Cadaveric spasm

Cadaveric spasm, also known as postmortem spasm, instantaneous rigor, cataleptic rigidity, or instantaneous rigidity, is a rare form of muscular stiffening that occurs at the moment of death and persists into the period of rigor mortis.[1] Cadaveric spasm can be distinguished from rigor mortis as the former is a stronger stiffening of the muscles that cannot be easily undone, as rigor mortis can.[2]

The cause is unknown but is usually associated with violent deaths under extremely physical circumstances with intense emotion.[3]

Manifestation

Cadaveric spasm may affect all muscles in the body, but typically only groups, such as the forearms, or hands. Cadaveric spasm is seen in cases of drowning victims when grass, weeds, roots or other materials are clutched, and provides evidence of life at the time of entry into the water. Cadaveric spasm often crystallizes the last activity one did before death and is therefore significant in forensic investigations, e.g. holding onto a knife tightly.[4]

Physiological mechanism

ATP is required to reuptake calcium into the sarcomere's sarcoplasmic reticulum (SR). When a muscle is relaxed, the myosin heads are returned to their "high energy" position, ready and waiting for a binding site on the actin filament to become available. Because there is no ATP available, previously released calcium ions cannot return to the SR. These leftover calcium ions move around inside the sarcomere and may eventually find their way to a binding site on the thin filament's regulatory protein. Since the myosin head is already ready to bind, no additional ATP expenditure is required and the sarcomere contracts.

When this process occurs on a larger scale, the stiffening associated with rigor mortis can occur. It mainly occurs during high ATP use. Sometimes, cadaveric spasms can be associated with erotic asphyxiation resulting in death.

Cadaveric spasm has been posed as an explanation for President Kennedy's reaction to the fatal head shot in his 1963 assassination, to indicate why his head moved backward after the shot.

Controversy

Matthias Pfaffli and Dau Wyler, Professors of Legal Medicine at University of Bern, Switzerland, posed five requirements in order for a death to have been observed and classified as containing a cadaveric spasm:

  1. The body part hypothesized as having undergone cadaveric spasm must be freestanding against the force of gravity[5]
  2. The deceased must be observed before the rigor mortis has developed [6]
  3. There must be adequate and continuous documentation of post mortem changes in respect to the lividity of the deceased
  4. The scene of the death must be undisturbed before examination of the crime scene
  5. No third party may be present at the death to ensure no manipulation of the body

Because of the improbability that all of these requirements may be examined in one subject, cadaveric spasms are unlikely to be consistently documented and therefore proved existent.[5]

Very little to no pathophysiological or scientific basis exists to support the validity of cadaveric spasms. Chemically, this phenomenon cannot be explained as being analogous to “true” rigor mortis. Therefore, a variety of other factors have been examined and explored in an effort to alternatively account for the cases of supposed instantaneous rigor mortis that have been reported. In a study reported in The International Journal of Legal Medicine, there was no consistent evidence of cadaveric spasms even in deaths of the same type. Out of 65 sharp-force suicides, only two victims still held their weapon post mortem. This low incidence rate suggests that genuine cadaveric spasm was not exhibited.[4] Gravity may play a large factor in the trapping of limbs and other objects under the body at the time of death, and the subsequent observed placement of limbs after death.[6] In fatalities related to cranial or neural injury, nerve damage in the brain may inhibit the ability to release a weapon from the hand.[4] The flexion of agonist and antagonist muscles in conjunction may additionally contribute to the observed fixation of an object or weapon.[5]

