Reviewer in Forensic Medicine: Melcon S. Lapina, Mscrim
Reviewer in Forensic Medicine: Melcon S. Lapina, Mscrim
Reviewer in Forensic Medicine: Melcon S. Lapina, Mscrim
FORENSIC MEDICINE
By
MELCON S. LAPINA,
MSCrim
Q1
The scope of forensic medicine
can be summed in two words.
a. Absolute and complicated
b. Broad and encompassing
c. Definite and wide-ranging
d. Specific and delimiting
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answer
Q2
It is the inner framework of the
body. It gives form and rigidity to
the body, and serves to protect
many vital organs.
a. Digestive system
b. Integumentary system
c. Muscular system
d. Skeletal system
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answer
Q3
An effect of injury that takes place
when the stimulus applied is
insufficient to cause injury and the
body resistance is great.
a. Apparent
b. Real
c. Immediate
d. Delayed
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answer
Q4
Under the physics of wound
production, this factor explains
why an M-16 will do more damage
than .38 caliber bullet.
a. Area of Transfer
b. Elasticity and plasticity of tissue
c. Kinetic energy
d. Time
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answer
Q5
Sensation of heat or increase in
temperature.
a. Rubor
b. Calor
c. Dolor
d. Loss of function
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answer
Q6
Wound brought about by blunt
instrument could be any of the
following, EXCEPT
a. Contusion
b. Hematoma
c. Laceration
d. Incision
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answer
Q7
X, a doctor, wanted to kill his wife by poisoning.
During dinner time, he put poison on the food
of his wife. Moments after, his wife suffered
excruciating pain in the stomach. Seeing his
wife in agony, he pitied his wife and
administered an antidote. Thus, his wife did
not die. What is the crime committed by X?
a. Frustrated parricide
b. Attempted parricide
c. Serious physical injuries
d. Murder
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answer
Q8
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answer
Q9
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answer
10
Q1
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11
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12
Anatomy
Physiology
Biochemisty,
Physics
Other allied sciences
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13
Nature of Study
Knowledge in
Pathology
Surgery
Gynecology
Toxicology
Other branches of medicine
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Next Question
14
Q2
It is the inner framework of the
body. It gives form and rigidity to
the body, and serves to protect
many vital organs.
TOPIC: Human Anatomy & Physiology
a. Digestive system
b. Integumentary system
c. Muscular system
d. Skeletal system
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15
2. Skeletal System
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4. Digestive System
-
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6. Respiratory System
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18
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Next Question
19
Q3
An effect of injury that takes place
when the stimulus applied is
insufficient to cause injury and the
body resistance is great.
TOPIC:
Medico
Legal
a. Apparent
Aspects of Physical
b. Real
Injuries
c. Immediate
d. Delayed
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20
SOURCE: Except as otherwise stated, the materials taken from this slide and
subsequent slides were taken from - Solis, P. P. (1987). Medico-Legal
21
Causes of Physical
Injuries
Physical violence
Heat or cold
Electrical energy
Chemical energy
Radiation by radio-active substances
Change of atmospheric pressure
(barotrauma)
Infection
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Next Question
22
Q4
Under the physics of wound
production, this factor explains
why an M-16 will do more damage
than .38
caliber
bullet.Injuries
TOPIC:
Physical
Brought
a. Area of Transfer
about
Physicalof tissue
b. Elasticity
andby
plasticity
Violence
c. Kinetic energy
d. Time
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23
Effect of Physical
Violence
Production of wound
Wound:
Solution of natural continuity of any
tissue of living body
Disruption of anatomic integrity of
tissue of body
Interchangeably used w/ wound
NOTE: physical violence not always
resulting to wound but wound always
result of physical violence
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Physics of Wound
Production
Wound = kinetic energy X time X area X
other factors
Kinetic Energy = MV2/2
Kinetic Energy:
Explains why M-16 bullet (speed: 3,200
ft/sec) will do more damage than .38 caliber
bullet (heavier but has much slower velocity)
Time:
Shorter time of transfer of energy, greater
production of damage
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25
Physics of Wound
Production
Area of transfer
Larger area of contact, lesser damage to
body
Instrument for stabbing greater than blunt
instrument
Other factors
Less elastic & plastic tissue, greater
laceration
Movement of parts of body resulting from
force applied & local stretching of tissue
cause internal injuries
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Next Question
26
Q5
Sensation of heat or increase in
temperature.
