forensic medicine

1. PERSONAL
IDENTITY

2. MEDICO-LEGAL
IMPORTANCE
OF
AGE

3. 1.1. INTRA-UTERINE LIFEINTRA-UTERINE LIFE:-:-
 4-8 WEEKS------------ORGANOGENESIS4-8 WEEKS------------ORGANOGENESIS
 26 WEEKS-------------VIABILITY26 WEEKS-------------VIABILITY
 40 WEEKS-------------FULL TERM BIRTH40 WEEKS-------------FULL TERM BIRTH
These periods are of importance because inThese periods are of importance because in
cases of Istaqat-e-Hamal & Istaqat-e-jinincases of Istaqat-e-Hamal & Istaqat-e-jinin
we have to identify the period & accordinglywe have to identify the period & accordingly
punishment is givenpunishment is given

4. 2.2. EXTRA-UTERINE LIFEEXTRA-UTERINE LIFE:-:-
 UP TO 2 YEARS-------INFANCYUP TO 2 YEARS-------INFANCY
 UP TO 5 YEARS-------SCHOOL AGEUP TO 5 YEARS-------SCHOOL AGE
 16-18 YEARS---------MARRIAGE/CONSENTING AGE16-18 YEARS---------MARRIAGE/CONSENTING AGE
ATTAINMENT OF MATURITY/ATTAINMENT OF MATURITY/
VOTE CASTINGVOTE CASTING
 21 YEARS-------------PROPERTY INHERITANCE21 YEARS-------------PROPERTY INHERITANCE
 25 YEARS-------------CONTEST LEGISLATIVE ELECTION25 YEARS-------------CONTEST LEGISLATIVE ELECTION
 45 YEARS-------------CONTEST ELECTION OF PRESEDENT45 YEARS-------------CONTEST ELECTION OF PRESEDENT
OF PAKISTANOF PAKISTAN
 60 YEARS-------------RETIREMENT60 YEARS-------------RETIREMENT

5. AGE
ESTIMATION

6. AGE ESTIMATIONAGE ESTIMATION
 For age estimation we have to study theFor age estimation we have to study the
following:-following:-
 General appearanceGeneral appearance
 BonesBones
 teethteeth

7. INTRA-UTERINE LIFEINTRA-UTERINE LIFE
 PRE-EMBRYONIC STAGE-----1-3 WEEKSPRE-EMBRYONIC STAGE-----1-3 WEEKS
 EMBRYONIC STAGE-----------4-8 WEEKSEMBRYONIC STAGE-----------4-8 WEEKS
 FOETAL STAGE----------------9 WEEKS-10 LUNARFOETAL STAGE----------------9 WEEKS-10 LUNAR
MONTHSMONTHS
 Age is calculated by:Age is calculated by:
 General appearanceGeneral appearance
 Length of foetusLength of foetus
 Weight of foetusWeight of foetus
 Appearance of ossification centresAppearance of ossification centres
 Stage of developing teethStage of developing teeth

8. GENERAL APPEARANCE IN PRE-GENERAL APPEARANCE IN PRE-
EMBRYONIC STAGEEMBRYONIC STAGE
 Placental developmentPlacental development
 CR length of embryo: less than 1 cm at 3CR length of embryo: less than 1 cm at 3
weeksweeks
 Weight-about 2 grams at 3 weeksWeight-about 2 grams at 3 weeks

9. 1.1. POST-EMBRYONIC STAGE:POST-EMBRYONIC STAGE:
• Placental developmentPlacental development
• CR length—1-4 cmCR length—1-4 cm
• Weight------10-15 gms at 4-8 weeksWeight------10-15 gms at 4-8 weeks
• Appearance of pharyngeal archesAppearance of pharyngeal arches
• Appearance of limb buds 6-8 weeksAppearance of limb buds 6-8 weeks
• Appearance of ossification centres for clavicle,Appearance of ossification centres for clavicle,
skull bones, long bones, mandibleskull bones, long bones, mandible
• Ribs & vertebraeRibs & vertebrae

10. 2.2. FIVE MONTHS:FIVE MONTHS:
 Lanugo hair on scalpLanugo hair on scalp
 Eyebrows become visibleEyebrows become visible
 Testicles start descendingTesticles start descending

