Professional Documents
Culture Documents
Classification
Description
Medico-legal Importance
Cont.
2 meanings:
A simple object created by humans, from a particular period in
past for any practical purpose which have cultural or historical
interest, so usually used by historians. (a favorite word among
them)
Four types
1. Due to resuscitative or therapeutic measures
2. Between death and autopsy
3. Due to injuries or lesions of organs before death
4. During post-mortem examination
Due to resuscitative or therapeutic
measures
1. From the very outset, I want to state that HISTORY OF
PATIENT is of utmost importance in every branch of medical
science, either clinical or non-clinical, so is applied to
Forensic Medicine.
2. Marks of injection & defibrillator on chest
3. CPR – fracture of ribs & sternum
a) Can cause haemothorax & haemopneumothorax
b) Fat embolism from fractured ribs or sternum
c) Laceration of spleen, liver and diaphragm
4. Positive pressure ventilation – emphysema, sub-pleural air
blebs, tension pneumothorax.
Cont.
DEFIBRILATOR MARKS SIMULATING ANTEMORTEM ABRASION
OVER CHEST
5. Counter irritation Chinese style on neck – extravasation
of blood under skin – suspicion of throttling.
6. Endo-tracheal intubation – inexperienced hands – injury
to larynx and adjacent tissue – suspicion of foul play.
7. Carotid Angiography – neck muscle bruise – suspicion
of throttling.
8. Antemortem surgeon’s intervention on wounds may
mislead autopsy findings.
Between death and autopsy
1. Agonal artefact – ‘agonal’ the struggle that precedes
death.
a. Common agonal artefact is REGURGITATION &
ASPIRATION
Ante mortem Agonal Reaction Post mortem Agonal Artefact
Stomach contents aspirated and Never reaches to lower
goes to lower respiratory tract respiratory tract.
mixed with fluid and mucus
choking effect death
b. Vascular collapse or shock before death
Area underlying
simulate bruise
Exhumed body
4. Artefacts due to handling of cadavers
• From transportation
• Abrasion, laceration, blood spots on clothes and body
which was absent in original.
• From careless handling
• Bruise in occipital area due to head bumping on hard
surface, differentiated by wiping off the bruise.
• Fracture ribs and vertebras.
• Weak, osteoporotic bones may get fractured due to
counteract the Rigor Mortis.
• Brush abrasions on back by dragging.
Abrasion
Antemortem Postmortem
Looks brownish or reddish Brown or parchment like
Scab is noticed if gets older Scab is never noticed
Bleeding surface present if fresh No bleeding surface is evident
Healing is evident No such thing can ever happen
Can be found on any part of body Usually on bony prominences
Surface is moist Surface is dry
Laceration
Antemortem Postmortem
Vital reactions will be seen No vital reaction will be seen
Margin is bruised No bruising is seen on margin
Post mortem abrasion
Bruise – it is essentially a vital phenomena
Antemortem Postmortem
Swelling Cannot be similar as antemortem
Evidence of extravasation of blood Can be produced like antemortem to
some extent with in 2 minutes to
maximum of 2-3hrs, that to on the
tissue which can be forcibly
compressed against the bone.
Extravasated blood will impart But disproportionate to effect of force,
colouring to the affected area bruise will always be less
Colour changes denote resolution of Occipital postmortem bruise simulate
bruise antemortem bruise , difference is
absence of vital reaction apart from
microscopy.
Detection of enzyme ascertain
antemortem origin eg. – esterase,
aminopeptidases, acid phosphatase,
alkaline phosphatase
False simulated artificial bruise
• Irritant substances can do so
• Done to substantiate a false charge of assault
• By plumbago zeylanica, rolsea, semicarpus anacardium
• Margins contain tiny vesicles containing acrid serous
fluid
• Surrounding skin shows inflammatory reaction
• Diagnosis is made by incision, clot cannot be wiped off
Clotted blood
Antemortem Postmortem
It cannot be wiped off as it It can be wiped off easily
fibrin. because it does not have
fibrin.
