Pugilistic attitude is seen in: March 2011
Correct Answer: Burns
Description: Ans. A: Burns The burnt body presents the so called attitude of defense, known as boxing attitude, pugilistic attitude or fenching posture Terminology commonly discussed in relation with thermal injuries in forensic pathology: 1. Cherry red lividity In individuals with a significant carboxyhemoglobin concentration in the blood (due to carbon monoxide exposure), the livor mois has a distinctive, bright, cherry red color. The affinity of carbon monoxide to bind to hemoglobin is 200-250% that of oxygen. Cyanide may also produce a bright red coloration of the blood and muscles of the body and has a characteristic bitter almond smell. 2. Epidural hematoma In burned bodies, epidural hematoma results from blood and marrow in the cancellous diploe of the skull boiling and being extruded by the intense heat, resulting in a brown, granular, and at times foamy or dried and flaky deposit in the epidural space. This is also a postmoem heat-related aifact and is easily distinguished from an antemoem epidural hematoma by the difference in color and texture. Fuhermore, antemoem hematomas are often associated with linear skull fractures, with injury to the middle meningeal aery. 3. Fire fractures Fire fractures are another postmoem heat-related aifact and should not be confused with antemoem injuries. Because of the extreme heat, the muscle, tendons, and soft tissue are charred, resulting in exposure of the underlying bones to heat, with resultant heat-induced fractures. Skull fractures are usually seen on the temporal bones, often radiating from a central point. The fractured edges are ragged and may cross suture lines, unlike antemoem fractures that usually terminate at suture lines. Additionally, these fractures may be of paial thickness, with exposure of the cancellous layer. 4. Lichtenberg figure, ferning, keraunopathy Keraunopathy is most generally the study of lightning-related injury, and the term is also used occasionally as synonymous with ferning, the arborizing pattern of skin discoloration seen on some bodies after a lightning strike. The finding can be seen on both living individuals surviving a lightning strike and those dying of it. The Lichtenberg figure is another term for this same finding. Lichtenberg figures, or ferning, on the human body can be transient, lasting hours to days, and their cause remains unclear. 5. Pugilistic attitude The burned body assumes what appears to be a boxer's stance. This is a postmoem aifact resulting from the effects of heat on the muscle protein: denaturation and dehydration. The flexors are bulkier than the extensors, and hence, the overall effect is one of contractures, with flexion at the elbows, wrists and knees. Often the joint spaces are exposed and the aiculating surfaces of the bones are charred. Pugilistic attitude as a result of heat-related contractures. In fire-related deaths, heat-induced contractures result in exposure of the peripheral joint spaces, with charring of the aiculating surface of the bones. 6. Skin splits Skin splits are usually seen on or near joint surfaces, the extensor surfaces of the extremities, and the head. These splits can extend to the underlying adipose and skeletal muscle, dependent on the intensity of the heat. These are also a postmoem aifact. The muscles split parallel to the long axes of the myofibers rather than across them. The soft-tissue splits may be full thickness, paicularly on the abdomen, resulting in charring of the exposed bowel surface. Skin and subcutaneous splits due to intense heat. 7. Soot Soot is an amorphous black material found in the airways (mouth, nares, trachea, bronchi) of individuals inhaling smoke during a fire. Its presence in the airways at autopsy indicates that the decedent was breathing and thus alive during the fire.
Category:
Forensic Medicine
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