1. POST MORTEM CHANGES
POST MORTEM CHANGES
Signs of Death
Signs of Death
And
And
Postmortem changes after death
Postmortem changes after death
Immediate Changes
Immediate Changes
Early Changes
Early Changes
Late Changes
Late Changes
2. Immediate changes
Immediate changes
• Permanent Cessation of Brain function
Permanent Cessation of Brain function
• Complete Cessation of Circulatory function
Complete Cessation of Circulatory function
• Entire and permanent cessation of Respiratory
Entire and permanent cessation of Respiratory
function
function
3. Permanent Cessation of Brain function:
Permanent Cessation of Brain function:
• Loss of Sensations; viz,
Loss of Sensations; viz,
touch, pain and temperature
touch, pain and temperature
• Loss of reflexes
Loss of reflexes
• Total loss of E.E.G. Rhythem
Total loss of E.E.G. Rhythem
• Confirmation of Brain- stem death
Confirmation of Brain- stem death
4. Brain –stem death:
Brain –stem death:
• The patient must be comatose state at least six
The patient must be comatose state at least six
hours.
hours.
• No Abnormal Decorticate or decerebrate
No Abnormal Decorticate or decerebrate
postures should be present
postures should be present
• All brain-stem reflexes must be absent
All brain-stem reflexes must be absent.
.
5. • Pupils should be fixed
Pupils should be fixed
• No Corneal reflex
No Corneal reflex
• Absent of the oculo-cepralic reflex
Absent of the oculo-cepralic reflex
• Absent vestibulo-ocular reflexes
Absent vestibulo-ocular reflexes
• No Motor responses
No Motor responses
• No Gag reflex
No Gag reflex
• No Respiratory movements
No Respiratory movements
After disconnection of ventilator.
After disconnection of ventilator.
6. Complete Cessation of Circulatory Function
Complete Cessation of Circulatory Function
• Magnus’s test
Magnus’s test
• Finger nail test
Finger nail test
• Diaphanous test
Diaphanous test
• Icard’s Fluorescein test
Icard’s Fluorescein test
• Heat test
Heat test
• Artery incision test
Artery incision test
• A flat E.C.G. for a continuous period of five
A flat E.C.G. for a continuous period of five
minutes
minutes
7. Entire and permanent cessation of respiratory
Entire and permanent cessation of respiratory
function
function
• Mirror test
Mirror test
• Feather test
Feather test
• Winslow’s glass water test.
Winslow’s glass water test.
8. Suspended Animation
Suspended Animation
It is a condition in which the vital functions of the body
It is a condition in which the vital functions of the body
are at such a low level that they cannot be appreciated
are at such a low level that they cannot be appreciated
by clinical examination
by clinical examination
Apparent death
Apparent death
This may last few seconds to minutes.
This may last few seconds to minutes.
Voluntary- by yogis
Voluntary- by yogis
Involuntary – drowning, electrocution, heat stroke,
Involuntary – drowning, electrocution, heat stroke,
typhoid fever etc.
typhoid fever etc.
9. Early Changes
Early Changes
• Changes in the eye
Changes in the eye
• Changes in the skin
Changes in the skin
• Cooling of the body/Algor mortis
Cooling of the body/Algor mortis
• Post mortem lividity/Hypostasis
Post mortem lividity/Hypostasis
• Rigor mortis/Cadaveric rigidity
Rigor mortis/Cadaveric rigidity
10. Changes in the eye
Changes in the eye
Corneal Changes;
Corneal Changes;
• Loss of Clear Glistening
Loss of Clear Glistening
• Dry, Cloudy and opaque
Dry, Cloudy and opaque
• Loss of reflexes
Loss of reflexes
• Light reflex abolished
Light reflex abolished
• Intra Ocular tension falls, eye balls become flaccid
Intra Ocular tension falls, eye balls become flaccid
and sink in the orbit
and sink in the orbit
• Blood flow in the retina becomes dotted and
Blood flow in the retina becomes dotted and
segmented look
segmented look.
.
11. • Optic disc looks pale.
Optic disc looks pale.
• Pupils fully dilated in the early stage and constict
Pupils fully dilated in the early stage and constict
later due rigor mortis.
later due rigor mortis.
• Brownish discolouration of the sclera due to cellular
Brownish discolouration of the sclera due to cellular
debris and dust
debris and dust
Taches Noires
Taches Noires
12. Changes in the Skin
Changes in the Skin
• Loss of its translucency
Loss of its translucency
• Pale and Ashy white appearance
Pale and Ashy white appearance
• Loss of Elasticity
Loss of Elasticity
• Wounds will not gape if it is inflicted after
Wounds will not gape if it is inflicted after
death
death
• Wounds caused during life will retain their
Wounds caused during life will retain their
characteristic features.
characteristic features.
