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Year One - Principles of Disease > Post-Mortem Teaching > Flashcards

Post-Mortem Teaching Flashcards

1
Q

What are post-mortem changes useful for?

A

Confirming death

Recongising when resucitation of the individual is futile

Estimate the death post-mortem interval (PMI)

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2
Q

What are the three early post-mortem changes?

A

Algor Mortis - temperature degradation

Liver Mortis - change in colour

Rigor Mortis - stiffening

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3
Q

What are the four late post-mortem changes?

A

Decomposition & Autolysis (Putrefaction) - breakdown of cells and tissues

Mummification - preservation of skin and flesh due to cool, dry conditions. Results in the skin drying, shrinking and becoming leathery

Adipocere - greyish waxy substance formed by the decomposition of soft tissue in bodies subjected to moisture. Body fat transformed to acids by hydrolysis.

Skeletonization - last vestiges of soft tissue have decayed or died to the point where the skeleton is exposed

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4
Q

When do the early post-mortem changes occur?

A

Hours after death

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5
Q

When do the late post-mortem changes occur?

A

Days, weeks, moths after death

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6
Q

What are the usual timeline of post-mortem changes?

A

Algor mortis

Liver mortis

Rigor mortis

Putrefaction

Skeletonization

Mummification

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7
Q

When can algorithmic mortis be a useful indicator of PMI?

A

First 24 hours

Location of a normal room temperature

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8
Q

How do we measure body temperature?

A

Rectal thermometer or liver thermometer

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9
Q

When should a rectal thermometer not be used? Why?

A

Sexual cases

Contaminate evidence

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10
Q

Why does algor mortis occur?

A

Loss of heat from body due to conduction, convection and radiation

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11
Q

What surfaces cool quicker?

A

External surfaces cool quicker than interior surfaces

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12
Q

How quick does algor mortis occur?

A

Immediately, until the body reaches the same temperature as atmospheric temperature

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13
Q

What factors will affect the rate of cooling?

A

Body size - larger surface area, greater heat loss

Environmental temperature

Draft and humidity - if body is near a draft they will cool quicker than a body found near a heat source

Clothing - individuals wearing multiple layers of clothing will cool slower than a naked person

Immersion - body cools quicker in water than air

Flooring - body on a tiled floor will cool quicker than a body on the carpet

Circadian rhythm - normal variation in temperature throughout the day

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14
Q

What does it indicate if the body temperature is lower than 37 degrees at the time of death ?

A

Cause of death is due to hypothermia, cardiac failure or haemorrhage

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15
Q

What does it indicate if the body temperature is higher than 37 degrees at the time of death?

A

Cause of death is due to fever, heatstroke or exercise

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16
Q

What colour change is observed? Why?

A

Pinkish/purple skin discolouration

Gravitational pooling of blood in the blood vessels and cessation of circulation in death

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17
Q

Why is liver mortis a poor indicator of PMI?

A

Variable interval prior to visibility

May appear shortly before death

Development delayed and intensity affected by natural disease, blood loss and poisoning.

May not be evident at all in some cases

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18
Q

What liver mortis is usually seen within the first 6 hours of death?

A

Incompletely formed blanching

Unfixed, which means that it can shift position if the body is moved.

If moved, primary pattern fades away and the secondary pattern develops according to the new position

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19
Q

What liver mortis is usually seen between the 10-24 hours of death?

A

Blanching well established

Partially fixed, which means that if the body is moved from its from onto its back we can see two patterns.

If moved, the primary pattern fixed enough to remain. Secondary pattern also develops.

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20
Q

What liver mortis is usually seen after 24 hours of death?

A

Blanching is fully established

Fixed

If moved, the primary pattern persists. No secondary patten develops

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21
Q

Why does rigor mortis occur?

A

Muscle fibre relaxation requires ATP to break actin-myosin bonds, which is no longer supplied to cells

Increase in calcium which causes muscle contraction

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22
Q

What is rigor mortis eventually superseded by?

A

Decomposition

23
Q

When does rigor mortis develop?

A

When residual ATP in the body is depleted

24
Q

Which muscles usually are affected by rigor mortis quicker than others?

A

Smaller muscles are affected quicker than larger ones

25
Q

What is the onset and duration of rigor mortis dependent on?

