PERSONALIDENTITY

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 cases of These periods are of importance because in cases of Istaqat-e-Hamal & Istaqat-e-jinin we have to identify Istaqat-e-Hamal & Istaqat-e-jinin we have to identify the period & accordingly punishment is giventhe period & accordingly punishment 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, skull Appearance of ossification centres for clavicle, skull

bones, long bones, mandiblebones, 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 2020THTH WEEK-----------------400 GMS WEEK-----------------400 GMS 2828THTH WEEK-----------------1100-1300 GMS WEEK-----------------1100-1300 GMS 4040THTH WEEK-----------------2700-3500 GMS WEEK-----------------2700-3500 GMS

CENTRES FOR OSSIFICATIONCENTRES FOR OSSIFICATION

The center of ossification can be detected by dissecting the The center of ossification can be detected by dissecting the bone itself. The order of appearance of primary centres of bone itself. The order of appearance of primary centres of ossification are as follows: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 claviclearticular 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 spacepunched 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 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

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.

THEEND