KING ABDULAZIZ UNIVERSITY
Faculty of Medicine
FORENSIC MEDICINE
&
TOXICOLOGY
Study Guide
2009
TABLE OF CONTENTS
TOPIC
Page
THE OUTCOMES OF THE UNDERGRADUATE CURRICULUM
3
AIMS & OBJECTIVES
5
CURRICULUM MAP
8
INTRODUCTION
9
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
11
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
PRACTICAL
NO.
(Names)
Page
01
Identification
59
01
Ballistics –Gross Specimen
60
03
Primary medico legal report and death certificate.
62
04
Blood & Hair and Fibbers
63
3
Faculty of Medicine
NO.
Pathology-core course-1
STUDENT-DIRECTED LEARNING (SDL)
Page
Medico legal importance of Consent
01
01
03
Medico legal Significance of Car seat belt and Expected
injuries in car accident.
Medico legal evidence collection and reservation methods and
chain of custody.
TUTORIALS
NO.
01
Discussion on Medico legal importance of wounds.
Discussion on Addiction (Drugs and mechanism physiological
01
antidotes.
4
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
6
Phase II
Pathology core course 1
Faculty of Medicine
Undergraduate Program Learning Outcomes
Learning Outcomes
Code
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
Pathology core course 1
Faculty of Medicine
Identify the "Red flags" indicating seriousness in the different clinical
presentations.
Cognitive Skills
By the end of the program the graduate will be able to:
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
one’s 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 patient’s medical problems.
Formulate accurate hypotheses to serve as the basis for making diagnostic
and treatment decisions.
Reflect on one’s 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
By the end of the program the graduate will be able to:
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
patient’s 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
By the end of the program the graduate will be able to:
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
Pathology core course 1
Faculty of Medicine
D4
D5
present information clearly in written, electronic and oral forms
work within a changing, multi-task environment
Psychomotor Skills
By the end of the program the graduate will be able to:
E1
Elicit accurate comprehensive and focused medical history by employing
techniques that facilitate the patient’s 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
9
Phase II
Pathology core course 1
Faculty of Medicine
CURRICULUM MAP
STRUCTURE OF THE MODULE
Module Units (Hours)
413
SDL
Toxicology
Tutorials
PATM
PSL
Forensic Medicine and
Credit
Practical
Code/No
Theoretical
Module
17
4
2
2
3
TEACHING DEARTMENTS:
Pathology Department
10
Hours
2
Phase II

Pathology core course 1
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
Pathology core course 1
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
Pathology core course 1
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
Pathology core course 1
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.
14
Phase II
Pathology core course 1
Faculty of Medicine
Icons (standards)
The following icons have been used to help you identify the various
experiences you will be exposed to.
Learning objectives
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
Pathology core course 1
Faculty of Medicine
Topic Outlines
16
Phase II
Pathology core course 1
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
Pathology core course 1
Faculty of Medicine
Continue … 1: Identification & Mass disaster
Student Notes:
5. Role of the pathologist in mass
disaster (a-Forward planning-bOutline 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
(Insert here handouts and additional
pages for notes if needed)
18
.
Phase II
Pathology core course 1
Faculty of Medicine
Lecture 2: DEATH & POSTMORTEM CHANGES AND
BRAIN DEATH (I)
Student Notes:
Department: Pathology
Lecturer:
DR. Ayman Abdel Hamid
Nagy
At the end of the lecture you should be able
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…..Hypostasis…Rigor
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
(Insert here handouts and additional
methods of measuring.
pages for notes if needed)
19
.
Phase II
Pathology core course 1
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.
Simpson's Forensic Medicine BY
Bernard Knight, eleventh edition.
Remember, However, That, The early
diagnosis of death is so important in
endemics and organ transplantation but
should be in accurate way.
(Insert here handouts and additional
pages for notes if needed)
20
.
Phase II
Pathology core course 1
Faculty of Medicine
Lecture 3: : DEATH & POSTMORTEM CHANGES AND
BRAIN DEATH (II)
Student Notes:
Department: Pathology
Lecturer:
DR. Ayman Abdel Hamid
Nagy
At the end of the lecture you should be able
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 medicolegal significance
5. Timing the postmortem interval
1.