a. Rubor
TOPIC: Vital
b. Calor
Reaction
c. Dolor
d. Loss of function
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27
Vital Reaction
Vital Reaction
Reactions of living to tissue to
trauma:
Calor: sensation of heat or increase
in temperature
Dolor:
pain
on
account
of
involvement of sensory nerve
Loss of function: tissue losing
ability to function normally
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Vital Reaction
Importance: differentiates antemortem injury vs post-mortem
injury
Vital reactions not observable:
Physical injuries inflicted during
agonal state
Sudden death, ex: sudden coronary
occlusion
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30
Q6
Wound brought about by blunt
instrument could be any of the
following, EXCEPT
TOPIC: Classification of
a. Contusion
b. Hematoma wounds
c. Laceration
d. Incision
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Classification of Wounds
As to Severity
Mortal wound: capable of causing
death
32
Classification of Wounds
Instrument Used
Blunt
instrument:
contusion,
hematoma, lacerated wound
Sharp
instrument:
(1)
incised
wound sharp-edged instrument;
(2) punctured wound sharppointed instrument; (3) stab wound:
sharp-edged
&
sharp
pointed
instrument
Tearing force: lacerated wound
Change of atmospheric pressure:
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Classification of Wounds
Instrument Used
Heat/Cold: frostbite, burns or scald
Chemical
explosion:
gunshot/shrapnel wound
Infection
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Classification of Wounds
Manner of Infliction
Hit: bolo, blunt instrument, axe
Thrust/Stab: bayonet dagger
Gunpowder
explosion:
projectile/shrapnel wound
Sliding/rubbing or abrasion
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Classification of Wounds
Depth of Wound
Superficial: only layers of skin
Deep: inner structure beyond
layers of skin
Penetrating
no
exit:
punctured, stab & gunshot
wounds
Perforating w/ exit
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Classification of Wounds
Relation of Site of Application of
Force & Location of Injury
Coup Injury: injury @ site of
application of force
Contre-Coup Injury: injury opposite
site of application of force
Coup Contre-Coup Injury: injury @
site & opposite site of application of
force
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Classification of Wounds
Relation of Site of Application of
Force & Location of Injury
Locus Minoris Resistencia: injury not
@ site & opposite but areas offering
least
resistance.
Ex:
blow
on
forehead, contusion @ eyeball
Extensive injury: injury on greater
area more than site of application of
force. Ex: fall from height, run-over
victim of vehicular accident
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Classification of Wounds
Special Types of Wounds
Defense
wound:
result
of
instinct of self-protection
Patterned wound: w/ nature &
shape of object/instrument
Self-inflicted wound: produced
on oneself but no intention to
end life
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Classification of Wounds
Self-Inflicted Wounds: Motive
Pension/workmans compensation
Escape obligations/punishment
New identity/destroy existing one
Attention/sympathy
Psychotic behavior
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Next Question
40
Q7
X, a doctor, wanted to kill his wife by poisoning.
During dinner time, he put poison on the food
of his wife. Moments after, his wife suffered
excruciating pain in the stomach. Seeing his
wife in agony, he pitied his wife and
TOPIC: Legal
administered an antidote. Thus, his wife did
Physical
not die.Classification
What is the crimeof
committed
by X?
a. Frustrated parricide
Injuries
b. Attempted parricide
c. Serious physical injuries
d. Murder
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42
43
Integumentary
System Animation
Skin: true integument covering
surface of body
Largest organ of vertebrate body
15-16% of total body weight of
adult human
17.5 sq ft for ave. woman; 20 sq
ft for ave. man
1-2 mm thick
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Integumentary System
Layers
Epidermis (thinner;
thick)
Dermis (thicker)
10-30
cells
Melanocytes
Scattered at juncture between deep
layers of epidermis & dermis
Cells
producing
dark
pigment
melanin
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45
Integumentary System
Melanin
Absorbs UV rays
Tanning:
increase
in
melanin
production by much exposure of
UVR
Light
vs
Dark:
Production
of
melanin
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46
Stratum Granulosum:
Spinosum:
Lucidum:
Basale:
Corneum:
a.k.a.
