What is a major sign of dependent lividity?

The major sign of dependent lividity is the settling of blood in the lowest parts of the body after death. This phenomenon occurs due to gravity pulling the blood towards the lowest point of the body. As the heart stops beating and circulation ceases, blood no longer circulates and begins to pool in the areas that are closest to the ground, leading to a discoloration of the skin in those areas. This sign can be used to help determine the position of the body at the time of death and can also give insight into the time since death.

Other options, while they may be related to post-mortem changes, do not specifically indicate the phenomenon of blood pooling and discoloration associated with dependent lividity. Cold skin temperature can occur post-mortem but is not unique to dependent lividity. Bloating of the abdomen is related to the breakdown of tissues and gas accumulation, which occurs later in the post-mortem process. Pooling blood in the extremities does happen, but it is not as definitive or specific as stating that blood is settling in the lowest parts of the body, which precisely describes the process of dependent lividity.