Understanding Death: A Comprehensive Guide to Signs, Processes, and Legal Aspects
Cooling Cadavers: Algor Mortis
Algor mortis, also known as the decrease in body temperature, is established in the human body at death. As the temperature begins to drop, it does so gradually and steadily.
Evolution:
The cadaver does not cool completely around the body at the same speed. It begins feet first, followed by the hands and face, which can already show rigor mortis after two hours. The lid with the side dorsal fingers continues to spread after the proximal parts of limbs, chest, and finally the abdomen, armpits, and neck.
The deep abdominal organs are the last to cool, keeping the temperature for longer. It has even been observed that they have not lost any temperature up to 24 hours.
Factors that Alter Algor Mortis
Individual factors: age, height, weight, and nutritional status.
Factor Age:
The body of a fetus, newborns, and children cool faster than the bodies of adults.
Factor Weight:
The body of an emaciated person cools faster than the body of a well-nourished person.
Factor Nutrition:
A person’s body is cooled more easily than a person who is well-fed.
Factor Tract:
The body of a fasting person is cooled more quickly than someone who has recently ingested food to the moment when death surprised them.
Pathological Factor of the Cause of Death
Chronic diseases, death from bleeding, and poisoning accelerate rigor mortis.
Cooling occurring in cadavers from acute diseases, infections, death from heat stroke, and sudden death in previously healthy individuals retard rigor mortis.
Environmental Factors
Temperature:
The lower the temperature, the faster the cooling corpse. The drop in temperature is inversely proportional to the temperature.
Ventilation:
The greater the ventilation, the faster the drop in body temperature.
Humidity:
The higher the humidity, the faster the algor mortis.
Situational Factors
Vestimenta:
The more covered the body, the longer it will take for algor mortis to set in. The temperature decrease is inversely proportional to the amount of clothing the body has.
Medico-Legal Significance of Algor Mortis
Diagnosis of Sure Death:
Abiotic consecutive serves as a sign for diagnosing certain death, and a body temperature of 20 º C is incompatible with life.
Data of Death:
Although you cannot say with certainty the time of death of the body, the body temperature in the rectal cavity can be suggestive by the decrease we discussed earlier.
Eye Signs
Loss of Transparency of the Cornea:
This is a relatively early sign, which can begin to be observed from 45 minutes of death if the person died with their eyes open. If the body has remained with closed eyes, this sign is seen at 24 hours of death. This loss of transparency of the cornea results in a slimy scum, which is commonly known by the name of fish eyes.
Signo or Stain Sommer – Larcher:
This is a dark stain, with black contours that are not defined, which appears first on the outside of the eyeballs and adopts a triangular shape, with the base directed toward the cornea. Then it appears in the inner corner of the eyes, with an equally triangular outer core.
Hypotonia of the Eyeball:
This is due to the evaporation of the intraocular fluid (vitreous humor and ocuoso) that lowers the intraocular pressure and allows for the collapse of the eyeballs to digital pressure. Its appearance is also conditional on whether the corpse has been with the eyelids open or closed.
Livor Mortis or Lividity
This is one of the abiotic row signs, consisting of wine-red spots that appear on the skin. Its production mechanism is due to the deposit of blood by gravity into the sites of the body that decline, due to the repletion of blood from arterial vessels.
Localization:
There are always sites that decline. So then, if the body has remained in the same position, it must be on sloping sites because the blood flows to these sites by gravity.
The rule that is derived is: Livor mortis is present in regions of the body that decline, thus indicating the position the body remained. Livideces are not evident in the sites of compression, folds, areas of the body compressed by the clothes, wrinkles, or creases.
Color:
Livor mortis has a purplish-red color, varied between these two shades, from pink to dark blue. The variations are explained by the color tones that the blood had at the time of death.
Livor mortis is dark red in mechanical suffocation deaths, while it will be light red in deaths from hemorrhage.
Status of Livor Mortis
Livor mortis appears in the 45th minute in the neck.
In the rest of the body, it occurs 3 to 5 hours after death.
Livor mortis occupies the level of decline at 12 hours of death.