a.k.a.
a.k.a.
a.k.a.
a.k.a.
stratum
hyalin
spinous
granular
cornified
layer;
germinativum
layer;
layer;
flat
layer
pickle
&
initiates
or
translucent
or
cells
horny
generating
process
layer;
many
dead
of
outermost
cells;
keratinization
sided
layer;
appears
cells
creates
layer;
w/ spines
(dying
only
new
flat,
onprocess
cells;
arranged
palms
protruding
deepest
&ofsoles
in
cells);
rows
from
layer;
last
as
surface.
dead
of
parallel
living
cells.
cells.
to basement
membrane.
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47
Dermis
Contains:
Muscle fibers
Glands
Pigment cells
Blood vessels
Sensory nerves
48
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49
2 Parts
Axial Skeleton
Appendicular
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50
Axial Skeleton
Skull
Vertebral Column
Ribs
Sternum
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51
Appendicular Skeleton
Upper
pectoral
appendages
(arms)
& girdle (scapula:
shoulder
blade&
clavicle:
collarbone)
Lower pelvic appendages (legs) &
girdle (ilium, ischium, & pubis,
collectively called as hips)
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Appendicular Skeleton
Arms
Upper arm Humerus
Forearm
Radius &
Ulna
Wrist
Carpals
Palm
metacarpa
ls
Fingers
Phalanges
Legs
Thigh
Femur
Shank
Tibia &
Fibula
Knee Cap Patella
ankle
Tarsals
Sole
Toes
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Metatarsal
s
Phalanges
53
Appendicular Skeleton
Distribution of Bones: (1) adult
human: 206 bones; (2) Infants:
over
270 bones
Skeleton
No.
Skeleton
No.
Cranium
Ears
Vertebral
column
Ribs
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8
6
26
Face
Hyoid
Sternum
14
1
1
24
64
back
54
Muscular System
Tissues w/ ability to contract
Myofibril: basic unit of all muscles;
minute, thread-like structure
Muscle fiber: each muscle cell; contains
several myofibrils: myofilaments of 2
types, thick & thin.
Thick myofilament: several hundred
molecules of protein myosin
Thin myofilament: 2 strands of protein
actin
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Digestive System
Chain of organs:
Mouth
Oral cavity
Pharynx
Esophagus
Stomach
Small intestine
Large intestine
Anus
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59
by
atrioventricular valves; tricuspid
Atria (upper 2) valve: right & bicuspid
left. Valves: allow
Ventricles (lower valve:
2)
blood to flow down only,
never up. VEINS: carry
blood into atria; ARTERIES:
carry
blood
out
of
ventricles
Heart Beat:
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Circulatory System
Blood Vessels: circulates thru
body by means of tubes that
varyin size & function
Arteries
Veins
Capillaries
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61
Respiratory System
Breathing mechanism operates
throughout lifetime: taking in
oxygen & giving off carbon
dioxide
Comparative absence & survival
W/out food for 40 days: survives
W/out water for 5 days: survives
W/out oxygen for only a few
minutes: death
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Nostrils
Pharynx (throat)
Glottis
Larynx (voice box)
Trachea (windpipe)
Bronchi
lungs
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Skull
Framework of head
Most complex of all parts of endoskeleton
Cartilaginous during embryonic stage
Includes:
Cranium (primary brain case)
3 pairs of sense capsule for organs of smell,
sight & hearing
Visceral skeleton for tongue (hyoid apparatus)
Ear (incus, malleus, & stapes) for sound
conduction
Throat
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Skull
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Skull Animation
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67
Vertebral Column
Backbone
Main axial support of vertebrates
Composition:
segmentally
arranged vertebrae from base of
skull to tip of tail
Protects spinal cord
Provides rigidity of body
Direct or indirect attachment of
appendicular skeleton
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Vertebral Column
Adult human: 26
vertebrae
-7 cevical vertebrae
(neck)
- 12 thoracic
vertebrae (chest)
- 5 lumbar vertebrae
