Download - Thanatologi International 2007
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Thanatology
Dr. Cahyono Kaelan Sp.PA(K), PhD , DFM.
Dept of Forensic PathologyFac. of Medicine Unhas
Makassar
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Meaning and Definition
• Thanatos = Death• Logos = Science
• Thanatology = Science describing of the causes and changes after death.
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Purposes of Thanatology
1. Diagnosis of death(Scene )
2. Determine time of death(Alibi)
3. Predict the Cause of death
4. Predict the manner of death
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DEATH • Definition : What is death?
1. Death = Soul separates with body 2. Brain death 3. Coma 4. Unconscious (decrease of consciousness) 5. Wake = Live
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Definition of DEATH
Human = 2 dimensions (individual and collection of cells
Death• 1. Live is breathing and function of vital
s(Lung, heart and brain) Marked by Oxygen consumption
• Death = Stop oxygen consumption. Permanent Stop function of vital organ (lung, heart and brain) do not need Oxygen anymore
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Defines Death (cont)
2. Cellular death= lack of Oxygen cells die. In the brain cell only lasting of 7 minutes
3. Brain death = Stop of brain function, even other organ still working due to respirator)
4. Indonesian Doctors Association (IDI,1989), follows death when is brain death
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How to define Death
Stopping vital functions (H,L) 10 minutes
Respirator (breathing apparatus) this criteria does not fit
Now taken “Brain death = is death”How to justify Brain death ?
Taken from the most lasting part of the brain ( brain stem), other has gone
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Methods?• No Response on command/• Loss of stimuli• Reflexes of pupil, corneal, cough
(-))• Ice stimuli to inner ear
disappear(-)• Stopping respirator no
spontaneous response• EEG flat• Need # 3 doctors (Anesthetist,
Neurologist and other) ICU
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Simple Test on Death Scene• Auscultation (no heart beat) need
time + larynx• Winslow test: glass of water put on
the top of belly ( moving still alive)• Mirror Test : Mirror and spectacle
damp / blurred still alive• Feather Test : moving of Chicken
feather or cotton on nostril –due to respiration alive
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II. Changes after death
• Face• Muscle relaxation• Eyes• Body temp• Livor Mortis• Rigor Mortis (Stiffness)• Putrefaction
(Decay/Decomposition)
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Skin Face
• Face Pale no blood running anymore, exception of CO intoxication Cherry red
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Muscle relaxation• Relaxation of muscle and muscle
tone decrease Yaw goes down, open mouth need to be tied up the yaw.
• Relaxation of face muscles a younger looking than his real age.
• Pupil (eye) wider / dilatation• Relaxation of muscles start from
heart , neck muscles, face than followed by upper extremity and the rest of the body weak toneless
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Changes of Eye• No shine (damp sight) empty (death
fish eye)• Light and corneal reflexes (-)• Retinal Vein damage in 10 seconds• Corneal dry and blurred• Decrease of eyeball tone (softness of
eye ball)
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Body Temperature
• Decrease of body temp• Except bacterial infection (sepsis warm)• Depend on vicinity temperature• Location / Medium (Water > quicker than
room temp)• Body constituent : Thin > Fat• Clothing : Thin > thick • Estimation only when death within <12 hrs
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Livor Mortis
• Due to gravity force• Blood pool into blood vessel on the lower surface• Occurred 1- 2hours after death• Potision lie on the back appear on the back of
the body, back, buttock, and extremities and vice versa
• > 4 hrs capillary and blood corpuscle damage livor permanently
• >12 hrs livor will not changes anymore• • Color of Livor : Red (Cherry red CO) Chlorate
Brown , Asphyxia Black.
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Rigor Mortis =Postmortem Rigidity• ATP ADP + LA• Small muscle first ( Face, palpebrae,
Jaw) due to less of Glycogen• Heart, neck, face, extremity and
upper part of body and other• Occur 6 hours after death• 12 hrs all part of the body stiff• 12- 36 hrs persistent stiff (rigorous)u• >48 hrs return of relaxation
(Secondary)
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Decay = Putrefaction = Decomposition• Autolysis=Mikrobacteria• Coecum region• Gas putrefection• 48 hrs• Change in color on right bottom
region belly Greenish • Gas H2S + Hb Sulf-Met-Hb
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Putrefaction signs• Greenish in color (Coecum region)• Superficial vein dilatation• Swelling of face• Abdominal distended (gases)• Scrotum / vulva Swelling• Skin blister• Fluid come up through mouth and nose• Tongue and eye ball protruded out• Belly and chest blast due to gas pressure• Hair and nail easy to pull or discharges• Internal organ decays and porridge like Uterus,
brain, spleen , lung, kidneys. But a little lasting are prostate for male and uterus on female
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Special Circumstances1.Mummification: Dry of air , cool, low humidity no bacterial
contamination after a few months• Corpus smaller / shrinkage• Dry• Blackish in color• Skin covered bones• Odorless• Anatomical composition intact
2. Adipocere (Saponifikation): occurred when
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Saponifikation• Fat fatty acid unsaturated fatty
acid saturated fatty acid+ alkali (base)
• Reaction with alkaline forms Salt (Salt not dissolve in water)
• Occurred in part of the body contains fat (check, omentum)
• White in color• Smell sting like decay of coconut oil
• FAT + alkali SALT (Soap)
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Summary
1. Vital signs2. Brain death3. Changes after death
4. Postmortem changes(Early to late)
5. Purposes of Thanatology
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Reference.
• 1. Forensic Medicine • 2. Forensic Pathology
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THANK YOU