POSTMORTEM CHANGES (Changes after death)

• I. Immediate changes
  a) Stoppage of function of Nervous System
  b) Stoppage of respiration
  c) Stoppage of Circulation
• II. Early changes
  a) Facial Pallor
  b) Loss of elasticity of the skin
  c) Primary relaxation of the muscles
  d) Contact flattening & Pallor
  e) Changes in the eye
• III. Intermediate Changes
  a) Cooling of the body
  b) Postmortem Lividity
  c) Rigor Mortis
• IV. Late changes
  a) Putrefaction
  b) Adepocere formation
  c) Mummification

IMMEDIATE CHANGES
1) Stoppage of function of Nervous System
Ø Loss of sensory functions
Ø Loss of motor function
Ø Loss of reflexes
Ø Loss of tonicity of the muscles

2) Stoppage of respiration
Total stoppage of respiration can be established by the following tests
1. Inspection
2. Palpation
3. Auscultation
4. Feather Test
If a downy feather or a few cotton fibres are held in front of nose, then, if respiration continuing, it will rhythmically move with inspiration and expiration.
5. Mirror Test
The reflecting surface of a mirror is held in front of the nose & mouth the person. If respiration is continuing then the mirror will partly become hazy due to condensation of the moisture of the expired air.
6. Winslow’s Test
A small bowl with water is placed over the chest of the subject with arrangement of some light rays falling on the surface of the water. Slightest movement of the chest wall will disturb the plain of the surface of the water, which can be well marked from the rays of light reflected from the surface of water.

3) Stoppage of Circulation
can be established by the following tests
1. Palpation
§ Radial pulse
§ Brachial pulse
§ Femoral Pulse
§ Carotid pulse

2. Auscultation of heart

3. Diaphanous or Transillumination test
§ The outstretched hand is held against some bright light rays in dark room, if circulation continuing hand will appear pinkish & translucent, if circulation has ceased then the hand will appear yellowish and opaque.
4. Magnus Test
§ A ligature is applied on a finger sufficiently tightly to compress the superficial veins but not the arteries, if circulation is continuing then, after a while the part of finger distal to the ligature will appear swollen & bluish due to venous obstruction.
5. Icard’s Test
§ 1ml of 20% alkaline fluorescein solution is injected in the dermis, if circulation has not stopped the area of yellowish discolouration spreads locally.
6. Pressure Test
§ In a living subject if pressure is applied on the nail of a finger then, it becomes pale but soon becomes red on release of the pressure. In case of cessation of circulation it takes much more time to return to its normal colour.
7. Cut Test
§ If circulation is continuing then, there is active bleeding from a small superficial cut.
8. Heat Test
§ a small area of the skin is brought in contact with some hot (say 100ºC) object.
§ If circulation is continuing then, at the site of contact there will be blister formation surrounded by red ring, if the period of contact is very short then, there may not be any blister formation, but there will be redness over the area of contact.
§ If circulation has stopped then the above changes will not happen. Instead, the area of contact will become dry, firm without any redness.
9. ECG Test