POST MORTEM CHANGES

MUSCULAR CHANGES
AFTER DEATH MUSCLES OF THE BODY
PASS THROUGH THE FOLLOWING THREE
STAGES.THEY ARE:

PRIMARY RIGOR MORTIS

SECONDARY
RELAXATION OR CADAVERIC
FLACCIDITY
OR FLACCIDITY RIGIDITY
 PRIMARY RELAXATION
During this stage, death is only somatic and it lasts for
one to two hours.
All the muscles begin to relax soon after death.
Lower jaw falls, eyelids loose tension, and the joints
are flexible.
Body flattens over areas which are in contact with the
surface on which it rests(contact flattening).
Muscular irritability and response to mechanical and
electrical stimuli persists.
Peristalsis may occur in the bowel, and the ciliary
movements and movement of white cells may
continue.
Anaerobic chemical processes may continue in the
tissue cells, e.g.,The liver cells may dehydrogenate
ethyl alcohol to acetic acid and complex changes
may occur in the muscles.
Pupils react to atropine or physostygmine but not to
light.
Musle protoplasm may be slightly alkaline.
TENDON REACTION OR ZASKO’S
PHENOMENON:

Striking the lower third of the QUADRICEPS

FEMORIS muscle about 10cm. Above the patella
with a reflex hammer causes an upward
movement of the patella because of the
contraction of the whole muscle . This can be
seen upto 1 to 2hrs after death.
RIGOR MORTIS
It is a state of stiffening of
muscles,sometimes with slight shortening of
the fibres.
Individual cell death takes place in this stage.
 STRUCTURE:
 A voluntary muscle consists of bundles of long fibres.
Each fibre is formed by densely packed myofibrils extending
through the whole length.
 These myofibrils are the contractile elements and are made
up of protein filaments of two types –actin and myosin
filaments.
In the relaxed condition the actin filaments interdigitate with
the myosin filaments only to small extent.
Under the influence of nerve impulse ,the arrays of actin
filaments are drawn into the arrays of myosin filament rather
like pistons into the cylinders.
This causes muscle to contract.
MECHANISM:
During life, the separation of actin and myosin filaments,
and the energy needed for contraction are dependent on
adenosinetriphosphate(ATP).
The dephosphorylation of ATP by the action of ATPase
produces ADP and phosphate,and a large amount of
energy which is used for muscle contraction.
The free phosphate then engages in a phosphorylation
reaction that converts glycogen to lactic acid.
Lactic acid enters the blood stream and is reconverted to
glycogen in the liver.
The lost ATP is replaced during life by resynthesis, which
is dependent upon the supply of glycogen.
At the time of somatic death, enough ATP is present in the
muscle to maintain relaxation.
After death the ATP is progressively and irreversibly
destroyed leading to increased accumulation of lactates
and phosphates in the muscles.
There is no resynthesis of ATP.
The postmortem alteration of ATP is due to
dephosphorylation and deamination .
Postmortem loss of integrity of the muscle cell
sarcoplasmic reticulum allows calcium iron to flood the
contractile units of muscle fibres initiating the binding of
actin and myosin molecules and mimicking the normal
contraction process.
Normal relaxation in life is achieved by energy dependent pumping
of calcium back across the membrane of the sarcoplasmic reticulum,
but this fails after death because of membrane disruption and lack of
ATP, due to which increased calcium llevels in sarcomeres causes
muscle contraction.
When the ATP is reduced to a critical level (85% of normal),the
overlapping portions of myosin and actin filaments combine as a
rigid links of actomyosin ,which is sticky and inextensible, and
causes hardness and rigidity of muscle rigor.
The actin-myosin complex is trapped in a state of contraction until it
is physically disrupted by the onset of putrefaction.
This process is characterised by proteolytic detachment of actin
