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Asphyxia presentation Asphyxia presentation Presentation Transcript

  • ASPHYXIA
  • Definition
    It isany condition thatleads to:
    - reduction of the oxygensupply to the blood and the tissues below the the normal physiologicallevel (hypoxia).
    - elevation of CO2 in the blood (hypercapnia).
    **Hypoxiameans (lowoxygen) whileanoxiameans (withoutoxygen).
  • Types of anoxia:
    (1) Anoxicanoxia:
    - Ambient.
    - Central.
    - Paralytic.
    - Mechanical (violent asphyxia).
    - Obstruction of the blood flow to the lungs.
    (2) Anemicanoxia:
    - Chemicallycombinedhemoglobin.
    - Hemolysis.
    - Hemorrhage.
    (3) Stagnant anoxia.
    (4) Histotoxicanoxia.
  • Stages of mechanicalanoxia or violent asphyxia:
    Three stages:
    (1) Stage of forced respiration:
    - It is due to stimulation of the respiratory center.
    - Clinicalpicture: DYSPNEA
    (2) Stage of convulsions:
    - It is due to cerebral irritation.
    - Clinicalpicture: CONVULSIONS, CYANOSIS, HYPERTENSION, LOSS OF CONSCIOUSNESS, CONSTRICTED PUPILS.
    (3) Stage of paralysis:
    - Clinicalpicture: LOSS OF CONSCIOUSNESS, FLACCID MUSCLES & LOST REFLEXES, DEEP CYANOSIS, DILATED PUPILS, IRREGULAR BREATHING (Cheyne-Stokes respiration).
    **Deathoccurs in about 5 minutes..
  • General postmortempicture of mechanicalanoxia:
    - Deepcyanosis.
    - Proptosis of the eyeballs.
    - Bloody frothfrom the nose and mouth.
    - Congested face withpetechialhemorrhage all over.
    - Dark violet or blue extensive hypostasis.
    ** All these are externalsigns
    N.B: Blood isdark and fluid in consistancy due to increased CO2 and fibrinolysisrespectively.
  • Hanging
    Definition:
    It is the mechanicalanoxicdeath due to suspensionof the body from the neck by a ligature.
    Causes of death:
    - Cerebralischemia.
    - Vagal cardiac inhibition.
    - Mechanicalanoxia.
    - Transection of the spinal cord (judicialhanging).
  • Post-mortem picture:
    (1) General
    (2) Specialfeatures
    - Protrusion of the tongue.
    - Dribbling of saliva.
    - Hypostasis of the lowerhalf of the body.
    - Neck signs:
    .Elongated and the headistilted to the opposite side of suspension point.
    .Ligature marks (HIGH UP in the neck, OBLIQUE, INCOMPLETE, has an IMPRINT of the ligature).
    ** Homicidal, suicidal or accidental
  • Types of hanging
  • Strangulation
    Definition:
    It is the mechanicalanoxicdeathcaused by constriction of the neck by a ligature occluding the air passages fromoutside.
    Causes of death:
    - Mechanicalanoxia.
    - Reflex cardiac inhibition.
    - Delayededema of the glottis and choking.
  • Postmortempicture of strangulation:
    (1) General
    (2) Specialfeatures
    All are neck signs:
    - Ligature marks:
    . Low in the neck below the thyroid cartilage.
    . Transverse.
    . Complete.
    . Deep all through.
    . Abrasions and contusions taking the shape of the ligatingmaterial.
    - Inward fracture of the hyoidbone and the thyroid cartilage maybefractured.
    - Contusions and lacerations of the neck muscles.
    **Homicidal, suicidal or accidental
  • Throttling «Manual strangulation»
    Definition:
    It is the mechanicalanoxicdeathcaused by constriction of the neck by the hand occluding the air passages fromoutside.
    Causes of death:
    - Mechanicalanoxia.
    - Reflex cardiac inhibition.
    - Cerebralanoxia.
    - Delayedglotticedema and choking.
  • Postmortempicture:
    (1) General
    (2) Specialfeatures
    All are neck signs
    - Multiple contusions and fingernail abrasions.
    - Inward fracture of the hyoidbone (itis the mostcommon cause of hyoidbone fracture) and fracture of the thyroid cartilage.
    - Contusions of the deep tissues of the neck.
    ** Homicidal, suicidal or accidental
  • Smothering
    Definition:
    It is the mechanicalanoxicdeathcaused by occlusion of the externalrespiratoryopenings by the hand or soft objects.
    Causes of death:
    Mechanicalanoxia
    Postmortempicture of smothering:
    (1) General
    (2) Specialfeatures
    - Multiple contusions and fingernail abrasions.
    - Contusions in the buccal mucosa.
    - Ventral hypostasis in cotdeath.
    ** Homicidal, suicidal or accidental
  • Traumatic asphyxia: Overlaying
    Definition:
    It is the mechanicalanoxicdeath due to mechanical pressure by a heavyobject on the chestwith or without abdominal compression leading to prevention of respiratorymovements.
    Causes of death:
    - Mechanicalanoxia.
    - Injury to vital organs.
  • Postmortempicture
    (1) General
    (2) Specialfeatures
    - Contusions and abrasions of the chest and abdomen.
    - Fracture ribs.
    - Rupture of internalorgans.
    - Line of demarcationbetween the discoloredupper part of the body and the lower part.
    ** Homicidal, suicidal or accidental
  • Choking
    Definition:
    It is the mechanicalanoxicdeathcaused by occlusion of the respiratory passages frominside.
    Causes of death:
    - Reflex cardiac inhibition
    - Mechanicalanoxia
    Types:
    - Pathological
    - Non-pathological
    **Homicidal, suicidal or accidental
  • Drowning
    Definition:
    It is the mechanicalanoxicdeath due to submersion of the respiratoryopeningsunder water.
    Causes of death:
    - Direct causes: mechanicalanoxia
    - Indirect causes:
    . Reflex cardiac inhibition due to vagal stimulation
    . Head injury or other fatal injuries.
  • Posrmortempicture of drowning
    - Sure externalsigns:
    . Froth
    . Cadavericspasm
    - Probable externalsigns:
    . Related to anoxicanoxia: cyanosis
    . Related to presence of the body in water:
    skin is pale&wet
    Goose skin
    Washerwoman skin
    Postmortem injuries
    . Affection of postmortem changes due to presence in water:
    Cooling, hypostasis, adipocere, putrefaction
    **Homicidal, suicidal or accidental