LEGAL MEDICINENOTES(IPMANALIGOD)

Chapter 1 – ANATOMY

Posterior View – Back side

Anterior View – Front side

Types of Wounds
 Incision – sharp object was used, cut is
clean
 Laceration – blunt weapon was used,
Lateral View - SideView cut is messy
 Contusion – injury where the blood
capillaries were ruptured ( Pasa )
 Abrasion – area damaged by scraping
( gasgas)
 Hematoma – solid swelling of clotted
blood within the tissue (namuo ung
Ventral View – Front w/o head region dugo nagmukhang bukol na hindi
Dorsal View – Back w/o head region maitim)
 Hemorrhage - an escape of blood from
Rostral (towards the head) and Caudal a ruptured blood vessel, especially
(towards the tail) when profuse (dumugo sa loob)

Regions of the Skull

Body Planes
 LEGAL MEDICINENOTES(IPMANALIGOD)

Chapter 2 – DNA & Biometrics Basic Ridge Characteristics

Types of patterns
 Finger Ridge Pattern (fingers)
 Finger Vein Pattern (fingers)
 Palm Pattern (palm)
 Hand geometry
 Retinal Pattern (eye)
 Iris Pattern (eye)
 Odontometrics (teeth)
 Face Recognition (face)

Purpose of Biometrics
 Identification
 Verification

Parts of a fingerprint Dental Profiling

 Core  Important when the cadaver is already
 Delta decomposed
 It can determine the persons age and
ancestry background
 DNA is present in the tooth’s pulp
 PD 1575 - REQUIRING PRACTITIONERS OF
DENTISTRY TO KEEP RECORDS OF THEIR
PATIENTS
o Section 1. It shall be obligatory upon all
practitioners of dentistry to keep and
maintain an accurate and complete
record of the dentition of all their
patients which shall include a history
and description of the patient's dentition
Kinds of Fingerprints and the treatments made thereon.
 Arch o Section 2. Upon the lapse of ten years
 Loops from the last entry, dental practitioners
shall turn over the dental records of their
 Whorls patients to the National Bureau of
Investigation for record purposes:
Provided, that the said practitioners may
retain copies thereof for their own files.
o Section 3. Any violation of the
provisions of this Decree shall be
punishable by a fine of not less than one
hundred pesos nor more than one
thousand peso

Behaviometrics
 Handwriting
 Voice
 Scent
 Gait (manner of walking)
 Keystroke Pattern
 LEGAL MEDICINENOTES(IPMANALIGOD)

Attributes of Handwriting  Infrared luminescence

 Unique  Visible Filter Viewing
 Consistent
 Degree of instictiveness Voice recognition
 Spontaneity  The vocal chords vibrate to produce
sound
Legal Application of Behaviometrics  Diarization - the process of partitioning an
 Contracts input audio stream into homogeneous
segments according to the speaker identity
 Wills
DNA
 Negotiable Instruments
 Deoxyribonucleic Acid
 Falsification
 Present in the nucleus and the
mitochondria
Forgery – Basis of determining authenticity
 Humans are comprised of 23
 Form
chromosomes (tightly knit DNA)
 Line quality
 Has two parts the Exon(coding part)
 Formatting
and the Intron(non-coding part)
 Content
 The Intron is the DNA fingerprint, it is
what makes you unique from others
Indicators of Forgery
and contains unique repeating patterns
 Slowness of execution
 Touching up
 Charge of hold
 Wavering
 Uncertain interrupted strokes
 Uniformity
 Irregularities

Points of comparison
 Strokes
 Alignment
 Spacing
 T-bars and i-dots
 Slant If number 2 has O (oxygen), it is considered as
 Weight of strokes Ribose.
 Circle formation If number 2 is absent of O (oxygen), it is
 Initial and final strokes deoxyribose (DNA)
 Needle, wedge, round, and flat
People vs Villejos
Tools used  PCR (polymerase chain reaction) –
copies a particular DNA sequence to
 Magnifying glass identify the DNA
 Microscope  STR ( short tandem repeat) – the
 Digital imaging introns are being analyzed
 3-D imaging software  DNA extraction is valid, only
 Infrared Viewing testimonial evidence is prohibited
 UltraViolet viewing Chapter 3 – Reproduction
 Fluorescent viewing
 LEGAL MEDICINENOTES(IPMANALIGOD)

