Thanatology

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Thanatology

• The scientific study of death.

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Death

• Death means persistence stoppage of all vital
  processes in the body. OR
• Permanent cessation of both circulation and
  respiration. OR
• Irreversible loss of brain function (brain stem).

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Different tissues and organs in a living body
die at different rates

• 1-Somatic death
• 2- Cellular (molecular) death

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Importance of determination of clinical death

• 1. To write death certificate.
• 2. To stop life support measures.
• 3. To determine the moment of death (e.g.
  inheritance).
• 4. For organ transplantation considering the
  concept of brain stem death.
• 5. For rapid burial in cases of epidemics e.g.
  cholera.

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The immediate signs of death

• 1-Pallor and loss elasticity of the skin.
• 2-Ocular signs includes.
• 3-Primary flaccidity of the muscles.
• 4-Cessation of circulation
• 5- Cessation of respiration

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Eye signs Postmortem (PM)
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Post mortem changes which appear during the first
12 hours after death

• 1- Cooling of the body
• The body after death is estimated to loss about 1
  .5 C every hour in the first 6 hours after death
  i.e. 9 C.
• On the second 6 hours the body looses 1oC
  every6hours .

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2-Post-mortem hypostasis (PM lividity or PM
suggilation)

• Blood tends to accumulate in the capillaries and
  small veins in the dependent parts of the body.
• Hypostasis occurs in the skin and also in
  viscera.

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Post-mortem hypostasis (PM lividity or PM
suggilation)

• Starts
• Appear
• Complete
• Ante mortem
• It is present in all bodies, although it may be
  unremarkable in some cases (e.g. dark skin).

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ML importance of hypostasis

• It is a sure sign of death.
• Estimation the time pass science death.
• Position of the body at the time of death
• The cause of death .
• Mistaken with bruises (Contusions).

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3- Rigor mortis

• The initial flaccidity of the body after death is
  soon followed by stiffening or rigor mortis.

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Mechanism

• Rigor mortis is due to the disappearance of
  adenosine triphosphate (ATP) from the muscle .
  Leading to muscle stiffness

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Appearance

• Rigor mortis is reported first to appear in the
  eyelids,
• face,
• lower jaw and neck.
• Then, it involves the trunk and limbs .
• Complete in 12 hours

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Medico legal importance of rigor mortis

• 1-It is sure sign of death.
• 2-Estimation the time pass since death
• 3-It fixes the body's position at the time of
  death.
• 4-It may suggested to the cause of death,
• 5-It may be mistaken with other conditions of
  stiffness after death as

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a) Cadaveric spasm

• Onset
• Mechanism
• Type of death
• Type of muscle
• Extension
• Primary flaccidity

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b) Heat stiffness

• This stiffness due to coagulation of the muscles
  proteins in cases of burning leading to
  stiffening of the body and rigor mortis does not
  develop in the muscles

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c) Cold stiffness

• This cases are due to frozen of the body,
  resulting in freezing of inter and intra cellular
  fluids of the tissues and also freezing the
  synovial fluids in the joints.

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Cadaveric spasm in 43-year-old male with razor in
right hand.
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4-Putrefaction

• It is the last stage that takes place in the dead
  body.
• After 24 Hs in summer of 36 Hs in winter,
• Marbling phenomenon (48H)
• After 1-3 days after death, the green
  discoloration is all over, the face.

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4-Putrefaction

• One Week after death putrefactive bulla
• Two weeks after death there is peeling of the
  skin
• At 6 months after death
• At one year after death

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Factors affecting the rate of putrefaction

1. Age.
2. Causes of death .
3. Temperature.
4. Moisture.
5. Air current.
6. Manner of burial.
7. Blood content.

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Conditions that may replace putrefaction

• 1- Adipocere formation
• Definition.
• Mechanism.
• Condition required .
• ML importance.

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Adipocere
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Buried a few years prior to this exhumation
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A woman drowned and was submerged for seven
months.
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2- Mummification
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The natural mummification
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Mummification brown skin
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3- Embalming
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Embalming neck veins
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4- Maceration

• Intrauterine fetal death

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Estimation of post-mortem interval

• Entomology of the dead
• From gastric content.
• Hypostasis
• RM
• Putrefaction
• Adipocere
• Mummification

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Some websites

• http//www-medlib.med.utah.edu/WebPath/webpath.htm
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• http//www.le.ac.uk/pathology/teach/va/titlpag1.ht
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• http//www.hbo.com/autopsy/interactive/

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