(lower back)
- 1 on pelvis (sacrum)
- 1 on tail (coccyx)
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Vertebral Column
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Ribs
Series of cartilaginous/elongated bony
structures attached to vertebrae
Stout, arched structures surrounding
thoracic cavity & uniting ventrally w/
sternum
Forms thoracic cage
12 pairs of ribs 1st-7th pairs: true ribs,
directly attached to sternum; 8th-10th pairs:
false ribs, ends unite w/ cartilages of true
ribs; 11th-12th pairs: floating ribs, ends
terminate freely
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Ribs
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Sternum
Breatbone
Elongated structure lying in central
portion of chest
Flat & narrow
3 parts: (1) manubrium: upper part;
(2) gladiolus: middle/body & largest
part; (3) xiphoid: lowest portion
Protect heart; holds sternal ends of
ribs & some abdominal muscles
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Sternum
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Skeletal Muscles
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Attached
to
skeleton
by
tendon
Responsible
for
voluntary
movement
of
body
A.k.a. striated
muscles:
striations
made
by
76
alternating
Smooth Muscles
A.k.a. visceral muscles
Found
in
internal
organs
(involuntary movement)
Involved in automatic process
w/out
conscious
actions:
disgestion & blood pressure
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Cardiac Muscles
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- Only in heart
- W/ striations
like striated
muscles
(skeletal
muscles)
- Involuntary
contraction
of heart
78
3 Types of Muscles
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79
Arteries
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- Large, elastic,
thick-walled
tubes
- Carry
blood
away
from
heart
- Location: deep
w/in
body;
exception:
in
wrists,
back
80
Veins
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- Large, inelastic
tubes
- Carry
blood
back to heart
- Walls:
equipped
w/
valves
preventing
blood
from
flowing
back
81
back
Capillaries
Heart: 4 Chambers
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83
Heart Beat
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84
Melanocytes
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7 Cervical Vertebrae
SOURCE: General Anatomy & Physiology: The Seven Cervical Vertebrae. (2012). Retrieved August 15,
2012, from Wisc-Online: http://www.wisc-online.com/Objects/ViewObject.aspx?ID=AP12104
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86
12 Thoracic Vertebrae
SOURCE: General Anatomy & Physiology: The Twelve Thoracic Vertebrae. (2012). Retrieved August 15,
2012, from Wisc-Online: http://www.wisc-online.com/Objects/ViewObject.aspx?ID=AP12104
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87
5 Lumbar Vertebrae
SOURCE: General Anatomy & Physiology: The Five Lumbar Vertebrae. (2012). Retrieved August 15,
2012, from Wisc-Online: http://www.wisc-online.com/Objects/ViewObject.aspx?ID=AP12104
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90
Agonal
pertaining
suffering.
to
death
or
extreme
SOURCE: agonal. (2012). Retrieved August 18, 2012, from The Free Dictionary by Farlex:
http://medical-dictionary.thefreedictionary.com/agonal
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Sudden Coronary
Occlusion
Coronary refers to arteries carry
blood containing oxygen and
other nutrients essential to the
normal functioning of the heart
muscle.
Occlusion refers to blockage
SOURCE: Team, T. N. (2010, January 11). What is coronary occlusion? Retrieved August 18, 2012, from
netdoctor: http://www.netdoctor.co.uk/ate/heartandblood/203287.html
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92
Contusion
issue Emergencies. (2007, January 27). Retrieved August 18, 2012, from http://www.raems.com/softtissueemergencies
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93
Hematoma
Dreisbach, B. (2011, July 16). Boxing: See Pictures of Pawel Wolak's Face After Brutal Fight with Delvin
Rodriguez.