Sexual and Asexual

Primary Infertility
Asexual Reproduction  Unable to bear children
 Gemules  Unable to carry a pregnancy
 Budding
 Fragmentation Secondary Infertility
 Regeneration  Has been pregnant before but can no
 Parthenogenesis (reproduction from an longer bear children or be pregnant.
ovum without fertilization, especially
as a normal process in some Non-Conventional Pregnancy
invertebrates and lower plants.) ex.  Artificial Insemination
bees, wasps, ants, fish, reptiles.  Invitro Fertilization
 Surrogacy
Sexual  Gamete interfallopian Transfer
 Ovum  Cloning
 Sperm

For Males
 Spermatogenesis in the testes, which is
the main organ of Reproduction

For Females
 Oogenesis or the production of eggs in
the ovary which is the main organ of
reproduction

Arousal Disorders
 Impotence (male) – Erectile Disfunction
(ED)
 Frigiding (Female) – failure to produce
liquids for lubrication, or failure to be
aroused

Causes of ED
 Diabetes
 Trauma
 Neurological problems
 Hormonal insufficiencies
 Cardiovascular disease

Drugs that causes ED

 Antidepressants
 Antihistamines
 Muscle Relaxants
 Pain relievers
Chapter 4 – Virginity and Rape
Sterility or Infertility – inability to procreate
 LEGAL MEDICINENOTES(IPMANALIGOD)

Both Male and Female can be raped  DNA to establish identity

Important Vaginal Parts Symptoms of Rape

 Labia Majora – outer lip  Stomach ache, headache, nausea
 Labia Minora – inner lip  Depression
 Clittoris – Pleasure Gland  Vaginal pain
 Hymen – normally annular in shape,  Fearfulness
important in determining virginity  Nervousness
 Inappropriate laughter
Types of Hymen  Numbness
 Annular  Hostility and fear
 Cresentic
 Septate Rape Trauma Syndrome
 Psyche trauma
Types of Virginity  Both male and female
 Anatomical – intact Hymen  Subset of PTSS (post traumatic stress
 Physiological – Absent Hymen syndrome)
 Psycological – absent Hymen, but  Extent of psych damage
unwilling to have sex
 Surgical – reconstructed Hymen RTS Stages
 Anorgasmic – absent hymnen, but  Acute stage
never experienced orgasm  Outward Adjustment Stage
 True – no penetrative sex of any kind  Underground Stage
 Reorganization Stage
Medical Evidences  Renormalization Stage
 Ruptured hymen
 Presence of spermatozoa Acute Stage - The acute stage occurs in the
 Wounds both external and internal days or weeks after a rape. Durations vary as to
the amount of time the victim may remain in
Note: As long as the male penis touches the the acute stage. The immediate symptoms may
labia, it is considered rape last a few days to a few weeks and may overlap
with the outward adjustment stage.
Physical Evidences
 Physical exam  Diminished alertness.
 Pictures of wounds  Numbness.
 Xray  Dulled sensory, affective and memory
 CT scan functions.
 MRI  Disorganized thought content.
 Blood Exam  Vomiting.
 Vaginal Discharge (for STD)  Nausea.
 Clothing  Paralyzing anxiety.
 Pubic hair sample  Pronounced internal tremor.
 Fingernail scraping  Obsession to wash or clean
 Crime scene evidences themselves.
 Hysteria, confusion and crying.
Other Evidence  Bewilderment.
 Blood grouping
 LEGAL MEDICINENOTES(IPMANALIGOD)

 Acute sensitivity to the reaction of Renormalization Stage

other people.
 In this stage, the survivor begins to
Outward Adjustment Stage - Survivors in this recognize his or her adjustment
stage seem to have resumed their normal phase
lifestyle. However, they simultaneously suffer  survivors integrate the sexual
profound internal turmoil, which may manifest assault into their lives so that the
in a variety of ways as the survivor copes with rape is no longer the central focus
the long-term trauma of a rape of their lives; negative feelings
such as guilt and shame become
Underground Stage resolved, and survivors no
longer blame themselves for the
 Victims attempt to return to their lives attack
as if nothing happened.
 May block thoughts of the assault from
their minds and may not want to talk
about the incident or any of the related
issues. (They don't want to think about
it).
 Victims may have difficulty in
concentrating and some depression.
 Dissociation and trying to get back to
their lives before the assault.
 The underground stage may last for
years and the victim seems as though
they are "over it", despite the fact the
emotional issues are not resolved.