Putrefaction Sequance,
Putrefaction in immmersied, in
buried bodies and its medicolegal
significance
(Insert here handouts and additional
pages for notes if needed)
21
.
Phase II
Pathology core course 1
Faculty of Medicine
Continue … Lecture 4: :
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.
Simpson's Forensic Medicine BY
Bernard Knight, eleventh edition.
to be announced in lectures
(Insert here handouts and additional
pages for notes if needed)
22
.
Phase II
Pathology core course 1
Faculty of Medicine
Lecture 4: Medico legal Importance OF THE WOUNDS I
Student Notes:
Department: Pathology
Lecturer:
DR. Ayman Abdel Hamid
Nagy
At the end of the lecture you should be able
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.
23
(Insert here handouts and additional
pages for notes if needed)
.
Phase II
Pathology core course 1
Faculty of Medicine
Continue …
Lecture 4: Medico legal Importance OF THE WOUNDS I
Student Notes:
To be listed in the lecture.
Simpson's Forensic Medicine BY
Bernard Knight, eleventh edition.
Self-assessment
Briefly answer the following short question:
1- What is the medicolegal importance of
wounds?
(Insert here handouts and additional
pages for notes if needed)
24
.
Phase II
Pathology core course 1
Faculty of Medicine
Lecture 5: Medico legal Importance OF THE WOUNDS II
Student Notes:
.
Department: Pathology
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.
11.
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)
25
Phase II
Pathology core course 1
Faculty of Medicine
Continue …
Lecture 6: Medico legal Importance OF THE WOUNDS II
Student Notes:
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.
Simpson's Forensic Medicine BY
Bernard Knight, eleventh edition.
.
In the computer cluster also you have the
opportunity to see some useful web site.
www.google.com
Self-assessment
Briefly answer the following short question:
List the differences between contused and
incised wound
(Insert here handouts and additional
pages for notes if needed)
26
.
Phase II
Pathology core course 1
Faculty of Medicine
Lecture 6: Head Injuries
Student Notes:
.
Department: Pathology………
Lecturer: DR. Ayman Abdel Hamid
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
(Insert here handouts and additional pages for
causes of deaths from head injuries.
notes if needed)
27
Phase II
Pathology core course 1
Faculty of Medicine
Continue …
Lecture 6: Head Injuries
Student Notes:
Remember, However, That, All Head injuries
should be hospitalised for observation of post
concussion symptoms and signs?
Simpson's Forensic Medicine BY
Bernard Knight, eleventh edition.
You have the opportunity to watch the CD-ROM
You can access the CD-ROM during your spare
time.
In the computer cluster also you have the
opportunity to see some useful web site :
www. forensic pathology for student.com
www.studentconsult.com
Self-assessment
Briefly answer the following short question:
What is the lucid interval?
28
(Insert here handouts and additional
pages for notes if needed)
.
Phase II
Pathology core course 1
Faculty of Medicine
Lecture 7: FIRE ARM INJURIES
Student Notes:
Department: Pathology
Lecturer:
DR. Ayman Abdel Hamid
Nagy
At the end of the lecture you should be able
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.
(Insert here handouts and additional
pages for notes if needed)
29
.
Phase II
Pathology core course 1
Faculty of Medicine
Continue …
Lecture 7: FIRE ARM INJURIES
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.
Simpson's Forensic Medicine BY
Bernard Knight, eleventh edition.
You have the opportunity to watch the CD-ROM
about the. You can access the CD-ROM during
your spare time.
(Insert here handouts and additional
pages for notes if needed)
30
.
Phase II
Pathology core course 1
Faculty of Medicine
Continue …
Lecture 7: FIRE ARM INJURIES
Student Notes:
In the computer cluster also you have the
opportunity to see some useful web site about the
inflammatory process:
www.Fleshandbones.com
www.webpath.com
Self-assessment
Briefly answer the following short question:
Enumerate the factors affecting FAI shape.
(Insert here handouts and additional
pages for notes if needed)
31
.
Phase II
Pathology core course 1
Faculty of Medicine
Lecture 8: - Physical injury
Student Notes:
.
