1. What are at least 3 late signs of death?

2. What is rigor mortis?

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1. Signs of Early death

2. Define/Process of Mummification

3. Characteristics of Sub-dural hematoma

1. Signs of Late death

2. What is Rigor mortis?

3. Characteristics of Epi-dural hematoma

1. Early and Late signs of death ( just name of them)

2. Everything you know about stab wound and hacking injury

3. Everything you know about sub-dural and epi-dural hematoma

1. What is rigor mortis?

2. List late signs of death

3. Write about sub-dural hematomas

1. List the late signs of death

2. Write down the features of rigor mortis

3. List the parts of the wound

4. List the types of intra-cranial hemorrhages

1) Name the early and late signs of death:

Early: Late:
a) Hypostasis a) Putrefaction
b) Cooling b) Adipocere formation (Grave wax)
c) Rigor mortis c) Mummification
d) Desiccation d) Postmortal injuries (animals)

2) Describe the lesion cause by: incised, stabbing and hacking injury

a) Stabbing injury:
- caused by instrument with pointed end (e.g.: needle, knife, scissors)
- impact force of the attack follows the axis of the instrument
cha
raiteof
The wound
ewound dpen
shows:
atoneshapeofinstrument
1) Entry wound:
- piercing incision injury
- impression caused by the hilt
- its shape is like the instrument shape
- the edges are important because of the identification of the instrument
2) Penetration channel:
- penetration channel can be longer than the blade of the instrument

edge
b) Hacking injury:
aural by
instrumentwithasharp
- caused by a heavy, sharp instrument that moves perpendicular to the length of the edge and the
character of the wound reveals the size of the blade, the sharpness of the instrument and the
strength of the force.
- caused by: heavy knife, hatchet

The wound shows:

- side—> sharp
- edge —> pointed
- walls —> fatty tissue bulges slightly
- area —> abrasion

c) Incised injury:
- The effect of a sharp-edged instrument comes about by moving the edge over material along the
direction of its axis.
- examples: knife, glass, razor
- the greatest expanse of the injury is its length; the alteration depends on the region of the body,
and the extent of separation by the cutting line in relation to the cleavage plane of the skin.
- causes only shallow damage to the surrounding tissue and tend to heal well

The wound shows:

- edges —> sharp
- shape —> cut sharply
- base —> sharply cut, more or less in a v-shape
Incised injury Stab injury Hacking injury

cause of death - air embolism - air embolism same

- bleeding - bleeding
- PTX, cardiac
temponade, peritonitis

suicide - predilection - naked - rare

- tentative marks - tentative marks - predilection- head
- naked body parts - internal tentative - tentative marks
marks

homicide - predilection - situation of the - self-defense injury

- self-defense type of wounds - multiple
wounds - penetrate the clothes - serious
- multiple stub wound
- self-defense marks
3) write the features of rigor mortis:
Rigor mortis is caused by chemical changes in the muscles after death, causing the limbs of the
corpse to stiffen. Physiologically, it is the result of the lack of ATP resulting in non-separation of the
cross bridges between the myosin head continue binding with the actin protein.
main features:
- affect both striated and smooth muscle
- rigor mortis does not affect all the muscles at the same time: it starts at the muscles of
mastication and the nuchal region muscles, and than spreads to the face, neck, upper limbs and
lower limbs.
- it starts first in the heart after 30 min after death
- visible external signs may be observed 2-4 hours after death. 6-12 hours later the whole body is
involved.
- between 2-=84 hours the body become stiff enough to be stood up, and may limp again between
24-140 hours.
- rigor mortis depends on: age, musculature, environmental temp., disease state
4) list the parts of the wound:

a) edge/end
b) base
c) shape
d) margin/side
e) dimension
f) area
5) explain the main feature of the different types of intracranial bleeding:

Epidural hematoma Subdural hematoma Subarachnoid

hematoma

Definition layer blood builds up between blood builds up between the extravasation of
inner
ofit
the skull and the dura the dura and the blood into the
matter. It a lease-shaped arachnoid matter. subarachnoid space
lesion Tens between the dura and
the arachnoid matter.
middlemeningealart
Mostly bleeding due to
injury in the circle of
Willis.