Once set, it does not change color or shape.
The skin of the opposite body is pale.
After 24 hours, there are no livideces.
Status of Livor Mortis
Livor mortis varies from position to mobilize the body before 10 to 12 hours from the moment of death.
Once the position of the body is changed, there are new livideces tones, which are fainter than those originally installed. These are called paradoxical livideces.
Rigor Mortis or Rigidity
Concept:
This is the abiotic sign characterized by consecutive stiffness and hardness of the body, which affects muscle tissue.
Evolution:
It starts in the smooth muscle (myocardium, diaphragm, sphincters, etc.).
In the striated muscles, it starts at 3 to 6 hours of death.
It begins in the masseter, orbicularis of the eyelids, face, neck, thorax, abdomen, and finally in the limbs.
The sequential order occurs when the body is in a supine position. It is installed completely at 12 hours.
Rigor Mortis or Rigidity
The athletic body takes the position called for the highlight of the muscles of the upper and lower limbs, and stiffness is present simultaneously.
The present approach and hands are lightly adducted, with the thumb toward the center. That position is called the preacher’s hand.
The face presents approximation of the jaws and modification of the face.
Rigidity of Articles 3 Steps
Setup Phase:
It succeeds in overcoming the rigidity in applying force to members who recover the flaccidity, and rigidity is reinstalled later.
Status Phase:
At this stage, the above phenomena occur. It can cause fractures and lacerations.
Rigidity of Articles 3 Steps
Resolution Phase:
The highest intensity occurs at 24 hours. From 36 hours post-mortem, it is due to resistance. There is no danger of broken bones. It begins to disappear from 36 to 48 hours post-mortem, following the order in which it appeared.
Factors Altering Rigor Mortis
Nysten observed certain phenomena which he played in his famous law, which states: When started early, stiffness is low intensity and limited, while its implementation is delayed, the intensity is remarkable and its long duration.
Factors Altering Rigor Mortis
Factor Age:
In children and in old age, it provides an early rigor mortis, weak and of short duration. Therefore, it follows the law of Nysten.
Factor Fatigue:
In cases where death overtakes a tired person, rigor mortis is early, weak, and short-lived.
Cases in Which the Law of Nysten Does Not Continue
In convulsant disease deaths, such as tetanus, epilepsy, strychnine poisoning, the stiffness is early, lasting, and intense.
Factor Temperature:
In cases of death from heat, rigidity is premature, short-lived, and intense. In the case of cold, rigor mortis is early, intense, and lasting.
Medical-Legal Significance
Diagnosis of Death:
Determination of the Date of Death:
Determination of the Position the Body Stayed After Death:
Cadaveric Spasms
This is a sign consisting of the abiotic conservation and fixation of the latter attitude and position that the human body had at the time when death occurs.
The production mechanism is due to the lack of the relaxation phase of flaccidity and rigidity that comes after.
Etiology:
Cause of death in cases of individuals with tetanus, death by electrocution, certain mechanics of suffocation, also intense stress, and intense emotion immediately after death.
Forensic Importance:
Cadaveric spasm shows the last position and attitude that the victim was in when she was alive and allows the reconstruction of events, especially in cases of weapon subject to force and how to grab it.
Autopsy:
Autopsy results from auto = myself and ophis = view. It means that test with your own eyes. It is the anatomical examination, morphological and pathological body for the cause of death, as well as manifestations of the same nature relating thereto. It is also known by the name or Tanatopsia necropsy, although the custom and practice has established the Autopsy.
Types of Autopsy:
The Clinical Autopsy:
This studies the body to investigate the cause of death, as the various tissues and organs that have been altered due to morbid or pathological processes, and as such medications may have caused anatomical functional symptoms.
The Legal or Judicial Autopsy:
Instead, it deals with research and investigates injuries or anatomical abnormalities – pathology whose discovery or verification will serve to help clarify the cause of death in a legal case.
Requirements for Autopsy:
1-Provide appropriate media: from local (morgue), right, proper equipment and instruments, sufficient ventilation and lighting:
2-Lift of the body by the medical examiner or coroner.