13. Cooling of the body
Cooling of the body
• Imbalance between heat production and heat
Imbalance between heat production and heat
loss.
loss.
• Loss of heat of body by means of conduction
Loss of heat of body by means of conduction
convection and radiation, till it balances with
convection and radiation, till it balances with
the temperature of surroundings.
the temperature of surroundings.
• Rate of cooling is fast during first few hours
Rate of cooling is fast during first few hours
and later slows.
and later slows.
14. • Temperature is recorded by Chemical
Temperature is recorded by Chemical
thermometer- Thanotometer 25 cms.
thermometer- Thanotometer 25 cms.
• Recording of temperature :
Recording of temperature :
Normal temp. – Rectal temp.
Normal temp. – Rectal temp.
Rate of temp. fall/hour
Rate of temp. fall/hour
• Variation of body temperature
Variation of body temperature
• Conditions in which heat may be retained or
Conditions in which heat may be retained or
increased.
increased.
15. - Sun stroke and pontine haemorrhage, disturbed
Sun stroke and pontine haemorrhage, disturbed
heat regulating mechanism.
heat regulating mechanism.
- Tetanus and strychnine poisoning, due to
Tetanus and strychnine poisoning, due to
increase in heat production in the muscle.
increase in heat production in the muscle.
- Acute bacterial or viral infection, lobar
Acute bacterial or viral infection, lobar
pneumonia, typhoid fever, encephalitis, etc.
pneumonia, typhoid fever, encephalitis, etc.
- Intense asphyxial conditions- rise of temp by
Intense asphyxial conditions- rise of temp by
2-3 c at death
2-3 c at death
“
“ Postmortem Caloricity”
Postmortem Caloricity”
16. The rate of cooling of the body is modified by
The rate of cooling of the body is modified by
the following conditions;
the following conditions;
• Age
Age
• Condition of the body
Condition of the body
• Mode of death
Mode of death
• Surroundings
Surroundings
• Environmental temperature
Environmental temperature
17. Postmortem Lividity
Postmortem Lividity
It means discolouration or staining of the skin
It means discolouration or staining of the skin
and organs after death due to accumulation of
and organs after death due to accumulation of
fluid blood in the dependent parts of the body.
fluid blood in the dependent parts of the body.
Post mortem staining/Hypostasis/Suggilation/
Post mortem staining/Hypostasis/Suggilation/
Vibices/ Livour mortis.
Vibices/ Livour mortis.
1- 3 hr. Starts
1- 3 hr. Starts
6-8 hr. Fixes.
6-8 hr. Fixes.
18. • Commencement of Lividity
Commencement of Lividity
• Development of lividity
Development of lividity
• Fixation of lividity
Fixation of lividity
• Site of distribution
Site of distribution
• Pattern
Pattern
• Extent
Extent
• Difference between lividity and bruise.
Difference between lividity and bruise.
19. Medico-Legal Importance
Medico-Legal Importance
• It is a reliable sign of death
It is a reliable sign of death
• It gives the information about the position of
It gives the information about the position of
the body at the time of death
the body at the time of death
• Time since death can be estimated
Time since death can be estimated
• Colour suggest the cause of death
Colour suggest the cause of death
• Distribution of lividity may give the
Distribution of lividity may give the
information about the manner of death
information about the manner of death
20. Changes in the Muscles
Changes in the Muscles
• Primary relaxation/ Flaccidity
Primary relaxation/ Flaccidity
• Rigor mortis/Cadaveric rigidity
Rigor mortis/Cadaveric rigidity
• Secondary relaxation
Secondary relaxation
21. Primary relaxation
Primary relaxation
Starts immediately after death with generalised
Starts immediately after death with generalised
relaxation of muscle tone:
relaxation of muscle tone:
• Drop of lower Jaw
Drop of lower Jaw
• Eye balls lose their tension
Eye balls lose their tension
• Pupils are dilated
Pupils are dilated
• Joints are flabby
Joints are flabby
• Smooth relaxation- incontinence of Urine and
Smooth relaxation- incontinence of Urine and
Faeces.
Faeces.
22. Rigor Mortis/ Cadaveric rigidity :
Rigor Mortis/ Cadaveric rigidity :
This phenomenon comes immediately after the
This phenomenon comes immediately after the
muscles have lost the power of contractility
muscles have lost the power of contractility
and is irreversible changes in the muscles of
and is irreversible changes in the muscles of
the body, both voluntary and involuntary.
the body, both voluntary and involuntary.
