Upload
gopisankar-mg
View
6.670
Download
6
Tags:
Embed Size (px)
DESCRIPTION
a short review of Postmortem changes
Citation preview
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