Reorganization Stage

 May return to emotional turmoil

 The return of emotional pain can
extremely frighten people in this stage.
 Fears and phobias may develop. They
may be related specifically to the
assailant or the circumstances or the
attack or they may be much more
generalized.
 Appetite disturbances such
as nausea and vomiting. Rape
survivors are also prone to Chapter 5 – Pregnancy
developing anorexia
nervosa and/or bulimia. Symptoms
 Nightmares, night terrors feel like they  weight gain
plague the victim.  altered smell
 Violent fantasies of revenge may also  altered taste
arise  missed period
 LEGAL MEDICINENOTES(IPMANALIGOD)

 fatigue
 spotting and cramping 4th month
 Emesis Gravidarum ( morning sickness)  Can hear
 Linea nigra (stretch marks)  All major organs complete
 Chloasma (mask of pregnancy)  Can swallow and kick
 Can identify gender via UTZ
Breast related symptoms  7 inches long
 Tingly prickly nipples
 Tender swollen breast 5th month
 Darkening nipples  Quickening
 Vernix casseosa covers and protects
Examinations conducted and signs the body
 Ballotment – done by doctor at 18  Tiny white eyelashes and two arching
weeks eyebrows
 Pelvic examination  Fine wooly hairs called LARUGO
 Mc Donalds sign blanket the body
 Braxton Hicks sign  8-10 inches long
 Enlarging abdomen
6th month
Postive signs of pregnancy  Normal growth
 Mayors sign (fetal heart sound) 8-14  If born prematurely in this period, the
weeks baby will attempt to breath
 Outlining of fetal parts  14 inches long
 Quickening (baby movement) as early
as 13 weeks 7th month
 Blinks and eye opening
Fetal Development  Fat tissue increase
 Taste buds forms
1st month  Hearing fully develops
 Fertilization
 First heart beat 8th month
 Tad pole looking  Brain develops rapidly
 ½ inch long  All organs except lungs mature
 Heart, lungs, liver, brain develops  Skin stars to smoothen
 Fingernails now reach beyond
2nd month fingertips
 Head forms (eyes, nose, mouth etc.)  16-18 inches long
 Digestive organs forms
 Sex organs forms
9th month
rd
3 week
 Detectable heartbeat  Vernix casseosa and larugo disappears
 Tail disappearing
 Uncurl from C position Delivery
 Can thumbsuck
 Head nodding Proof of previous pregnancy
 About 3 inches long  Laxity of abdominal wall
 LEGAL MEDICINENOTES(IPMANALIGOD)

 Breast is lax with enlarged nipple

 Striae of pregnancy (stretch marks)

Estimate date of delivery

 Ultra sound
 Pregnancy calculator
 From 1st day of last menstruation, add
7 days and count 3 months backwards

Diagnosis of fetal death

 Uterine size remain unchanged
 Negative endoctrine test
 Cessation of fetal movement
 Absence of fetal heart sound
 Palpation of softened fetal head
 Breast ceases to enlarge

Chapter 6 – Abortion

Abortion
 Removal of the live fetus form the
womb
 Illegal and no exception
 LEGAL MEDICINENOTES(IPMANALIGOD)