Myofibrils
Myofibrils
Myosin and Actin
Myosin and Actin
Adenosine Triphosphate – A.T.P.
Adenosine Triphosphate – A.T.P.
23. Time of Onset :
Time of Onset :
Temperate climates – 3-6 hours
Temperate climates – 3-6 hours
Tropical climates – 1-2 hours
Tropical climates – 1-2 hours
• Rigor mortis generally occurs when body is
Rigor mortis generally occurs when body is
cold.
cold.
• Not related to nerves action
Not related to nerves action
• Develops in paralysed limbs also
Develops in paralysed limbs also
• First appear in involuntary muscles
First appear in involuntary muscles
• Last to be affected finger and toes muscles.
Last to be affected finger and toes muscles.
24. Duration :
Duration :
* Temperate climate – lasts for 2-3 days.
* Temperate climate – lasts for 2-3 days.
• Tropical climate – 24 – 48 hours in winter
Tropical climate – 24 – 48 hours in winter
18 - 36 hours in summer
18 - 36 hours in summer
• In general – 1-2 hours sets on
In general – 1-2 hours sets on
for , 12 hours develops
for , 12 hours develops
for - 12 hours maintaines
for - 12 hours maintaines
and after 12 hours passes of
and after 12 hours passes of
25. Circumstances modifying the Onset and
Circumstances modifying the Onset and
Duration of Rigor mortis.
Duration of Rigor mortis.
Age- Rigor – Mortis is very rare in premature
Age- Rigor – Mortis is very rare in premature
infants.
infants.
Rigor –mortis is slow in adolescent
Rigor –mortis is slow in adolescent
and healthy adults
and healthy adults
Muscular conditon and activity before death.
Muscular conditon and activity before death.
Onset is slow and duration is longer in muscular
Onset is slow and duration is longer in muscular
and healthy body at rest.
and healthy body at rest.
26. Manner of death :
Manner of death :
• In wasting disease and great exhaustion-
In wasting disease and great exhaustion-
cholera, plague, typhoid, T.B. Cancer etc. the
cholera, plague, typhoid, T.B. Cancer etc. the
onset is early and disappears soon.
onset is early and disappears soon.
• In diseases – Pneumonia, asphyxia and
In diseases – Pneumonia, asphyxia and
nervous conditions- onset is delayed
nervous conditions- onset is delayed
Atmospheric condtions:
Atmospheric condtions:
• In dry and cold air-onset slow and lost for long
In dry and cold air-onset slow and lost for long
time. Warm and moist air onset is rapid and
time. Warm and moist air onset is rapid and
duration short.
duration short.
27. Conditions Simulating Rigor-Mortis
Conditions Simulating Rigor-Mortis
• Heat Stiffening
Heat Stiffening
• Cold Stiffening
Cold Stiffening
• Cadaveric Spasm
Cadaveric Spasm
Secondary Relaxation :
Secondary Relaxation :
• Muscles become soft and Flaccid
Muscles become soft and Flaccid
• Do not respond to a mechnical and electrical
Do not respond to a mechnical and electrical
stimulus.
stimulus.
28. Late Signs Of Death
Late Signs Of Death
Decomposition / Putrefaction.
Decomposition / Putrefaction.
Adipocere formation / Saponification.
Adipocere formation / Saponification.
Mummification.
Mummification.
29. Decomposition / Putrefaction
Decomposition / Putrefaction
Last stage in the resolution of the body,from the
Last stage in the resolution of the body,from the
organic to the inorganic state, is a certain sign of
organic to the inorganic state, is a certain sign of
death.
death.
AUTOLYSIS
AUTOLYSIS
Rise of enzyme levels in the tissue cells after
Rise of enzyme levels in the tissue cells after
death.
death.
Softening & liquefying of the body tissue.
Softening & liquefying of the body tissue.
Starts 3-4 hrs after death and continues for 2-3
Starts 3-4 hrs after death and continues for 2-3
days.
days.
30. BACTERIAL ACTION
BACTERIAL ACTION
Action of bacterial enzymes on tissue
Action of bacterial enzymes on tissue
components – carbohydrates/fat/proteins.
components – carbohydrates/fat/proteins.
Bacterial growth – warmth,moisture are
Bacterial growth – warmth,moisture are
conditions favourable.
conditions favourable.
Clostridium welchii, streptococci, E coli, B
Clostridium welchii, streptococci, E coli, B
proteus.
proteus.
