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Foundations of Medicine > Post Mortem Changes > Flashcards

Post Mortem Changes Flashcards

1
Q

Define death

A

Irreversible failure of the cardiovascular system

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2
Q

Why are post mortem changes important?

A

Confirm death - indisputable changes

Allows estimation of time of death

Can destroy evidence of identify, injury and disease

Forensic use - position/movement of body at time of death

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3
Q

What are the early post mortem changes?

A

Livor mortis
Algor mortis
Rigor mortis

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4
Q

What are late post mortem changes?

A

Autolysis and putrefaction
Mummification
Adipocere
Skeletonisation

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5
Q

When do early post mortem changes occur?

A

In the minutes, hours and days following a death

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6
Q

Define livor mortis

A

Discolouration of death

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7
Q

What happens in livor mortis?

A

Once someone dies, the blood starts draining from the extremities, down to the area of the body thats on the ground

A body lying flat on its back would be pale in the front and darker in the back

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8
Q

Define algor mortis

A

Coldness of death

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9
Q

What happens in algor mortis?

A

Body temperature cools down until it reaches the ambient temperature

Lasts for few hours after death but only starts to take place 30-60 mins after death.

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9
Q

What happens in algor mortis?

A

Body temperature cools down until it reaches the ambient temperature

Lasts for few hours after death but only starts to take place 30-60 mins after death.

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10
Q

Define rigor mortis

A

Stiffness of death

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11
Q

What happens in rigor mortis?

A

The stiffening and shortening of muscles after death - rigidity of musculature and fixation of joints

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12
Q

When does rigor mortis become apparent?

A

Becomes apparent 5-7 hours after death

Fully established 8-12 hours after death

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13
Q

What can algor mortis be a useful indicator of?

A

Post mortem interval in the first 24hrs due to rapid cooling

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14
Q

What does the rate of cooling depend on?

A

Body size
Environmental temperature
Drafts and humidity
Clothing
Immersion - cools down quicker in water than air

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15
Q

Why does the body cool after death?

A

No energy production

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16
Q

During the first 12 hours after death, what is the most valuable measurement to determine time of death?

A

Measurement of body temperature

17
Q

What is the general rule of thumb in determining time of death from body temperature?

A

1 degree celsius per hour

18
Q

Can the rate at which the stomach empties be used as a means of measuring the time of death - or the time since the last meal?Why?

A

No,

Too many factors which influence the rate at which the stomach empties

The condition of the material remaining might be able to give an indication of what the patient last ate

19
Q

What affects the development of rigor?

A

Ambient temperature

20
Q

What causes rigor mortis?

A

Muscle fibre relaxation needs ATP to break actin-myosin bonds

ATP needs oxygen

Decrease in ATP post mortem means bonds cannot break, leading to rigor mortis

21
Q

Why does rigor mortis not occur right after death?

A

Due to residual ATP in body

22
Q

What supersedes rigor mortis?

A

Decomposition

23
Q

What is the sequence of onset in rigor mortis?

A

Develops in all muscles

Small muscles usually become completely involved before larger ones eg eyelids, jaw and neck, small joints of the hands and feet ect

Not constant or symmetrical

24
Q

What impacts the rate of development of rigor mortis?

A

Body temp at death
Ambient temperature
Muscle activity immediately prior to death (in times of high intensity exercise, there is a quicker RM onset)

25
Q

What is the rule of thumb surrounding post mortem changes and the post mortem interval?

A

Warm and without rigor: <3 hours

Warm and with rigor: 3-8 hours

Cold and with rigor: 8-36 hours

Cold and without rigor: >36 hours

26
Q

What is autolysis?

A

Enzymatic breakdown of cells/tissues

27
Q

What is putrefaction?

A

Bacterial breakdown of cells/tissue

28
Q

What are the types of decomposition?

A

Maceration
Wet putrefaction
Skeletonisation
Adipose
Mummification

29
Q

What is maceration?

A

Sterile autolysis of foetus,

Specific to a foetus in a uterus.

No exposure to maternal or enviromental bacteria.

30
Q

What is wet purification?

A

Bacterial and enzymatic

31
Q

What is adipocere?

A

Saponification of soft tissues

Requires wet condition

32
Q

What is mummification?

A

Desiccation of soft tissues

Requires cool, dry conditions

33
Q

What are the features of putrefactive bacteria?

A

Temp dependant (optimal at 21-38C)

Mainly commensal bacteria from GI system and respiratory tract

Pathogenic bacteria:

Organ/tissue specific infection
Septicaemia

34
Q

What happens to abdominal skin 2-3 days after death?

A

Greenish discolouration due to overgrowth of colonic bacteria

35
Q

What happens to the face and neck 3-4 days after death?

A

Greenish black discolouration and swelling due to gas production from bacteria

36
Q

What happens to the nose and mouth after death?

A

Reddish brown purge fluid - not to be mixed up with blood

37
Q

What is mummification?

A

Dry decomposition - desiccation of the body with little bacterial involvement

38
Q

What is post mortem hypostasis?

A

Pooling of stagnant blood in dependant regions of the body under the influence of gravity.

39
Q

Where are areas of pallor found in post mortem hypostasis?

A

In a body surface that has had pressure applied preventing the ingress of blood

40
Q

What is post mortem useful for establishing?

A

Position of the body after death, and can indicate if the body has been moved after death

41
Q

What does a cherry red colour of post mortem hypostasis indicate?

A

Carbon monoxide poisoning

Foundations of Medicine (56 decks)

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