unit 1.3: postmortem changes

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Postmortem changes

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Tags and Description

45 Terms

1

Postmortem changes

refers to a continuum of changes that occur in a dead body following death

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2

Algor Mortis

  • Cold Death

  • First demonstrable change after death is cooling of the body

  • Not a reliable indicator as to the time of death due to the different temperature of the environment

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3

2 to 2.5 deg F/hr

Algor Mortis

1st hour

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4

1.5 to 2 deg F/hr

Algor Mortis

next 12hrs

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5

1 deg F /hr

Algor Mortis

next 12-18hrs

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6

Rigor Mortis

Rigidity of the body due to hardening of the skeletal muscles caused by a series of physiochemical events after death

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7

formation of locking-chemical bridges between actin & myosin

Rigor Mortis

Lack of ATP regeneration and increased lactic acidity

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8

energy dependent breakage of sarcomere contraction

Rigor Mortis

the glycogen stores are rapidly depleted, preventing ___

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9

Sets within 2 hrs after death

Rigor Mortis

head & neck → small muscles → larger muscles

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10

6-12 hrs

Rigor Mortis

complete and fully fixed

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11

36-48 hours

Rigor Mortis

Dissipates

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12

Anti-gravitational Rigor Mortis

Rigor Mortis

Fixed rigor mortis of the upper extremities wherein the arms are suspended against gravity indicating they were previously held in that position during time of death

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13

Livor Mortis or Postmortem hypostasis

  • Blood supply gravitates to the skin vessels which become toneless and dilate after circulation ceases

  • deep purple-red discoloration in the skin

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14

Blanching

Livor Mortis

occurs in gravity dependent areas of the body that come into contact with firm surfaces

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15

20 min after death

Livor Mortis

Becomes evident as early as ___

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16

Erythrocyte Sedimentation Rate

Livor Mortis

rate of settling of red blood cells

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17

within 4 hrs

Livor Mortis

Fully evident

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18

8 - 12 hrs

Livor Mortis

fixed

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19

Lividity

Livor Mortis

  • Blood settles down in the lowest elevation of the body

  • pink to purple discoloration

    • blood pooling in dependent areas of the body

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20

Tardieu Spots

Livor Mortis

  • Auguste Ambroise Tardieu

  • ecchymoses; subpleural spots of ecchymosis that follow the death of a newborn child by strangulation or suffocation

  • purple to black spots

    • rupture of capillaries

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21

Tache noir de la sclerotique

  • After death, the skin and mucosal membranes may desiccate resulting in a change in color and character of these tissues

  • horizontal linear scleral blackening along the equator of the globe of the eye

    • sclera is exposed to drying when the eyelids are incompletely shut

    • initially red in appearance and over time becomes black

  • Lips, tip of tongue and scrotum darken with postmortem drying

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22

mastoid-to-mastoid incision

Techniques for Autopsy

scalp

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23

I-incision

Techniques for Autopsy: Trunk

straight line incision from chin to pubic symphysis

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24

Y-incision

Techniques for Autopsy: Trunk

starts from the acromion and meets at the xiphoid process and continues up to the pubic symphysis

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25

Modified Y-incision

Techniques for Autopsy: Trunk

made from suprasternal notch to symphysis then extends over clavicle to its center on both sides and passes upwards over neck and behind the ear

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To expose:

  1. chambers of the Heart

  2. inner lungs

  3. inner liver

  4. urinary bladder cavity

  5. GIT lumen

Purposes of Opening Up

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27

Technique of Virchow

Conventional Techniques for Autopsy

organs removed and dissected individually

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head → thoracic → abdominal organs

Conventional Techniques for Autopsy: Virchow

order of examination

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29

Technique of Rokitansky

Conventional Techniques for Autopsy

  • in-situ dissection in part combined with en bloc-technique

  • analysis/study on site

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30

Technique of Ghon

Conventional Techniques for Autopsy

  • en bloc Technique - only get a portion

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31

Technique of Letulle

Conventional Techniques for Autopsy

  • en masse Technique - complete removal

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32

Needle Autopsy

Conventional Techniques for Autopsy: Minimally Invasive

get a sample using a needle

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33

blind biopsies

Conventional Techniques for Autopsy: Minimally Invasive

Multiple percutaneous needle biopsies after death

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34

Laparoscopic (abdominal) and thoracoscopic (chest)

Conventional Techniques for Autopsy: Minimally Invasive

investigation with tissue sampling

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35

Mini-autopsy

Conventional Techniques for Autopsy: Minimally Invasive

extensive organ sampling or removal via a limited incision

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36

CT and MRI

Conventional Techniques for Autopsy: Imaging Autopsies

red vessels, areas with mass, areas with blockage, etc.

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37

3 months after final report

Suggested Material Retention: Non-Forensic

Wet Tissue

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38

10 years

Suggested Material Retention: Non-Forensic

Paraffin blocks, Slides, Reports

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39

3 years

Suggested Material Retention: Forensic

Wet Tissue

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40

indefinitely

Suggested Material Retention: Forensic

Paraffin blocks, Slides, Reports, Gross Photos, Dried Blood stain or frozen tissue for DNA

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41

1 year

Suggested Material Retention: Forensic

Body Fluids & Tissues for Toxicology

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42

Liver: 1500-1800gm

heaviest human organ

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43

Ovary: 5-7gm

lightest human organ

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44

Right atrium

thinnest heart blah

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45

Left ventricle

thickest heart blah

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