Department: Pathology
Lecturer:
DR. Ayman Abdel Hamid
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
(Insert here handouts and additional pages for
mortem versus postmortem burns.
notes if needed)
32
Phase II
Pathology core course 1
Faculty of Medicine
Continue … 8
Student Notes:
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.
(Insert here handouts and additional
pages for notes if needed)
33
.
Phase II
Pathology core course 1
Faculty of Medicine
Continue … 8
Student Notes:
Simpson's Forensic Medicine BY
Bernard Knight, eleventh edition.
You have the opportunity to watch the CD-ROM
about the. You can access the CD-ROM during
your spare time.
In the computer cluster also you have the
opportunity to see some useful web site about the
www.forensic pathology for students.com
Self-assessment
Briefly answer the following short question:
Differentiate scaldes from dry and corrosive
burns
34
.
Phase II
Pathology core course 1
Faculty of Medicine
Lecture 9: ASPHYXIA I
Student Notes:
Department: Pathology
Lecturer:
DR. Ayman Abdel Hamid
Nagy
At the end of the lecture you should be able
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.
(Insert here handouts and additional
pages for notes if needed)
35
.
Phase II
Pathology core course 1
Faculty of Medicine
Continue … 10
Student Notes:
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…
(Insert here handouts and additional
pages for notes if needed)
\
36
.
Phase II
Pathology core course 1
Faculty of Medicine
Continue … 9
Student Notes:
Simpson's Forensic Medicine BY
Bernard Knight, eleventh edition.
You have the opportunity to watch the CDROM about the. You can access the CDROM during your spare time.
In the computer cluster also you have the
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
37
.
Phase II
Pathology core course 1
Faculty of Medicine
Lecture 10: ASPHYXIA II
Student Notes:
Department: Pathology
Lecturer: DR. Ayman Abdel Hamid
Nagy
At the end of the lecture you should be able
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
(Insert here handouts and additional
pages for notes if needed)
and sea water.
38
.
Phase II
Pathology core course 1
Faculty of Medicine
Continue … 10
Student Notes:
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
(Insert here handouts and additional
pages for notes if needed)
39
.
Phase II
Pathology core course 1
Faculty of Medicine
Lecture 11: SEXUAL OFFENSES
Student Notes:
Department: Pathology
Lecturer:
DR. Ayman Abdel Hamid
Nagy
At the end of the lecture you should be able
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
(Insert here handouts and additional
induced abortion.
pages for notes if needed)
40
.
Phase II
Pathology core course 1
Faculty of Medicine
Continue … 11
Student Notes:
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.
(Insert here handouts and additional
5. Medicolegal types of abortion and
pages for notes if needed)
medicolegal regulations of termination of
pregnancy.
6. Methods of induction of abortion.
41
.
Phase II
Pathology core course 1
Faculty of Medicine
Continue … 11
Student Notes:
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
(Insert here handouts and additional
pages for notes if needed)
42
.
Phase II
Pathology core course 1
Faculty of Medicine
Continue … 11
Student Notes:
Simpson's Forensic Medicine BY
Bernard Knight, eleventh edition.
In the computer cluster also you have the
opportunity to see some useful web site
www.forensic pathology for student.com
Self-assessment
Briefly answer the following short
question:
What is the medicolegal significance of
abortion and pregnancy?
43
.
Phase II
Pathology core course 1
Faculty of Medicine
Lecture 12: GENERAL ASPECTS OF FORENSIC
TOXICOLOGY
Student Notes:
Department: Pathology
Lecturer: DR. Ayman Abdel Hamid Nagy
At the end of the lecture you should be able
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.
(Insert here handouts and additional
Diagnosis of poisoning.
General treatment of poisoning
exposure
pages for notes if needed)
44
.
Phase II
Pathology core course 1
Faculty of Medicine
Continue … 12
Student Notes:
Remember, That to safe the life of poisoned
patient the type of poison should be not the first
thing you should to know.
Simpson's Forensic Medicine BY
Bernard Knight, eleventh edition.
In the computer cluster also you have the
opportunity to see some useful web site
www. forensic pathology for medical
students.com
(Insert here handouts and additional
pages for notes if needed)
45
.
