FORENSIC MEDICINE- POSTMORTEM CHANGES

1. DR.SYLVIA
POST GRADUATE
FORENSIC MEDICINE

2.  THESE ARE CHANGES SEEN IN THE BODY AT
THE TIME OF DEATH
 INSENSIBILITY
 RESPIRATORY ARREST
 CIRCULATORY ARREST

3.  CHANGES SEEN IN THE DEAD BODY IN FIRST
12 – 24 Hrs OF DEATH
 EYE CHANGES
 SKIN CHANGES
 POSTMORTEM COOLING
 POSTMORTEM LIVIDITY
 MUSCLE CHANGES

4.  CHANGES SEEN IN THE DEAD BODY AFTER 24
Hrs OF DEATH AND INCLUDE CHANGE OF
EVENTS KNOWN AS POSTMORTEM
DECOMPOSITION ( PUTREFACTION)
 PUTREFACTION
 ADIPOCERE FORMATION
 MUMMIFICATION
 SKELETONISATION

5.  EARLIEST SIGN OF DEATH
 CONIDITION WHICH CAN BE MISTAKEN
PROLONGED FAINTING ATTACK
NARCOSIS
EPILEPSY
CATALEPSY

6.  IT SHOULD BE COMPLETE AND CONTINUOUS

7.  STOPPAGE OF HEART BEAT FOR >5MINS IS
IRRECOVERABLE AND IS ACCEPTED AS
EVIDENCE OF DEATH.

8.  SIGNS OF LIFE NOT FOUND , AS THE
FUNCTIONS ARE INTERRUPTED FOR SOMETIME
OR ARE REDUCED TO MINIMUM
Yoga – 5 to 30 mins
MEDICAL CONDITIONS- VAGAL INHIBITION,
NEWBORN, SUNSTROKE, ELECTROCUTION.

9.  PALE
 LOSS OF ELASTICITY
 LIPS DARK RED TO BLACK IN COLOUR.

10.  LOSS OF CORNEAL REFLEX
 OPACITY OF CORNEA
TACHE NOIR
 FLACCIDITY OF EYEBALL
 PUPILS –
INITIALLY- DILATE
ONSET OF RM- CONSTRICT
 RETINAL VESSELS- FRAGMENTATION

11.  NOT COOL ACCORDING TO NEWTON’S LAW
 AFTER STOPPAGE OF CIRCULATION
CONVECTIONAL TRASPORT OF HEAT INSIDE THE
BODY STOPS
 METABOLIC ACTIVITY OF DYING TISSUSE AND
INTESTINAL BACTERIA TEMP DOSE NOT FALL
INITIALLY.

12.  INITIALLY LOSS OF SURFACE TEMPERATURE
THEN
LOSS OF CORE TEMPERATURE (CONDUCTION)
 NON CONTACT AREA – CONVECTION
 CONTACT AREA – CONDUCTION
 INITIAL 1 HR THE RECTAL TEMP FALLS LITTLE
OR NOT AT ALL.
 COOLING SLOPE- UNIFORM IN ITS SLOPE
0.4deg C – 0.6 Deg C PER Hr

13.  25CM
 8 -10CM INSERTED
 FOR 2MINS
 IN RECTUM
 SMALL OPENING IN PERITONEAL CAVITY
TOUCHING INF SURFACE OF LIVER
 EXT MEATUS TOUCHING TM
 NASAL CAVITYTOUCHING CRIBRIFORM PLATE

14. NORMAL BODY TEMP – RECTAL TEMP
RATE OF FALL OF TEMPERATURE/ Hr

16.  THE DIFFERENCE IN TEMPERATURE BETWEEN
BODY AND THE MEDIUM
 PHYSIQUE OF THE CADAVER
 ENVIRONMENT OF THE BODY
 COVERING ON AND AROUND THE BODY

17.  TEMP OF BODY REMAINS RAISED FOR FIRST 2 Hrs.
 SUN STROKE
 NERVOUS DISORDER
 CONVULSION
 TETANUS
 STRYCHINE POISONING
 SEPTICEMIA
 CHOLERA

18. SYNONYMS:
 POST MORTEM HYPOSTASIS
 POST MORTEM LIVIDITY
 SUGGILLATIONS
 POST MORTEM STAINING
 VIVICES

19.  BLUISH PURPLE OR PURPLISH RED
DISCOLOURATION ( DEOXY
HAEMOGLOBIN), WHICH APPEARS
UNDER THE SKIN IN THE MOST
SUPERFICIAL LAYERS OF THE
DERMIS (RETE MUCOSUM) OF THE
DEPENDENT PARTS OF THE BODY
AFTER DEATH DUE TO CAPPILO
VENOUS DISTENTION.

