Last of the Lecture notes for 111 (exam 4) Flashcards Preview

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1

One of the basic necessities for bacterial growth, water, has been eliminated from the body.

  • Environment- hot dry desert or cold mountainous regions with dehydrated air with perma frost will desiccate bodies.

Permanent Preservation (Mummification)

2

  • Adipose tissue formation
  • Facial features swollen beyond recognition
  • Intense odor of putrefaction
  • Protruding eyes and tongue
  • Massive skin slip (desquamation)
  • Blue-black streaked with red in color (marbleized)
  • Purge from all orifices
  • Hair, finger nails, and toe nails have dropped off or are loose.
  • Intense odor of ammonia

Characteristics of a wet or dry floater

3

A fetus dies in the uterus and remains enclosed in the amniotic sac. In a much broader sense, it could refer to the moistening and softening of any tissue decomposing in a liquid medium.

Maceration

4

The extreme or complete dehydration of a body so as to form a dry, brown, hard structure which is light in weight and resistant to decomposition.

Mummification 

5

A two-step reaction involving the removal of the amino grops from amino acids (refer to protein break down).

Deamination

6

With the help of oxygen, atoms of carbon and oxygen are pulled off the molecular structure. This reaction is associated with decay.

(removes the carboxyl group from an amino acid)

Oxidative Decarboxylation

7

A modification of putrefaction which is characterized by the transformation of certain fatty tissues of the body into a substance known as adipocere tissue or grave wax.

Saponification (Adipocere formation)

8

  • Has a greasy, slimey feel.
  • It is either pure white or pale yellow in color
  • Has the odor of decayed cheese.
  • It is highly reisistant to putrefactive organisms. Instead of decomposing, it turns into soap.
  • Considered rare

Characteristics of Adipocere

9

Any substance altering the velocity of a chemical change.

  • As one of these, enzymes accelerate or speed up the chemical changes associated with decomposition. These enzymes secreted by the tissue cells are called autolytic enzymes.

Catalyst

10

  • Cupping of the eyeball 
  • Greenish discoloration over the abdominal area.
  • Postmortem stain
  • Dehydrated lips and eyelids

1-3 Days

of Putrefaction at 70oF in air

11

  • Purge
  • Green discoloration spreading over whole body
  • Visceral gas and some tissue gas
  • Odor

3-5 Days

Of Putrefaction at 70oF in air

12

  • Tissue gas present in all parts of the body
  • Massive skin slip
  • Body Swollen
  • Starting to turn dark

8-10 Days

Of Putrefaction at 70oF in air

13

  • Bubbles and blisters over the body
  • Mottled red, green and brown
  • Intense odor of putrefaction
  • Nails and hair loose
  • Eyes and tongue bulging
  • Recognition of features difficult

14-20 Days

Of Putrefaction at 70oF in air

14

  • Thoracic and abdominal cavities may burst open 
  • Body liquification and gases escaping.
  • Feature recognition is impossible
  • Bones separating from joints.

1 to 6 Months

Of Putrefaction at 70oF in air

15

The perfentage of hydrogen ions in concentration, pH may be defined as the degree of acidity or alkalinity of a substance. Simply, pH is a measure of the strength of an acid or base.

  • pH scale ranges from 0-14
  • 0 is most acid
  • 15 is most alkaline or base

pH

16

The normal pH of blood is 7.4 (7.35-7.45)

During Life

17

The pH may be as low as 5 to 6.

  • 6.3-6.6, slightly acidic, is usually the norm with an average of 6.5
  • The acidic tissues do not coagulate well with formalin solutions resulting in a rubber like texture rather than the firmness associated with formaldehyde.

During the maximum stage of rigor mortis

18

The tissues will return to an alkaline pH and between 7.5-8.5 with 8.0 as a norm, putrefaction will occur.

During advanced decomposition, the pH returns to an alkaline register

19

Most of these have a slightly alkaline pH. A group of chemicals called buffers are used to control embalming fluid pH and tissue pH.

Embalming Fluids

20

As the body contains much more protein than carbohydrates, the ammonia by-products resulting from a gradual build up in the tissues of nitrogen products will cause an increase in this.

Formaldehyde Demand

21

A postmortem stiffening of the body muscles, both voluntary and involuntary, by natural body processes. The stiffening will disappear naturally in a variable period of time as a result of natural body processes. Thus, this is a temporary stiffness of the dead muscle tissue as a result of the coagulation of the muscle juices.

Rigor mortis (Caderveric Rigidity)

22

The coagulating agent causing rigor mortis is said to be this.

Sarcolactic acid

23

Glycogen -> Pyruvic Acid = Sarcolactic Acid

Formula for Rigor Mortis

24

A carbohydrate stored in the muscles and living during life.

Glycogen

25

In death, an absence of oxygen will cause glycogen to form and release this. This will then break down to form sarcolactic acid.

Pyruvic Acid

26

Will combine with muscle juices or extracts such as myosinogen and/or paramyosinogen which will cause the formation of insoluble myosin or myosinfibrin resulting in rigor mortis.