31. CHARACTERISTIC FEATURES
CHARACTERISTIC FEATURES
COLOUR CHANGES
COLOUR CHANGES
Greenish discoloration of skin over caecum
Greenish discoloration of skin over caecum
and flanks after death appears 18-24 hrs.
and flanks after death appears 18-24 hrs.
Greenish to black discoloration-
Greenish to black discoloration-
‘Sulphmethahaemoglobin’ formed by H2S due
‘Sulphmethahaemoglobin’ formed by H2S due
to microorganisms in the large intestine.
to microorganisms in the large intestine.
Appears early in summer & delayed in winter.
Appears early in summer & delayed in winter.
32.
Discoloration spreads- front of abdomen,
Discoloration spreads- front of abdomen,
external genitals, chest, neck, face, arms
external genitals, chest, neck, face, arms
and legs – spreads whole body in 24-36 hrs.
and legs – spreads whole body in 24-36 hrs.
Discoloration of vessel walls due to
Discoloration of vessel walls due to
pigmentation from decomposed blood over
pigmentation from decomposed blood over
the shoulder and groin.
the shoulder and groin. Arborescent
Arborescent
pattern- ‘Marbling’
pattern- ‘Marbling’
33. GASES OF PUTRIFACTION
GASES OF PUTRIFACTION
Development of gases under the skin and
Development of gases under the skin and
hollow viscera 18-36 hrs. 24-48 hrs in solid
hollow viscera 18-36 hrs. 24-48 hrs in solid
viscera.
viscera.
H
H2
2S, ammonia, phosphated hydrogen, CO
S, ammonia, phosphated hydrogen, CO2
2
and methane.
and methane.
Causes pseudo rigidity, exerts pressure.
Causes pseudo rigidity, exerts pressure.
More gases accumulation, body floats in
More gases accumulation, body floats in
water.
water.
34. PRESSURE EFFECTS OF PUTREFACTIVE
PRESSURE EFFECTS OF PUTREFACTIVE
GASES
GASES
Displaces the diaphragm upwards.
Displaces the diaphragm upwards.
Discolored fluid and liquefied tissue mixes with
Discolored fluid and liquefied tissue mixes with
gases producing froth.
gases producing froth.
Bloating of the features.
Bloating of the features.
Shifting of the area of hypostasis.
Shifting of the area of hypostasis.
Changes in skin, hair and wound.
Changes in skin, hair and wound.
Extrusion of fluid from the mouth and nose.
Extrusion of fluid from the mouth and nose.
Emptying of the heart.
Emptying of the heart.
Changes in appearance of genitals.
Changes in appearance of genitals.
35. APPEARANCE OF MAGGOTS
APPEARANCE OF MAGGOTS
Flies lay eggs over the decomposed body-
Flies lay eggs over the decomposed body-
nose, mouth, vagina and anus in 18-36 hrs.
nose, mouth, vagina and anus in 18-36 hrs.
After 24-36 hrs eggs hatch into larvae or
After 24-36 hrs eggs hatch into larvae or
maggots, enter the body and destroy the
maggots, enter the body and destroy the
tissues.
tissues.
After 4-5 days develop into pupae.
After 4-5 days develop into pupae.
After 7-8 days into adult fly.
After 7-8 days into adult fly.
36. OTHER SEQULAE
OTHER SEQULAE
Fall of teeth
Fall of teeth
Separation of skull sutures
Separation of skull sutures
Liquefied brain matter oozes out.
Liquefied brain matter oozes out.
‘
‘Colliquative putrifaction’
Colliquative putrifaction’ – this process
– this process
takes place between 7-14 days.
takes place between 7-14 days.
37. INTERNALLY
INTERNALLY
STOMACH
STOMACH
Dark red patches over the walls
Dark red patches over the walls
Perforation due to autolysis
Perforation due to autolysis
LIVER
LIVER
Softens and flabby
Softens and flabby
Becomes spongy
Becomes spongy ‘Foamy liver’
‘Foamy liver’
38.
Early putrefaction 24-48hrs
Early putrefaction 24-48hrs
Larynx, trachea, brain of infants, stomach,
Larynx, trachea, brain of infants, stomach,
intestines, spleen, omentum and mesentery,
intestines, spleen, omentum and mesentery,
liver and adult brain.
liver and adult brain.
Late putrefaction 2-3 weeks
Late putrefaction 2-3 weeks
Heart, lungs, kidneys, bladder, esophagus,
Heart, lungs, kidneys, bladder, esophagus,
pancreas, diaphragm, blood vessels,
pancreas, diaphragm, blood vessels,
prostate, testis and non gravid uterus,
prostate, testis and non gravid uterus,
ovaries.
ovaries.
