unit 1.3: postmortem changes

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45 Terms

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Postmortem changes
refers to a continuum of changes that occur in a dead body following death
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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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2 to 2.5 deg F/hr
### Algor Mortis

1st hour
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1\.5 to 2 deg F/hr
### Algor Mortis

next 12hrs
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1 deg F /hr
### Algor Mortis

next 12-18hrs
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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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formation of **locking-chemical bridges between actin & myosin**
### Rigor Mortis

**Lack of ATP** regeneration and increased **lactic** **acidity**
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energy dependent breakage of sarcomere contraction
### Rigor Mortis

the glycogen stores are rapidly depleted, preventing ___
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Sets **within 2 hrs after** death
### Rigor Mortis

head & neck → small muscles → larger muscles
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6-12 hrs
### Rigor Mortis

complete and fully fixed
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36-48 hours
### Rigor Mortis

Dissipates
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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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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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Blanching
### Livor Mortis

occurs in gravity dependent areas of the body that come into contact with firm surfaces
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20 min after death
### Livor Mortis

Becomes evident as early as ___
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Erythrocyte Sedimentation Rate
### Livor Mortis

rate of settling of red blood cells
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within 4 hrs
### Livor Mortis

Fully evident
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8 - 12 hrs
### Livor Mortis

fixed
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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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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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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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mastoid-to-mastoid incision
### Techniques for Autopsy

scalp
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I-incision
### Techniques for Autopsy: *Trunk*

straight line incision from chin to pubic symphysis
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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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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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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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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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Technique of Ghon
### Conventional Techniques for Autopsy

* **en bloc** Technique - only get a portion
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Technique of Letulle
### Conventional Techniques for Autopsy

* **en masse** Technique - complete removal
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Needle Autopsy
### Conventional Techniques for Autopsy: *Minimally Invasive*

get a sample using a needle
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blind biopsies
### Conventional Techniques for Autopsy: *Minimally Invasive*

Multiple percutaneous needle biopsies after death
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**Laparoscopic** (abdominal) and **thoracoscopic** (chest)
### Conventional Techniques for Autopsy: *Minimally Invasive*

investigation with tissue sampling
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Mini-autopsy
### Conventional Techniques for Autopsy: *Minimally Invasive*

extensive organ sampling or removal via a **limited incision**
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CT and MRI
### Conventional Techniques for Autopsy: *Imaging Autopsies*

red vessels, areas with mass, areas with blockage, etc.
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3 months after final report
### Suggested Material Retention: *Non-Forensic*

Wet Tissue
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10 years
### Suggested Material Retention: *Non-Forensic*

Paraffin blocks, Slides, Reports
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3 years
### Suggested Material Retention: *Forensic*

Wet Tissue
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indefinitely
### Suggested Material Retention: *Forensic*

Paraffin blocks, Slides, Reports, Gross Photos, Dried Blood stain or frozen tissue for DNA
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1 year
### Suggested Material Retention: *Forensic*

Body Fluids & Tissues for Toxicology
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**Liver**: 1500-1800gm
heaviest human organ
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**Ovary**: 5-7gm
lightest human organ
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Right atrium
thinnest heart blah
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Left ventricle
thickest heart blah