Phase II
Pathology core course 1
Faculty of Medicine
Lecture 13: VOLATILE POISONS AND NOXIOUS GASES(1)
Student Notes:
Department: Pathology
Lecturer:
DR. Ayman Abdel Hamid
Nagy
At the end of the lecture you should be able
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
(Insert here handouts and additional
pages for notes if needed)
46
.
Phase II
Pathology core course 1
Faculty of Medicine
Continue … 13
Student Notes:
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).
(Insert here handouts and additional
pages for notes if needed)
47
.
Phase II
Pathology core course 1
Faculty of Medicine
Continue … 13
Student Notes:
listed:
will be announced in lecture
Simpson's Forensic Medicine BY
Bernard Knight, eleventh edition.
You have the opportunity to watch the CD-ROM
about the. You can access the CD-ROM during
your spare time.
In the computer cluster also you have the
opportunity to see some useful web site
www.google.com
Self-assessment
Briefly answer the following short question:
Discuss autopsy findings in alcohol toxicity
(Insert here handouts and additional
pages for notes if needed) .
48
Phase II
Pathology core course 1
Faculty of Medicine
Lecture 14: VOLATILE POISONS AND NOXIOUS GASES
(II)
Student Notes:
Department: Pathology
Lecturer:
DR. Ayman Abdel Hamid
Nagy
At the end of the lecture you should be able
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.
Medicolegal significance of
poisoning and autopsy finding.
5.
Carbon monoxide poisoning,
Conditions of poisoning,
management of poisoning.
6.
Medicolegal significance of
poisoning and autopsy finding.
1.
Cyanide poisoning, sources and
condition of poisoning, fatal and
toxic dose, c/p of toxicity and
(Insert here handouts and additional
management, autopsy findings
pages for notes if needed)
and medicolegal significance of
cyanide toxicity.
49
.
Phase II
Pathology core course 1
Faculty of Medicine
Continue … 14
Student Notes:
2. Carbon monoxide poisoning,
sources and condition of
poisoning, fatal and toxic dose,
c/p of toxicity and management,
autopsy findings and medicolegal
significance of carbon monoxide
toxicity.
3. Carbon dionoxide poisoning,
sources and condition of
poisoning, fatal and toxic dose,
c/p of toxicity and management,
autopsy findings and medicolegal
significance of carbon dionoxide
toxicity.
4. Diagnostic laboratory tests and
role of physation in collection and
preservation of samples.
(Insert here handouts and additional
pages for notes if needed)
50
.
Phase II
Pathology core course 1
Faculty of Medicine
Continue … 14
Student Notes:
Remember, That the CO poisoning is the silent
Killer.
Simpson's Forensic Medicine BY
Bernard Knight, eleventh edition.
You have the opportunity to watch the CD-ROM
about the
. You can access the CD-ROM during your spare
time.
In the computer cluster also you have the
opportunity to see some useful web site
www.google.com
Self-assessment
Briefly answer the following short question:
What is the autopsy findings of cyanide and Co
poising?
51
.
Phase II
Pathology core course 1
Faculty of Medicine
Lecture 15: PLANT POISONOUS AND DRUG DEPENDENCE (1)
Student Notes:
Department: Pathology
Lecturer:
DR. Ayman Abdel Hamid
Nagy
At the end of the lecture you should be able
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, management of toxicity,
medicolegal importance of toxicity.
5. Strychnine toxicity, sources and
chemistry, management of toxicity,
medicolegal 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
(Insert here handouts and additional
pages for notes if needed)
52
.
Phase II
Pathology core course 1
Faculty of Medicine
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
of toxicity.
(Insert here handouts and additional
pages for notes if needed)
53
.
Phase II
Pathology core course 1
Faculty of Medicine
Continue … 15
Student Notes:
Remember, however, that not all medicinal
plants are absolutely safe.
Simpson's Forensic Medicine BY
Bernard Knight, eleventh edition.
You have the opportunity to watch the CD-ROM
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.
www.studentconsult.com
Self-assessment
Briefly answer the following short question:
What is the legal precautions of morphine
prescription?
(Insert here handouts and additional
pages for notes if needed)
54
.