References

  1. ^ "Postmortem Changes and Time of Death" (PDF). Dundee.ac.uk. Archived from the original (PDF) on 2012-09-05. Retrieved 2012-08-22.
  2. ^ KNÜSEL, CHRISTOPHER (1996). "DEATH, DECAY, AND RITUAL RECONSTRUCTION: ARCHAEOLOGICAL EVIDENCE OF CADAVERIC SPASM". Oxford Journal of Archaeology. 15: 121–128.
  3. ^ Lyle, Douglas P. (2004). Forensics for Dummies. Indianapolis, Indiana: Wiley Publishing, Inc. p. 165. ISBN 978-0-7645-5580-0.
  4. ^ a b c Bedford, Paul J.; Tsokos, Michael (2013-06-01). "The occurrence of cadaveric spasm is a myth". Forensic Science, Medicine, and Pathology. 9 (2): 244–248. doi:10.1007/s12024-012-9391-5. ISSN 1547-769X. PMID 23179991.
  5. ^ a b c Pirch, J.; Schulz, Y.; Klintschar, M. (2013-09-01). "A case of instantaneous rigor?". International Journal of Legal Medicine. 127 (5): 971–974. doi:10.1007/s00414-013-0881-0. ISSN 0937-9827. PMID 23801091.
  6. ^ a b Madea, Burkhard (2013-06-01). "Cadaveric spasm". Forensic Science, Medicine, and Pathology. 9 (2): 249–250. doi:10.1007/s12024-012-9403-5. ISSN 1547-769X. PMID 23288693.

Bibliography

  • Jayawardena, Hemamal, Forensic Medicine and Medical Law, 2 Eds (2004), Siddhartha Press, Colombo Sri Lanka.
Algor mortis

Algor mortis (Latin: algor—coldness; mortis—of death), the second stage of death, is the change in body temperature post mortem, until the ambient temperature is matched. This is generally a steady decline, although if the ambient temperature is above the body temperature (such as in a hot desert), the change in temperature will be positive, as the (relatively) cooler body acclimates to the warmer environment. External factors can have a significant influence.

The term was first used by Dowler in 1849. The first published measurements of the intervals of temperature after death were done by Dr John Davey in 1839.

Cadaver

A cadaver is a dead human body that is used by medical students, physicians and other scientists to study anatomy, identify disease sites, determine causes of death, and provide tissue to repair a defect in a living human being. Students in medical school study and dissect cadavers as a part of their education. Others who study cadavers include archaeologists and artists.The term cadaver is used in courts of law to refer to a dead body, as well as by recovery teams searching for bodies in natural disasters. The word comes from the Latin word cadere ("to fall"). Related terms include cadaverous (resembling a cadaver) and cadaveric spasm (a muscle spasm causing a dead body to twitch or jerk). A cadaver graft (also called “postmortem graft”) is the grafting of tissue from a dead body onto a living human to repair a defect or disfigurement. Cadavers can be observed for their stages of decomposition, helping to determine how long a body has been dead.Cadavers have been used in art to depict the human body in paintings and drawings more accurately.

Dead on arrival

Dead on arrival (DOA), also dead in the field and brought in dead (BID), indicates that a patient was found to be already clinically dead upon the arrival of professional medical assistance, often in the form of first responders such as emergency medical technicians, paramedics, or police.

In some jurisdictions, first responders must consult verbally with a physician before officially pronouncing a patient deceased, but once cardiopulmonary resuscitation is initiated, it must be continued until a physician can pronounce the patient dead.

Death messenger

Death messengers, in former times, were those who were dispatched to spread the news that an inhabitant of their city or village had died. They were to wear unadorned black and go door to door with the message, "You are asked to attend the funeral of the departed __________ at (time, date, and place)." This was all they were allowed to say, and were to move on to the next house immediately after uttering the announcement. This tradition persisted in some areas to as late as the mid-19th century.

Death pose

Dinosaur and bird fossils are frequently found in a characteristic posture consisting of head thrown back, tail extended, and mouth wide open. The cause of this posture—sometimes called a "death pose"—has been a matter of scientific debate. Traditional explanations ranged from strong ligaments in the animal's neck desiccating and contracting to draw the body into the pose, to water currents randomly arranging the remains in the position.Faux and Padian suggested in 2007 that the live animal was suffering opisthotonus during its death throes, and that the pose is not the result of any post-mortem process at all. They also reject the idea of water as responsible for randomly arranging the bodies in a "death pose", as different parts of the body and the limbs can be in different directions, which they found unlikely to be the result of moving water. They also found that the claim that drying out of ligaments would make the position does not seem believable either.

