoning
11. Medicolegal importance of paraquat
poisoning
Continue 17
12. Medicolegal importance of new insecticide
58
Student Notes:
Phase II
Faculty of Medicine
poisoning. Know the most acquired

preneoplastic disorders
1. What is animal toxicology, definition

and classifications
2. Poisonous snakes, Classifications,
mechanisms of snake poisoning, fatal
period and fatal dose, Management of
toxicity.
4. Poisonous scorpiones, Classifications,
mechanisms of scorpion poisoning,
fatal period and fatal dose,
Management of toxicity.
6. Medicolegal importance of bee stings
and autopsy findings.
7. Definition and classification of insecticides.
8. Conditions of poisoning.
9. Medicolegal importance of
organophosphorus poisoning (Diagnosis,
D.D, Treatment, Autopsy findings)
10. Medicolegal importance of Carbamates
poisoning (Diagnosis, D.D, Treatment,
Autopsy findings)
11. Medicolegal importance of paraquat
poisoning (Diagnosis, D.D, Treatment,
Autopsy findings).

Continue 17
Student Notes:
59
Phase II
Remember, however, that the insecticide

and organophosphrous poisoning are a
house hold poisoning.

You have the opportunity to watch the CDROM about the. You can access the CDROM during your spare time.
On the website you will find many

interactive cases for discussion, MCQs and
images.
Self-assessment
question:
What are the autopsy findings in snakes
poison and scorpion?
Practical 1:
Identification
60
Faculty of Medicine
Phase II
Faculty of Medicine
TUTOR: DR. Ayman Abdel Hamid Nagy

OBJECTIVES:
Characteristics useful in identifying the living, dead remains.
Personal identity from skeletal remains.
General identification of human remains (Biological profile) as role of

individual prints (finger, foot, lip, DNA and others).
Estimating the subject's age from skeletal structures and role of teeth in
identification.
.Determination of sex.
Estimation of stature and race from skeletal remains..
Teaching material of different gross specimens demonstrating the following lesions:

1.
2.
3.
4.
5.
6.
Images and X-rays

Long bone
Skull
Pelvis
Sternum
Jars of foetus
61
Phase II
Faculty of Medicine
Practical 2:
Ballistcs- gross specimens
Know the types of firearm weapons including rifled weapons and non
rifled weapons.
Know the mechanics of missile injury.
Identify characters of wounds from smooth bore guns and rifled

weapons including; contact wounds, intermediate and far distance
wounds.
Differentiate and identify the entrance and the exit of wounds.
Estimating the range of discharge.
Know the doctors duty in firearm injuries and deaths.
Types of firearm weapons including rifled weapons and non rifled

weapons.
The mechanics of missile injuries.
Types and characters of firearms injuries from rifled and non rifled
weapons.
Factors affecting the shape of Firearm injuries.
The differences between entrance and the exit of fire arm injuries.
Estimating the range of discharge.
The medicolegal significant of firearm injuries and doctor's duty in firearms

injuries.free radicals
62
Phase II
Faculty of Medicine
Teaching material of different gross specimens demonstrating the following lesions:

1. Complete bullet
2. Fired and non fired bullets
3. Empty cartage
4. Different types of powders
5. Images of different shapes of fire arm injuries.
6. Brown atrophy heart
.
Simpson's Forensic Medicine By Bernard Knight, eleventh edition.
63
Phase II
Faculty of Medicine
Practical 3:
Primary medicolegal reports and
Death certificates
OBJECTIVES:
1. Medico-legal aspect of wounds, and the role of physician in evaluation of
wound for medico-legal point of view.
2. Definition, mechanism, age, medico legal aspects of Abrasion, bruises,
and laceration.
3. The duty of General practitioner GP, ER physician in evaluation of wounds
from medico-legal point of view.
4. Medicolegal aspects of defence and fabricated wounds.
5. Histological and histochemical changes in wounds and its medicolegal importance
in dating of wounds.
6. Investigations and differentiation between suicidal, accidental and homicidal
wounds.
7. How to write a primary medicolegal report.
8. Indications of death.
9. Postmortem Changes of forensic importance..HypostasisRigor mortis.
10. Timing the postmortem interval
11. Death certificate.
64
Phase II
Faculty of Medicine
Practical 4:
Blood & hair and fibbers
Department: PATHOLOGY
OBJECTIVES:
Medicolegal importance of evidence in scene of crime in general.

