DEATH.

NECROSIS.
APOPTOSIS.
E S H I E VA A S E L
• Death is an irreversible cessation of the life of the organism.

• Natural death - in people of old age, it eats (physiological) deterioration of the body

• Violent death - in the result of some force (intentional or unintentional), such as murder, suicide,
death from injuries, incidents

• Death from disease. Usually slow, with fasting extinction of life f-s. It happens sudden, or sudden
- with a hidden flow of neglect, with which suddenly death is complicated
• Clinical death is characterized by cessation of breathing and blood circulation for up to several
minutes.

• Biological death is an indispensable change in the life of the organism, the beginning of
autolytic processes.
• The order of death:
• 1. Central nervous system: 5-6 minutes after the respiratory and blood circulation - destruction
of parenchymal cells of brain and spinal cord
• 2. After several hours - skin, kidneys, heart, lungs
SIGNS OF DEATH

• Clinical
 Absence of breath
 Absence of heartbeat

• Biological
 Postmortem changes
POSTMORTEM CHANGES

• Cooling of the corpse

• Rigor mortis
• Rigor drying
• Redistribution of blood
• Cadaver spots
• Corpse decomposition
COOLING THE CORPSE
RIGOR MORTIS
RIGOR DRYING
REDISTRIBUTION OF BLOOD
CADAVER SPOTS
CORPSE DECOMPOSITION
NECROSIS

• Necrosis is an intravital necrosis

of cells and tissues of the body
under the influence of various
pathogenic factors
STAGES OF NECROSIS

• 1) paranecrosis - dystrophies with a reversible character;

• 2) necrobiosis - dystrophic processes deepen and become irreversible;

• 3) cell death - the cell ends its functioning,

• 4) autolysis – autocell melting

EXTERNAL (MACROSCOPIC) SIGNS OF
NECROSIS:
• 1) the tissue structure in the necrosis zone is disturbed, the tissue is structureless;

• 2) the consistency of tissue can be dense- dry nec., soft-wet nec.

• 3) the color of the tissue in the zone of necrosis can be black or dirty green (with gangrene), yellow-gray color,
red or red-blue color in a lung infarction;

• 4) the smell in the zone of necrosis in gangrene is associated with the fact that putrefactive microorganisms
(Pseudomonas aeruginosa, clostridia) are able to produce hydrogen sulfide, which interacts with iron sulfide.
MICROSCOPIC CHANGES

• karyopyknosis (hardening of chromatin and a decrease in the nucleus)

• karyorrhexis (disintegration of the nucleus into separate fragments)
• karyolysis (the nucleus is completely dissolved)
• the cytoplasm of cells occurs protein coagulation,
 plasmorexis (rupture of the cytoplasm into separate fragments) and
 plasmolysis.
CLASSIFICATION OF NECROSIS

• 1. By etiology:

• 1) traumatic

• 2) toxic

• 3) trophoneurotic

• 4) vascular necrosis

• 5) allergic necrosis
• By development mechanism:

• 1) direct necrosis - a direct effect on the tissue of a pathogenic factor (traumatic, toxic);

• 2) indirect necrosis - due to the effect on the tissue not of the pathogenic factor itself, but
indirectly through the vessels, nerves, etc.
• By clinical and morphological forms:

• 1) coagulation or dry necrosis: cheesy with tuberculosis and syphilis; waxy - in the muscles;
fibrinoid for disorders of connective tissue and valves;

• 2) colliquative necrosis (in the substance of the brain and intestines) - heart attack;

• 3) gangrene.
COLLIQUATIVE NECROSIS
• Characterized by melting of dead tissue and formation of cysts.
COAGULATIVE NECROSIS
• Characterized by formation of dry, dense, greyish-yellow focuses.
GANGRENE

• tissue necrosis, which communicates with the external environment, becomes infected with
putrefactive microbes with the rejection of dead tissue as a result. Localization of gangrene:
lower and upper extremities, internal organs that communicate with the external environment
(lungs, large intestine, appendix, bladder and uterus). Gangrene can be dry or wet. For dry
gangrene, circulatory disorders are necessary, for wet gangrene - venous stasis, edema,
lymphostasis
DRY GANGRENE
WET GANGRENE
BEDSORES

• Necrosis of a surface
of a body (skin, soft
tissues) that is forced
by pressure.
APOPTOSIS

• is the natural and programmed death of a cell in whole or in part. It occurs under physiological
conditions - this is natural aging (death of erythrocytes, T and B-lymphocytes), with
physiological atrophies (atrophy of the thymus gland, gonads, skin).
• Apoptosis mechanism:

• 1) condensation of the core chromatin;

• 2) fragmentation of the core and protrusion of internal organelles;

• 3) cell fragmentation with the formation of apoptotic bodies.

• 4) lysis of the apoptic bodises