Alicia Cutler and colleagues from Brigham Young University in Provo, Utah, think it is related to water. In 2012, paleontologists Achim G. Reisdorf and Michael Wuttke published a study regarding death poses. According to the conclusions of this study, the so-called "opisthotonic posture" is not the result of a cerebral illness creating muscle spasms, and also not of a rapid burial. Rather, peri-mortem submersion resulted in buoyancy that enabled the Ligamentum elasticum to pull the head and tail back.

Death rattle

Terminal respiratory secretions (or simply terminal secretions), known colloquially as a death rattle, are sounds often produced by someone who is near death as a result of fluids such as saliva and bronchial secretions accumulating in the throat and upper chest. Those who are dying may lose their ability to swallow and may have increased production of bronchial secretions, resulting in such an accumulation. Usually, two or three days earlier, the symptoms of approaching death can be observed as saliva accumulates in the throat, making it very difficult to take even a spoonful of water. Related symptoms can include shortness of breath and rapid chest movement. While death rattle is a strong indication that someone is near death, it can also be produced by other problems that cause interference with the swallowing reflex, such as brain injuries.It is sometimes misinterpreted as the sound of the person choking to death, or alternatively, that they are gargling.

Dignified death

Dignified death is a somewhat elusive concept often related to suicide. One factor that has been cited as a core component of dignified death is maintaining a sense of control. Another view is that a truly dignified death is an extension of a dignified life. There is some concern that assisted suicide does not guarantee a dignified death, since some patients may experience complications such as nausea and vomiting. There is some concern that age discrimination denies the elderly a dignified death.

Dysthanasia

In medicine, dysthanasia means "bad death" and is considered a common fault of modern medicine.Dysthanasia occurs when a person who is dying has their biological life extended through technological means without regard to the person's quality of life. Technologies such as an implantable cardioverter defibrillator, artificial ventilation, ventricular assist devices, and extracorporeal membrane oxygenation can extend the dying process.

Dysthanasia is a term generally used when a person is seen to be kept alive artificially in a condition where, otherwise, they cannot survive; sometimes for some sort of ulterior motive. The term was used frequently in the investigation into the death of Formula One driver Ayrton Senna in 1994.The etymology of the term is from the Greek language: δυσ, dus; "bad, difficult" + θάνατος, thanatos; "death".

Lazarus sign

The Lazarus sign or Lazarus reflex is a reflex movement in brain-dead or brainstem failure patients, which causes them to briefly raise their arms and drop them crossed on their chests (in a position similar to some Egyptian mummies). The phenomenon is named after the Biblical figure Lazarus of Bethany, whom Jesus Christ raised from the dead in the Gospel of John.

Maceration (bone)

Maceration is a bone preparation technique whereby a clean skeleton is obtained from a vertebrate carcass by leaving it to decompose inside a closed container at near-constant temperature. This may be done as part of a forensic investigation, as a recovered body is too badly decomposed for a meaningful autopsy, but with enough flesh or skin remaining as to obscure macroscopically visible evidence, such as cut-marks. In most cases, maceration is done on the carcass of an animal for educational purposes.

Megadeath

Megadeath (or megacorpse) is one million human deaths, usually caused by a nuclear explosion. The term was used by scientists and thinkers who strategized likely outcomes of all-out nuclear warfare.

Necronym

A necronym (from the Greek words νεκρός, nekros, "dead" and ὄνομα ónoma, "name") is a reference to, or name of, a person who has died. Many cultures have taboos and traditions associated with referring to such a person. These vary from the extreme of never again speaking the person's real name, often using some circumlocution instead, to the opposite extreme of commemorating it incessantly by naming other things or people after the deceased.