11. 3.3. SEVEN MONTHS:SEVEN MONTHS:
 Nails up to finger tipsNails up to finger tips
 Eyelids open & separatedEyelids open & separated
 Pupilary membrane disappearsPupilary membrane disappears
 Testicles descended up to inguinal ringTesticles descended up to inguinal ring

12. 4.4. FULL TERM:FULL TERM:
 Lanugo hair absentLanugo hair absent
 Nails grown beyond finger tipsNails grown beyond finger tips
 Testicles descended in to scrotumTesticles descended in to scrotum

13. LENGTH
OF
FOETUS

14. Rule of Hasse (1895):
According to this rule the age of foetus is
calculated by the square root of crown heel
length in centimeter.
For example if the crown heel length is 16
cm, the age of the foetus is about 4 weeks intra
uterine life.
Rule of Morrison (1964):
This rule states that the crown heel length of
the foetus in centimeters, divided by five gives
the age in month.
For example if the length is 40 cm, the age is
8 months. It is applicable after 5 months of intra
uterine life.

15. LENGTH OF THE FOETUSLENGTH OF THE FOETUS
 To determine length of foetus we applyTo determine length of foetus we apply
rule called “RULE OF HESSE’S”. Crownrule called “RULE OF HESSE’S”. Crown
heel length is best criteria for determiningheel length is best criteria for determining
length of foetus UP TO 5 MONTHS oflength of foetus UP TO 5 MONTHS of
gestation length presents the square ofgestation length presents the square of
age in months such as :age in months such as :

16. LENGTHLENGTH AGEAGE
9 CM9 CM
16 CM16 CM
25 CM25 CM
3 MONTHS3 MONTHS
4 MONTHS4 MONTHS
5 MONTHS5 MONTHS

17. LENGTH OF THE FOETUSLENGTH OF THE FOETUS
 AFTER 5 MONTHS AGE:AFTER 5 MONTHS AGE:
it is estimated by measuring the length ofit is estimated by measuring the length of
foetus in cms. and dividing it by 5 (Rule offoetus in cms. and dividing it by 5 (Rule of
Morrison). This gives age in months suchMorrison). This gives age in months such
as length of foetus is 35 cms. Then age ofas length of foetus is 35 cms. Then age of
foetus is 35/5=7 months.foetus is 35/5=7 months.

18. WEIGHT OF FOETUSWEIGHT OF FOETUS
 2020THTH
WEEK-----------------400 GMSWEEK-----------------400 GMS
 2828THTH
WEEK-----------------1100-1300 GMSWEEK-----------------1100-1300 GMS
 4040THTH
WEEK-----------------2700-3500 GMSWEEK-----------------2700-3500 GMS

19. CENTRES FOR OSSIFICATIONCENTRES FOR OSSIFICATION
 The center of ossification can be detected by dissectingThe center of ossification can be detected by dissecting
the bone itself. The order of appearance of primarythe bone itself. The order of appearance of primary
centres of ossification are as follows:centres of ossification are as follows:
SKULL BONES & CLAVICLE—----------------SKULL BONES & CLAVICLE—---------------- 5-6 WEEKS5-6 WEEKS
CALCANEUM ISCHIUM & PUBIC BONES--CALCANEUM ISCHIUM & PUBIC BONES-- 5 MONTHS5 MONTHS
LONG BONES--------------------------------------LONG BONES-------------------------------------- 7-8 WEEKS7-8 WEEKS
TALUS------------------------------------------------TALUS------------------------------------------------ 7 MONTHS7 MONTHS
LOWER END OF FEMUR, CUBOID----------LOWER END OF FEMUR, CUBOID---------- 9 MONTHS9 MONTHS

20. Ossification of bones
 Examination of bone helps us in the estimation of age of
a person,
 Human skeleton develops from separate ossification
centers
 Long bones are more helpful in determining age
 Typical long bones have three centers or principal foci
for growth.
 Diaphysis : mid portion of shaft
 Epiphysis : lower or distal end
 Diaphysio-epiphyseal Zone: b/w epiphysis and diaphysis

21.  On X-Ray by observing these areas exact
age of an individual can be determined.
 As a rule the main areas focused on x-ray are
 Wrist in children
 Elbow and knee in adult
 Skull, vertebrae and sternum in old people
In long bones specially in limbs
appearances of the secondary centers of
ossification, and finally union of epiphysis
with the diaphysis is the index up to
25years of age.
This union takes place earlier in females by
two years than in males, except in case of
suture of skull, where the suture obliterate
slowly and little later in females than in
males.

