TANATHOLOGY

YUDHA NURHANTARI, DR, PHD.,SPF

DEPT. OF FORENSIC MEDICINE

FAC. OF MEDICINE, GADJAH MADA UNIVERSITY

Objectives

Medicolegal investigation systems

Death

Cause-mechanism-manner of death

Postmortem changes :

- Livor mortis

- Rigor mortis

Decomposition, mummification, adipocere

estimation of ime of death

Reference

Forensic Pathology, second edition, Vintcent JDi

Maio, Dominick DiMaio, CRC Press Boca Raton

2001

Forensic Pathology, Bernard Knight, 1996

Medicolegal investigative system

Coroner (not physician) investigate the cause and

manner of death

Not required to consult a physician, may or may not

order an autopsy

1-2 weeks training

modified

Medical examiner (physician) investigate the

cause and manner of death

US

Board certification

Continental system : the police investigator ask the

doctor to examine the body.

Indonesia

death

Respiratory-cardiovascular-neurology stop permanently

Brain stem death

Criteria: Deep coma with ventilation (inadequate spontaneous respiration caused by brain damage)

Dx by 2 doctors 5 years registered and experienced

Cause, Manner,Mechanism of death

Cause of death is any injury or disease that produce a physiological derangement in the body that results in the death

Mechanism of death is the physiological derangement produced by the cause of death

Manner of death explain how the cause of death came out: natural, homicide, suicide, accident, undet

Cause mechanism death

cause

Stab wound to the chest

Adenocarcinoma of the lung

mechanism

hemorrhage

septicemia death

Sudden or unexpected natural death

Can be instantaneous(ventricular arrhythmia),

sudden but not instantaneous (myocardial infarction)

or cases where the individual was found death

Unexpected or unexplained naturaldeath

tanathology

Study of death and postmortem changes

Postmortem changes have specific pattern

- estimation/determination post mortem interval

- mobilization/position of the victim after death

- Cause-manner of death

Time of death

Postmortem changes determination time of death

Livor mortis, rigor mortis, body temperature, degree

of decomposition, chemical changes

Flow-cytometry, stomach contents, insect activity,

and scene markers

Livor mortis

=postmortem hypostatis=lividity

Circulation ceases gravity pulls down stagnant

blood to the lowest accessible area sedimentation

of red cells bluish red discoloration

Distributed to the lowest area with free compression

depend on the body position after death

Begin within 30 minutes- 2 hours, develops

gradually, usually reach its maximum discoloration

at 8-12 hours

Examination : displacement of livor mortis on thumb

pressure

Usual bluish red oxygenation at death

In drowing, may turn to pink oxyhemoglobin formation at the expense of the darker reduced hb

Cherry-pink colour of hypostasis carboxyhemoglobin CO poisoning

Dark blue-pink hue cyanide

Brownish red methaemoglobinemia chlorate

Subcutaneous

bleeding

May be any where

Thumb pressure (-)

Slightly raise

Accumulation of red

cell be gravity

Lowest are free

compression

Thumb pressure

flat

bruish Livor mortis

Rigor Mortis

Muscles stiffening after death dissapearence of ATP actin and myosin filament permanently complexed and rigor mortis sets in

Appears 2-4 h, fully develops in 6-12 h. after 24-36 h disappear.

Consuming ATP prior to death speed up

Drowning fully 2-3 h

All muscles at the same time and rate most evident in small muscles

Cadaveric spasm: instantaneous appearance intense physical and or emotional activity

Heat stiffening denatured and coagulated tissue protein as in cooking pugilistic

Cold stiffening freeze

decomposition

Mixed process : internal autolysis and external process (bacteria, fungi etc)

Factor : temperature, body state humidity etc

First greenish discoloration of lower right abdomen 24-36 h other body

swelling due to gas formation and marbling ( hemolysis of blood vessel

60-72 h undergoes generalized bloating, followed by

Vesicle formation, skin slippage, hair slippage the body is green-black.

Decomposition fluid will drain from nose and mouth, and accumulate in body cavity

Hastened by obesity, heavy clothing, sepsis, high T

Delayed in the cool environment

When the decomposition has set in, refrigeration may not stop decomposition completely

Internaly, decomposition slower than at surface

Immersed body slows up putrefaction:

- lower ambient temperature

- protection from insect and small mammal predator.

Buried bodies in the earth much slower than in air or water

Adipocere formation

Adipocere : a waxy substance derived from body fat moisture condition

Assist by Cl perfringens that produce lecithinase which facilitates hydrolysis and hydrogenation

After months (3-12 month)brittle and chalky.

Adipocere inhibits putrefaction by increasing tissue acidity, dehydration slows the growth of bacteria

mummification

A drying of the tissues in place of liquefying

putrefaction

Only occur in dry environment ,but can occur in

freezing condition

The skin and underlying tissue are hard

Postmortem damage by predator

Animal predation is aprt of natural food chain returns the protein, fats and carbohydrates.

Damage from canine nad rodent predators is usually obvious

The most active tissue removers are maggots, larval stage of flies

The adult insects lay eggs on the fresh body, choosing wounds or moist areas. The eggs hatch in a day or so, and several cycles of maggot develop, shedding their cases at intervals depending on the species

In water, all aquatic animals can mutilate immersed

body

Dogs and foxes may leave puncture wound due to

sharp teeth penetration

calliphora

Adult calliphora lay the eggs on the body 8-14 h

hatch at 6-7 C (will not hatch at t below 4C) first instar/stage persist another 8-14 h second instar another 2-3 day third instar stay 3 days pupa 12 days winged fly

Some maggots, adults, pupae, empty pupa and eggs should be sent after fixation with alcohol 80%, labeled, numbered

Post mortem Chemistry

Humor vitreous PM interval (Sturner)= 7.14x

potassium concentration (mEq/L)-39.1

Chloroide and sodium decrease

Glucose decrease

Body cooling

After death metabolism stop temperature

decrease environment temperature

Time since death = 37 C-rectal temp +3

Time since death= (98.6F-rectal temp)/1.5

Gastric emptying

Estimate the interval between eatning and death

Spitz Small meal (sandwich) is digested in 1 h

Large meal takes 3-5 h

Adelson light meal -2 h, medium size meal 3-4

h, and heavy meal 4-6 h.

Flow cytometry

Comparison of the cell degradation degree in tissue

with standard

DNA degradation degree