3-Accompany leaf removal.
4-Anatomo the doctor perform – forensic pathologist.
Medico-Legal Autopsy Rules:
1-An autopsy is directed to investigate injuries and disorders that can be caused by death.
2-The skin incisions of the body must be linear, impacting with the knife perpendicular to the skin, allowing the subsequent closure by proper suture, always respecting the physiognomic character of the corpse.
3-The autopsy should be complete, while considering any body part, whichever include the rachis.
4-Must open the three cavities: cranial, thoracic, and abdominal. Often used Virchow technique for its simplicity and ease.
5-Take samples of tissues, organs, and content essential to the histological and toxicological tests (sample of blood, kidney, liver, and stomach).
6-Do not rely on memory and note in writing all data to be watching.
7-The report is written in the so-called Autopsy, which must be delivered to the coroner within 24 hours to complete the expertise.
Signs Attached to Cardiocirculatory SECE Function:
Bouchut-sign:
This consists in the absence of heart sounds when performing the auscultation of the precordial region for 15-20 minutes.
Sign of Magnus:
This consists in the absence of discoloration in compressing a limb or a finger. In the living, we see a bluish coloration.
Transiluminaciòn:
This involves inserting a light in the mouth or under the hand. In vivo, we see a characteristic pink coloration, while in the body, there is an absence of this sign.
Forcipresiòn:
This involves taking skin with tweezers for several minutes. It seems that the dead body disappears imprint.
Electrocardiogram:
There is no cardiac activity, observed an isoelectric line in the body. This test is one of the safer, higher fidelity, safe course that this review is done in cardiac electro hospitals and clinics.
Respiratory Signs:
Try the Mirror:
There is no fogging to place a mirror before the body breathing holes.
Lint-Test:
There are no movements.
Flame-Proof:
There are no oscillations.
Try the Glass of Water:
This consists in placing in a glass of water Epigastro, and appreciate the presence of oscillations in water level.
Laet-Test:
Consists of a pre-activate a puncture and balloon drops hide vitreous, which come into contact with the reagent to demonstrate the acidification in the body.
Auscultation of the Chest:
Encouraging absence of breath sounds.
Neurological Signs:
Immobility of the Body:
Especially the same attitude.
Muscle Flaccidity and Softness:
Loss of Sensation:
Paralysis of Sphincters:
Jodi-sign:
This is the shape change of the pupil from circular to elliptical or oval, cross pressure of the eyeball.
Requirements for Removal of the Corpse:
A-Being charged by the coroner or medical examiner.
B-Notification by the agency instructor.
C-Appeared at the site where the corpse.
D-Examine the corpse.
E-Material and equipment.
Indications:
1.-In case of violent death. 2 .- Sudden death. 3 .- The number of homicides. 4 .- Death by poisoning. 5 .- In infanticide. 6 .- Death by abortion. 7 .- Death in judicial detention, prisons, and so on. 8 .- Death of alleged medical liability. 9 .- In exhumations.
Procedures:
A-ID the body.
B-Name (full, clear, and readable).
C-Date of birth and age.
D-Identity cards.
E-Lifting date, day, month, and year.
F-Site of the uprising.
G-Place of death.
H-Date and time of death or signs of some cronotanatodiagnóstico.
I-Description of clothing and personal items, stain, fingerprints, bleeding, etc..
J-Description of the position of the body and/or orientation.
K-Description of injuries, nature, area, shape, number, size, direction, characters.
L-Background.
M-Name and a coroner.
N-Issue the death certificate.
Cadaveric Destructive Processes:
Putrefaction:
A transformative destructive abiotic sign, characterized by the decomposition of organic matter proteinita with fermentation gas production.
Evolution:
It starts at the end of rigid, ie after 24 – 36 hours of death. Saprophytic bacteria agency aerobic type, found throughout the digestive tract on the first microorganisms are beginning to act. Van remaining oxygen consuming tissues of the body to make way for anaerobic bacteria to reproduce and proliferate albuminoids decomposing substances, leading to chemical bodies simpler, releasing abundant gases (hydrogen sulphide). The body is modified to lead to its destruction still remain the most bones, teeth, hair, nails, and other components of calcareous nature.