22. KROGMAN
 Has divided skeletal developmental
changes for the estimation of age into
seven periods:

23. PERIOD 1
 From birth to 5th year
 age determination depends on centre of
ossification that appears after birth
 1 year - head of femur, humerus, tibia
 2 years - lower tibia, radius
 3 years - patella
 4 years - upper fibula, greater
trochanter of femur
 5 years - lower fibula

24. PERIOD 2
 From 5-12 year
 age estimation depends on growth of above centres of
ossification and appearance of additional secondary
centres
 size of center indicates age
 6 years - head of radius, lower ulna
 7 years - scaphoid, rami of ischium and pubis unites
 8 years - medial epicondyle of humerus, olecranon
 10 years - lesser trochanter of femur
 11 years - trochlea of humerus
 12 years - acetabular y-cartilage
 10-12 years - pisiform

25. PERIOD 3
 From 12-20 year
 age estimation depends on union of epiphyses with
their shafts in most of the long bones
 13 years - lateral epicondyle of humerus appears &
unites with trochlea and capitulum
 14 years - coracoid united to scapula
 16 years - olecranon united to ulna
 18 years - head of femur and radius fuse with shafts
 20 years
 lower radius, ulna and femur to shafts
 iliac crest to body

26. PERIOD 4
 From 20-25 years
 nearly all the epiphysis in the body have
united except the centre in the medial
end of clavicle
 21 years - appearance of centre at
inner end of clavicle
 22-24 years
fusion of secondary epiphysis of inner end
of clavicle
articular facets of ribs

27. PERIOD 5
 From 25-36 years
 skull sutures begin to close
 extent of closure of sutures is helpful
 union starts from inner aspect
 30-35 years - sagital suture

28. PERIOD 6
 From 36-50 years
 further progress in closure of sutures
 35-40 years - coronoid suture
 45-50 years - lambdoid suture
 Early degenerative changes occur in articular
surfaces of the long bones in the joints
lipping of ends/bones
loss of joint space
punched out areas of osteoporosis
 40 years - xiphisternum unites with body

29. PERIOD 7
 From 50 year onward
 further proceeding in closure of sutures and
joint change
 calcification of laryngeal and costal cartilages
 prominent feature is pathological changes in
the skeleton
 55-60 years - parietomastoid and squamous
sutures
 70 years - sphenoparietal suture
 40-60 years - greater cornu of the hyoid bone
unites with body

30. Age changes in mandible:
Feature Infant Adult Old age
Ramus Short, oblique
and forms
obtuse angle
with body
Large, vertical
and forms right
angle with the
body.
Size
comparatively
reduced and
forms an
obtuse angle
with the body.
Mental
foramina
Near lower
margin
Middle of upper
and lower
border
Close to upper
border
Condyle Nearly in line
with the body,
not rojecting
above the
coronoid
process
Enlarged and
projecting
above the
coronoid
process
Relation ship is
erratic

31. Height and weight data:-
 Height data:-
 During intra uterine life the length of fetus gives indication about
the age.
 A full term fetus is 45 to 50 cm in length
 60 cm at the end of 6 months,
 68cm at the end of one year,
 double the length at birth at the end of 4th
year.
 Weight data:-
 Average weight at birth is 2.5 to 3 kg
 Avg increase in wt is 0.5 per month for 1st
year,
 doubles the wt at birth at 6th
month and
 three times the birth weight at the end of 1st
year.
 Due to individual variation growth charts have little medicolegal
value

32. Miscellaneous
 birth record
 changes occurring at puberty
 changes due to old age

33. Birth Record
 Birth and death register is maintained by
municipality
 Reporting and registration of birth and death is
made compulsory by law.
 It can be used as a reliable indicator for
determining age, if the name of an individual has
been entered
 This also provide legal proof for identity, age,
nationality, parentage and civil status f an
individual.

34. Changes occur at puberty
 Pubic hair Ϙ13 years, σ 14years
 Axillary hair Ϙ14 years, σ 15 years
 Hair on face σ 16-18 years
 Breasts appear in Ϙs at 13-14 years of
age and menstruation generally starts
 voice in σ becomes deeper at 16-18 years

35. Changes due to old age:
 Retrogressive changes like wrinkle on
face appear at 40 years of age
 Arcus senilis
 Cataract
 Graying of hair
 Note pubic and axillary hair never turn
grey before 50 years of age.

36. THE
END