Cause mainly following head mainly traumatic head Traumatic or

injury causing arterial injury causing damage to
bleeding, and sometimes the bridging veins,
damage to the veins. resulting in increase ICP
which in turn can
compress the underlying
brain tissue.
* associated with coup-
counter coup head
movement
* predilection fir parietal
and occipital lobes.
loss
of
cesium
other causes:
- alcoholics
- brain atrophy
- patients using
anticoagulant drugs
(aspirin)
spontaneous:
1) Traumatic: mainly
due to contusion,
most pronounced at
the place of the
“counter-coup”
movement.
2) Spontaneous: due to
rupture of aneurysm,
also mainly occur in
the circle of Wills
(e.g., anterior
cerebral artery)

Symptoms papillary edema, - secondary damage to severe headache with

bradycardia, one or two the pons- mid brain rapid onset, vomiting,
sided dilated pupils, bleeding due to rapid confusion, seizures
decerebration signs, increase in ICP.
hemiparesis - hypophysis injury
clitzmes - infection
headache cont syrup
other lumbar puncture is lumbar puncture is
contra. contra.
6) Explain the early and late signs of death:

Early signs of death: hypostasis, Cooling , Rigor mortis, Desiccation

a) Hypostasis: No circulation, blood pools at lowest area (gravitational force). Upper area Pallor
mortis (Pale), Lower area Livores mortuales (Dark red). If pushed turns pale then returns dark
red. Area under force remains red. Time: seen on skin (back , neck) organs (lung) 20-30 min
after death in small scattered areas. In 45-240 min join into larger pools. Whole body between
3-12 hours. When body position is moved 206 h after death forms Per rhexim hemorrhages
Punctat hemorrages at the site of wandered hypostasis.
b) Cooling: Algor mortis: End of metabolism decrese body temp, depends on Body, diseases,
environment. Measured at liver rectal brain. TOD: 1-1.5 C/h
c) Rigor Mortis: Limbs become stiff difficult to move, muscles lose its tone, facies hippocratica
(wrinkles on the face smoothen) affects striated and smooth muscles. Biochem: Lactic Acid +
Loss of O2 causes Loss of ATP production. Ca2+ ATPase cannot transfer Ca2+ back into SR
which causes increase of Ca2+ in the sarcoplasma which keep troponin tropomyosin active
which will expose the myocin binding site in actin which will bind myocin. Since ATP is gone,
myocin will keep its attachment to actin without relaxation until the protiens are broken down by
digestive enzymes during decomposition. (Nysten’s Rule) Starts 1st in the heart muscle 30 min
after death, visibile signs begins in muscles of mastication TMJ after 2-4 h, then nuchal region,
spread to the face neck the upper extremities then lower extremities, whole body after 6-12h,
stiff body 20-84 h, limp again 24-140h. (Varies by Age, Muscle Size, Temp, diseases) in skin
causes Cutis anserina = goose pimples , in face causes risus sardonicus. Happens once,
breakable and newly onset 0-12h, after 12h breakable but remains.
d) Desiccation: Happens in thin epithelial surfaces and mucous membranes; sharply bordered
yellowish- brown spots. Larcher spot (triangular shaped cornea. Scrotum, labia minora dry out.

Late signs of death: Putrefaction, Adipocere (grave wax) Mummification, Postmortal injuries
(animals).

a) Putrefaction: Humidity, temp, clothing, indoor, diseases fever sepsis diabetes, starts 24 h
visibile in 48- 72h. Bacterial (ecoli proteus) and enzymatic digestion (autolysis gastric
pancreatic), temp 20-37C. H2S hemoglobin= grey-greenish decoloration, turns black, blisters
form. Decomp gases (sulfur hydrogen methane) inflate abdomen scrotum and penis, face,
tongue between teeth uteral prolapsus, coffin birth. Proteolysis: the rigor dissolves 2-3 weeks
the upper layer of skin is gone, the hair loosens.
b) Grave Wax (adipocere): lack of O2, anaerobic environ, in water, mass-grave, wet, clayey soil.
Yellow- gery, rusty rancid smell, fatty, crumbly, waxy, hydrophobic, Saponification, 6-8 months,
preserve body for 10-20 years.
Ic) Mummification: Non humid dry, hot windy desert or very cold winter. Body shrink become wizen
(parchment-like). Many months to form; remain intact for long time.
d) Postmortal injuries (animals): insects ants hornets fly. Maggot-pupa state (8th day), winged fly
(14th day). Dog, fox boar, cat, bird, rat, mouse. In water: crab, leech, fish.