Phase Color or Color:
Characterized by the presence of the green spot, which begins at the abdomen at the level of the right iliac fossa, extending to the rest of the abdomen and whole body. Green color is due to oxidation of hemoglobin begins within 24 hours of death and lasts several days (3-5 days).
Emphysematous or Gas Phase:
Recaracteriza by the great production of biogas can invade the subcutaneous tissue bulging thoracic and abdominal cavity, bulging eyeballs, and any region of the body having loose tissue, so the scrotum and vulva of the bodies acquire a macrosomic aspect, gigantic and very characteristic. At the level of circulating blood vessel, having penetrated the resulting gases by blood circulation to the periphery. This phase has a duration of several days to two weeks to escape the gas.
Liquefaction or Liquefaction Phase:
The liquid exude tissue produces lifting of the epidermis, appearing large blisters or fluid-filled blebs reddish brown. Leads to the appendages (nails and hair). The eyeballs are depressed, fluid comes out through the nostrils, Torco abdominal cavity is depressed. All viscera undergo this process of liquefaction. It lasts eight to twelve months.
Phase Skeleton:
The viscera, muscle mass, and eventually parts become an amorphous mass, which is available on the sides of the spine putrílago denominating. This period varies from two to five years. In the thorax, sternum, and ribs desisertan, the same process has the spine and the head that has broken the lower jaw, and the same fate occurs in the extremities, carried the corpse to a total skeleton. According to the age of the skeleton are of three types; Recent (where conservation is seen in the medulla, cartilage, and ligaments); skeleton of median data (no waste of cartilage and bone marrow is gone, 10 to 15 years) and old skeleton, of a standing of more than 25 years, since the drying is complete and total bone. Now, all these phases do not occur one after the previous one has disappeared, but it is happening without the prior completely disappeared.
.- There are influences or conditions that affect the evaluation of putrefaction which are classified schematically below:
Individual conditions:
Old constitution constitutional elements.
Environmental conditions: .- Aeration. .- Temperature: cold and heat. .- Humidity.
Saponification:
A sign abiotic, transformative, conservative, showing the formation of an oily material, oily and slippery in wet body. It is also called the adipocere. It is due to the decomposition of body fat into glycerol and fatty acids. It is characterized not begin before the sixth week of death and is seen in sites that have more body fat, and subcutaneous tissue of the skin. No aeration is required. There are two types of saponification: The recent Froth: occurring or slippery oily to the touch, allowing molded with finger pressure, allowing divided with an instrument, and in these cases, it is possible to recognize through the skin into deeper tissues, muscles, aiming, etc.., so the forensic importance is significant.
Saponification ANTIGUA:
Presented hard, dry, brittle, homogeneous structure and crumbles when you try to section him. It is also important to note that saponification may be in the body in whole or in part.
Forensic importance. When saponification is complete, an injury can be demonstrated through the skin, if you’ve been in the underlying anatomical areas, although they are produced long before and could cause death evident, for example, a wound, a choke groove, etc.. The other forensic importance in the possible identification of the corpse.
Allowing the forensic investigation:
It is a sign abiotic transformative conservative, characterized by the consistent appearance throughout its length that has the skin of the body, very similar to the leather. It requires no less than two years to produce and establish conservation cadaverous process in full. The manifestations of the same are represented by severe dehydration and drying of all tissues, consistency, flexibility, and maintenance of the skin that takes a grayish yellow color and the townhouse of the skin to underlying tissues and anatomical elements that shapes them, outwardly expressing its structure and viscera and volume shrink by drying.
MEDICAL – LEGALLY CAN BE OBTAINED:
Identification of the body. Identify injuries and therefore the cause of death.
MUMMIFICATION:
A process of drying the body, due to dehydration of the evaporation of the liquid holders, giving rise to persist outside the body shape dramatically, occurring naturally or spontaneously, and in an artificial or induced.
