Postmortem changes

Unclotted blood

• Septicemia• CO poisoning• Rapid death from asphyxia• Large dose of anticoagulants• Hypofibrinogenimia• Amniotic fluid embolism• Retained abortion • Puerperal sepsis

Post mortem fliuidity

• In most deaths of asphyxia ..blood is fluid and incoagulable

• Due to the presence of fibrinolysins from vascular endothelium

Exhumation

• Body is exhumed only when there is written order from the Executive magistrate

Harverd criteria of Brain Death

• Unreceptivity and unresponsivity• No movement• Apnoea• Absence of elicitable reflux• Isoelectric EEG

Signs of death

• Immediate• Early• Late

Suspended animation

• Inanimation for some time• Resuscitation is effective1. Freezing2. Sever drug poisoning3. New borns4. Drowning5. Electrocution6. Sunstroke7. Shock8. Hypothermia9. Cerebral concussion10. Cholera11. Insanity

Tachi noir

Kevorkian sign

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.

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

• 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

Muscular changes

1. Primary relaxation/flaccidity2. Rigor mortis/cadaveric rigidity3. Secondary flccidity

Primary relaxation

Rigor Mortis• Individual cell death occurs at this stage

D/D fo rigor mortis

1. Heat stiffening2. Cold stiffening3. Cadaveric spasm/instantaneous

rigor

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

Decomposition

1. Autolysis2. Putrifaction

Putrifaction

• Cl.welchii-Lecithinase1. Change in colour red green--1-

2days… …black colour 3-4 days2. Gas formation-1-2days3. Liquifaction of tissues

Colour change

• Sulph Hb• Ext-first-at

caecum• Int-under srface

of liver

Post mortem purge

Order of putrifaction

Adipocere• Hydrolysis

and hydrogenation of fat----higher fatty acids+calcium and ammonium ions---adipocere resists putrifaction

Embalming

• Method of chemical stiffening• Done within 6hrs of death• 70 kg body===10L fluid

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