20. STOPPAGE OF CIRCULATION
STAGNATION OF BLOOD
SINK BY FORCE OF GRAVITY

21. APEARS BY 1 TO 3 Hrs AS SERIES OF
MOTTLED PATCHES
INCREASES IN SIZE AND COALESCE IN
3-6HrS
FIXED BY 6-8 Hrs

22.  DOSE NOT BLANCH ON PRESSURE WITH
THUMB AFTER 8 HRS

23.  POSTERIOR PORTION OF CEREBRAL LOBES
 CEREBELLUM
 POSTERIOR SURFACE OF HEART, LUNGS,
KIDNEYS, SPLEEN, LARYNX, STOMACH,
INTESTINE.

24. HAEMORRAGE / ANAEMIA PALE
ASPHYXIA DARK PURPLE
CARBON MONOXIDE CHERRY RED
CYANIDE BRIGHT PINK
POTASSIUM CHLORATE CHOCOLATE BROWN
PHOSPHOROUS DARK BROWN
HYDROGEN SULPHIDE BLUISH GREEN
OPIUM GRAYISH/BLACK

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28. 1. PRIMARY PHASE OF FLACCIDITY
2. RIGOR MORTIS
 stiffen due to chemical changes within the
muscle after 3 hours of TOD which lasts up to 36
hours
 NO RESPONSE TO ANY STIMULUS.
3. SECONDARY PHASE OF FLACCIDITY

29.  ATP INHIBITS THE ACTIVATION LINKAGES ACTIN &
MYOSIN
 FALL ATP LEVEL - IRREVERSIBLE DEVELOPMENT OF
LINKAGES.
 NOT DEPENDENT ON NERVOUS SYSTEM THOUGH
THERE IS DELAYED APPEARANCE OF RIGOR IN
PARALYSED LIMB.

30. GENERAL RULE
 WHEN ONSET IS RAPID, ITS DURATION IS
RELATIVELY SHORT.
 RIGOR COMMENCES IN 6 HOURS & TAKES ANOTHER
6 HOURS TO BECOME FULLY ESTABLISHED
 REMAINS FOR 12 HOURS
 PASSES OFF DURING THE SUCCEEDING 12 HOURS

31.  NYSTEN’S RULE- RIGOR DOSEN’T START IN ALL
MUSCLES SIMULTAENEOUSLY.
 FIRST APPEARS IN INVOLUNTARY MUSCLES
 1 HR- MYOCARDIUM
 EYELIDS  NECK LOWER JAW  MUSCLES OF
FACE MUSCLES OF CHEST  UPPER LIMB 
ABDOMEN  LOWER LIMB  LASTLY FINGERS AND
TOE

32.  AGE – FOETUS <7MONTHS NO RIGOR MORTIS
 NATURE OF DEATH –
ONSET EARLY AND DURTION LESS
* DISEASE WITH GREAT WASTING AND
EXHAUTION (CHOLERA,TB)
* VIOLENTS DEATHS

33. EARLY ONSET
* ORGANOPHOSPHATE POISONING
DELAYS APPEARANCE
* CO POISONING , CONDITIONS CAUSING
MUSCLE PARALYSIS
 ATMOSPHERIC CONDITION
COLD – LATE ONSET AND LATE DISAPPEARANCE
VERY HOT – DISSAPPEARS VERY EARLY

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37.  WHEN BODY IS EXPOSED TO TEMPERATURE
> 65 DEGREE A RIGIDITY IS PRODUCED WHICH IS
MUCH MORE MARKED THAN THAT FOUND IN
RIGOR .
RIGOR MORTIS DOSE NOT OCCUR

39.  CATALEPTIC RIGIDITY
 SINGLE GROUP OF VOLUNTRY MUSCLE
 FREQUENTY INVOLVES HAND

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41. DECOMPOSITION
AUTOLYSIS PUTREFACTION