 Therapeutic Abortion is present only shall cause an abortion or assist in causing the
when the fetus is already dead when same.
conducted. Any pharmacist who, without the proper
Laws prescription from a physician, shall dispense
any abortive shall suffer arresto mayor and a
Art. 256. Intentional abortion. — Any person fine not exceeding 1,000 pesos
who shall intentionally cause an abortion shall
suffer: Chemical Abortion
1. The penalty of reclusion temporal, if he shall  Methotrexate and Misoprostol
use any violence upon the person of the o 7 ½ weeks of pregnancy
pregnant woman. o Metho first introduced then
2. The penalty of prision mayor if, without Miso afterwards
using violence, he shall act without the  Methotrexate
consent of the woman. o For cancer and rheumatoid
3. The penalty of prision correccional in its arthritis
medium and maximum periods, if the woman o Inhibits synthesis of of DNA,
shall have consented. RNA and proteins
Art. 257. Unintentional abortion. — The o Fetus does not form well
penalty of prision correccional in its minimum  Misoprostol
and medium period shall be imposed upon any o For stomach ulcer
person who shall cause an abortion by o Induces labor
violence, but unintentionally. o Prevent post-partum bleeding
 Miferpristone and Misoprostol
Art. 258. Abortion practiced by the woman o Use up to the 1st 7-9 weeks of
herself of by her parents. — The penalty of
pregnancy
prision correccional in its medium and
 Miferpristone
maximum periods shall be imposed upon a
o For HIV infection and
woman who shall practice abortion upon
psychiatric condition
herself or shall consent that any other person
o Competitive progesterone
should do so.
receptor
Any woman who shall commit this offense to
conceal her dishonor, shall suffer the penalty
Physical Method
of prision correccional in its minimum and
 Manual Vacuum Aspiration
medium periods.
o Used as early as 3 to 12 weeks
If this crime be committed by the parents of
the pregnant woman or either of them, and since last period
they act with the consent of said woman for o Used to suck the baby out
the purpose of concealing her dishonor, the Note: in the Philippines, life is
offenders shall suffer the penalty of prision protected from conception
correccional in its medium and maximum (fertilization)
periods.  Dilatation and curetilage (Raspa)
o Suctioned and stirred
Art. 259. Abortion practiced by a physician or o 9 weeks
midwife and dispensing of abortives. — The  Dilatation and Extraction (used in
penalties provided in Article 256 shall be bigger fetus)
imposed in its maximum period, respectively, o Up to the 2nd trimester (not
upon any physician or midwife who, taking exceeding 6 months)
advantage of their scientific knowledge or skill,
 LEGAL MEDICINENOTES(IPMANALIGOD)

o This procedure involves cutting

off parts the removing them

Legal Grounds (in other countries)(when

abortion done is legal)
 To save the life of the woman
 Preserve physical health
 Preserve mental health
 Rape or incest
 Fetal impairment
 Economic and social reasons
 Available on request
Note: Autorization of Abortion requires
consultation with a panel of professionals
How to prove abortion
 Testimonial evidence
 Photograph of the fetus or parts of it

Abortion Methods
 Misoprostol
 Hormonal pills
 Catheter
 Massage
 Aspirin
 Traditional herbs
 Alcohol
 Fasting
 jumping

Chapter 7 – Infancy and Childhood

Breastfeeding

Advantages of breastfeeding for the child

 LEGAL MEDICINENOTES(IPMANALIGOD)

 economical  green - indicates 4-5 days

 contains anti bodies to fight disesase  yellow – indicates 7-10 days
 decreases the likelihood of
gastrointestinal infections Shaken Baby Syndrome (SBS)
 decreased incidence of diseases during  too much shaking of the infant that can
adulthood lead to death
 it is because the infant’s head weighs
Advantages of breastfeeding for the mother more than ¼ of the body
 economical  impact is 30x that of gravity (naalog
 convenience ang utak due to spaces in the head)
 promotes weight loss
 natural contraceptive Signs of SBS
 decreased incidence of diseases  irritability
 pale or blue skin
Child Abuse  lethargic (inaantok)
 vomiting
Signs of Child Abuse (Child)  breathing difficulties
 sudden change in behaviour  seizures
 deterioration of school performance
 learning problems SBS injuries
 always watchful of surrounding and  deafness
always preparing for something to  retardation
happen  paralysis
 seems frightened to his parents  death

Child pornography
Signs of Child Abuse (Parents) Kinds
 little concern for the child  non sexual nude poses
 blames the child  erotic nude
 asks teacher to discipline the child  explicitly sexual
harshly  videos of sexual activity
 rarely touches or talks to the child  pay per view
 consider their relationship extremely
negative Child Labor
 Agricultural
Physical Signs of Child abuse o Aged 5-17
 unexplained bruises burns or bites o 7days a week
 cigarette burns o P150 a day
 scalds o Mostly in rural areas
 puncture woulds  Mining
 skull fractures o Much worse due to the
 rib fractures presence of harmful
substances such as mercury
Skin Color Test  Deep Sea Fishing
 red – indicates immediate 24 hours o Net and rope injuries
 purple – indicates more than 24hrs  Child Soldiering
 LEGAL MEDICINENOTES(IPMANALIGOD)

Effects of Child Abuse

 Depression
 Eating disorder
 Poor self esteem
 Behavioural problems
 Crime during adulthood
 Self destructive behaviour
 Substance abuse
 Suicide
 Physical injury
 Sexualized behaviour

Infanticide
 The crime of killing a child within a
year of birth.
Neonaticide
 Killing within 24hrs after birth
 Usually by mothers

