Postmortem changes

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a short review of Postmortem changes

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  • Tardieu spots
  • Postmortem changes

    1. 1. Postmortem changes
    2. 2. Unclotted blood <ul><li>Septicemia </li></ul><ul><li>CO poisoning </li></ul><ul><li>Rapid death from asphyxia </li></ul><ul><li>Large dose of anticoagulants </li></ul><ul><li>Hypofibrinogenimia </li></ul><ul><li>Amniotic fluid embolism </li></ul><ul><li>Retained abortion </li></ul><ul><li>Puerperal sepsis </li></ul>
    3. 3. Post mortem fliuidity <ul><li>In most deaths of asphyxia ..blood is fluid and incoagulable </li></ul><ul><li>Due to the presence of fibrinolysins from vascular endothelium </li></ul>
    4. 5. Exhumation <ul><li>Body is exhumed only when there is written order from the Executive magistrate </li></ul>
    5. 6. Harverd criteria of Brain Death <ul><li>Unreceptivity and unresponsivity </li></ul><ul><li>No movement </li></ul><ul><li>Apnoea </li></ul><ul><li>Absence of elicitable reflux </li></ul><ul><li>Isoelectric EEG </li></ul>
    6. 7. Signs of death <ul><li>Immediate </li></ul><ul><li>Early </li></ul><ul><li>Late </li></ul>
    7. 8. Suspended animation <ul><li>Inanimation for some time </li></ul><ul><li>Resuscitation is effective </li></ul><ul><li>Freezing </li></ul><ul><li>Sever drug poisoning </li></ul><ul><li>New borns </li></ul><ul><li>Drowning </li></ul><ul><li>Electrocution </li></ul><ul><li>Sunstroke </li></ul><ul><li>Shock </li></ul><ul><li>Hypothermia </li></ul><ul><li>Cerebral concussion </li></ul><ul><li>Cholera </li></ul><ul><li>Insanity </li></ul>
    8. 9. Tachi noir
    9. 10. Kevorkian sign
    10. 11. Cooling of body/algor mortis <ul><li>Approximate time in hours of death=(Normal Body temperature-rectal temp)/rate of fall of temperature per hr. </li></ul><ul><li>Postmortem caloricity-temperature raised for first 2 hrs </li></ul><ul><li>Sunstroke </li></ul><ul><li>In some nerve disorders </li></ul><ul><li>Tetanus and strychnine poisoning </li></ul><ul><li>Excessive bacterial activity in septicemia,cholera,etc. </li></ul>
    11. 12. Postmortem hypostasis <ul><li>Due to capillo-venous distension-----deoxy Hb-----stains bluish-purple/purplish red </li></ul><ul><li>/PM staining/s/c hypostasis/livor mortis/darkening of death/cadaveric lividity/sagilations/vibices </li></ul><ul><li>D/D-Frost erythema,hypothermia induced red-purple spots </li></ul><ul><li>Appears in about 6-12 hrs </li></ul>
    12. 13. <ul><li>When first develops-blanches on pressure,reappears </li></ul><ul><li>Primary lividity-max-2-6 hrs </li></ul><ul><li>Non displacement/non shifting-haemoconcentration due to fluid loss—intense in asphyxia whr the blood wont readily clot,sudden death </li></ul><ul><li>It is less marked in haemorrhage,anaemia,wasting d/s,lobar pneumonia,--whr there is rapid coagulation </li></ul><ul><li>Contact pallor/blanching-pressure of one area with other </li></ul><ul><li>Drowning in moving water –no lividity </li></ul>
    13. 14. Muscular changes <ul><li>Primary relaxation/flaccidity </li></ul><ul><li>Rigor mortis/cadaveric rigidity </li></ul><ul><li>Secondary flccidity </li></ul>
    14. 15. Primary relaxation
    15. 16. Rigor Mortis <ul><li>Individual cell death occurs at this stage </li></ul>
    16. 18. D/D fo rigor mortis <ul><li>Heat stiffening </li></ul><ul><li>Cold stiffening </li></ul><ul><li>Cadaveric spasm/instantaneous rigor </li></ul>
    17. 19. Cadaveric spasm/cataleptic rigidity <ul><li>Contracted muscles at life, becomes rigid after death without passing to the stage of ralaxtion </li></ul><ul><li>Sudden death </li></ul><ul><li>Fear </li></ul><ul><li>Severe pain </li></ul><ul><li>Excitement </li></ul><ul><li>Cerebral haemorrhage </li></ul><ul><li>Exhaustion </li></ul>
    18. 20. Decomposition <ul><li>Autolysis </li></ul><ul><li>Putrifaction </li></ul>
    19. 21. Putrifaction <ul><li>Cl.welchii-Lecithinase </li></ul><ul><li>Change in colour  red green--1-2days… …black colour  3-4 days </li></ul><ul><li>Gas formation-1-2days </li></ul><ul><li>Liquifaction of tissues </li></ul>
    20. 22. Colour change <ul><li>Sulph Hb </li></ul><ul><li>Ext-first-at caecum </li></ul><ul><li>Int-under srface of liver </li></ul>
    21. 23. Post mortem purge
    22. 24. Order of putrifaction
    23. 25. Adipocere <ul><li>Hydrolysis and hydrogenation of fat----higher fatty acids+calcium and ammonium ions---adipocere resists putrifaction </li></ul>
    24. 26. Embalming <ul><li>Method of chemical stiffening </li></ul><ul><li>Done within 6hrs of death </li></ul><ul><li>70 kg body===10L fluid </li></ul>
    25. 27. Embalming fluid Upto 10 L Water 800 mg Sodium chloride 600 ml Glycerine 90 ml Soluble wintergreen 30 ml Eosin 1% 900 mg Sodium citrate 600 mg Sodium Borate 1.5 L Formalin Proportion Ingredient

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