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Forensic Medicine > Post Mortem Changes and Bodies from Water > Flashcards

Post Mortem Changes and Bodies from Water Flashcards

1
Q

How long does it take for irreversible brain damage?

A

3-9 minutes

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2
Q

In the hospital, what four things are death determined by?q

A
  1. Cessation of breathing
  2. No response to pain or voice
  3. No pupillary response to light
  4. Cessation of pulse and heart beat
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3
Q

How many doctors establish brainstem death?

A

Two

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4
Q

What two organs show the most cellular resilience to hypoxia?

A

Bone and corneas (48 hours)

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5
Q

What two organs show the least cellular resilience to hypoxia?

A

Brain and spinal cord (4 minutes)

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6
Q

What do post mortem changes do to confirmation?

A

They confirm death. Resuscitation is futile.

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7
Q

What is Post Mortem Interval

A

Post-mortem interval (PMI) is the time that has elapsed since a person has died.

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8
Q

What colour will abrasions which occur in life be?

A

Red

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9
Q

What colour will abrasions that occur in death be?

A

Orange and parchmented

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10
Q

What sort of sites do animal artefacts occur in?

A

Exposed

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11
Q

What are these artefacts of:

Entry impact
Washerwoman change
Gooseflesh (Cutis anserina)

A

Artefacts of immersion

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12
Q

What is skin splitting an artefact of?

A

Fire and heat

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13
Q

What can extradural haematoma be an artefact of?

A

Fire and heat

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14
Q

What post mortem changres occur in hours?

A

Algor mortis
Livor mortis
Rigor mortis

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15
Q

What post mertem changes occur in days to weeks?

A

Putrefaction

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16
Q

What two post mortem changes occur after months?

A

Skeletonisatin

Mummification

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17
Q

Chill of death?

A

Algor mortis

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18
Q

Darkening of death?

A

Livor mortis

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19
Q

Stiffening of death?

A

Rigor mortis

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20
Q

What can be a useful indicator of PMI in the first 24 hours of death, only in temperate and cool climates?

A

Algor mortis

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21
Q

When assessing for algor mortis what method of determining core body temperature must you avoid in sexual cases?

A

Anal

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22
Q

When assessing for algor mortis what method of determining core body temperature could you use instead of anal?

A

Liver by subcostal stab- creates a wound

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23
Q

Loss of heat from the body due to conduction, convection and radiation. Little heat lost by evaporation

A

Algor mortis

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24
Q

Who will cool quicker- an obese individual or a thin person?

A

obese- larger surface area

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25
Q

What can there be a slight rise of temperature in after deatgh?

A

Decomposition

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26
Q

What is Henssge’s Normogram based on?

A

a mathematical cooling model

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27
Q

What does Henssge’s Normogram allow for correction of?

A

Body weight
Clothing
Drafts
Immersion in water

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28
Q

What does Henssge’s Normogram assume?

A

Normal body temp at death

No ariation in ambient temperature during cooling period

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29
Q

What are some exclusions to using Henssge’s Normogram?

A
  1. Near strong heat source
  2. Near cooling source
  3. Floor tiles
  4. Abnormal body temperature at death
  5. Body moved between death andtemperature reading i.e. fridge
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30
Q

How much faster does body cool in still water than air?

A

Twice as fast

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31
Q

How much faster does body cool in flowing water than air?

A

Three times as afast

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32
Q

Gravitational pooling of blood in blood vessels due to cessation of circulation in death

A

Livor mortis

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33
Q

Can you see livor mortis in internal organs too?

A

Yes

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34
Q

What is development of livor mortis delayed by?

A

Blood loss e.g. AAA, gastric ulcers and haemorrhage and poisoning

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35
Q

What happens to livor mortis at under 6 hours?

A

Incompletely formed, blanching, unfixed.

Primary pattern fades and secondary pattern develops according to new position.

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36
Q

What happens to livor mortis at 10-24 hours?

A

Well established, partially fixed- if moved from front to back will exhibit two patterns. Primary pattern fixed enough to remain, secondary pattern develops giving dual distribution.

37
Q

What happens to livor mortis >24 hours?

A

Fully fixed, Primary pattern persists. No secondary patter ndevelops.

38
Q

What does early lividity look like?

A

bLOTCHY SPOTS

39
Q

Give two causes of bright pink lividity?

A

Refrigeration

Hypothermia (oxyhaemoglobin)

40
Q

Give one cause of cherry pink lividity?

A

Carbon monoxide

41
Q

Give one cause of scarlet lividity/

A

Cyanide

42
Q

Give one cause of chocolate brown lividity?

A

Aniline dye

43
Q

What causes vibices?

A

Rupturing of small blood vessels:

Intravascular hydrostatic pressure
PM weakening/breakdown of vessel wall

44
Q

Where are vibices typically limited to?

A

Livid tissues

45
Q

What causes rigor morits?

A

Muscle relaxation requires ATP to break actin-myosin bonds. ATP requires oxygen. Decrease in ATP post mortem means bonds cannot be broken causing rigor mortis. Also calcium build PM promotoes actin myosin cross bridging.

46
Q

What is rigor superseded by?