Direct/active Infanticide
 Dehydration
 Starvation
 Suffocation
 Head Injuries

Causes of Infanticide
 Unwanted pregnancy
 Superstitions
 Poverty
 Post-partum psychosis
 Genetic

Sudden Infant Death Syndrome (SIDS)

 Sudden death of an infant which is not
predicted by any medical history
 Remains unexplained
 No signs of struggling
 Highest risk during sleep

Prevention of SIDS Chapter 8 – Physical Injuries

 Put to sleep in supine position
(nakadapa) Types of Wounds
 No loose bedding  Incision – sharp object was used, cut is
 Firm mattress separate from but close clean
to caregivers  Laceration – blunt weapon was used,
cut is messy
 LEGAL MEDICINENOTES(IPMANALIGOD)
 Contusion – injury where the blood
capillaries were ruptured ( Pasa )
 Abrasion – area damaged by scraping
( gasgas)
Mutilation
 Aguirre vs Sec. Of justice
o Removal of an essential
reproductive organ
o Art. 262. Mutilation. — The
penalty of reclusion temporal
to reclusion perpetua shall be
imposed upon any person who
shall intentionally mutilate
another by depriving him,
either totally or partially, or
some essential organ of
reproduction.
 RPC art 263 (1)– physical injuries
resulting to insanity and imbecility
o The penalty of prision mayor, if
in consequence of the physical
injuries inflicted, the injured
person shall become insane,
imbecile, impotent, or blind;
o Deprived completely of reason,
discernment, and freedom of
will
 People vs Madarang
o For insanity to be exempting,
the accused must have
completely no power to
discern between right and
wrong.
 RPC art 263 (2) - The penalty of prision
correccional in its medium and
maximum periods, if in consequence of
the physical injuries inflicted, the
person injured shall have lost the use
of speech or the power to hear or to
smell, or shall have lost an eye, a hand,
a foot, an arm, or a leg or shall have
lost the use of any such member, or
shall have become incapacitated for
the work in which he was therefor
habitually engaged;
o Physical injuries which leads to
blindness and impotence
 Physical Injuries causing Impotence
o Traumatic brain Injury
 Falls
 Motor vehicle
accidents
 Assaults
o Spinal cord injury
 Motor vehicle
accidents
 Falls
 Acts of violence
 Physical Injuries causing blindness
o Hits to the occipital region of
the head, where the part of the
brain responsible for sight is
located
o Head trauma
o Delayed diagnosis due to
unconsciousness
o Motor vehicle accidents
o Burns
o Chemical injuries
 Loss of hearing, speech, and ability to
smell
o Brain injury
o Olfactory nerve injury
o Medication
 Art 263 (3) - The penalty of prision
correccional in its minimum and
medium periods, if in consequence of
the physical injuries inflicted, the
person injured shall have become
deformed, or shall have lost any other
part of his body, or shall have lost the
use thereof, or shall have been ill or
incapacitated for the performance of
the work in which he as habitually
engaged for a period of more than
ninety days;
 Art 263 (4) - The penalty of arresto
mayor in its maximum period to
prision correccional in its minimum
period, if the physical injuries inflicted
shall have caused the illness or
 LEGAL MEDICINENOTES(IPMANALIGOD)

incapacity for labor of the injured  Brain

person for more than thirty days  Heart
 Lungs
Gunshot Wounds  Liver
 Rifle weapons  Kidneys
 Smooth-bored weapons (shotguns)

Factors affecting magnitude of injury

 Frontal Area
 Velocity
 Distance

Frontal Area
 Profile
 Tumble
 Fragmentation

Velocity
 Medium velocity
 High velocity – more damage
o If more than 1500 ft/sec
o Uses larger cartridges/bullets

Contact Gunshot Wound

 Usually with burnt muzzle imprint,
normally seen is suicide cases or
gunpoint scenarios

Intermediate Gunshot Wound

 Point blank range
o Lesser burnt muzzle imprint

Distant Gunshot Wound

 Much clearer wound
 Hexagonal appearance
 No muzzle imprint

Exit wound
 Wound where the bullet exited the
body

Re-entrant Gunshot Wound

Chapter 9 – Gender and Sexuality
 Bullet enters one part of the body,
then exits, then enters another part of
Gender and Sexuality
the body
 Can be distinguished by morphology
Vital Organs to note
 LEGAL MEDICINENOTES(IPMANALIGOD)

