POST MORTEM CHANGES

Signs of Death
And
Postmortem changes after death

Immediate Changes
Early Changes
Late Changes

Immediate changes

Permanent Cessation of Brain function

Complete Cessation of Circulatory function

Entire and permanent cessation of Respiratory

function

Permanent Cessation of Brain function:

Loss of Sensations; viz,

touch, pain and temperature
Loss of reflexes
Total loss of E.E.G. Rhythem
Confirmation of Brain- stem death

Brain stem death:

The patient must be comatose state at least six

hours.

No Abnormal Decorticate or decerebrate

postures should be present

All brain-stem reflexes must be absent.

Pupils should be fixed

No Corneal reflex
Absent of the oculo-cepralic reflex
Absent vestibulo-ocular reflexes
No Motor responses
No Gag reflex
No Respiratory movements
After disconnection of ventilator.

Complete Cessation of Circulatory Function

Magnuss test
Finger nail test
Diaphanous test
Icards Fluorescein test
Heat test
Artery incision test
A flat E.C.G. for a continuous period of five
minutes

Entire and permanent cessation of respiratory

function

Mirror test
Feather test
Winslows glass water test.

Suspended Animation
It is a condition in which the vital functions of the body
are at such a low level that they cannot be appreciated
by clinical examination
Apparent death
This may last few seconds to minutes.
Voluntary- by yogis
Involuntary drowning, electrocution, heat stroke,
typhoid fever etc.

Early Changes

Changes in the eye

Changes in the skin

Cooling of the body/Algor mortis

Post mortem lividity/Hypostasis

Rigor mortis/Cadaveric rigidity

Changes in the eye

Corneal Changes;
Loss of Clear Glistening
Dry, Cloudy and opaque
Loss of reflexes
Light reflex abolished
Intra Ocular tension falls, eye balls become flaccid
and sink in the orbit
Blood flow in the retina becomes dotted and
segmented look
.

Optic disc looks pale.

Pupils fully dilated in the early stage and constict

later due rigor mortis.

Brownish discolouration of the sclera due to cellular

debris and dust
Taches Noires

Changes in the Skin

Loss of its translucency

Pale and Ashy white appearance
Loss of Elasticity
Wounds will not gape if it is inflicted after
death
Wounds caused during life will retain their
characteristic features.

Cooling of the body

Imbalance between heat production and heat

loss.

Loss of heat of body by means of conduction

convection and radiation, till it balances with
the temperature of surroundings.

Rate of cooling is fast during first few hours

and later slows.

Temperature is recorded by Chemical

thermometer- Thanotometer 25 cms.
Recording of temperature :
Normal temp. Rectal temp.
Rate of temp. fall/hour
Variation of body temperature
Conditions in which heat may be retained or
increased.

Sun stroke and pontine haemorrhage, disturbed

heat regulating mechanism.
Tetanus and strychnine poisoning, due to
increase in heat production in the muscle.
Acute bacterial or viral infection, lobar
pneumonia, typhoid fever, encephalitis, etc.
Intense asphyxial conditions- rise of temp by
2-3 c at death
Postmortem Caloricity

The rate of cooling of the body is modified by

the following conditions;

Age
Condition of the body
Mode of death
Surroundings
Environmental temperature

Postmortem Lividity
It means discolouration or staining of the skin
and organs after death due to accumulation of
fluid blood in the dependent parts of the body.
Post mortem staining/Hypostasis/Suggilation/
Vibices/ Livour mortis.
1- 3 hr. Starts
6-8 hr. Fixes.

Commencement of Lividity

Development of lividity

Fixation of lividity

Site of distribution

Pattern

Extent

Difference between lividity and bruise.

Medico-Legal Importance

It is a reliable sign of death

It gives the information about the position of
the body at the time of death
Time since death can be estimated
Colour suggest the cause of death
Distribution of lividity may give the
information about the manner of death

Changes in the Muscles

Primary relaxation/ Flaccidity

Rigor mortis/Cadaveric rigidity

Secondary relaxation

Primary relaxation
Starts immediately after death with generalised
relaxation of muscle tone:
Drop of lower Jaw
Eye balls lose their tension
Pupils are dilated
Joints are flabby
Smooth relaxation- incontinence of Urine and
Faeces.

Rigor Mortis/ Cadaveric rigidity :

This phenomenon comes immediately after the
muscles have lost the power of contractility
and is irreversible changes in the muscles of
the body, both voluntary and involuntary.
Myofibrils
Myosin and Actin
Adenosine Triphosphate A.T.P.

Time of Onset :
Temperate climates 3-6 hours
Tropical climates 1-2 hours
Rigor mortis generally occurs when body is
cold.
Not related to nerves action
Develops in paralysed limbs also
First appear in involuntary muscles
Last to be affected finger and toes muscles.

Duration :
* Temperate climate lasts for 2-3 days.
Tropical climate 24 48 hours in winter
18 - 36 hours in summer
In general 1-2 hours sets on
for , 12 hours develops
for - 12 hours maintaines
and after 12 hours passes of

Circumstances modifying the Onset and

Duration of Rigor mortis.
Age- Rigor Mortis is very rare in premature
infants.
Rigor mortis is slow in adolescent
and healthy adults
Muscular conditon and activity before death.
Onset is slow and duration is longer in muscular
and healthy body at rest.

Manner of death :

In wasting disease and great exhaustioncholera, plague, typhoid, T.B. Cancer etc. the
onset is early and disappears soon.
In diseases Pneumonia, asphyxia and
nervous conditions- onset is delayed
Atmospheric condtions:
In dry and cold air-onset slow and lost for long
time. Warm and moist air onset is rapid and
duration short.

