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Early signs of death
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EARLY SIGNS OF DEATH Mate Žaja Mentor: A. Žmegač Horvat early changes rigor mortis cadaveric rigidity post-mortem hypostasis cooling of the body
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Early changes no corneal reflex pupils stop reacting to light “trucking” or “shunting” of the retinal vessels (fragmentation of columns of blood) loss of intraocular tension
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Early changes primary flaccidity ◦ complete loss of tone ◦ may retain reactivity ◦ may respond to touch and other forms of stimulation hours after cardiac arrest ◦ focal twitching decreases with time (discharges of dying motor neurons)
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Early changes paleness of the skin, conjuctivae and mucous membranes ◦ fall of blood pressure and cessation of circulation of the blood ◦ skin of the face and the lips may remain red or blue in hypoxic/congestive deaths
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Early changes hair does not continue to grow after death because hair follicles die at the same time as the rest of the skin
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Early changes loss of muscle tone in the sphincters (voiding of urine) emission of semen regurgitation ◦ very common feature of terminal collapse ◦ common complication of resuscitation
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Rigor mortis O ₂ anoxic pathway of energy production ATP cell acidity binding of actin and myosin fibres and formation of gel stiffness of muscles (isometric contraction)
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Rigor mortis first the smaller muscle groups ◦ around the eyes ◦ around the mouth ◦ jaw ◦ fingers from the head to the legs
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Rigor mortis estimation of time of death ◦ it should never be used alone variable process affected by temperature ◦ the colder the temperature the slower the reactions
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Rigor mortis temperate conditions ◦ face: 1 to 4 hours ◦ limbs: 4 to 6 hours strength increases next 6 to 12 hours secondary flaccidity: 24 to 50 hours standard conditions for temperature and pressure (STP) 20°C 101,325 kPa
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Rigor mortis ◦ warm and flaccid – less than 3 hours ◦ warm and stiff – 3 to 8 hours ◦ cold and stiff – 8 to 36 hours ◦ cold and flaccid – more than 36 hours
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Cadaveric rigidity forensic rarity onset immediately at death high levels of emotional or physical stress immediately before death ◦ drowning ◦ battlefield casualties ◦ suicidal shooting possibly neurogenic mechanism
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Post-mortem hypostasis post-mortem lividity or suggilation passive settling of blood under the influence of gravity pink or bluish colour change of the lowest areas
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Post-mortem hypostasis cessation of circulation relaxation of muscular tone of the vascular bed simple fluid movement within the blood vessels
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Post-mortem hypostasis may be absent due to: ◦ age – very young or very old ◦ anaemia ◦ severe blood loss may be masked due to: ◦ dark skin colour ◦ jaundice ◦ some dermatological conditions
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Post-mortem hypostasis compressed areas remain pale (blanching): ◦ surface ◦ clothing ◦ body areas
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position of the body
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Post-mortem hypostasis colour of hypostasis: ◦ from pink to dark pink to deep purple ◦ blue - some congestive hypoxic states ◦ cherry pink – carbon monoxide poisoning ◦ dark red (brick red) – cyanide poisoning ◦ bronze - Clostridium perfringens infection
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Post-mortem hypostasis hypothermia: ◦ usual colour can be unusually pink ◦ unusual distribution around large joints and over dependent areas of the body
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Post-mortem hypostasis no significant role in determining time of death affected by the movement of the body (even after normal post-mortem coagulation of the blood)
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Cooling of the body indicator of the time of death based only on three forensic assumptions: ◦ 37°C at the time of death ◦ extrapolation of temperature and applying it to the non-uniform body as a whole (more readings are optional) ◦ thermally static environment
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Cooling of the body other variables and factors: ◦ mass of the body ◦ mass/surface area ◦ body temperature at the time of death ◦ site of reading body temperature ◦ posture of the body – extended or curled ◦ clothing – material, position on the body, lack of it ◦ obesity ◦ emaciation – lack of muscle bulk ◦ environmental temperature ◦ winds, draughts, rain, humidity
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