For instance, in some cultures it is common for a newborn child to receive the name (a necronym) of a relative who has recently died, while in others to reuse such a name would be considered extremely inappropriate or even forbidden. While this varies from culture to culture, the use of necronyms is quite common.

Necrophobia

Necrophobia is a specific phobia which is the irrational fear of dead things (e.g., corpses) as well as things associated with death (e.g., coffins, tombstones, funerals, cemeteries). With all types of emotions, obsession with death becomes evident in both fascination and objectification. In a cultural sense, necrophobia may also be used to mean a fear of the dead by a cultural group, e.g., a belief that the spirits of the dead will return to haunt the living.Symptoms include: shortness of breath, rapid breathing, irregular heartbeat, sweating, dry mouth and shaking, feeling sick and uneasy, psychological instability, and an altogether feeling of dread and trepidation. The sufferer may feel this phobia all the time. The sufferer may also experience this sensation when something triggers the fear, like a close encounter with a dead animal or the funeral of a loved one or friend. The fear may have developed when a person witnessed a death, or was forced to attend a funeral as a child. Some people experience this after viewing frightening media.The fear can manifest itself as a serious condition. Treatment options include medication and therapy.The word necrophobia is derived from the Greek nekros (νεκρός) for "corpse" and the Greek phobos (φόβος) for "fear".

Outline of death

The following outline is provided as an overview of and topical guide to death:

Death – termination of all biological functions that sustain a living organism.

Pallor mortis

Pallor mortis (Latin: pallor "paleness", mortis "of death"), the first stage of death, is an after-death paleness that occurs in those with light/white skin.

Post-mortem interval

Post-mortem interval (PMI) is the time that has elapsed since a person has died. If the time in question is not known, a number of medical/scientific techniques are used to determine it. This also can refer to the stage of decomposition of the body.

Rigor mortis

Rigor mortis (Latin: rigor "stiffness", mortis "of death"), or postmortem rigidity, is the third stage of death. It is one of the recognizable signs of death, characterized by stiffening of the limbs of the corpse caused by chemical changes in the muscles postmortem. In humans, rigor mortis can occur as soon as four hours after death.

Skeletonization

Skeletonization refers to the final stage of decomposition, during which the last vestiges of the soft tissues of a corpse or carcass have decayed or dried to the point that the skeleton is exposed. By the end of the skeletonization process, all soft tissue will have been eliminated, leaving only disarticulated bones. In a temperate climate, it usually requires three weeks to several years for a body to completely decompose into a skeleton, depending on factors such as temperature, humidity, presence of insects, and submergence in a substrate such as water. In tropical climates, skeletonization can occur in weeks, while in tundra areas, skeletonization may take years or may never occur, if subzero temperatures persist. Natural embalming processes in peat bogs or salt deserts can delay the process indefinitely, sometimes resulting in natural mummification.The rate of skeletonization and the present condition of a corpse or carcass can be used to determine the time of death.After skeletonization, if scavenging animals do not destroy or remove the bones, acids in many fertile soils take about 20 years to completely dissolve the skeleton of mid- to large-size mammals, such as humans, leaving no trace of the organism. In neutral-pH soil or sand, the skeleton can persist for hundreds of years before it finally disintegrates. Alternately, especially in very fine, dry, salty, anoxic, or mildly alkaline soils, bones may undergo fossilization, converting into minerals that may persist indefinitely.

Spasm

A spasm is a sudden involuntary contraction of a muscle, a group of muscles, or a hollow organ such as the heart.

A spasmodic muscle contraction may be caused by many medical conditions, including dystonia. Most commonly, it is a muscle cramp which is accompanied by a sudden burst of pain. A muscle cramp is usually harmless and ceases after a few minutes. It is typically caused by ion imbalance or muscle overload.

There are other causes of involuntary muscle contractions, and some of these may cause a health problem.

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