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Y3R2 - Forensic ⚠️ > L1: Death > Flashcards

L1: Death Flashcards

1
Q

Def of Death

A
  • Death is irreversible cessation of life, and it is a process not an event.
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2
Q

Def of Somatic Death (Clinical Death)

A
  • Complete and irreversible cessation of vital functions of brain, heart and lungs (the tripod of life)
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3
Q

Phases of Death

A

1st Phase: Somatic Death (Clinical Death)

2nd Phase: Molecular Death (Cellular Death)

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4
Q

Charcters of Somatic Death

A
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5
Q

what happens to tissues & Cells after somatic death? and what does it depend on?

A
  • Tissues and cells continue to survive for variable periods of time, depending upon their oxygen requirements.
  • After somatic death, Tissues and cells can respond to chemical and electrical stimuli
  • Pupils also dilate and constrict.
  • Organs can be removed during this “physiological gap” from the cadavers for transplantation.
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6
Q

Dx of Somatic Death

A
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7
Q

what are simulating conditions to Somatic Death?

A
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8
Q

Def of Molecular Death (Cellular Death)

A

It is the ultimate death of all cellular elements.

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9
Q

Characters of Molecular Death

A
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10
Q

Time of living of various tissues after Somatic Death

A

It is reported that nervous tissue dies rapidly.

  • Vital centers of brain die in about 5 minutes
  • While muscle tissue lives up to 3 to 4 hours after cessation of circulation.
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11
Q

when is Molecular Death completed?

A
  • Within 2 to 4 hours of somatic death
  • Can be confirmed by absence of any response to an electrical, thermal or chemical stimulus in tissues.
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12
Q

MLI of distinction between somatic and molecular Death

A
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13
Q

Types of Signs of death

A
  • Immediate Changes (Somatic Death)
  • Early Changes (Molecular Death)
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14
Q

Immediate Changes of Death

A
  • Insensibility and Loss of Voluntary Power.
  • Irreversible Cessation of Circulation and Respiration.
  • Brain/Brainstem Death
  • Cerebral/Cortical Death
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15
Q

Characters of Cortical/Cerebral Death

A
  • Brainstem is intact
  • With continuous heart sounds and respiration
  • No muscular movement with generalized flaccidity.
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16
Q

Def of Cortical Death

A
  • Severe brain damage, which does not involve the brainstem, may result in a persistent vegetative state “Living Cadaver”.
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17
Q

Characters of patients with Cortical Death

A

These patients:

  • Breathe spontaneously
  • Open and close their eyes
  • Swallow
  • Make facial grimaces
  • do have a preserved sleep-wake cycle.
  • However, they show no behavioral evidence of awareness (Patient does not speak or obey commands).
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18
Q

is EEG enough to diagnose death?

A

No

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19
Q

Dx of Cortical Death

A
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20
Q

Caracters of Brainstem Death

A
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21
Q

Dx of Brainstem Death

A
22
Q

what are examples of brainstem reflexes lost in Brainstem Death?

A

s

23
Q

Exclusion criteria before certifying brainstem death

A
24
Q

what is Whole Brain Death?

A
  • It is a combination of both cortical and brain stem death.
25
Q

What has Whole Brain Death allowed?

A
  • This has allowed feasibility of removal of vital organs such as heart, kidney, liver, etc. from a donor body for purpose of organ transplantation successfully without any ethical or legal complications.
26
Q

what is Time of Death?

A
27
Q

when is Harvest of organs after death allowed?

A

“after established brain stem death”

27
Q

Viability of the cornea after death

A

The cornea of eye may still be suitable for transplant up to 24 hours after death.

28
Q

Early Changes of Death

A
  • Changes in skin and facial pallor
  • Primary flaccidity
  • Contact flattening
  • Ocular signs
29
Q

Changes in skin and facial pallor

(Early Changes of Death)

A
  • Skin becomes pale due to Stoppage of circulation
    & Drainage of blood from capillaries and small vessels
  • The skin loses its elasticity, and face looks younger
    due to loss of creases.
  • Lips appear brownish, dry and hard due to drying.
30
Q

why does skin lose its elasticity in (Early Changes of Death)?

A

due to loss of creases.

30
Q

why does skin become pale in (Early Changes of Death)?

A
  • Stoppage of circulation
  • Drainage of blood from capillaries and small vessels
31
Q

Primary Flacidity in (Early Changes of Death)

A
32
Q

What causes 1ry Flacidity in (Early Changes of Death)?

A

All muscles of the body lose their tonicity and become flaccid (complete relaxation)

  • As control from higher brain centers is lost.

Though, muscles are physically capable of responding to electrical/mechanical stimuli.

33
Q

when does 1ry flacidity occur?

A
  • occurs immediately after death.
    “ ends after 2 hours in winter.
34
Q

Signs of 1ry flacidity in (Early Changes of Death)

A
  • Jaw drops
  • Pupils dilate
  • Limbs fall flat
  • Thorax collapses
  • Sphincters relax
  • There may be involuntary passage of urine and feces
35
Q

Describe Contact Flattening

A
  • The areas which remain in contact with ground become flat and blood from vessels of these areas is pressed out,
  • This continues even after formation of postmortem staining over surrounding areas.
36
Q

Example of Contact Flattening

A
  • flattening of convex parts of body (e.g., buttocks, calves etc.) when cadaver lies on its back.
37
Q

Ocular Signs in Early Changes of Death

A
  • Loss of corneal reflex
  • Pupils
  • Loss of intraocular tension
38
Q

Loss of Corneal reflex in Early Changes of Death

A

It may be seen in all cases of deep coma (not a reliable sign)

39
Q

Pupils in Early Changes of Death

A
40
Q

Loss of IOP in Early Changes of Death

A
  • Intraocular tension falls rapidly after death.
  • It becomes zero in 4-8 h (10-22 mm Hg during life),
  • The eyeballs look sunken in orbit.
41
Q

Def of Suspended Animation (Apparent Death)

A
  • It is a death like state in which vital signs of life (heartbeat and respiration) are not detected by routine clinical methods as functions are reduced to a minimum compatible with life.
  • It lasts for seconds to hours.
42
Q

Types of Suspended Animation (Apparent Death)

A
43
Q

MLI of Suspended Animation (Apparent Death)

A
  • The patient can be resuscitated by Cardiac massage or electric stimulator or Artificial respiration.
  • The death certificate should not be issued without
    ECG or EEG record.
44
Q

what is the origin of Euthanasia?

A
45
Q

Def of Euthanasia

A
  • Intentional killing by act or omission of a dependent human being for his or her alleged benefit.
  • In Egypt, there is no legislation permitting euthanasia.
46
Q

Types of Euthanasia

A
47
Q

Reasons for Euthanasia

A
  • Unbearable pain (Euthanasia relieves suffering).
  • The patient’s condition is terminal with no hope of recovery.
48
Q

Def of Sudden Natural Death

A
  • It is unexpected death of an apparently healthy person.
  • WHO defines it as “sudden death that occurs within 24 h from onset of symptoms
49
Q

MLI of Sudden Natural Death

A
50
Q

Causes of Sudden Natural Death

A

most common causes are cardiovascular as coronary artery disease.

Y3R2 - Forensic ⚠️ (7 decks)

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