Cont

ents

IdentIfICatIon 5

X-ray 15

wounds 21

asphyXia 25

firearm injuries 27

head injuries 31

abortion 47

ballIstICs 49

hairs and fibers 63

tests for blood 65

tests for semen 67

general toXicology 69

antIdotes 73

house hold poisons 77

reinsch test 81

toXic seeds 85

5 IdentIfIcatIon

1- left humerus aged below 14 years (if male) due to:

-Trochlea and capitalum are not united (unites at 14 years in males).

2- left humerus aged more than 20years (if male) due to:

-The head is united with the shaft(epiphysis unites at 20 years in males)

3- (a): right ulna aged less than 16 years (if male) due to-The upper end of ulna is not united with the shaft(epiphysis unites at 16 years in males).

3- (b): left radius aged less than 17 years (if male) due to:-The head of radius is not united with the shaft (epiphysis unites at 17 years in males).

14

15 X-Ray

1- X ray, antero-posterior view of shoulder joint. the age is more than 20 years (if male) due to:

The epiphysis of head of humerus is united with the shaft (unites at 20 years in males).

2- X ray, antero-posterior and lateral views of elbow joint. the age is less than 14 years (if male) due to:

-The epiphysis between trochlea and capitulum is not united (unites at 14years in males).

22Wounds

3- Stab penetrating wound of the heart & over-lying Skin

Specimen: Opened heart and overlying skinlesions: Stab penetrating wound in the heart & overlying skin with 2 acute anglescausative instrument: Sharp pointed bi-bladed instru-ment “elliptical wound”possible cause of death: May be shock, hemorrhage or cardiac tamponade

4- Stab penetrating wound of the left ventricle of the heart & overlying cheSt wall

Specimen: Heart & overlying chest walllesions: Stab penetrating wound in the left ventricle & over-lying chest wall, regular edges and acute angles.causative instrument: Sharp pointed instrumentpossible cause of death: May be shock, hemorrhage or cardiac tamponade

25 AsphyxiA

1- A piece of skin of the neck with A ligAture mArk (most probAbly of hAnging).

Specimen: A piece of the skin of the neck.LeSionS: A ligature mark high up in the neck (notice hair line), and it is incomplete.-The mark is in the form of a depression with abrasions and contusions at the edges.mechaniSm of death: Cerebral anoxia, congestion, as-phyxia or reflex vagal inhibition.

26

27 Firearm injuries

1- A piece of Anterior chest wAll showing two fireArm inlets.specimen: A piece of the skin of the anterior chest walllesions:- Two injuries with loss of substance (firearm injury)- One is circular (perpendicular firing) & the other is oval or slit like (oblique firing)causative instrument: Rifled weapon possible cause of death: may be shock, hemorrahage or injury to vital organs

2- inlet &exit of fireArm wound in the heArt.specimen: Heartlesions:- 2 injuries with loss of substance (firearm injury)- 1st one in the right ventricle with regular inverted edges (inlet)- the other one is in the left ventricle which is rounded with irregular everted edges (exit)causative instrument: Rifled weapon possible cause of death: may be shock or hemorrahage

30

31 HEAD INJURIES

1-A trAnsverse section in the brAin And skull showing locAlized depressed comminuted frActure with nibbling And subdurAl hemAtomA.

specimen: A transverse section in the brain and skull.lesion: 1-Localized depressed comminuted fracture in the right parieto- occipital bone with nibbling.2-A big hematoma under dura matter (subdural hemorrhage) is present in left parieto-temporal bone.causative instrument: Heavy blunt instrument with local-ized striking surface area and high momentum.possible cause of death: May be brain compression.

46Abortion

2-The specimen is a feTus aged more Than 7 monThs and less Than 8 monThs gesTaTion.

aged more than 7 monthS geStation due to:• Itisabout35cminlength• Skinisstillwrinkled.• Ossificcentersappearincalcaneum(at5thmonthgesta-tion)andintalus(at7thmonthgestation).

aged LeSS than 8 monthS geStation due to:• Noossificcenterinthelowerepiphysisoffemur.

1-The specimen is a feTus aged more Than 4 monThs and less Than 5 monThs gesTaTioan.

aged more than 4 monthS geStation due to:• Fetallengthis16cm.• Sexisdifferentiated.

aged LeSS than 5 monthS geStation due to:• Noossifiedcenterincalcaneum(appearsat5thmonth).

49 Ballistics

1- the specimen is a complete, non fired cartridge of sporting gun (non-rifled weapon)

- It’s a complete, non fired cartridge (no dimple on the percussion cap)- It’s long, made of plastic with brass base- Inside the Cartridge there is Inner wad, outer wad and small rounded shots in between.- powder: is smookless or Black

2- the specimen is an empty, fired cartridge of sporting gun (non-rifled weapon)

it is an empty cartridge and fired (dimple in the percussion cap).it is long, made of plastic with brass base.the complete cartridge contains internal wad, external wad and small rounded shots in between.powder: is smookless or black

62Hairs & Fibers

1- Silk fiberDescription:

-Translucent cylinders.-Clear margin.-Refracting light.-No Surface markings.-No twists, No swellings.

DD: From hair and other types of fibers

2- linen fiberDescription:-Bamboo Like.-Segmented (may be swollen at Joints of segments with projections).DD:From hair and other types of fibers.

