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There are two phases of death

Def:-Thanatology deals with death in all its aspects. (AIIMS Nov 08)

  1. Extinction of the personality is the immediate sign of vital process: somatic death
  2. Somatic death or clinical death -
    Permanent and irreversible stoppage of respiration, circulation and brain function so called ,tripod of life (this does not hold good now as lung and heart could be maintained on artificial support system).
    Progressive disintegration of the body tissues : molecular or cellular death
  3. Molecular death – the tissues die after varying period of clinical death depending upon the ability of tissues to function without blood supply. The metabolic process of ganglionic cells stops in minutes which are most sensitive where as that of connective tissues stops in hours, which are least sensitive. Nervous tissue die rapidly, vital centers die in about 5 mins, muscles respond up till 1-2 hrs. Molecular death usually occurs 1 – 2 hrs. after somatic death. 

Brain death

It determines death on the basis of

  1. Lack of responsiveness to internal & external environment, complete unresponsiveness to most painful stimuli.
  2. No spontaneous muscular movement or in response to stimuli.
  3. Absence of spontaneous breathing movement for 3 mins.
  4. Absence of excitable reflexes-
    1. Pupil fixed dilated and non reactive to strong stimuli
    2. Absence of corneal and pharyngeal reflexes
    3. No ocular response to ice water stimulation of inner ear
    4. No reflexes except occasional spinal reflex Q. (like deep tendon reflexes).    
    5. No plantar responses
    6. Falling arterial pressure without support by drugs or other means . cessation of spontaneous cardiac rhythm (heart might continue to beat under the effect of drugs or on life-support system)
    7. Isoelectric EEG has confirmatory value.
    8. Flat isoelectric ECG.
    9. Temperature should not be < 320 C

Mode of death

There are three modes of death, depending on whether the death begins in one or other of the three systems, irrespective of what the remote causes of death may be. These modes are:
  1. Coma
  2. Syncope
  3. Asphyxia


Autopsy techniques

  1. Technique of R.Virchow – the organs are removed one by one.
  2. Technique of C. Rokitansky – in-situ dissection and removal of organs. It is specially suited for autopsy on infants.
  3. Technique of A. Ghon (en-block removal) – Removal 0of different organ systems separately. The thoracic, cervical structures, the abdomonal organs and the urogenital systems are all removed separately as organ blocks.
  4. Technique of M. Letulle (en-masse removal): All the organ systems i.e.  the thoracic, cervical, abdominal and pelvic organs are removed as one block. 
    1. Spinal cord is not opened routinely in an autopsy.
    2. It is opened only if some injury is suspected in the spinal cord.
    3. The body is placed prone and an incision is made in the midline extending from occipital protrubence to lower end of the scarum.

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