Retrieved
August
18,
2012,
from
bleacher
report:
http://bleacherreport.com/articles/769287-see-pictures-of-pawel-wolaks-face-after-brutal-fight-with-delv
in-rodriguez
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94
Lacerated Wound
Cosmell, H. (2011, May 3). 9 Of The Worst Beatings in Boxing/MMA History. Retrieved August 18,
2012,
from
totalprosports.com:
http://www.totalprosports.com/2011/05/03/9-of-the-worst-beatings-in-boxing-mma-history/
9/29/15
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95
Incised Wound
Eriksson, S. (2012). The Med Cell: The Foot. Retrieved August` 18, 2012, from Fight Times:
http://www.fighttimes.com/magazine/magazine.asp?article=396
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96
Punctured Wound
Home Treatment for Puncture Wound. (2009, September 18). Retrieved August 18, 2012, from
hometreatment
net:
http://hometreatment.net/home-remedies/common-injuries/home-treatment-for-puncture-wounds/
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97
Stab Wound
Lyle, D. (2010, February 20). Stab Wounds Dont Always Kill. Retrieved August 18, 2012, from The
Writer's
Forensic
Blog:
http://writersforensicsblog.wordpress.com/2010/02/20/stab-wounds-don%E2%80%99t-always-kill/
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98
Barotrauma
Sinus Barotrauma Symptoms and Treatment. (2012). Retrieved August 18, 2012, from best-diving.org:
http://best-diving.org/barotrauma-and-diving/137-sinus-barotrauma/162-sinus-barotrauma-symptoms-an
d-treatment
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Frostbite
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Scald
Scald Prevention. (2012). Retrieved August 19, 2012, from National Fire Protection Association:
http://www.nfpa.org/itemDetail.asp?categoryID=2360&itemID=55362&URL=Safety%20Information/For%2
0consumers/Unintentional%20injuries/Scald%20prevention
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Gunshot Wound
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Shrapnel Wound
Addario,
L.
(n.d.).
Retrieved
August
19,
2012,
http://www.lynseyaddario.com/#/iraq-medics/42-15133312
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from
lynseyaddario.com:
103
Coup Injury
SOURCE: Child Head Injury - Brain Injury in Children. (n.d.). Retrieved August 19, 2012, from
braininjury.com: http://www.braininjury.com/children.shtml
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Contre-Coup Injury
SOURCE: El Sayed, T., Mota, A., Fraternali, F., & Ortiz, M. (n.d.). Biomechanics of traumatic
brain injury. Retrieved August 19, 2012, from Fernando Fraternali research:
http://www.fernandofraternaliresearch.com/article.asp?id=7&pg=3
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Defense Wound
SOURCE: Taylor, J. R. (2009, November 17). Love Hurts: Theories on Relationship Violence.
Retrieved
August
20,
2012,
from
Living
Las
Vegas:
http://living-las-vegas.com/2009/11/preventing-relationship-violence/
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Self-Inflicted Wound
SOURCE: Marazzi, P. (n.d.). Self-inflicted wounds on arm. Retrieved August 20, 2012, from
Sciencephotolibrary: http://www.sciencephoto.com/media/264295/view
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Elements of Mutilation
1. Castration
(intentional
mutilation (totally/partially) of
organ for reproduction
a. Castration
b. Intention
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108
Penalty of Mutilation
1. Castration RT-RP
2. Mayhem PM med & Max
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Mutilation: Important
Points to Remembers
1. Castration: intentional
2. 1 degree higher: victim 12 yrs
old
3. Offender
has
intention
to
deprive offended party of part of
his body
4. Mutilation lopping/clipping off
of some part of body
5. Mayhem other intentional
mutilation
back
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back
111
Mutilation: Important
Points to Remember
1. Commission:
wounding, 8. Deformity: (a) physical
beating,
ugliness, (b) permanent &
assaulting/administering
definite abnormality, & (c)
injurious substance
conspicuous & visible
2. Also
by
reckless 9. Deformity by loss of teeth:
imprudence/simple
not reparable by nature
imprudence/negligence
10.Illness: not healing w/in
3. No intent to kill
period
4. Blindness
(complete)
& 11.Medical attendance not
loss of eye: (a) par 1 both
important in SPI
eyes; (b) par 2 1 eye only
12.Pars 2 & 3: must have work
5. Loss of power to hear: (a)
at time of injury
par 2 both ears; (b) par 3 13.Par 4: incapacity for labor
1 ear only
14.Illness/incapacity for labor:
6. Loss of hand/incapacity of
needs proof; otherwise,
usual work: permanent
slight PI only
7. Par 2: principal members of 15.SPI by excessive
body; par 3: any other
chastisement by parents:
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member
not
principal
not
qualified.
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