Age & its medicolegal importance

45,118 views 36 slides Feb 18, 2016
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About This Presentation

forensic medicine


Slide Content

PERSONAL
IDENTITY

MEDICO-LEGAL
IMPORTANCE
OF
AGE

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 in These periods are of importance because in
cases of Istaqat-e-Hamal & Istaqat-e-jinin cases of Istaqat-e-Hamal & Istaqat-e-jinin
we have to identify the period & accordingly we have to identify the period & accordingly
punishment is givenpunishment is given

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 PRESEDENT 45 YEARS-------------CONTEST ELECTION OF PRESEDENT
OF PAKISTANOF PAKISTAN
60 YEARS-------------RETIREMENT60 YEARS-------------RETIREMENT

AGE
ESTIMATION

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

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

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

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

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

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

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

LENGTH
OF
FOETUS

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.

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

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

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

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

CENTRES FOR OSSIFICATIONCENTRES FOR OSSIFICATION
The center of ossification can be detected by dissecting The center of ossification can be detected by dissecting
the bone itself. The order of appearance of primary the 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

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

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.

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

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

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

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

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

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

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

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

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

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 4
th
year.
Weight data:-
Average weight at birth is 2.5 to 3 kg
Avg increase in wt is 0.5 per month for 1
st
year,
 doubles the wt at birth at 6
th
month and
three times the birth weight at the end of 1
st
year.
Due to individual variation growth charts have little medicolegal
value

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

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.

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

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.

THE
END
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