Requirements. To produce mummification occurring requires certain environmental conditions, mainly related to temperature, humidity, and ventilation. As for the temperature factor requires a high temperature. The aeration factor must be present to provide abundant oxygen: facto and humidity should be low.
INDIVIDUAL FACTORS IN THE PRODUCTION OF THE SON MUMMIFICATION:
Age:
In children, mummification is easier because the dehydration of the tissues is more intense.
Constitutional factor:
It’s easier and often in asthenic, which in pyknic habits.
Factor sex:
It is more common in women than in men.
Cause of death: S and seen more often in those who have died from heavy bleeding, dehydration, or have had prolonged treatment with antibiotecoterapia.
EVOLUTION:
The spontaneous mummification, start first by the anatomical regions displayed, such as: face, hands, and feet, progressing then to the rest of the body in a time of one year or more.
FEATURE:
Great consistency of the skin and integument.
Great loss of body weight and volume of the body giving the appearance of being younger.
The conservation of the ways the body is remarkable, that can recognize the traits significantly.
The duration and persistence of it is of great medicolegal importance.
The characteristics we have described allows us to obtain data of great forensic interest, which are:
1.-Identification of the body. 2 .- The cause of death is possible in many cases. 3 .- The time of death.
THEME II DEATHS
Apparent Death:
The disease status of the human body that has an attenuation of vital functions, to such an extent that it appears that vital signs were abolished. Has the following features: A-Loss of consciousness. B-neuro-muscular immobility. C-apparent absence of heartbeat and pulse and breathing movements, although in reality, these signs are too weak to come to pass unnoticed but they are never totally abolished. This type of death apparently seen in: A – state of severe coma, syncope, concussion. B – In severe poisoning. C – In cases of psychiatric diseases such as conversion Neurosis (Hysteria). D – Member of mechanical asphyxia as submersion, catalepsy. Said Dr. Risquez is common knowledge that some states of catalepsy simulating death, to the point of having given rise to frequent burials defatting fed infants. He said the case of the late Mexican artist Joaquin Pardave, who was buried and exhumed after being found in prone position inside the coffin.
Death On:
It is a state characterized by the effective suspension of the functions cardiovasculatorias, respiratory, and neurological, which can be achieved through extraordinary measures preanimación, the revival of the individual.
Middle Death:
The state in which gradually extinguished the biological activities of survival and are no longer available with resuscitation get back to the vitality of the whole human organism. Eg In a state of cerebral anoxia with decerebrate or plant life.
Absolute Real or Death:
It is the total disappearance of all vital activity.
Sudden Death:
The death comes unexpectedly, on any violent cause in a person who, by dint of their apparent health status or disease that does not inspire immediate fears to expect a fatal outcome.
Violent Death:
The death from external causes of mechanical, physical, or chemical, and rapid effects. Death eg winding, by a gunshot wound, poison. Etc.
Death:
It is characterized by the full suspension, permanent, and irreversible brain functions.
Brain Death:
It is characterized by the full suspension, permanent, and irreversible brain functions.
Sudden Death:
The death that occurs quickly in an individual suffering from a disease, either acute or chronic, who awaits his death.
Inhibition Death:
A sudden death occurs within seconds or at most a minute or two in people who have suffered trauma or a stimulus sensoperceptive minimum, which is normally harmless in most people.
Natural Death:
The death from a disease or a result of disease of any cause, whether infectious, tumoral, degenerative, and so on., And where there is no external cause has intervened violently.
Legal Death:
Death certificate.
Agony:
The time from death to survive, in a non-sudden. Etymologically it means fighting. It is important medico – legal diagnosis of agony, because in this state is a decrease of the psyche, ie, brain function, which has enormous legal implications, for example. The annulment of a will or a power of attorney without the clarity required for the above legislation. It describes three ways traditionally agony: The Lucida, the comatose, and delirious.
Just as the dying, who is a patient is entitled to:
1-Require physicians who assist him and other health team members, a degree of professional competence elevpado and expect the same impeccable moral conduct.
2 – To be treated in a respectful and cordial physician and other health team members.
health team members.