Unit 7 Mortality

1. Unit 7 Mortality Students will investigate various aspects of death and dying.

2. Vocabulary • Anatomical Position • Superior, Inferior • Anterior, Posterior • Dorsal, Ventral • Medial, Lateral • Proximal, Distal • Bilateral, Unilateral • Deep, Superficial • Parietal, Visceral • Supine, Prone • Body Cavities • Body Quadrants • Body Regions • Accidental death • Suicidal death • Homicidal death • Natural death • Undetermined death • Autopsy • Algor Mortis • Rigor Mortis • Taphonomy • Putrefaction • Black Putrefaction • Dry decay • Butyric fermentation

3. ANATOMICAL POSITION • The position where the body is standing with the arms at the sides and the palms forward. • Of importance in anatomy because it is the position of reference for anatomical terms. • Anatomic terms such as anterior and posterior, medial and lateral, abduction and adduction, and so on apply to the body when it is in the anatomical position.

5. Body Planes • Human movements are described in three dimensions based on a series of planes and axis. There are three planes of motion that pass through the human body. • sagittal plane • frontal plane • transverse (horizontal) plane • The sagittal plane lies vertically and divides the body into right and left parts. • The frontal plane also lies vertically however divides the body into anterior and posterior parts. • The transverse plane lies horizontally and divides the body into superior and inferior parts.

6. Body Planes

7. Directional Terms • Anterior: Toward or on the front of the body: in front of • The pectorals are on the anterior aspect of the body • Posterior: Towards or on the back of the body: behind • The rhomboids are on the posterior aspect of the body • Superior: Toward the head or upper part of a structure: above • The humerus is superior to the radius • Inferior: Toward the lower part of a structure: below • The tibia is inferior to the femur • Medial: Toward or at the midline of the body: inner side • The adductors are on medial to the abductors • Lateral: Away form the midline of the body: outer side • The abductors are on the lateral aspect of the leg

8. Directional Terms • Proximal: Closer to the origin of a point of reference • The elbow is proximal to the wrist • Distal: Further from the origin or point of reference • The foot is distal to the knee • Dorsal: Near the upper surface, toward the back • The vertebrae are dorsal to the heart. • Ventral: Toward the bottom, toward the belly • The liver is ventral to the stomach. • Deep: Towards the interior or inside of. • The pancreas is deep to the liver. • Superficial: Towards the surface or outside of. • The skin is superficial to the muscles.

9. Parietal: of or relating to the walls of a part or cavity; of, relating to, or forming the upper posterior wall of the head • The parietal wall of the abdomen. • Visceral: felt in or as if in the internal organs of the body; of, relating to, or located on or among the viscera • The pain was visceral. • Supine: Lying down with the face upwards • The body was in the supine position in preparation of an appendectomy. • Prone: Lying down with face downwards • The body was found in a prone position.

10. BODY CAVITIES • 1. Dorsal cavity • a. cranial cavity • b. spinal cavity • 2. Ventral Cavity • a. abdominal cavity • b. pelvic cavity • c. thoracic cavity

12. Body Quadrants 1. Right Upper Quadrant (RUQ) 2. Right Lower Quadrant (RLQ) 3. Left Upper Quadrant (LUQ) 4. Left Lower Quadrant (LLQ) What organs are in each quadrant?

14. Body Regions What organs are in each region? 1. Right hypochondriac 2. Epigastric 3. Left hypochondriac 4. Right lumbar 5. Umbilical 6. Left Lumbar 7. Right inguinal 8. Hypogastric 9. Left inguinal

16. Manner vs Method (cause) of Death • The MANNER of a person's death is a legal determination or finding based on evidence and opinion. • There are 5 types of manners of death • The METHOD (cause) of death is a medical determination or finding based on evidence and opinion. • Asphyxia, gunshot, stabbing, blunt force trauma, cancer, etc.

17. Five different manners of Death • Accidental, Suicidal, Homicidal, Natural, Undetermined • A. Accidental death: Death that happens by chance and was not planned or expected. • B. Suicidal death: The intentional taking of one’s own life. • C. Homicidal death: The act of a human killing another human being. Often called murder. • D. Natural death: Death that occurs from physiological or biological functions. This is the cause of the majority of deaths. • E. Undetermined death: Reason(s) for death cannot be determined/proven.

18. Autopsy Tupac Skakur: post-autopsy photo: “The official cause of death was noted as respiratory failure and cardiopulmonary arrest in connection with multiple gunshot wounds.[“ Wikipedia

19. Autopsy Procedure • An autopsy is done by a coroner or pathologist. • It reveals the cause of death, approximate time of death and weapons that were used in the death. • Permission from the next of kin must be obtained when the law does not require an autopsy to be done. • An autopsy procedure: • http://video.nationalgeographic.com/video/player/science/health-human-body-sci/human-body/real-csi-sci.html • http://www.nlm.nih.gov/visibleproofs/galleries/media/autopsy/index.html

20. Steps of an Autopsy • Steps of an autopsy procedure • 1. External examination performed • Photographed from head to toe • All physical characteristics documented • Body measured, weighed and x-rayed. • Fingerprints obtained. • 2. Y-shaped incision made • Deep cut made from the front of each shoulder to the bottom end of the sternum; then to the pubic bone. • Skin peeled back with the top flap placed over the face.

