Post-Mortem Changes Part II
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Slide 1 :
POST MORTEM CHANGES PART II
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Putrefaction Putrefaction is the post-mortem destruction of the soft tissues of the body by the action of bacteria and endogenous enzymes and is entirely capable of skeletonizing a body.
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Putrefaction is brought about by two processes Autolysis Bacterial multiplication and its action
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Autolysis Autolysis, an aseptic chemical process in which enzymes are released after death from tissue cells causing softening and liquefaction of muscles.
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Bacterial Multiplication and Its Action Ferments are produced by living saprophytic microorganisms, which resolve the complex organized tissues of the body into simpler inorganic compounds. These microorganisms are commensals Clostridium welchii, B. proteus, B. coli and others Enzyme lecithinase causes hemolysis and helps in the hydrolysis and hydrogenation of body fat
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Two Main Changes of Putrefaction Change in Color and Liquefaction Emission of Foul Smelling Gases These same changes seen on the surface of the body occur simultaneously in the internal organ
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The First Visible Sign Of Putrefaction Greenish discoloration of the skin of the anterior abdominal wall due to SULPHA-HAEMOGLOBIN formation In summer, the green discoloration spreads over the entire abdomen and the external genitals in about twelve to eighteen hours after death. As time passes, the green discoloration spreads over the chest, neck, face, arms and legs. The color may be deeper and become purple and dark blue.
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Marbling The appearance of an arborescent skin pattern Indicates vessels in which hemolyzed blood has reacted with hydrogen sulfide to produce characteristic greenish black discoloration
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Factors Affecting Rate of Putrefaction
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Effect of Body Temperature in Rate of Putrefaction rapid cooling of the body following a sudden death will markedly delay its onset. In a temperate climate the degree of putrefaction reached after 24 hours in the height of summer may require 10 to 14 days in the depth of winter.
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Gases Produced By Putrefaction De-carboxylation of the amino acids ornithine and lysine yields carbon dioxide the foul smelling gases like Ptomaines, Putrescine (1,4-butanediamine) Cadaverine (1,5-pentanediamine) Bacterial and fungal fermentation yield ethyl alcohol (ethanol), confounding the interpretation of post-mortem alcohol concentrations
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Early putrefaction is heralded by the waning of rigor, green abdominal discoloration, a doughy consistency to the tissues and hemolytic staining of vessels. In summer, from twelve to eighteen hours these gases collect in the intestine and abdomen swells up. The sphincters relax, and the urine and feces may escape. From eighteen to forty hours of death in summer, the gases collect in the tissues. Face and trunk start to bloat.
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The scrotum, penis, eyelids and other sites of loose skin attachment may be strikingly inflated, and crepitus is readily elicited on palpation of these areas. These gaseous accumulations in the tissues make the feature unrecognizable. The cellular tissues are inflated throughout so that the whole body appears stouter and older than actually is.
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Eyes are forced out of socket, tongue protrudes and the lips are swollen and everted. Frothy blood comes out from nose and mouth. These gaseous form blisters under the skin containing a reddish colored fluid. When these burst, the cuticle is peeled off. These are characterized by absence of vital reaction.
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Insects and Their Role Common houseflies are attracted to the body and lay their eggs in the open skin. The eggs hatch into maggots within one day during hot weather. The maggots crawl into the interior of the body and help in destroying the soft tissues. The maggots become pupae in four or five days and adult flies in the course of three to five days. They are of some help in estimating the time since death. Ants can also cause abrasions which can readily be distinguished from ante mortem abrasions showing no vital reaction.
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