Cadaveric spots

After the cessation of cardiac activity, blood and lymph, because of their severity begin in blood and lymphatic vessels gradually fall in the underlying departments of the corpse. Accumulated in these departments blood passively extends venous blood vessels and shines through the skin, forming a dead spot.
Localization cadaveric spots depends on the position of the body of a corpse. They are formed on the back and posterolateral surface of neck, chest, waist and extremities with the position of the body at the back. If the corpse is lying on his stomach, cadaveric spots appear on the face, the front surface of the chest and abdomen. For the hanging corpse stains found on a limb (of the forearm and hand, leg and foot), the lower part of the lower back and abdomen. The skin of a corpse, pressed by the weight of the body to the planes, on which lies a corpse, have a grayish white color as the skin vessels in these areas are stavlenniku, blood in them is absent and there are no conditions for the formation of a dead spots. This is most often observed in the neck, shoulders, buttocks, back of the thighs and shins. On the cadaver spots can be seen negative marks of clothes and items under the corpse. Thus, the position of the corpse, if it has not been changed, predetermines the localization of cadaveric spots.
The severity of cadaveric spots depends on many reasons. Rich, which is bottled cadaveric spots occur, for example, when mechanical asphyxia, in which there is a liquid state of the blood and pronounced a plethora of internal organs. Prolonged agony, the formation of red and white bundles that creates an obstacle to the rapid formation of a dead spots. If the death was preceded by the blood, corpse spots usually develop slowly and poorly expressed.
Color cadaveric spots is of great diagnostic value. In case of poisoning with carbon monoxide is formed carboxyhemoglobin, which gives blood is bright red, and cadaveric spots respectively acquire pronounced reddish-pink. When poisoning, causing the formation of methemoglobin (vertoletov salt, nitrite and others) cadaveric spots are grayish-brown.
There is a certain regularity in the formation of a dead spots. Usually celebrated three stages in their development: gepostet, diffusion (or stasis), imbibery.
Stage of gipoteza - the initial period of the formation of cadaveric spots, which is caused by the movement of blood in the lower divisions of the corpse. Cadaveric spots in this stage usually appear in the first 2-4 hours after the time of death, sometimes they are formed later, for example, at heavy blood loss. In the stage of gipoteza color cadaveric spots with pressure disappears completely, as the blood moves from blood vessels. After a few seconds or a minute after you stop pressing their original color is restored. When changing body position cadaveric spots in the stage of gipoteza fully move in the underlying divisions in accordance with the new position of the corpse.
The second stage cadaveric spots - diffusion - usually formed within 12-15 hours after the time of death. During this period, lymph and intercellular liquid gradually diffuse through the walls of blood vessels inside them, dilute the blood plasma, contributing to the hemolysis of erythrocytes. The liquid part of blood also diffuses through the blood vessels and permeates the surrounding tissue. Cadaveric spots in this period do not disappear when pressed, and slowly fade and restore its original color. When changing body position cadaveric spots in the stage of diffusion may be partially transferred to, and appear on a new underlying areas of the body. Previously formed cadaveric spots remain, but their color becomes slightly paler.
The third stage cadaveric spots - hypostatic imbibery, begins to develop by the end of expiration, days after his death, continuing to increase in the subsequent hours. Liquid consisting of lymph circulation, interstitial fluid, and filtered out of the blood vessels plasma, nourishes the skin. Cadaveric spots in this stage do not disappear and turn pale when pressure, and retain its original color, cadaveric spots are not moved by changing the position of the corpse.
The changing nature of corpse spots when pressed serves the experts guide sign for the establishment of limitation of death and should be considered in conjunction with other data. Normally the pressure is specially designed dynamometer, which allows strictly dosed pressure on the region cadaveric spots. The results of dynamometry map with the data given in the tables.
In some cases in the study of cadaveric spots may be admitted expert errors. Under tight scarf, tie, etc., from a dead spot not formed, therefore formed on the background of cadaveric spots of light strips, for example from the collar, can be taken for strangulation furrow, which is one of the main signs of death from mechanical asphyxia while squeezing neck loop. Bruises, located outside the zones cadaveric spots are usually easy to recognize. Diagnosis of bruises, located on the border of cadaveric spots, and especially in its area, is a great challenge. A careful study of the bruise you can see some of his bulge over a total surface, the definition of edges and sometimes its shape. Unlike cadaveric spots of color of bruises does not change when pressed. Always in the field of tissue in which suspected the presence of a bruise, it is recommended to perform cross sections. If there are bruises, as a rule, are well visible bruise or a section of the cloth, soaked in blood, covering a limited area that is not in cadaver spots. If necessary suspicious area of the skin with subcutaneous tissue cut and subjected to microscopic examination. On the microscopic preparations bruise visible available erythrocytes, densely infiltrating fabric reticular layer of the skin and subcutaneous tissue. For objective establish the presence of bruises on the background of cadaveric spots, putrid modified and mummified corpses method, which is based maceration of the skin, which is suspected the presence of a bruise, in running water with the subsequent processing of its acetic acid alcohol solution or alkali. At the same time existing bruises contribute and become brownish, with different shades of color in the background of yellow-grayish intact skin.
Simultaneously with the appearance of a dead spots in the skin, the formation of the so-called corpse hypostasis in the internal organs. The blood accumulates in the lower divisions of internal organs, which gives them a reddish-purple color.
If the corpse lying on his back, the back of the lungs become pronounced cyanotic shade, different from other areas of lung tissue, and some dense part, which is a consequence of corpse hypostasis. Such a condition of the lungs mistake can be taken for pneumonia. Gipotezy in the intestinal loops can be interpreted as the inflammatory process. Careful examination of the internal organs, as a rule, helps to avoid such errors, and the results of histological studies completely eliminated.
Thus, the presence of a dead spots, being a reliable sign of the coming of death, is one of the sources for the solution of the issue of limitation of death indicates a change of the original position of a corpse (to seeing him on the spot detection), orients in the diagnosis of some of the causes of death.