Note: female brain is more unorganized  XY – Male

compared to males  OY – Lethal (cannot survive)
 OXY – lethal
Gender  XXX – 40% normal, 60% required
 Male special education
 Female  XYY – typically normal, normally taller
 Intesex than others
Hermaphroditism – have both male and female
Terms karyotypes
 Gender neutrality
 Gender identity Determinant of sexual orientation
o Cis Gender – youre a female  Biological
and you think that youre a o Genetic
female and vice versa o Developmental
o TransGender – youre male but o Biological sex
your brain thinks youre female  Social
 Sexual Orientation o Family upbringing
o Heterosexual – excited by the o Cultural
opposite sex
o Homosexual – excited by the
same sex
o Bi sexual – excited by both
sexes
o Asexual – not excited by
anyone
o Transsexual – person who
changed his or her sexual
orientation mostly by sexual
transplant

Biological genetic differences

 Male karyotype (XY chromosome)
 Female Karyotype (XX or YY
Chromosome)

Androgen Insensitivity Syndrome

 Cells doesn’t respond to androgen
 It will result in female characteristics

Aneuploidy
 XX – female
 XO – Turners syndrome (normally
webbed neck)
 XXY – Klinefelters syndrome(affects Chapter 10 – Insanity
males) (lower testosterone level and
sometimes testicles fail to develop or Basic Brain Functions
shrink in size)  Frontal – thinking and memory
 LEGAL MEDICINENOTES(IPMANALIGOD)

 Cerebellum – balance and coordination hallucination is seeing something that

 Occipital – sight is nonexistent or not even there at all.
 Parietal – language and touch
 Temporal – hearing, learning, and Manic Depressive/Bipolar
feelings  Mood disorder
 Brain stem – breathing, heartraten  Two or more episodes in which the
temperature patient’s mood and activity levels are
significantly disturbed
2 systems used to diagnose mental disorder  Some occasions of an elevation of
 ICD 10 – International Statistical mood and increased energy
Classification of diseases and related
health problems Mania possible causes
 DSM 5 – diagnostic and statistical  Disfunction of certain
manual for mental disorders neurotransmitters in the brain
o This is the one that is most o Norepinephrine
widely used o Serotonin

Mania Mania-triggering causes

 People vs Bonoan  Social stress
o Mentally deranged (baliw)  Altered eating habits
o Dementia praecox  Substance abuse
(schizophrenia) o Alcohol
 Fundamental and o Cocaine
characteristic o Ecstasy
distortions of thinking  Excessive caffeine
and perception and  Medications
effects that are o Anti-depressants
inappropriate o Appetite suppressants
 Can be continuous or  People vs Formigones
episodic with o Mental deficiency –
progressive or stable encompasses all degrees of
deficit, or there can be educational and social
one or more episodes deficiency
with complete or o Feeblemindedness – high
incomplete remission functionality, less mental
 Symptoms of Mania proficiency
o Though echo o Imbecility – median
o Thought broadcasting o Idiocy – the highest and sever
o Delusions of control form of mental illness
o Influence or passivity
o Hallucinatory voices discussing
in the 3rd person
o Thought disorder
Note: Illusion vs hallucination – illusion
is merely seeing things a different F70 – Mild mental retardation
perspective than others, whereas  IQ of 50 – 69
 Mental age is 9 to under 12 years old
 LEGAL MEDICINENOTES(IPMANALIGOD)
 Many adults will be able to work and
maintain a good social relationship
 Also known as feeblemindedness
F71 – Moderate Mental Retardation
 IQ of 35-49
 Mental age is 6 to under 9 yrs old
 Can be independent but the patient
still requires a certain degree of care
F72 – severe mental retardation
 IQ of 20-34
 Mental age is 3 to under 6 yrs old
 Patients under this category need
continuous support and care
F73 – Profound Mental Retardation
 IQ under 20
 Mental age is below 3 years old
 Also needed continuous support
Intellectual Disability – can be assessed via IQ
test or adaptive functioning tests
Causes of intellectual Disablility
 Genetic Condition
o Ex. Down syndrome (trisomy
21)
 Problems during pregnancy
o Alcohol and drug abuse
o Malnutrition
o Certain infections
 Problems during childbirth
o Baby was deprived of oxygen
o Born EXTREMELY premature
 Illness
o Meningitis
o Whooping cough
o Measles
 Injuries
o Severe head injury
o Toxic substances
o Near-drowning
o Extreme malnutrition
Schizophrenic spectrum
 A test conducted to test delusions,
hallucination, disorganized thinking,
and disorganized motor behaviour
Hallucinations can be
 Visual (sight)
 Auditory (hearing)
 Tactile (touch)
 Olfactory (smell)
 Gustatory (taste)
Disorganized thinking
 Jumps from one thought to another
which does not make sense
 “Word salad”
Disorganized motor behaviour
 Catatonic – does not change position
or stuck on one position
Schizophrenia
 Split mind, but not personality
 A mental disorder wherein a person
fails to understand what is real and
what is not
Organic Mental Disorder
 Normally acquired after stroke
Anti Social personality Disorder
 Failure, inability, or fear to socialize
with others
Dependent Personality Disorder
 Too dependent on others
 Cannot perform a task without
assistance from others
Histronic Personality Disorder
 Attention seeking disorder
 Always wants to be the center of
attraction or attention
Narcissistic Personality Disorder
 Grandiose or need for admiration
 Perusive pattern of grandiosity
 Exaggerates talents
 Expects to be recognised as superior
 LEGAL MEDICINENOTES(IPMANALIGOD)