A

Body temperature at death - hypothermia delays the onset of rigor mortis and hyperthermia increases the onset of rigor mortis

Ambient temperature - occurs sooner in warmer temperatures than in cooler temperatures

Muscle activity immediately prior to death - high intensity of exercise causes a quicker onset of rigor mortis

26
Q

What is rigor mortis disappearance dependent on?

A

Decomposition

Breaking - forcible stretch of lies during autopsy means rigor mortis does not re-develop in these areas

27
Q

What is autolysis?

A

Enzymatic breakdown of cells and tissue

28
Q

What is putrefaction?

A

Bacterial breakdown of cells and tissue

29
Q

What are the features of putrefactive bacteria?

A

Temperature dependent, function optimally at 21-38 degrees

Form in GI or respiratory tract

30
Q

What is the signs of putrefaction?

A

Green discolouration in the lower abdomen.

Greenish, black discolouration and swelling of the face and neck, occurs due to gas production from bacteria.

Reddish, brown purge fluid may extrude from the nose

Skin slippage from the scalp and blistering can occur

Marbling

31
Q

What increases the rate of putrefaction?

A

Slow Initial Cooling

Warm Environment

High Humidity

Fever At Time of Death

Infection

Wound/Tissue Disruption

32
Q

What decreases the rate of putrefaction?

A

Rapid Initial Cooling

Cold Environment

Dry Conditions

Hypothermia At Death

Blood Loss

Embalming

Burial

33
Q

What is maceration?

A

Autolysis of foetus in womb

34
Q

What is wet putrefaction?

A

Enzymatic and bacterial breakdown of cells and tissues occurs at the same time

35
Q

What is an injury?

A

Associated with damage and a wound

36
Q

What is a lesion?

A

Includes areas of injury, disease or local degeneration in a tissue, causing in its structure or function changing

37
Q

What five physical factors affect injuries to the body?

A

Degree of force applied

Area of application of force

Duration of application

Direction of application

Tissue properties

38
Q

What type of energy is imparted to the tissues when a moving object strikes the body or the moving body strikes a stationary object?

A

Kinetic energy

39
Q

What are the four classification of injuries?

A

Sharp force injuries - stab and incision injuries

Chop wound injuries

Blunt force injuries - abrasion, bruise and laceration injuries

Ballistic injuries - explosion and gunshot injuries

40
Q

What are blunt force injuries caused by?

A

Impact with a blunt object, which may be mobile or static

41
Q

What is an abrasion?

A

Graze or scratch

Caused by injury to the skin surface. This injury is usually superficial or partial and only affects the epidermis.

The injury could by crushing (vertical force) or scraping (tangible force)

42
Q

What is a contusion?

A

Bruise

Result from injuries that crush the dermal blood vessels, causing leaking of blood from vessels into the skin

43
Q

Where do contusions usually appear?

A

In spaces where there is sufficient space surrounding the damaged vessel in which the blood can accumulate in

44
Q

What are lacerations?

A

Cut, tear

Due to the crushing of skin, which may be partial or full thickness of the skin.

45
Q

What are sharp face injuries?

A

Caused by a weapon with a sharp, cutting injury.

46
Q

What causes incised wounds? What are the features of an incised wound?

A

Caused by superficial sharp force injuries caused by slashing motions with an object with a sharp edge

The wound is longer on the skin surface than it is deep

The wound is well cut and has well defined margins

No associated bruising or abrasions

Would bleeds profusely

Complete division of all tissues within the wound tract, no tissue bridges

47
Q

How can we suggest that a wound is due to a suicide attempt?

A

Site is accessible

Site of perceived harm which have been concealed on the individuals body

48
Q

What are the features of a laceration wound?

A

Ragged margins

Marginal abrasion

Associated with bruising

Tissue bridging

Slight bleeding

Trace evidence

49
Q

What are stab the features of stab wounds?

A

Greater depth than the length on the skins surface

Clean and well defined margins

Involves full thickness of the skin and extends into underlying tissues

Not associated with bruising or abrasion

Clean division of all the tissues within the wound tract, so no tissue bridging

50
Q

What are the three types of wounds caused by blunt force injuries?

A

Abrasion

Contusion

Lesion

51
Q

What are the two types of wounds caused by sharp force injuries?

A

Incised

Stab

52
Q

What are chop wound injuries?

A

Caused by heavy-bladed instruments.

53
Q

What are the features of wounds that result from chop injuries?

A

Associated with abrasion or bruising, which can appear widely from the margins of the wound

Incised edges

Longer on the skin surface than it is deep

Year One - Principles of Disease (15 decks)

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