molecules from the end of the sarcomeres and consequent loss of the
structural integrity of the contractile units.
The muscles then soften and relax.
ORDER OF APPEARANCE OF RIGOR
All muscles of the body,both voluntary and involuntary are affected.
It first appears in involuntary muscles,the myocardium becomes
rigid in an hour.
It begins in the eyelids, lower jaw, and neck and passes to the
muscles of the chest ,upper limbs,abdomen,lower limbs and lastly in
the fingers and toes.
The progress of rigor mortis is proximo-distal.
Such a sequence is not constant, symmetrical or regular.
In the individual limbs, it usually passes from above downwards,
Usually passes in the same order in which it has appeared.
Rigor mortis always sets in, increases and decreases gradually.
 DEVELOPMENT:
The development of rigor is concerned with muscles only.
It is independent of the integrity of the nervous system,though it is
said to develop more slowly in the paralysed limbs.
Before rigor mortis develops, the body can be moved any posture,
and the rigor will fix in that posture.
When rigor is developing, the extremities can be moved and the
rigor, temporarily overcome,develops later and fixes the
extremities in their new position, but the rigidity will be less than
other symmetrical groups, which have been not disturbed.
If force is applied when rigor is fully developed,stiffness is broken
up permanently and the rigid muscles may show pm ruptures.
Frequent handling of the body breaks the rigor in certain places.
FEATURES
When rigor is fully developed, the entire body is stiff,the
muscles shortened,hard and opaque ;knees,hips,shoulders and
elbows are slightly flexed and fingers and toes often show
marked degree of flexion.
Rigor of erector pilae muscles may show roughness of skin
known as cutis anserina or goose skin.
Testis may be drawn upto the groin and semen may be forced
out of seminal vesicles, and the pupils may be partially
contracted.
Pm emission of semen may occur agonally or later due to
mortis in dartos of the scrotum, and has no significance.
Rarely if the uterus is in labor at the time of death, the rigor
mortis may cause the uterus to contract and expel the foetus.
 TESTING:
Rigor is tested by trying to lift the
eyelids, depressing the jaw and gently
bending the neck and various joints of
the body.
TIME OF ONSET:
In india,it begins one or two hours after
death and takes further one to two hours to
develop.
In temperate countries,it begins in 3 to 6
hours and further takes two to three hours to
develop.
DURATION:
In India, it begins one or two hours after death and
lasts for 24-48hrs in winter, and 18 to 36hrs in
summer.
It may begin to disappear in about 12hrs in
summer.
These times are variable because of many intrinsic
and extrinsic factors. It lasts for 2-3 days in
temperate regions.
When rigor sets in early, it passes of quickly and
vice versa.
CONDITIONS ALTERING THE
ONSET AND DURATION:
1.AGE
2.NATURE OF DEATH
3.MUSCULAR STATE
4.ATMOSPHERIC CONDITIONS
AGE:
Foetus of less than 7 months- rigor does not
occur
Children- feeble and rapid
Adults- slowly but is well marked
Old people-feeble and rapid
NATURE OF DEATH:
Onset early, duration short-death from
diseases causing great exhaustion and wasting
and also from violent deaths. e.g.- Cholera,
typhoid, firearms,electrocution
Onset early, duration longer-death due to
HCN poisoning
Onset delayed- death from asphyxia, severe
haemorrhage, nervous disoders causing
paralysis of muscles.
MUSCULAR STATE

Onset slow, duration longer- healthy muscles

which are at rest before death
Onset rapid-muscle exhausted before death
ATMOSPHERIC CONDITIONS

Onset slow, duration long- cold weather

Onset rapid, duration short due to heat
because of increased breakdown of atp
MEDICOLEGAL IMPORTANCE

1.SIGN OF DEATH
2.TO SOME EXTENT HELPS IN ESTIMATING
THE TIME OF DEATH ,WHICH IS NOT
RELIABLE.
3.INDICATES THE POSITION OF THE BODY AT
THE TIME OF DEATH.