39. FACTORS MODIFYING PUTREFACTION
FACTORS MODIFYING PUTREFACTION
EXTERNAL
EXTERNAL
Warmth and clothing
Warmth and clothing
Putrefaction begins at 10°
Putrefaction begins at 10°C and occurs
C and occurs
rapidly at 37
rapidly at 37°
°C.
C.
Freezing point – bacterial growth
Freezing point – bacterial growth
inhibited and putrefaction will not
inhibited and putrefaction will not
occur.
occur.
Clothing hastens putrefaction initially
Clothing hastens putrefaction initially
and protects against flies and insects.
and protects against flies and insects.
40. Moisture
Moisture
Help in rapid multiplication of organisms.
Help in rapid multiplication of organisms.
Bodies recovered from water if left in air,
Bodies recovered from water if left in air,
decomposes rapidly.
decomposes rapidly.
Air
Air
1 week in air = 2 weeks in water = 8 weeks
1 week in air = 2 weeks in water = 8 weeks
buried – ‘Casper dictum’
buried – ‘Casper dictum’
41. Manner of burial
Manner of burial
In air tight coffins, very little change of
In air tight coffins, very little change of
body for long periods.
body for long periods.
Without coffins, putrefaction is very rapid.
Without coffins, putrefaction is very rapid.
Bodies in deep graves putrefy very slow.
Bodies in deep graves putrefy very slow.
Bodies buried in lime, decomposition is
Bodies buried in lime, decomposition is
retarded.
retarded.
Bodies in sandy and porous soils are
Bodies in sandy and porous soils are
conducive to mummification.
conducive to mummification.
43. ADIPOCERE
ADIPOCERE
Modification of the process of putrifaction
Modification of the process of putrifaction
in the dead body is (checked and is
in the dead body is (checked and is
replaced) adipocere formation.
replaced) adipocere formation.
Hydrolisation of fatty tissue into fatty acids.
Hydrolisation of fatty tissue into fatty acids.
Bacterial fat splitting enzymes and moisture
Bacterial fat splitting enzymes and moisture
are essential – Lecithinase.
are essential – Lecithinase.
Composed of saturated fatty acids by
Composed of saturated fatty acids by
palmitic, stearic, hydroxystearic, olic acids
palmitic, stearic, hydroxystearic, olic acids
44. Yellowish white, greasy wax with rancid
Yellowish white, greasy wax with rancid
smell.
smell.
It forms at any site where fatty tissue is
It forms at any site where fatty tissue is
present.
present.
Time required, in summer-3 wks, in tropics-
Time required, in summer-3 wks, in tropics-
5 to 15 days.
5 to 15 days.
M.L.I.
M.L.I. – to establish the identity
– to establish the identity
- cause of death
- cause of death
- time since death
- time since death
- place of death
- place of death
45. MUMMIFICATION
MUMMIFICATION
It is a peculiar desiccation of a dead body
It is a peculiar desiccation of a dead body
where by its soft parts shrivel up but retain
where by its soft parts shrivel up but retain
the natural appearance and the features of
the natural appearance and the features of
the body.
the body.
Rusty brown color, dry, leathery skin
Rusty brown color, dry, leathery skin
adherent to bones.
adherent to bones.
Internal organs get transformed into a thick
Internal organs get transformed into a thick
brown mass.
brown mass.
46.
Mummification occurs in bodies buried in
Mummification occurs in bodies buried in
shallow graves, in dry sandy soils.
shallow graves, in dry sandy soils.
Time – 3 months to 1-2 yrs
Time – 3 months to 1-2 yrs
M.L.I.
M.L.I. – Identification
– Identification
- Cause of death
- Cause of death
- Time since death
- Time since death
- Place of death
- Place of death
47. Time since death/ post mortem
Time since death/ post mortem
interval
interval
Important clue for investigation of time.
Important clue for investigation of time.
It helps apprehend the person likely to be
It helps apprehend the person likely to be
involved.
involved.
Point to be ascertained are;
Point to be ascertained are;
-cooling of the body
-cooling of the body
-post mortem lividity
-post mortem lividity
-rigor mortis
-rigor mortis
-decomposition changes
-decomposition changes
48. - Contents of stomach and bowels
Contents of stomach and bowels
- Contents of urinary bladder
Contents of urinary bladder
- Biochemical changes
Biochemical changes
- Circumstantial evidence
Circumstantial evidence