 Feeling a grandiose of importance

 Preoccupied with fantasies of
unlimited success, power, beauty, or
ideal love.

Chapter 11 – Drug Abuse

Marijuana
 LEGAL MEDICINENOTES(IPMANALIGOD)

 No overdosage  Used as a chemical weapon

 Reduce nausea and vomiting  Considered as weapon of mass
 Induces appetite destruction
 Treat chronic pain  Death in 1 – 10 minutes
 Improves sleep
Alcohol Intoxication
Ecstasy  The eye test is the test used to
 Short term effect determine if a person is drunk
o Derealisation  Other tests are as follows:
o Depersonalization o The walk and turn test
o Visual hallucinations o One leg Stand Test
o Pseudo hallucinations (person o Breathe Test
is aware that he is o Urine Alcohol Test
hallucinating) o Blood Test (can measure up to
3-4 weeks of alcohol)
Opium Poppy  Anti – Drunk Driving Act
 Derivatives of Opium o For Non-pro licence holders
o Morphine driving a vehicle not exceeding
o Codeine 4500 kg, an alcohol level of
 Morphine signs 0.05% or more is prohibited
o Blurred vision o For professional Drivers driving
o Double vision trucks, buses and similar
 Physical signs of Morphine use vehicles, an alcohol level
o Needles exceeding 0.00% is prohibited
o Pin point pupils (in short bawal ka uminom ng
 Behavioral Signs kahit anong alak)
o Prescription abuse  Severe Alcohol Intoxication can cause
o Multiple Drug Providers death
o Changes in Social Behavior
o Hallucinations Arsenic
o Abnormal Thinking  Can cause skin damage
o Extreme Agitation  Increased risk of cancer
 Causes Nerve damage
Toxins  Causes Circulatory problems in the skin
 Can be acquired from volcanic
RA6969 – Toxic substances and hazardous eruptions, manmade sources such as
nuclear waste act toxic waste, also from the air or water
after the said eruption.
Types of Toxins  Can be obtained by:
 Sarin o Inhalation
 Alcohol o Dermal (through the skin)
 Arsenic o Ingestion
 Lead o Arsenic in Food
 Mercury o Arsenic in Water
Sarin
 Colourless and odourless Lead Poisoning
 No useful purpose in the body
 LEGAL MEDICINENOTES(IPMANALIGOD)

 Affects every organ system

 Mimics the actions of calcium once it
enters the body
 Effects are:
o Decreased libido
o Depression and mood changes
o Diminished cognitive
performance
o Diminished hand dexterity
o Diminished reaction time
o Impotence
o Reduced IQ scores
 Sources are:
o Lead paint
o Soil
o Painted toy containing lead

Mercury
 Highly regulated
 Can bio accumulate (occurs when an
organism absorbs a substance at a rate
faster than that at which the substance
is lost by catabolism and excretion.
Thus, the longer the biological half-
life of a toxic substance, the greater
the risk of chronic poisoning, even
if environmental levels of the toxin are
not very high)
 Minimata Disease – contracted via
Mercury poisoning
o Symptoms are
 Itching burning pain
 Skin discoloration
 Swelling

