POST MORTEM CHANGES

Methods of estimating time

3 following heads
o Immediate
o Early
o Late

Immediate Changes
-

Insensibility
o No response to sensation
o Touch, pain, temperature
o TEST: flat EEG

Loss of voluntary power

Cessation of respiration
o Complete stoppage: 3 mins
o Thorough auscultation for breath sounds
Upper part of chest
Larynx
o For a minimum of 5 mins, confirms cessation of breathing.
o Other test:
Feather test no movement of feather in front of nose
Mirror test no moisture of breath on the mirror
Winslows Test no movement of water surface (in bowl)
kept on the chest.

Cessation of circulation
o Complete absence of heart sounds; > 3-5mins
o Flat ECG; > 5 mins
o Other test:
Ligature test Distal to ligature, no congestion.
Fingernail test No Capillary refilling
Diaphanous test
Icards Test

Early Changes
-

Primary Flaccidity of the Muscles

o Muscles lose tonicity.
o Flaccid, loose and lax.

o Although physically capable of responding to electrical/

mechanical stimuli.
-

Postmortem Stiffening (Rigor Mortis)

o Rigor Mortis
o ATP is needed to remove head of myosin from actin, and this
cause relaxation of the muscle.
o Depletion of ATP - Prolonged contraction.
o Onset: 1-2 hr
o Gradually developed : 6-12 hr
o Maintained : 12 hr
o Gradually passed off : 12 hr

Postmortem Hypostasis (Livor Mortis)

o Livor MortisI
o Cessation of circulation BP dropping flow slowing and
gradually stopped pooling of blood gravitational force
pulling down the Red Blood Cells containing haemoglobin (either
Carboxyhaem or Oxyhaem).
o Pooling at the capillary-venous region.
o Give rise to the reddish purple discoloration.
o Starts: 1-2 hr after death.
o Complete: 6-12 hr
o Differences between Postmortem Hypostasis VS Antemortem
Bruises
POSTMORTEM HYPOSTASIS
Lowest parts of the body
(Gravitational dependent parts)
Well-defined margin
Blanch with pressure; OR,
Whittish at the area pressed with
pressure
No swelling at the area or adjacent
area
Due to Gravitational Pooling of Blood
at the CapilloVenous Distension

BRUISES
Anywhere
(near injury marks)
Ill-defined
No blanching with pressure

There is swelling
Extravasation of Blood from vessels
due to Injury

Postmortem cooling (Algor Mortis)

o Occurs due to:
Cessation of energy production;
Inactivity of the heat regulating Centre after somatic
death.

o Loss of heat from body by conduction, convection and radiation.

o Factors affecting Algor Mortis:
Environmental temperature;
Air movement; Well ventilated room will cool more rapidly
Humidity; damp air fasten heat loss
Cadavers body built;
Clothing;
Age and Sex : Children and elderly loss heat easily
Bigger BSA/ Body Volume ratio. Female retain heat longer.
o The curve of cooling pattern is sigmoid:
Initial phase PLATEU PHASE: Isothermic phase.
Residual energy is being used up to maintain normal body
temperature. Including still actively operating
Thermoragulation centre.
Intermediate phase used up residue energy and
inactivated Thermoregulation Centre.
Terminal phase Slightly above the line; actively
bacterial autolysis activities.
o Site:
Most commonly, Rectum (8-10 cm above anus)
Subhepatic (Inferior surface of liver; Core Body
Temperature)
Ext Audi Meastus
o Instrument and Methods of Measurement:
Chemical thermometer 10-12 inches long, ranging from 050oC.
Series of recording at certain fixed intervals, say 0.5-1 hr ly.
Average body temperature fall in Tropical country ~ 0.8oC/
hr.
o TSD (in hrs) = (Normal rectal temp (36.3 37.8oC)
Recorded rectal temperature) / Rate of temperature fall
per hour, 0.8oC

Eye changes
o Cornea:
Loss of corneal reflex

Opacity of the cornea: due to drying, dust or debris

deposition. Delayed, if the lids are closed after death. This
initial haziness is transient and passes off, with water
washing. After about 10-12 hr of death, permanent
haziness due to decomposition.

o Pupils
Loss of pupillary reflex (myosis and mydriasis);
Pupils are dilated after death. Soon, during rigor
mortis, constricted.
Pupils are not circular in shape. Even both pupils are not
symmetrical by means of diameter or shape.
o Flaccidity of the eyeball: intraocular pressure decreases soon
after death. Intraocular pressure formed primarily by the orbital
arterial pressure.
o Tache Noire 2 yellow triangles, on the sclera, each one
at each side of the iris. Yellow brown black.
o Changes in retinal vessels:
trucking of blood loss of blood pressure vessels
become segmented
Pallor of Optic Disk
-

Skin
o
o
o
o
o
o
o

Changes
Pallor (eg: facial)
Ashy-white
Loses Elasticity
Asphyxia congested face, bluish black for sometime
Jaundice Yellow discoloration
CO poisoning Reddish-pink
HCN Reddish-pink

Late Changes
-

The death is the end of dying.

It is a spectrum of process not an event.

Therefore, while some cells of some tissues are still alive, the other
cells may be dying or dead.
Putrefaction or Decomposition
o Final stage of;
o Dissolution of body tissues.
o Two process contribute to this decomposition:
Autolysis
It is brought about by the digestive action of
enzymes released by dying cells.
Can be prevented by freezing the tissues.
Bacterial action
It is more dominant process (compared to the
Autolysis)
Putrefaction
Action of microorganism,
Aerobic or anaerobic bacteria.
Bowel Clostridium welchii Lecithinase
o Greenish discoloration of skin of anterior abdominal wall,
especially at the region of right iliac fossa;
First ever viable sign of putrefaction (bacterial action lysis)
Due to caecum as reservoir that rich in bacteria and fluid
content;
Greenish conversion of haemoglobin -> Sulphmethemoglobin
Usually appears 12-18 hr (in summer), 1-2 days (in winter)

o Gradually, spreading of the greenish discoloration over the entire

abdominal wall
May be observed by about 24 hr in summer.
Greenish Purple Dark-blue

o Bacteria largely originate from intestines get infested in the

venous system;
The blood is haemolysed
Give stained to the vessels and adjacent tissue.
marbled appearance
Becomes prominent at about 36-48 hr is summer.
o
Adipocere
Mummification
Skeletonisation