65

1- PHENOL – PHTHALEIN TEsT

Principle: It depends on the presence of peroxidase enzyme. Result: Pink color.Value: The stain may be blood (It is a preliminary test).

2- guAIAcum TEsT:

Principle: It depends on the presence of peroxidase enzyme. Result; Greenish-blue color.Value: The stain may be blood (It is a preliminary test).

TesTs For blood

Screening (MacrocheMical teStS)

66TesTs For blood

1-TEIcHmANN TEsT

Principle: It depends on the formation of special crystals of hemoglobin derivatives after addition of specific chemicals to the blood (Haemin crystals).Result: Small brown regular crystals with rhombic termination of acid hematin.Value: The stain is blood (It is confirmatory test).

2-TAkAyAmA TEsT

Principle: It depends on the formation of special crystals of hemoglobin derivatives after addition of specific chemicals to the blood (Hemochromogen crystals).Result: Needle salmon pink, feathery shaped crystals of alkaline hematin arranged in clusters or rosettes.Value: The stain is blood (It is confirmatory test).

confirMatory (MicrocheMical teStS)

67

1- Florence test

Principle: The test is based on the formation of brown rhombic crystals of choline periodideResult: Dark brown rhombic crystals of choline periodide arranged in clusters or crossed, (Larger than haemin crystals, disappear after 1/2 hour).Value: The stain may be semen.

2- BarBerios test

Principle: The test is based on the formation of yellowish green needle crystals of spermine picrate arranged in feathery appearance.Result: Yellowish green needle crystals of spermine picrate arranged in feathery appearance.Value: The stain may be semen.

TesTs For semen

70General ToxicoloGy

2- activated charcoal

Dose: Activated charcoal to poison ratio of 10:1 or 1 gm/kg is mixed with 60 to 90 ml of water. Contraindications of activated charcoal:

-Corrosives-Hydrocarbons-Intestinal obstruction, perforation or ileus.

3- oropharyngeal airway device

Placed in the mouth to lift the tongue and push it for-ward in comatosed patient or patient with depressed gag reflex.

73 ANTIDOTES

1- Diagnosis: Deferoxamine

- Target Poison: Iron- mechanism: It combines with iron forming deferoxam-ine-iron complex which is excreted via kidney.- Dose: 10-15 mg/k/hr up to 6 gm I.V. for serious toxicity.- route of administration: I.V.

2- Diagnosis: naloxone

- Target Poison: Opiate and Opioid toxicities.- mechanism: It competes & displaces drugs from Mu, Kappa & Delta opioid receptors.- Dose: 0.4 - 2 mg repeated every 2 minutes up to 20 mg.- route of administration: I.V.

78House-Hold Poisons

3- caustic Potash

Mechanism of action: Tissue injury by liquefactive necrosis. Fat & proteins are saponified resulting in deep tissue destruction; further injury is caused by thrombosis of blood vessels.Specific antidote: No specific antidote

4- naPhthalene

Mechanism of action: It’s an oxidative agent causing de-naturation of haemoglobin so haemoglobin precipitates inside RBCs leading to haemolysis of RBCs specially in patients with G6PD enzyme deficiency Specific antidote: No specific antidote

81 REINSCH TEST

1-Diagnosis: Container contains cupper foils with grey to black deposit indicating that it is arsenic or bismuth (+ve reinsch test). It must be followed by sublimation stage to differentiate bothPrinciple: Some metals precipitate on cupper foils giv-ing certain colors. Value +ve for soluble inorganic metals and negative for insoluble organic metals.

2-Diagnosis: Container contains Cupper foils with mirror-like deposit indicating that it is either mercury or silver (+ve reinsch test). It must be followed by sublimation stage to differentiate bothPrinciple: Some metals precipitate on cupper foils giving certain colors. Value :+ve for soluble inorganic metals and negative for insoluble organic metals.

84

85 TOXIC SEEDS1- Diagnosis : Nutmeg Seed

2- Description: About 3-4 cm in length. More or Less like a date. Slightly furrowed surface. Usedasaflavouringagen. Inmedicine:usedasgastricstimulantandabortificient.

3- Active principle: Myristicin ( hepatoxic )

4- Antidote: Nospecificantidote.

1- Diagnosis :Strychnusnuxvomicaseed.

2- Description: Ahard,rounded,buttonshapedseedwithacompressedconcavo-convex center and raised edges.It has central hilum at the middle of the seed.Ashgreyincolour,velvetsurface.It has intense bitter taste & no odour.

3- Active principle: Strychnus, brucine (alkaloids) and Loganin (glucoside).

4- Antidote: Diazepam.

89 TOXIC SEEDS

1- Diagnosis: Datura stramonium seed.

2- Description: 3-4mm in length. Kideny shaped. Finely mammillated. Black in colour.

3- Active principle: Atropine, Hyocine & Hyoscyamine.4- Antidote: Physostigmine.5- D.D: Onion seeds. Black pepper seeds.

1- Diagnosis: Onion Seed

2- Description: 1-2 mm in length. Irregularshapewithelevatedprotrusions(edible). Black in colour.

3- Antidote:Nospecificantidote.

4- D.D: Datura stramonium seed. Black pepper seeds.