Ch. 5 Agonal Death and Pre-Embalming Changes

A body is the agonal period is considered _____.

moribound

Moribound

Actively in the process of dying.

Death rattle

A respiratory gurgling caused by the excessive mucous accumulated due to the loss of the cough reflex.

Agonal Period

A process that takes time (death).

When does somatic death occur?

Begins what the body can no longer support vital life functions (death of the entire body).

Clinical Death

Cessation of spontaneous respiration and heartbeat.

What phase of somatic death is reversible?

Clinical Death

Brain Death

Prolonged cessation of all brain activity with complete absence of voluntary movements; no spontaneous breathing; no response to pain, noise, and other stimuli.

Brain waves have ceased; the EEG is flat

How long does it take for the brain and nervous system to die after being deprived of oxygen?

5 minutes

Biological Death

When simple life processes of various organs and tissues of the body cease

What type of death is impossible to restore respiration and circulation?

Biological Death

When does Postmortem Cellular Death begin?

- When cells used up all stored elements

- Overcome by autolytic processes

Autolytic

The breakdown of cells and tissues by enzymes.

True or false: Modern medical science has lengthened the agonal phase.

True

Agonal fever

Increase in body temperature immediately before death

Agonal Changes include:

1) Temperature of the body (lowers)

2) Ability of the body to circulate blood

3) Moisture content of tissue

4) Translocation of microorganisms within the body

Agonal Algor

The cooling of the body just prior to death.

Agonal Fever

An increase in body temperature.

Agonal hypostasis

Settling of blood into the dependent tissues of the body

Agonal Coagulation

A clotting of formed blood elements due to a lack of movement within the vascular system

Agonal capillary expansion

Opening of the pores in the walls of the capillaries to let O2-rich blood into tissues

Agonal Edema

An increase in the amount of moisture, or fluids, in the tissues and the body cavities. Causes skin slip.

Agonal Dehydration

A decrease in the amount of moisture, or fluids, in the tissues and body cavities.

Why does microorganisms begin to translocate?

Due to organisms losing their ability to keep track of motility.

What are the Postmortem Changes?

Physical, Chemical changes

Algor Mortis

Post-mortem cooling of the body to the surrounding temperature.

What factors affect the rate of algor mortis?

- Surface area to body mass

- Body temperature at the time of death

- Some combination of the first two

What factors influence hypostasis?

Temp., Medication, Disease processes

True or False: Hypostasis is the process, not the discoloration itself

True

Livor Mortis

-Postmortem, intravascular, red-blue discoloration resulting from hypostasis of blood.

- Appears within 1/2-2hrs after death

- Result of hypostasis

- AKA Postmortem Lividity or Cadaveric Lividity

______ factors affect the degree of livor mortis

Blood volume, Blood viscosity

What factors impact dehydration?

Surface evaporation & gravitation/hypostasis

Sludge

Extremely viscous blood that results from postmortem dehydration, Formed blood elements that clump and are difficult to remove

Postmortem edema

Caused by fluids moving into dependent (lower) areas of the body, tissue can become engorged and distended.

Imbibition

Absorption of water, causing an object to swell and distort

True or false: Dehydration increases blood viscosity

True

Cerebrospinal fluid becomes infected by microorganisms contained in the colon within ___ hrs.

4-6

Left ventricle of heart, lungs, urinary bladder and cisterna cerebellommedullaris become infected within ___ hrs by microorganisms.

4-8

Entire body becomes infected with recoverable microoganisms within ___ hrs after death

24-30

What are the hazards of translocating microorganisms?

- Escapement via natural or unnatural openings to contaminate

- Aerosolization spread

What organism is the most troublesome to the embalmer?

Clostridium Perfringens aka Tissue Gas

Postmortem Stain

extravascular color change that occurs when heme, released by hemolysis of red blood cells, seeps through the vessel walls and into the body tissues

Erythrocytes

red blood cells

Tardieu spots

Smaller scale in comparison to the postmortem scale

How long does it take for postmortem staining to occur?

6-10 hrs

What is the normal body pH level?

7.4

___ hrs postmortem the pH of blook and tissue fluids turns acidic.

3

Rigor mortis

Postmortem stiffening of the muscles by natural processes

What events does rigor mortis happen between?

Primary flaccidity: Total muscle reaction after death

Secondary flaccidity: Muscle relaxation after rigor has passed

True or false: It is best to embalm during the primary phase of flaccidity of rigor mortis?

True

Rigor moris will pass between ___ - ___ hours from the unembalmed body.

36-72hrs

True or false: After secondary flaccidity, the muscles lock together to create an insoluble protein.

True

Ideal temperatures of rigor mortis are between ___ and ___ F

98-100F

Cadaveric spasms

Sudden movement or convulsions brought about by involuntary muscular contractions

Decomposition

A breakdown of the peptide linkages between proteins via catalytic enzymes

Rigor marks end of muscle cell life and becomes observable between __-__ hrs after death.

2-4 hrs

Saprophytic Bacteria

- Normally reside within the human digestive tract

- They translocate after death and increase in numbers by feeding off of dead organic matter

- Aerobic bacteria can also enter the body and deplete tissues of oxygen, creating a favorable environment for anaerobic organisms

Lysosomes

Self-destruction mechanism of cells that occurs when the body's pH changes to acidic, and the surrounding membrane ruptures and releases digestive enzymes

Autolysis

The spontaneous breakdown of cells as they self-digest; enzymes begin to digest the surrounding cellular matter

What are the products of autolysis?

Acids, sugars, fatty acids, and glycerol, which are perfect for decomposition

Hydrolysis

The chemical breakdown of a compound due to reaction with water.

Amines

organic compounds with an amino group, derive from ammonia

Ptomaines

A group of amino acids

What are the two molecules that release the "death" odor?

Putrescine and Cadaverine

Putrefaction

Protein decomp via anaerobic bacteria

Decay

Decomp of protein via aerobic bacteria

What is the order of decomposition?

Cells, tissues, organs

What system is one of the last organ systems to decompose?

Vascular system

The 5 Classic Signs of Decomp:

1. Color

2. Odor

3. Skin Slip

4. Gases

5. Purge

Color change first happens over the _____.

right lower quadrant of the abdomen

What is color change caused by?

Hydrogen sulfide and hemoglobin

Desquamation

CreSkin slip, Hydrolysis of collagen and elastin causes the superficial skin to be pulled away easily from deeper layers

What proteins cause putrefactive odors?

Amines, mercaptans, and hydrogen sulfide

Crepitation

Moving to reduce gases via digital pressure (physical movement); makes a crackling sound

Purge

The evaluation of gases, liquids, and semisolids from a natural body orifice

True or false: Purge does not follow the path of least resistance

false

Stomach purge

Foul-smelling liquid that resembles coffee grounds

Lung purge

Frothy with a tan to reddish color

Brain purge

Grayish froth