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 Nasef Ahmed

Postmortal signs: Early and Late

Early signs of death: hypostasis, Cooling , Rigor mortis, Desiccation

Hypostasis: No circulation, blood pools at lowest area (gravitational force). Upper area Pallor mortis
(Pale), Lower area Livores mortuales (Dark red). If pushed turns pale then returns dark red. Area under
force remains red. Time: seen on skin (back , neck) organs (lung) 20-30 min after death in small
scattered areas. In 45-240 min join into larger pools. Whole body between 3-12 hours. When body
position is moved 206 h after death forms Per rhexim hemorrhages Punctat hemorrages at the site of
wandered hypostasis.

Cooling: Algor mortis: End of metabolism decrese body temp, depends on Body, diseases, environment.
Measured at liver rectal brain. TOD: 1-1.5 C/h

Rigor Mortis: Limbs become stiff difficult to move, muscles lose its tone, facies hippocratica (wrinkles on
the face smoothen) affects striated and smooth muscles. Biochem: Lactic Acid + Loss of O2 causes Loss
of ATP production. Ca2+ ATPase cannot transfer Ca2+ back into SR which causes increase of Ca2+ in the
sarcoplasma which keep troponin tropomyosin active which will expose the myocin binding site in actin
which will bind myocin. Since ATP is gone, myocin will keep its attachment to actin without relaxation
until the protiens are broken down by digestive enzymes during decomposition.

(Nysten’s Rule) Starts 1st in the heart muscle 30 min after death, visibile signs begins in muscles of
mastication TMJ after 2-4 h, then nuchal region, spread to the face neck the upper extremities then
lower extremities, whole body after 6-12h, stiff body 20-84 h, limp again 24-140h. (Varies by Age,
Muscle Size, Temp, diseases) in skin causes Cutis anserina = goose pimples , in face causes risus
sardonicus. Happens once, breakable and newly onset 0-12h, after 12h breakable but remains.

Desiccation: Happens in thin epithelial surfaces and mucous membranes; sharply bordered yellowish-
brown spots. Larcher spot (triangular shaped cornea. Scrotum, labia minora dry out.

List the late signs of death: Imbibition; Putrefaction; Maceration (water death; Adipocere (grave wax);
Exsiccation (mummification); Postmortal injuries (animals).

Imbibition: 8-24 h after death, Red large areas in the lower surface, unlike hypostasis it remains red with
pressure. With high humidity and temp becomes Putrefaction or grave wax in water. With Dry windy
environ becomes Exsiccation (mummification)

Putrefaction: Humidity, temp, clothing, indoor, diseases fever sepsis diabetes, starts 24 h visibile in 48-
72h. Bacterial (ecoli proteus) and enzymatic digestion (autolysis gastric pancreatic), temp 20-37C. H2S
hemoglobin= grey-greenish decoloration, turns black, blisters form. Decomp gases (sulfur hydrogen
methane) inflate abdomen scrotum and penis, face, tongue between teeth uteral prolapsus, coffin birth.
Proteolysis: the rigor dissolves 2-3 weeks the upper layer of skin is gone, the hair loosens.
 Maceration: submerged in water or amnion. Upper layer of skin exfoliates. Foetus maceratus
(lithopaedion)

Grave Wax (adipocere): lack of O2, anaerobic environ, in water, mass-grave, wet, clayey soil. Yellow-
gery, rusty rancid smell, fatty, crumbly, waxy, hydrophobic, Saponification, 6-8 months, preserve body
for 10-20 years.

Exsiccation (mummification): Non humid dry, hot windy desert or very cold winter. Body shrink become
wizen (parchment-like). Many months to form; remain intact for long time.

Postmortal injuries (animals): insects ants hornets fly. Maggot-pupa state (8th day), winged fly (14th day).
Dog, fox boar, cat, bird, rat, mouse. In water: crab, leech, fish.

Parts of the wound: dimension (length width), shape (sharp uneven undercut covered indented), edge
(singular multiple sharp dull uneven slipped crease), side (smooth bulging uneven undercut bridged by
CT), base(depth), area surrounding (dirty swollen).

Types of wounds: Incising (cut, laceration), Stab, Hacking, Blunt, Traffic, Electrical, Gunshot, Head-
induced.

Age of wound: 0-4 days: Reddish purple. 4-7 days: Green, 10-14 days Yellowish.

types of intracrainial hemorrahges: Epidural hemorrhage, subdural hemorrhage, subarachnoid

hemorrhage, Traumatic cerebral hemmoraghe. Contusio cerebri

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