21. Steps of an Autopsy • Steps of an autopsy procedure • 3. Internal examination • Chest cavity opened with an electric saw. • Ribs are sawn off and the anterior chest wall is cut away to expose the organs that are underneath. • 4. Internal organs removed and weighed • 5. Brain is removed • Skull is cut with an electric saw to create a cap. • Then a transverse incision is made through the brainstem so the brain can be removed.

22. Steps of an Autopsy • Steps of an autopsy procedure • 6. Intestines are drained • 7. Stomach is opened and drained • 8. Samples are taken from the tissues and organs. • 9. Major blood vessels are cut open and examined. • 10. Internal organs returned to the body and the head and chest are sewn up.

23. Determining Cause of Death through evidence from an autopsy • Visual examination • Organ examination • Wound/trauma marks analyzed • Toxicology reports (drugs, alcohol, etc – blood work) • Histology reports (slides of tissues – cancer, etc) • Cause of Death vs. Manner vs. Mechanism • What was the body’s physical reason for death (cause). • What caused the physical reason for death (manner)

24. Malcolm X

25. Jon Benet Ramsey medical report • http://crimeshots.com/AutopsyReport.html

26. Taphonomy: AKA Decomp • Taphonomy is science that studies decomposition over time. • Decomposition rates are HIGHLY VARIABLE. The days listed in the next section are based on temperatures of 70-90 degrees with moderate to lower humidity. Stages of decomposition • 1. Fresh stage • a. Occurs in the first few days, 0-3 days • b. Autolysis begins- destruction of cells and organs • c. Algor mortis occurs • d. Attracts insects that begin to lay eggs

28. Taphonomy: AKA Decomp • 2. Putrefaction stage (days 4-10) • a. Follows the fresh stage until about day 10 post mortem • b. Odor, color change and bloating occur to the body • c. A green color begins in the abdomen and spreads throughout the body because the bacteria within the body is breaking down. • d. Skin in fragile and the body hairs fall off • Black Putrefaction days 10-20

31. Taphonomy: AKA Decomp • Butyric Fermentation stage • a. Body odor is lost • b. Body begins to dry out and becomes mummified • C. Days 20-50 • http://australianmuseum.net.au/image/Butyric-fermentation-20-to-50-days

33. Taphonomy: AKA Decomp • 5. Dry Decay stage • a. Slow and longest stage of decomposition 50-375 days • b. Body becomes skeletonized: deterioration of the skeletal remains

35. Rigor mortis • Rigidity of the skeletal muscles after death. • After death the muscles relax and release ATP as the muscle breaks down making the muscles become rigid. • Begins in the smaller muscles of the jaw, neck and face. • Noticeable stiffness will occur within 3 hours of death. • Rigor mortis is affected by the environmental factors

36. Livor mortis • Postmortem lividity • The pooling of the blood in the body after the heart stops. • Indicated the position of the body at the time of death. • Begins within a half of an hour following death. • Most evident at approximately 12 hours following death. • After 12 hours the discoloration will not move no matter how the body is disturbed.

38. Algor mortis • The cooling rate of the body after death • As soon as the body dies there is no longer metabolic functions that keep the body at 98.6 degrees F. • The body temperature will begin to even out with the surrounding environment. • Consideration to the type of clothes, the surface area to body mass and surrounding conditions must be evaluated. • Most accurate temperature to determine time of death should be taken within 1-36 hours of death. • The body will cool at a rate of 1-1.5 degrees F per hour until it reaches the environmental temperature. • However, very difficult to correctly determine due to all the factors which can alter the cooling rate.

39. Insect life cycles (Entomology) • Only certain insects will feed and lay eggs on a dead corpses. Entomologist study the state of development of insects living on a corpse and count back the days to determine time of death. • Most insects follow a sequential life cycle of growth from a fertilized egg to a mature adult. This occurs in four stages.

40. Adult Greenbottle Fly Adult Hairy Rove Beetle Adult green blow fly Adult Hide Beetle Adult Red-tailed Flesh Fly Adult Bluebottle fly

41. Blow Fly Life Cycle • Adult flies lay eggs on a cadaver within minutes of death. • Each adult fly can lay up to 250 eggs. • Within 24 hours these eggs hatch and begin feeding. • After several hours, first-stage maggots molt into second-stage maggots (bigger size). These feed for several more hours until they molt into third-stage maggots (largest). • Masses of third stage maggots can increase the temp around them up to 10 degrees C! • Third-stage maggots crawl away from the food source to turn into a pupa. • The pupa molts into an adult blow fly.

43. Stage 1 • Egg: Deposited by female insect within minutes following death in natural openings and open wounds. Contact: Pam Mitchellinfo@BTERFoundation.org949-278-9756BioTherapeutics, Education & Research Foundation

44. Stage 2 • Larvae: Newly hatched wingless and wormlike form of the insect. Immature stage before metamorphosis occurs. For example a caterpillar, grub or maggot.

45. Stage 3 • Pupa: Non-feeding stage between larvae and adult. During this stage metamorphosis occurs and the insect hides itself in a cocoon or similar structure.

46. Stage 4 • Adult: After all changes have occurred and the insect is fully mature.

47. Environmental factors related to time of death • Temperature of the environment and the season. • Availability of oxygen and air movement. • Surrounding condition and surface the body is resting on. • Humidity. • Rainfall. • Clothing the person dressing in or wrapped in. • Type of burial. • Access of scavengers and insects to the body. • Person body size and weight. • Cause of death. • Any traumatic injuries or wounds.

48. In the right circumstances, a body can become at least partially skeletonized 24 hours after death!