Conditions Simulating Rigor-Mortis

Heat Stiffening
Cold Stiffening
Cadaveric Spasm

Secondary Relaxation :
Muscles become soft and Flaccid
Do not respond to a mechnical and electrical
stimulus.

Late Signs Of Death

Decomposition / Putrefaction.

Adipocere formation / Saponification.

Mummification.

Decomposition / Putrefaction
Last stage in the resolution of the body,from the
organic to the inorganic state, is a certain sign of
death.
AUTOLYSIS
Rise of enzyme levels in the tissue cells after
death.
Softening & liquefying of the body tissue.
Starts 3-4 hrs after death and continues for 2-3
days.

BACTERIAL ACTION
Action of bacterial enzymes on tissue
components carbohydrates/fat/proteins.
Bacterial growth warmth,moisture are
conditions favourable.
Clostridium welchii, streptococci, E coli, B
proteus.

CHARACTERISTIC FEATURES
COLOUR CHANGES
Greenish discoloration of skin over caecum
and flanks after death appears 18-24 hrs.
Greenish to black discolorationSulphmethahaemoglobin formed by H2S
due to microorganisms in the large intestine.
Appears early in summer & delayed in
winter.

Discoloration spreads- front of abdomen,

external genitals, chest, neck, face, arms
and legs spreads whole body in 24-36 hrs.
Discoloration of vessel walls due to
pigmentation from decomposed blood over
the shoulder and groin. Arborescent
pattern- Marbling

GASES OF PUTRIFACTION
Development of gases under the skin and
hollow viscera 18-36 hrs. 24-48 hrs in solid
viscera.
H2S, ammonia, phosphated hydrogen, CO 2
and methane.
Causes pseudo rigidity, exerts pressure.
More gases accumulation, body floats in
water.

PRESSURE EFFECTS OF PUTREFACTIVE

GASES
Displaces the diaphragm upwards.
Discolored fluid and liquefied tissue mixes with
gases producing froth.
Bloating of the features.
Shifting of the area of hypostasis.
Changes in skin, hair and wound.
Extrusion of fluid from the mouth and nose.
Emptying of the heart.
Changes in appearance of genitals.

APPEARANCE OF MAGGOTS
Flies lay eggs over the decomposed bodynose, mouth, vagina and anus in 18-36 hrs.
After 24-36 hrs eggs hatch into larvae or
maggots, enter the body and destroy the
tissues.
After 4-5 days develop into pupae.
After 7-8 days into adult fly.

OTHER SEQULAE
Fall of teeth
Separation of skull sutures
Liquefied brain matter oozes out.
Colliquative putrifaction this process
takes place between 7-14 days.

INTERNALLY
STOMACH
Dark red patches over the walls
Perforation due to autolysis
LIVER
Softens and flabby
Becomes spongy Foamy liver

Early putrefaction 24-48hrs

Larynx, trachea, brain of infants, stomach,
intestines, spleen, omentum and mesentery,
liver and adult brain.
Late putrefaction 2-3 weeks
Heart, lungs, kidneys, bladder, esophagus,
pancreas, diaphragm, blood vessels,
prostate, testis and non gravid uterus,
ovaries.

FACTORS MODIFYING PUTREFACTION

EXTERNAL
Warmth and clothing
Putrefaction begins at 10 C and occurs
rapidly at 37C.
Freezing point bacterial growth
inhibited and putrefaction will not
occur.
Clothing hastens putrefaction initially
and protects against flies and insects.

Moisture
Help in rapid multiplication of organisms.
Bodies recovered from water if left in air,
decomposes rapidly.
Air
1 week in air = 2 weeks in water = 8 weeks
buried Casper dictum

Manner of burial
In air tight coffins, very little change of
body for long periods.
Without coffins, putrefaction is very rapid.
Bodies in deep graves putrefy very slow.
Bodies buried in lime, decomposition is
retarded.
Bodies in sandy and porous soils are
conducive to mummification.

INTERNAL FACTORS
Age and condition of the body
Sex
Mode of death

ADIPOCERE

Modification of the process of putrifaction

in the dead body is (checked and is
replaced) adipocere formation.
Hydrolisation of fatty tissue into fatty acids.
Bacterial fat splitting enzymes and moisture
are essential Lecithinase.
Composed of saturated fatty acids by
palmitic, stearic, hydroxystearic, olic acids

Yellowish white, greasy wax with rancid

smell.
It forms at any site where fatty tissue is
present.
Time required, in summer-3 wks, in tropics5 to 15 days.
M.L.I. to establish the identity
- cause of death
- time since death
- place of death

MUMMIFICATION

It is a peculiar desiccation of a dead body

where by its soft parts shrivel up but retain
the natural appearance and the features of
the body.
Rusty brown color, dry, leathery skin
adherent to bones.
Internal organs get transformed into a thick
brown mass.

Mummification occurs in bodies buried in

shallow graves, in dry sandy soils.
Time 3 months to 1-2 yrs
M.L.I. Identification
- Cause of death
- Time since death
- Place of death

Time since death/ post mortem

interval

Important clue for investigation of time.

It helps apprehend the person likely to be
involved.
Point to be ascertained are;
-cooling of the body
-post mortem lividity
-rigor mortis
-decomposition changes

Contents of stomach and bowels

Contents of urinary bladder
Biochemical changes
Circumstantial evidence

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