11 Questions
What is the definition of death?
The irreversible cessation of life in a previously viable organism
What is the characteristic of somatic death?
Irreversible loss of personality and consciousness
What is the consequence of irreversible damage to the brainstem?
Irreversible coma and loss of spontaneous breathing
What is the outcome of hypoxic cardiac arrest in brain death?
Irreversible cardiac arrest and death
What is the significance of the 'physiological window' in brain death?
It enables the harvesting of organs for transplantation
What is the difference between somatic death and cellular death?
Somatic death occurs before cellular death
What is one of the signs of cessation of circulation?
Absent pulsations in big arteries
What is one of the indicators of cessation of respiration?
Apnea as checked by careful auscultation
What is the purpose of the apnea test in diagnosing brain stem death?
To determine if spontaneous respiration is possible
Why is it important to exclude reversible causes before diagnosing brain stem death?
To ensure accurate diagnosis of brain stem death
What is the significance of primary hypothermia in diagnosing brain stem death?
It is a reversible cause that must be excluded
Study Notes
Nature and Definition of Death
- Death is the irreversible cessation of life in a previously viable organism.
- A dead person is an individual who has sustained irreversible cessation of:
- Circulatory and respiratory functions, or
- All functions of the entire brain (cortex and brain-stem)
Phases of Death
- Somatic death: a person irreversibly loses their personality, becoming unconscious, unable to communicate with their environment, and unable to receive sensory stimuli or initiate voluntary movement, but reflexes and circulatory/respiratory functions may persist.
- Cellular or molecular death: cessation of respiration and metabolism of body tissues and their constituent cells, followed by autolysis and decay.
- Brain death:
- Cortical death: irreversible coma and failure of spontaneous breathing, leading to hypoxic cardiac arrest and cellular death.
- Brainstem death: irreversible damage to the brainstem, marking the end of somatic life, but not yet cellular death.
Diagnosis of Somatic or Clinical Death
- Cessation of circulation:
- Absent pulsations in big arteries (carotid or femoral).
- Undetected blood pressure.
- Absent heart beats.
- Flat ECG on all leads.
- Cessation of respiration:
- Apnea as checked by careful auscultation.
- Severe hypoxia and hypercapnea inconsistent with life in Arterial Blood Gas Analysis.
Diagnosis of Brain Stem Death
- Clinical tests:
- Absent pupilary response to light.
- Absent corneal reflex.
- Oculocephalic reflex (doll's eye) is absent.
- Vestibulo-ocular reflex is negative when icewater is introduced into the ears.
- Pharyngeal and tracheal reflexes are absent (gagging and coughing).
- Testing for apnea (failure of spontaneous respiration) if all previous clinical tests are lost.
- Exclusions:
- All reversible causes.
- Primary hypothermia.
This quiz covers the definition and stages of death, including somatic death and cellular or molecular death. Learn about the irreversible cessation of life in a previously viable organism. Understand the differences between antemortem and postmortem phases of death.
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