Phase II
Pathology core course 1
Faculty of Medicine
Lecture16: PLANT POISONOUS AND DRUG DEPENDENCE (II)
Student Notes:
Department: Pathology
Lecturer: DR. Ayman Abdel Hamid
Nagy
At the end of the lecture you should be able
to:
1. Ergot toxicity, sources and chemistry,
management of toxicity, medicolegal
importance of toxicity
2. Cocaine toxicity, sources and chemistry,
management of toxicity, medicolegal
importance of toxicity
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),
(Insert here handouts and additional
medicolegal importance of toxicity
pages for notes if needed)
3. Definition of dependence
55
.
Phase II
Pathology core course 1
Faculty of Medicine
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.
(Insert here handouts and additional
pages for notes if needed)
56
.
Phase II
Pathology core course 1
Faculty of Medicine
Continue … 16
Student Notes:
Remember, however, the magnitude of addiction
and increasing the number of addict drugs.
Simpson's Forensic Medicine BY
Bernard Knight, eleventh edition.
You have the opportunity to watch the CD-ROM
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.
www.studentconsult.com
Self-assessment
Briefly answer the following short question:
What is the medicolegal significance of drug
depends?
(Insert here handouts and additional
pages for notes if needed)
57
.
Phase II
Pathology core course 1
Faculty of Medicine
Lecture 17: ANIMAL POISONS & INSECTICIDIES POISONOUS
Student Notes:
58
.
Phase II
Pathology core course 1
Faculty of Medicine
Department: Pathology
Lecturer:
DR. Ayman Abdel Hamid
Nagy
At the end of the lecture you should be able
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.
5. Medicolegal importance of snake
poisoning and autopsy findings.
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
(Insert here handouts and additional
poisoning
pages for notes if needed)
Continue … 17
12. Medicolegal importance of new insecticide
59
Student Notes:
.
Phase II
Pathology core course 1
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.
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.
5. Medicolegal importance of snake
poisoning and autopsy findings.
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).
(Insert here handouts and additional
pages for notes if needed)
Continue … 17
Student Notes:
60
.
Phase II
Pathology core course 1
Remember, however, that the insecticide
and organophosphrous poisoning are a
house hold poisoning.
Simpson's Forensic Medicine BY
Bernard Knight, eleventh edition.
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.
www.studentconsult.com
Self-assessment
Briefly answer the following short
question:
What are the autopsy findings in snakes
poison and scorpion?
Practical 1:
Identification
61
Faculty of Medicine
Phase II
Pathology core course 1
Faculty of Medicine
TUTOR: DR. Ayman Abdel Hamid Nagy
Department: Pathology
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
62
Phase II
Pathology core course 1
Faculty of Medicine
Practical 2:
Ballistcs- gross specimens
TUTOR: DR. Ayman Abdel Hamid Nagy
Department: Pathology
.

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
Teaching material of different gross specimens demonstrating the following lesions:
1. Complete bullet
63
Phase II
2.
3.
4.
5.
6.
.
Pathology core course 1
Faculty of Medicine
Fired and non fired bullets
Empty cartage
Different types of powders
Images of different shapes of fire arm injuries.
Brown atrophy heart
Simpson's Forensic Medicine By Bernard Knight, eleventh edition.
64
Phase II
Pathology core course 1
Faculty of Medicine
Practical 3:
Primary medicolegal reports and Death
certificates
TUTOR: DR. Ayman Abdel Hamid Nagy
Department: Pathology
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…..Hypostasis…Rigor mortis.
10. Timing the postmortem interval
11. Death certificate.
65
Phase II
Pathology core course 1
Faculty of Medicine
Practical 4:
Blood & hair and fibbers
TUTOR: DR. Ayman Abdel Hamid Nagy
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.
66
Phase II
Pathology core course 1
Faculty of Medicine
Independent learning
“Independent learning is a very essential skill for tomorrow’s 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.
67
Phase II
Pathology core course 1
Faculty of Medicine
Problem Solving Learning PSL
“Problem Solving Learning is a very essential skill for tomorrow’s 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.
68
Phase II
Pathology core course 1
69
Faculty of Medicine
Phase II
Pathology core course 1
Faculty of Medicine
Further Reading
Course Text Book:
Simpson's Forensic Medicine
BY
Bernard Knight, eleventh edition.
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.
70