Chapter 12 – Medical Ethics

Purpose:
 LEGAL MEDICINENOTES(IPMANALIGOD)
 Autonomy
 Beneficence
 Non malfeasance
 Justice
 Dignity
 Truthfulness and Honesty
Beneficence
 Right to health
 Includes breastfeeding act, Magna
Carta for disabled persons and
National Health Insurance Act
Confidentiality of Health Information
 Rule 130 Sec 24 - Section 24.
Disqualification by reason of privileged
communication. — The following
persons cannot testify as to matters
learned in confidence in the following
cases:
o The husband or the wife,
during or after the marriage,
cannot be examined without
the consent of the other as to
any communication received in
confidence by one from the
other during the marriage
except in a civil case by one
against the other, or in a
criminal case for a crime
committed by one against the
other or the latter's direct
descendants or ascendants;
o (b) An attorney cannot,
without the consent of his
client, be examined as to any
communication made by the
client to him, or his advice
given thereon in the course of,
or with a view to, professional
employment, nor can an
attorney's secretary,
stenographer, or clerk be
examined, without the consent
of the client and his employer,
concerning any fact the
knowledge of which has been
acquired in such capacity;
o (c) A person authorized to
practice medicine, surgery or
obstetrics cannot in a civil case,
without the consent of the
patient, be examined as to any
advice or treatment given by
him or any information which
he may have acquired in
attending such patient in a
professional capacity, which
information was necessary to
enable him to act in capacity,
and which would blacken the
reputation of the patient;
o (d) A minister or priest cannot,
without the consent of the
person making the confession,
be examined as to any
confession made to or any
advice given by him in his
professional character in the
course of discipline enjoined by
the church to which the
minister or priest belongs;
o (e) A public officer cannot be
examined during his term of
office or afterwards, as to
communications made to him
in official confidence, when the
court finds that the public
interest would suffer by the
disclosure
Euthanasia
 Voluntary killing – with consent
 Non – Voluntary – patient wants to live
but you killed him
 LEGAL MEDICINENOTES(IPMANALIGOD)

 Involuntary – occurs in patients under

coma

Note: a Doctor is not required to resuscitate, if

the patient’s heart stops; this is designated to
prevent unnecessary suffering

Note: when is it necessary to pull the plug?

 You pull the plug when the person has

no brain waves, and no hope of quality
of life.

Prohibitions under medical ethics

 Medical research involving human

subjects

 Violations of the Nuremberg Code

 Violations of the international Ethic

Guidelines

 Organ Donation in violation of the

Organ Donations Act of 1991

 Cloning, medical and biological

engineering
 LEGAL MEDICINENOTES(IPMANALIGOD)

The difference between normal and locked in

syndrome is during locked in, even though the
person’s awareness and arousal are normal, his
muscles cannot be moved.

Chapter 13 – Death and Dying Stages of Death

 Pallor Mortis
Legal definition of death o Post mortem paleness
o Occurs within 15 to 20 minutes
 The irreversible cessation of circulatory after death
and respiratory functions or all  Algor Mortis
functions of the entire brain, including o Most useful indicator of death
the brain stem during the first 24hrs
o The human body cools down
Cardiac Arrest – when the heart stops moving and reached a temperature
or beating plateau which may last from ½
to 3-5 hours
Brain death – the irreversible end of all brain
activity. Also known as the death of neurons in
the brain

States of Consciousness

 Normal

 Coma

 Vegetative State  Rigor Mortis

o Hardening of the body caused
by chemical changes in the
 Conscious State
muscles after death, causing
the limbs to become stiff
 Locked in Syndrome
o Begins in 2-6 hours
o The higher the temperature,
the faster Rigor Mortis Occurs
 Livor Mortis
o Settling of the blood in the
lower portion of the bodyby
gravity.
o As the vessel walls become
permeable due to
decomposition, blood leaks
 LEGAL MEDICINENOTES(IPMANALIGOD)

through them and stains the

tissues
o “bababa ung dugo at
magmumukang pasa

 Putrefaction
o Decomposition of proteins
o Breaking down on proteins by
bacteria
o Gases leads to bloating

 Cadaveric Spasm
o Similar to Rigor Mortis.
o The difference is in cadaveric
spasm the muscle stiffen
immediately after death, while
Rigor Mortis stiffens within 2 to
6 hours after death.

 Lazarus Sign
o Reflex movement in brain dead
or brainstem failure which
causes them to briefly raise
their arms and drop them
crossed in their chest (similar
to mummy pose).
o “patay na gumalaw pa”

 Skeletonization
o All soft tissues are gone
o Only skeleton remains
Note: bones can disintegrate
depending on the acidity level of the
area.