Medicolegal importance of. hair &blood and fibbers.
How to preserve the forensic evidence?
What is the chain of custody?
Is it human?
Is it related to certain persn?
1.
:
Simpson's Forensic Medicine By Bernard Knight, eleventh edition.
65
Phase II
Faculty of Medicine
Independent learning
Independent learning is a very essential skill for tomorrows doctors. We
will train you to gain this important skill by asking you to read
independently about specific topics in pathology
List of Course student directed learning:

1- Medico legal importance of Consent
2- Medico legal Significance of Car seat belt and Expected injuries in car accident.
3- Medicolegal evidence collection and reservation methods and chain of custody.
66
Phase II
Faculty of Medicine
Problem Solving Learning PSL

Problem Solving Learning is a very essential skill for tomorrows doctors.
We will train you to gain this important skill by asking you to read
independently about specific topics in pathology
List of Course Problem Based Learning
1- It discuses house hold poisoning, and post mortem findings
in corrosive and heavy metal poisoning.
2- It discuses the house wife abuse, sexual abuse. Weapons
used, injuries findings and post mortem findings in this
case.
Log book requirement:
Students will be divided into groups each group consists of six
students they will work together to inspect and photo six medicolegal cases
( wounds, and/ or Post mortem changes). To write a full Primary
medicolegal report
By the end of the book it will be corrected and discussed according to cases.
67
Further Reading
Course Text Book:
Simpson's Forensic Medicine
BY
Other Information Resources:
1. Knight's Forensic Pathology by Pekka Saukko. Bernard Knight,
Third Edition ( Reading Text book).

2. Hand Book of Forensic Pathology By: Vincent J.M Di Maio
and Suzanna E. Daua (Reading Text book).

3. Forensic web site on the internet.
www.forensicmedicineformedicalstudent.co.uk
www.internt pathologylaboratory for medical education. co
4. Hand out of lectures.
5. King Abdul Aziz University Library.

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KING ABDULAZIZ UNIVERSITY

THE OUTCOMES OF THE UNDERGRADUATE CURRICULUM

AIMS & OBJECTIVES

Identification & Mass disaster

Death & Post mortem changes and brain death (I)

Death & Post mortem changes and brain death (II)

Medico legal importance of wounds (I)

Medico legal importance of wounds (II)

Fire Arm Injuries

General Aspects of Forensic Toxicology

Volatile and Noxious Gases (I)

Volatile and Noxious Gases (II)

Plant Poisonous and Drug Dependence (I)

Plant Poisonous and Drug Dependence (II)

Animal poins and Insecticides poisonous

Ballistics Gross Specimen

Primary medico legal report and death certificate.

Blood & Hair and Fibbers

STUDENT-DIRECTED LEARNING (SDL)

Medico legal Significance of Car seat belt and Expected

Discussion on Medico legal importance of wounds.

TRAINING IN FORENSIC MEDICINE

To give the medical students basic knowledge (as a future general

To highlight the major forensic problems in the community which

Each lecture would have specific aim(s) (take home message(s)),

Methods of fulfilling the aims:

Pathology core course 1

Anatomy, physiology, histology and biochemistry of the human

General and systemic pathology.

Simpson's Forensic Medicine

Pathology core course 1

Undergraduate Program Learning Outcomes

Pathology core course 1

Identify the "Red flags" indicating seriousness in the different clinical

Recognize, define and prioritize problems.

Pathology core course 1

present information clearly in written, electronic and oral forms

Elicit accurate comprehensive and focused medical history by employing

Pathology core course 1

Forensic Medicine and

Module Units (Hours)

Pathology core course 1

WELCOME to the forensic and toxicology course..

In order to establish this foundation, you will need to

Pathology core course 1

Pathology core course 1

Pathology core course 1

In this Course your performance will be assessed according to the

Continuous assessment quizzes

Final written Exams

Practical Exam (OSPE)

The most characteristic of the fire arm injury is:

Pathology core course 1

Content of the lecture

Independent learning from textbooks

Independent learning from the CD-ROM.

Independent learning from the Internet

Self- Assessment (the answer to self-assessment exercises will

The main concepts

Pathology core course 1

Pathology core course 1

Lecture 1: Identification & Mass disaster

At the end of the lecture you should be able