Sarcolactic Acid

27

  • It coagulates the soluble muscle juices to form insoluble myosin.
  • It causes a swelling of the muscle cell colloid which may be so great as to destroy the structure of muscle cells.

This combination of coagulation and swelling produces the stiffness of the muscles seen in rigor mortis.

The Two Actions Sarcolactic Acid Takes on Muscle Tissues

28

  • Temperature
  • Age
  • Gender
  • Cause and Manner of Death
  • Condition of the Muscles

Conditions affecting the onset, duration and termination of Rigor Mortis

29

  • The amount of clothing and moisture will either increase or retard the onset of rigor mortis.
  • The extent of physical activity before death will affect the production of sarcolactic acid.
  • Rigor mortis is accelerated by heat and retarded by the cold.
  • Febrile disease will cause an early onset of postmortem caloricity which will hasten the onset of rigor mortis.

Temperature (Rigor Mortis)

30

A feeble and transitory rigidity that is rapid in onset and rapid in retreat is characteristic of infants and the aged.

  • The opposite is true in healthy, young adults- slower onset, longer duration, slower retreat.

Age (Rigor Mortis)

31

Females, especially pregnant females, will go into rigor mortis faster than a male because of higher moisture content in the tissues.

  • Rigor mortis has a slower onset, a longer duration with greater intensity, and a slower retreat in the death of healthy, young males.

Gender (Rigor Mortis)

32

  • Exhausting diseases break down the muscles of the body and hasten rigor mortis.
  • Poisons which cause violent muscle contractions will accelerate rigor mortis.
  • Extreme muscular activity just prior to death will accelerate the onset of rigor mortis. (Example: strenuous exercise).
  • Cadaveric spasm will cause the over production of sarcolactic acid thus hastening the onset of rigor mortis.

Cause and Manner of Death (rigor mortis)

33

  • In well muscled bodies, rigor mortis appears slowly, the duration is lengthy, and the degree of rigidity is quite pronounced.
  • In emaciated bodies, whose muscular development is poor, rigor mortis appears quickly, the duration is brief, and there is a very feeble degree of rigidity.

 

Conditions of The Muscles

34

Rigor mortis is the worst indicator of this because the condition of the body with so many variable factors could put rigor mortis at almost any time.

Time of Death

35

Generally, we can say that all things being equal, rigidity will appear at this time after death, but could appear in minutes.

8-20 Hours

36

Rigor Mortis will usually last this amount of time, but it could remain for several days.

10-72 Hours

37

Pierre Hubert Nysten (French Pediatrician)

Rigor Mortis will appear first int he muscles of the face, then the neck and lower jaw, then the thoracic and abdominal cavity and lastly in the extremeties.

  • It also disappears in the same order that it appears.

Nysten's Law

38

  • The sooner rigor mortis appears, the sooner it will disappear and the less intense the rigidity.
  • The longer it takes for rigor mortis to develop and the longer it's duration, the more pronounced the rigidity will be.
  • Rigor mortis will appear and disappear first in the face and last in the fingers and toes.

Order of Appearance and Disappearance of Rigor Mortis

39

Retards due to the acidity in the tissue during rigor mortis.

Bacterial Growth

40

Because of the force of contraction exerted on vessel walls- arteries, veins, and capillaries.

Rigor Mortis Limits Arterial Fluid Distribution

41

The embalmer becomes confused as to whether the tissues are really firming or not.

By Rigor Mortis giving a false impression of fluid reaction

42

Destroys this ability on contact with HCHO. It will also weaken fluid strength when acid unites with HCHO.

Destroys the ability of tissue to coagulate

43

This occurs if rigor mortis is not relieved immediately. (Remains will swell during injection).

A distortion of facial features, hands and arms.

44

  • Primary Flaccidity
  • The stage of rigidity
  • Secondary Flaccidity

Three stages of rigor mortis

45

 

  • Muscles are soft and relaxed and will still react to stiumli (electric shock).
  • As cellular death increases, muscles will become rigid.
  • pH goes from alkaline to neutral to slightly acid.

The period of Primary Flaccidity

46

  • Cells are all dead.
  • Muscles no longer react to stimuli
  • Muscles and joints are firmly contracted and rigid.
  • pH goes from mildly acid to strongly acid to mildly acid.

The Stage of Rigidity

47

  • After a variable period of time, the rigidity disappears.
  • Muscles are again in a state of relaxation.
  • All power of contraction is lost forever.
  • pH goes from mildly acid to neutral to alkaline to strongly alkaline.

The Period of Secondary Flaccidity

48

Maximum rigidity (the pH level).

6.5

49

Bacterial decomposition will retard in this stage because bacteria will not grow in an acid medium.

 

Stage 2 (The stage of rigidity)

50

The best embalming results will occur in this stage.

