postmortem changes
DESCRIPTION
a short review of Postmortem changesTRANSCRIPT
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Postmortem changes
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Unclotted blood
• Septicemia• CO poisoning• Rapid death from asphyxia• Large dose of anticoagulants• Hypofibrinogenimia• Amniotic fluid embolism• Retained abortion • Puerperal sepsis
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Post mortem fliuidity
• In most deaths of asphyxia ..blood is fluid and incoagulable
• Due to the presence of fibrinolysins from vascular endothelium
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Exhumation
• Body is exhumed only when there is written order from the Executive magistrate
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Harverd criteria of Brain Death
• Unreceptivity and unresponsivity• No movement• Apnoea• Absence of elicitable reflux• Isoelectric EEG
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Signs of death
• Immediate• Early• Late
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Suspended animation
• Inanimation for some time• Resuscitation is effective1. Freezing2. Sever drug poisoning3. New borns4. Drowning5. Electrocution6. Sunstroke7. Shock8. Hypothermia9. Cerebral concussion10. Cholera11. Insanity
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Tachi noir
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Kevorkian sign
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Cooling of body/algor mortis• Approximate time in hours of death=(Normal
Body temperature-rectal temp)/rate of fall of temperature per hr.
• Postmortem caloricity-temperature raised for first 2 hrs
1. Sunstroke2. In some nerve disorders3. Tetanus and strychnine poisoning4. Excessive bacterial activity in
septicemia,cholera,etc.
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Postmortem hypostasis
• Due to capillo-venous distension-----deoxy Hb-----stains bluish-purple/purplish red
• /PM staining/s/c hypostasis/livor mortis/darkening of death/cadaveric lividity/sagilations/vibices
• D/D-Frost erythema,hypothermia induced red-purple spots
• Appears in about 6-12 hrs
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• When first develops-blanches on pressure,reappears
• Primary lividity-max-2-6 hrs• Non displacement/non shifting-
haemoconcentration due to fluid loss—intense in asphyxia whr the blood wont readily clot,sudden death
• It is less marked in haemorrhage,anaemia,wasting d/s,lobar pneumonia,--whr there is rapid coagulation
• Contact pallor/blanching-pressure of one area with other
• Drowning in moving water –no lividity
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Muscular changes
1. Primary relaxation/flaccidity2. Rigor mortis/cadaveric rigidity3. Secondary flccidity
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Primary relaxation
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Rigor Mortis• Individual cell death occurs at this stage
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D/D fo rigor mortis
1. Heat stiffening2. Cold stiffening3. Cadaveric spasm/instantaneous
rigor
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Cadaveric spasm/cataleptic rigidity• Contracted muscles at life, becomes
rigid after death without passing to the stage of ralaxtion
1. Sudden death2. Fear3. Severe pain4. Excitement5. Cerebral haemorrhage6. Exhaustion
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Decomposition
1. Autolysis2. Putrifaction
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Putrifaction
• Cl.welchii-Lecithinase1. Change in colour red green--1-
2days… …black colour 3-4 days2. Gas formation-1-2days3. Liquifaction of tissues
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Colour change
• Sulph Hb• Ext-first-at
caecum• Int-under srface
of liver
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Post mortem purge
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Order of putrifaction
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Adipocere• Hydrolysis
and hydrogenation of fat----higher fatty acids+calcium and ammonium ions---adipocere resists putrifaction
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Embalming
• Method of chemical stiffening• Done within 6hrs of death• 70 kg body===10L fluid
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Embalming fluidIngredient Proportion
Formalin 1.5 L
Sodium Borate 600 mg
Glycerine 600 ml
Sodium citrate 900 mg
Sodium chloride 800 mg
Eosin 1% 30 ml
Water Upto 10 L
Soluble wintergreen 90 ml