Postmortem blood clot is of 2 types:
Red current jelly: forms rapidly, soft, lump, slippery,
uniformly dark red.
Chicken fat: forms when clotting occurs slowly, consist of
2 layers:
Reddish moist lower layer: consist of red cells, soft, lumpy.
Bright yellow upper layer: of fibrin and serum, jelly like.
5. Artefacts due to Rigor Mortis
• To move the body, breaking is done, resulting in
asymmetrical Rigor Mortis
• May cause misinterpretation of Time Since Death.
• Heat/Cold stiffening may pose as an artefact against Rigor
Mortis.
• How to differentiate heat/cold stiffening to Rigor Mortis:
Gas stiffening may simulate Rigor Mortis, but with the
following features one can easily differentiate it from Rigor
Mortis:
Putrefactive changes will be seen, as it is due to inflation of
tissue spaces by gases of putrefaction, which is not seen in
heat or cold stiffening.
No particular order of appearance or disappearance as in
Rigor Mortis
Joints are not tight, so can be moved easily.
No muscle shortening as in heat stiffening.
Stiffening will pass if gas is allowed to escape by incisions over
the areas.
Rigor Mortis
Heat Stiffening
Gas Stiffening
6. Artefacts due to hypostasis
• Localised hypostasis may be mistaken as bruise
• Hypostasis in dependent part of –
• Heart - Resemble Myocardial Infarction.
• Lung - Pneumonic or broncho-pneumonic consolidation.
• Intestine – suggest corrosion or strangulation.
• Stomach – looks like poisoning.
• Hypostasis in nails sometime confuses with cyanosis.
• Hypostasis artefact colors in –
• Refrigeration – pink.
• Carbon Monoxide poisoning– cherry red.
• Hydrogen Cyanide poisoning – bright red.
• Potassium Chromate / Bichromate – chocolate brown.
• Phosphorus poisoning – dark brown.
Hypostasis like bruise
Hypostasis of lung
hypostasis in refrigerated body: pink
colour
Decomposition
artefacts:
• It brings lots of significant
changes which can be mistaken
as artefact on naked eye
examination. Some of the
following are:
Sl. No. Artefact Misinterpretation Remark
1 Swollen oedematous Antemortem obesity
corpulent in early stage
2 Blood stained froth Pulmonary oedema, History can tell about
from mouth and nostrils head injury etc head injury or drowning
3 Postmortem blisters Antemortem blisters Difference shown in other
due to burn or scald slide.
4 Post mortem bleeding Antemortem bleeding Antemortem bleeding
from severed blood cannot be wiped off
vessels
5 False groove over neck Strangulation Close observation,
due to tight collar, neck history, ecchymosis if
tie evident.
6 Separation of head Trauma Close observation and
sutures or burst of history
abdomen due to gas
7 Gas in heart and blood Embolism Alkaline Pyrogallol gas
vessels treatment - gas will turn
brown due to O2 in
antemortem embolism
Sl. No. Artefact Misinterpretation Remark
8 Rupture of oesophagus corrosive acid Absence of vital signs
& stomach due to poisoning
gastric juices
9 Hypostatic strangulated or History of hospitalization,
discolouration of infarcted bowel histopathology.
intestine
10 Stains on face due to chemical burns chemical analysis
regurgitation
11 Vaginal introitus will sexual assault History, vaginal swab,
be loose, lax and flaccid uterus examination and
with blood stained histopathology will bring
discharge with bluish the truth.
discolouration of
mucosa
After drying –
abrasion or thermal
burn
9. Artefacts associated with accidental deaths
– Railway electrician on electric poles
• Get electrocuted die
fall on track
run over by train
• Accidental run over antemortem
post mortem run over
antemortem abrasion
– Maggots – in antemortem injuries
Miscarriage of justice
Take home message
ARTEFACT MAY
LEAD
IMPRISONMENT
OF INNOCENT
AND FREEDOM
OF THE GUILTY.
THANK YOU