42.  SELF DIGESTION OF TISSUES
 EARLIEST AUTODIGESTION STARTS IN GLANDULAR
& PARECHYMATOUS TISSUE AND IN BRAIN.

43.  THE DISINTEGRATION OF BODY TISSUES AFTER
DEATH .
 PUTREFACTION/ DECOMPOSITION – SYNONYMS
 FOLLOWS DISAPPEARNCE OF RIGOR MORTIS

44.  1ST SIGN – GREENISH DISCOLOURATION OF SKIN
OVER THE REGION OF CEACUM
 12-18 Hrs – SUMMER
 24-48Hrs – WINTER
 MARBLING- LINEAR BRANCHING PATTERN
STARTS WITH 24Hrs ----- PROMINENT IN 36-48Hrs
POSTMORTEM PURGE
 PUTREFACTIVE EFFUSION OF FOUL SMELLING
BLOOD STAINED

45. -- REDUCTION OF COMPLICATED PROTIENS
AND CARBOHYDRATE
 BLISTER FORMATION : 18 – 24Hrs
 GAS ACCUMULATE IN TISSUE CAUSING
CREPITATION

46.  18 TO 36 Hrs – BODY BECOMES BLOATED
AND DISTORTED.
 PEELING OF SKIN
 EYE BULGED OUT
 TONGUE PROTRUDED OUT OF MOUTH
 BLOATED BREAST, SCROTUM

47.  IN 1 TO 2 DAYS
 PROTEOLYTIC TISSUE THAT DISSOLVES THE
TISSUE

48.  COLLIQUATIVE PUTREFACTION IN 5 TO 10
DAYS.
 ABDOMEN BURST
 BLOOD DISAPPEARS FROM BLOOD VESSELS

49.  EXTERNAL
 TEMPERATURE
 MOISTURE
 AIR
 CLOTHING
 MANNER OF BURIAL

50.  INTERNALLY
 AGE
 SEX
 CONDITION OF BODY
 CAUSE OF DEATH
 MUTILATION

51. BODY DECOMPOSES IN AIR
TWICE AS IN WATER
8 TIMES AS IN EARTH

58.  AMBIENT TEMPERATURE
 INSECT COLINISATION
 IN AIR, WATER- EARLY SKELETONISATION
 IN EARTH- NO AIR, ANIMAL LIFE – DELAYS
SKELETONISATION.

59.  IN INDIA UNCOFFINED BURIED BODY IS
REDUCED TO SKELETON WITHIN A YEAR,
 ACID SOIL- DECAY OF BONES IN 25-100YRS
 HOT CLIMATE ON GROUND SURFACE , DECAY
OF BONES IN 5 TO 10 YRS.

61.  CIRE = WAX
 MODIFICATION OF PUTREFACTION
 FATTY TISSUE OF THE BODY CHANGE INTO A
SUBSTANCE KNOWN AS ADIPOCERE.
 BODIES IMMERSED IN WATER OR IN DAMP,
WARM ENVIRONMENT .

62. FAT
HIGHER FATTY ACID
INSOLUABLE SOAP ( ACIDIC INHIBITS PUTREFACTIVE
BACTERIA)
HYDROLYSIS AND
HYDROGENATION
COMBINES WITH
CALCIUM AND
AMMONIUM IONS

63.  RATE OF ADIPOCERE FORMATION IS
EXTREMELY VARIABLE.
 IN INDIA- OBSERVED TO BEGIN WITHIN 4-5
DAYS
 FORMED FIRST IN FACE, BUTTOCKS, BREAST,
ABDOMEN.
 SOMETIME THE ENTIRE BODY IS COVERTED
INTO A ADIPOCERE.

65.  MODIFIED PUTREFACTION
 DEHYDRATION OR DRYING AND SHRIVELLING OF
THE CADAVER OCCURS FROM EVAPORATION OF
WATER , BUT THE NORMAL APPEARANCE OF THE
BODY AND GENERAL FACIAL FEATURES ARE
PRESERVED.

66.  SKIN MAY BE
SHRUNKEN AND CONTRACTED
DRY
BRITLE
LEATHERY
RUSTY BROWN – BLACK IN COLOUR

67.  ENTIRE BODY LOSES WEIGHT UPTO 60-70 %
 FACTORS NECESSARY FOR MUMMIFICATION
ABSENCE OF MOISTURE
CONTINUOUS ACTION OF DRY OR WARMED AIR