The early stage of primary flaccidity

51

Bacteria, Escherichia coli, as well as Clostridium perfringen- anaerobic bacillus present in life as entric bacteria, inhabiting the intestinal tract, necessary for processing human waste, will begin to infiltrate both the blood vascular system and skeletal system during this period of rigor mortis as the pH surpasses 8.0, thus initiating putrefaction.

Secondary Flaccidity

52

Arterial fluid mixed with water in the injector (embalming machine).

Primary Dilution

53

Arterial fluid solution uniting with bodily fluids and tissues in the body.

Secondary Dilution

54

  • Catalepsy
  • Cold Stiffening
  • Heat Stiffening

Conditions Often Mistaken For Rigor Mortis

55

A condition in which the vital signs of life are feebly maintained and there is a waxy rigidity over the body.

  • There is a pronounced muscular rigidity which occurs during life as the result of some nervous disorder.
  • Unlike rigor mortis, the rigidity of this cannot be relieved.
  • Examples: paralysis, cachexia, stroke, and other causes of antemortem tissue, nervous, and muscular rigidity.

Catalepsy

56

When exposed to temperatures near or below freezing, the body tissues become cold and rigid. 

  • Extreme coldness of the body indicates the cause of the rigidity.
  • This and rigor mortis coexist simultaneously.

Cold Stiffening

57

There is a more or less permanent coagulation and stiffening as a result of exposure to very high temperatures, as in burning or scalding.

  • This will persist until the muscles undergo softening during the process of putrefaction.

Heat Stiffening

58

A prolongation of the last violent contraction of the muscles into the rigidity of death. It will disappear naturally as does rigor mortis over a period of time. This is a rather rare phenomenon in which the last act of life is fixed in death.

  • Although primary flaccidity is brief or nonexistent, this is still considered a form of rigor mortis by most experts.

Cadaveric Spasm

59

  • Soldier killed in combat- grasp rifle
  • Automobile accident- clutch steering wheel
  • Suicide- clutch pistol
  • Murder - Victim aware- fear
  • Drowning- clutch grass, weeds
  • Falling of cliff- clutch branches
  • Sports
  • Down hill skiing accident- clutch poles

Examples of cadaveric spasms

60

Associated with cadaveric spasm. The over production of sarcolactic acid under duress. (antemortem settling).

Death Grip

61

An extravascular color change due to hemolysis.

  • Liberated hematin called heme seeps through the capillary walls and into the body tissues. This alone produces a stain which cannot be removed by normal arterial injection and venous drainage.

Postmortem Stain (Laking)

62

The breakdown of red blood cells. In effect, the hemoglobin separates from the red blood cells and passes through the capillary walls into the intercellular spaces (interstitial space). 

  • It can be described as an explosion of the red blood cells causing the fragments to fall into the intercellular spaces.

Hemolysis

63

Postmortem stain is not caused by the presence of blood in the tissues after death but rather the presence of the protein portion of this molecule in the tissues.

Hemoglobin

64

Postmortem Stain has been known to occur in as little as this amount of time from the of death, especially if the individual had been taking anticoagulants prior to death.

  • Life-support systems and ventilators can cause this to occur even while the person is alive (in agonal stage)

6 Hours

65

  • If they area lightens in color, it is livor mortis, and this will flush easily during injection and drainage.
  • If there is no clearing or change in color, then postmortem stain is present. The presents a critical embalming problem that will not be solved by normal injection and drainage.
    • A 6 point injection at loss pressure and flow, using a strong solution, and possibly a surface bleaching agent may be necessary to restore the complexion.

Distinguishing between Postmortem Stain and livor Mortis by touching

66

Is not a postmortem stain nor is it livor mortis. It is a bruished area usually raised above the surface level of the surrounding skin. Example: a black eye

Ecchymosis

67

By drawing a scalpel through the area. Little or no blood will flow if it is postmortem stain. A flow of effused blood or coagulum will flow if it is an ecchymosis. (extravasated blood).

Distinguishing echymosis from postmortem stain

68

This will always occur before hemolysis. Refridgerated bodies will cause this to go into hemolysis at a much faster rate. An individual who has taken large amounts of anticoagulant drugs during the agonal period will also go from this to hemolysis at a much faster rate. Both livor mortis and postmortem stain will occur in the viscera as well as surface tissue because at death, most blood will gravitate into the venous system.

Hypostasis

69

Will occur when formalin solutions contact trapped heme in surface tissues during postmortem stain. Active injectable dye such as eosin can be added to primary dilution to counter stain and offset this.

  • Surface bleach applied as pack application will also help.
  • Example: bleaching cavity fluid

Formaldehyde Gray

70

Will cause hemolysis to occur at a much faster rate resulting in a cherry red color to surface tissue.

Carbon Monoxide Poisoning

71

Usually found in cases of sudden death. Heat is continually produced after death by the metabolism of the food products in tissues. The various methods of cooling the body have ceased, causing heat to accumulate and the body temperature to rise.

  • As the oxygen of the cell is consumed, the body will cool to surrounding temperature. This is to say that this will always occur before algor mortis (a physical change).

Postmortem Caloricity (Postmortem Fever)

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