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Asphyxia presentation

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