A

Decomposition

47
Q

Does rigor mortis involve smaller or larger muslces first?

A

Smaller- eye lids, jaw and neck

48
Q

Hyperthermia at death does what to onset of rigor mortis?

A

Increases it

49
Q

In what other situation does rigor mortis come on quickyl?

A

Muscle activity immediatley prior to death

50
Q

Forenisc value of rigor mortis?

A

May indicate if body has been moved

51
Q

pugilistic atitude?

A

Kneeling position PM when exposed to high temperatuer

52
Q

What is the PM interval when: warm and without rigor?

A

less than 3 hours

53
Q

What is the PM interval when: warm with rigor?

A

3 - 8 hours

54
Q

What is the PM interval when: cold with rigor?

A

8-36 hours

55
Q

What is the PM interval when: cold and without rigor?

A

> 36 hours

56
Q

enzymatic breakdown of cells/tissues

A

Autolysis

57
Q

Bacterial breakdown of cells/tissues

A

Putrefaction

58
Q

What is maceration?

A

Type of decomp. Sterile autolysis of foetus in uterus.

59
Q

What conditions does adipocere need?

A

Wet

60
Q

What conditions does mummification need?

A

Cool and dry

61
Q

What happens within two days of putrefaction?

A

Green discoloration of lower abdomen due to overgrowth of colonic bacteria

62
Q

What happens within 3-4 days of putrefaction?

A

Greenish black discoloration and swelling of face and neck due to gas production from bacteria

63
Q

During putrefaction what might extrude from the mouth?

A

Reddish brown purge fluid

64
Q

How does marbelling occur during putrefaction?

A

Due to breakdown of haemoglobin within blood vessels- prominence of blood vessels on skin (days to a week)

65
Q

Name four gases found in gaseous bloating during putrefaction?

A

Methane
Hydrogen
Hydrogen sulphide
Carbon dioxide

66
Q

Who is mummication more common in?

A

Infants

67
Q

What term is given to the transformation of body fat to oleic, palmitic and stearic acids by hydrolysis?

A

Adipocere- saponification

68
Q

What are the causative bacteria for saponification?

A

Clostridium welchii

69
Q

What prolongs gastric emptying?

A

Alcohol. Stress delays it.

70
Q

State Casper’s Rule of decomposition.

A

At similar average temperatures, the degree of putrefaction in a body in open air for 1 week corresponds to that of a body immersed after 2 weeks or a body burried for 8 weeks.

71
Q

Estimation of duration of immersion if wrinkled fingers, palsm and feetS?

A

12-30 HOURS

72
Q

Estimation of duration of immersion if early decomp in head, neck, abdo and thighs?

A

4-10 days

73
Q

Estimation of duration of immersion if Bloating of face and abdomen, venous marbling &
peeling of epidermis on hands and feet, scalp slippage:

A

2-4 weeks

74
Q

Duration of immerstion if gross skin shedding, muscle loss and exposure of skeleton?

A

1-2 months

75
Q

If body temp is at 34 what happens?

A

Loss of consciousness and aspiration of water

76
Q

If body temp is at 28 what happens?

A

Ventricular fibrillation

77
Q

If body temp is at 24 what haPPENS?

A

Asystole

78
Q

What exacerbates circum-rescue collapse?

A

Cold water and vertical rescue

79
Q

Explain 3 steps in drowning in fresh (hypotonic water). Death in 4-5 minutes

A
  1. Water absorbed from airways into circulation- hypervolaemia
  2. Na diffuses from circulation into lung fluid- hyponatraemia
  3. RBC swell and burst (haemolysis)- raised blood K leading to VF
80
Q

Explain the two steps of drowning in salt (hypertonic) water. Death 8-10 minutes

A
  1. Water diffuses from cirulation into lung fluid- reduced blood volume nad increase blood concentration
  2. Na and Cl diffuse from lung fluid in to circulation - raised blood Na
81
Q

What is the mechanism of instantaneous drowning?

A

Reflex cardiac arrest (vagal inhibition)- triggered by cold water in nasal passages, sensation of myocardium by adrenaline and/or alcohol

82
Q

Skin maceration or washerwoman change occurs after how long in warm and cold water?

A

wARM- minutes

Cold- 4-5 hours

83
Q

Are there diagnostic features of drowning?

A

There are none.

84
Q

What are these signs suggestive of:

Foam in airways
Emphysema aqueosum
Foreign material in airways and stomach
Middle ear haemorrhage

A

Drowning

85
Q

Champignon de mousse

A

Foam in airways suggesting pulmonary oedema. Only found in freshly drowned bodies.

86
Q

In drowning id the lungs are voluminousl hyperinflated, overlapping and doughy?

A

Emphysema aqueosum

87
Q

In drowning what is the term for blue disclolouartion in bony roof of middle ear (tube)?

A

Middle ear haemorrhage

88
Q

What bruising is common in drowning?

A

Shoulder muscle bruising

89
Q

Name 4 lab tests for drowning.

A

Specific gravity of blood in left ventricle.
Plasma chloride
Plasma magnesium
Diatoms

Forensic Medicine (13 decks)

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