HELP WITH ASSGN (3) DUE IN 24 HOURS

Death – Agonal and

Postmortem Changes • DEATH IS A PROCESS AND NOT A MOMENT IN TIME.

• DURING THE PROCESS THERE IS A SERIES OF PHYSICAL AND

CHEMICAL CHANGES.

Agonal Period  The process takes place in a sequence of steps.

 The period of time over which the steps occur is known as the agonal period

 Agonal refers to death or dying. During the agonal period the body is said to

be moribund, a dying condition or dying.

Death rattle

 Death rattle is a respiratory gurgling or rattling in the throat of the

dying person, caused by the loss of the cough reflex and the accumulation of mucous.

Death Struggle

 Death struggle is the semi convulsive twitches that occur before death.

Somatic death

 Somatic death is the death of the entire body

 It proceeds in an orderly progression from:

 clinical death to

 brain death, then to

 biological death and finally to

 postmortem cellular death

Clinical Death

 Occurs when spontaneous respiration and heartbeat cease.

 During this time the person can be resuscitated and therefore, this is the

reversible phase of the somatic death process.

 Brain death will occur if respiration and heartbeat are not

reestablished.

Biological death

 Biological death refers to the period in the process where simple life

processes of the various organs and tissues of the body begin to cease.

 When biological death occurs, respiration and circulation cannot

be restored.

Postmortem cellular death

 Postmortem cellular death occurs when individual cells use up

stored elements, or are overcome by autolytic processes and die.

 Cells that are more specialized and/or active will react more quickly

to the decrease of oxygen or nutrients.

Progression of Cellular Death

 Brain & nervous system cells 5 minutes

 Muscle cells 3 hours

 Cornea cells 6 hours

 Blood cells 6 hours

Antemortem Period

 The antemortem period is the time before death and as death is

progressing:

Key terms

 Necrobiosis: the physiologic, or natural death of cells

 Necrosis: the pathologic death of body cells as a result of disease

processes (i.e. gangrene or decubitus ulcers)

Stages of Death

 Agonal period

 Somatic Death

 Clinical death

 Brain death

 Biological death

 Post mortem cellular death

Temperature Changes

Two thermal changes can occur during the agonal period

 Agonal algor: the cooling or decrease of the body temperature

prior to death.

 Agonal fever: the increase of the body temperature just prior to

death

Circulatory changes

 Agonal hypostasis: the settling of blood into the dependent tissues

of the body. The force of gravity overcomes the force of circulation as the circulation slows.

 Agonal coagulation: as the circulation of the blood slows and the

blood begins to clot.

 Agonal capillary expansion: the opening of the pores in the walls of

the capillaries to attempt to get more oxygen to the tissues and

cells.

Moisture Changes

Two changes in tissue moisture are possible

 Agonal edema: the increase in the amount of moisture, or fluids, in

the tissues and the body cavities.

 Agonal dehydration: the decrease in the amount of moisture, or

fluids, n the tissues and body cavities.

Translocation

 Translocation is the movement of microorganisms from one area of

the body to another.

Signs of Death

1. Cessation of respiration

2. Cessation of circulation

3. Muscular flaccidity

4. Changes in the eye, including:

a) Clouding of the cornea

b) Loss of luster of the conjunctiva

c) Flattening of the eyeball

d) Dilated and unresponsive pupils

5. Postmortem lividity

6. Rigor mortis

7. Algor mortis

8. Decomposition

POSTMORTEM CHANGES

 Physical Changes

 Algor mortis

 Hypostasis

 Livor mortis

 Dehydration

 Increased viscosity of the blood

 Endogenous invasion of microorganisms

POSTMOREM PHYSICAL CHANGES:

Algor Mortis

The postmortem cooling of the body.

Factors affecting the rate of cooling of the body are Intrinsic factors

and Extrinsic factors

 Intrinsic factors: within the body itself

 Ration of surface area of the body to the body mass

 Body temperature at the time of death

 Combination of the effects of the ration of the surface area to body

mass and body temperature at the time of death

 Extrinsic Factors: factors in the surrounding environment (outside the

body)

 Body coverings

 Surrounding environment

POSTMOREM PHYSICAL CHANGES:

Algor Mortis

POSTMOREM PHYSICAL CHANGES:

Hypostasis

 The process by which blood settles.

 Gravitational movement within the vessels to the dependent or lower

parts of the body.

 Contact pallor refers to the areas where the blood movement has been

inhibited.

POSTMOREM PHYSICAL CHANGES:

Livor Mortis  The settling of blood brings about discoloration that appears within ½ to 2 hours after

death.

 The result of hypostasis

 Also know as postmortem lividity or cadaveric lividity

POSTMOREM PHYSICAL CHANGES:

Dehydration

 Surface dehydration: results from passage of air or air currents over

the surface of the body. (keeping the body covered helps protect against surface dehydration)

 Gravitation or hypostasis dehydration: blood and body fluids settle

to the dependant areas of the body. The higher areas where the

liquids have moved from are more likely to be come dehydrated.

(The lower areas are more likely to have postmortem edema)

POSTMOREM PHYSICAL CHANGES:

Dehydration

 Imbibition: the ability of the cells to draw moisture from the

surrounding area into themselves.

POSTMOREM PHYSICAL CHANGES:

Increased viscosity of the blood

 As dehydration occurs, the blood becomes more viscous. Elements of the blood

stick together in clumps creating sludge.

 Dehydration will bring surface discolorations ranging from a yellow into the browns and finally black.

 Viscosity refers to the thickness of a liquid.

POSTMOREM PHYSICAL CHANGES:

Translocation

 Translocation of Microorganisms is the movement of microorganisms

from one area of the body to another.

 For the embalmer, the most troublesome organism that could

translocate is Clostridium perfringes.

 Clostridium perfringes is a tissue gas-producing anaerobic bacillus and is

responsible for true tissue gas.

 Within 1 or 2 hours of death c perfringens if in the tissue can produce

gases that distend the tissues to the point where viewing the body might

be impossible.

POSTMORTEM CHEMICAL

CHANGES

 Next Week