Forensic Pathology

April 6, 2009

Definition of Death
A person is dead if: He has suffered irreversible cessation of circulatory and respiratory functions Or, he as suffered irreversible cessation of all functions of the entire brain, including the brain stem Brain death: Coma and cerebral unresponsiveness, Apnea, Dilated pupils, Absent cephalic (brainstem)reflexes, Electrocerebral silence

Reversibility of Death
Dependent upon capability of tissues to recover from anoxia Resistance of organs variable

CNS has high sensitivity

Approx. 4-6 min. between loss of oxygen and irreversible brain damage With cutting edge techniques may be 15-16 minutes Age and temperature cause variability-up to 30 min.

Brain Death Physical characteristics:

Grayish appearance, marked swelling, herniation, anoxic damage, liquefaction Brain death changes become apparent 12-16 hrs. after end of cerebral circulation Persistent Vegetative State (PVS) Different from brain death Total permanent and total destruction

Postmortem Changes
Once dead, bodily functions cease and body begins to break down

Circulation stops, chemical composition of body fluids changes, digestion ends, natural bacteria in gut takes over, animals begin to feed on body
Happens in particular order-postmortem clock

Algor Mortis
Body cools to ambient temperature Cools at rate of 1.5o F to 2o F per hour Skin cools fastest, and isnt used in body temp determination

Body core temps used--rectum, liver, brain Rate of cooling changes with clothing, body fat, air currents, immersion in water, size

Ocular Changes
Eyes show some of the earliest postmortem changes Settling of rbcs in capillaries Thin film on cornea within 2-3 minutes, cloudiness within 2-3 hours If open, exposed areas develop tache noire (black spot)

Intraocular fluid--dries up in about 4 days

Vitreous Potassium
Potassium levels in the eye much higher than potassium levels in the blood
Due to the sodium-potassium pump After death pump no longer works, so potassium diffuses out Known rate:
(7.14 x K+ concentration) - 39.1 = hours since death

Purplish-blue discoloration due to settling of blood by gravitational forces within capillaries May be evident as early as 20 min. after death Fixed after 8-12 hours

Livor Mortis

Rigor Mortis
Right after death, muscles flaccid

Fibers in muscles bind together

Takes energy to relax

Rule of thumb: takes 12 hours to appear fully, lasts 12 hours, takes 12 hours to disappear
Variable: previous exercise, convulsions, electrocution, heat

Cadaveric Spasm
Sometimes rigor mortis hits without muscle flaccidity

Occurs in deaths preceded by great excitement or tension

Drowning, murder Clenched fist holding object

Stomach Contents
Stomach empties at known rate

Digestive processes cease after death

Solid food empties slower that liquid Starchy and fatty foods empty more slowly Light meals: 1 1/2-2 hours Heavy meals: 3-4 hours Liquid: 1/2 hour

Decomposition
Disintegration of body tissues
During life, biochemical process preserve integrity of cellular membranes and organelles

After death, cell enzymes leak out and microorganisms no longer killed
Autolysis--self dissolution by body enzymes Putrefaction--decomposition changes produced by action of bacteria and microorganisms

Anthropophagy--destruction of body by predators

Autolytic Changes
First changes occur in organs rich in enzymes

Pancreas, stomach, liver

Digestive juices present at death begin to eat away at organs Mucosal lining no longer produced

Putrefaction
Dependent upon temperature and prior health of individual
Gasses produced: methane, CO2, Hydrogen, Ammonia Environment--body exposed to air decomposes more rapidly than in water, which is more rapid than in soil 1 week in air=2 weeks in water=8 weeks in soil

Stages of Decomposition
Early decomposition begins after 24-30 hours Greenish discoloration of abdomen

Breakdown of hemoglobin by bacteria

Stages Cont.
Bloat--after about 3 days Dark discoloration of face Purging of fluids from nose and mouth

Marbling

Skin Slippage & Discoloration

Mummification
If environment dry, tissues wont decompose as readily
Skin becomes leathery, shrunken and dark Can last in this state a long, long time

Waxy fat (grave wax)--helps preserve the body

In high humidity and temperature, body fats turn into clay-like, gray substance Bacterial enzymes convert unsaturated fats into saturated solid fats Takes from 3-6 months to develop

Adipocere

Skeletonization
Once all soft tissue removed, only skeleton remains
Rate of skeletonization depends on climate Temperate areas: 1 1/2 years

In hot and humid areas: as little as 10 days

Any Questions?