This document discusses strangulation, including definitions, types, signs of asphyxia, ligature strangulation, manual strangulation, and hyoid bone fractures. It defines mechanical asphyxia and anoxia. Types of strangulation include ligature, throttling, garroting, mugging, and bansdola. Signs of asphyxia include cyanosis, facial swelling, bulging eyes, swollen tongue, bloodstained froth, clenched hands, and ligature marks. Ligature strangulation involves external constriction of the neck by materials like rope or wire. Manual strangulation involves compression of the neck by hands, which can cause hyoid bone or thyroid cartilage fractures. The document outlines differences between

1. STRANGULATI
ON
By- Sneha A
(MBBS UG)

2. Objectives
 Terms and terminologies
 Definition
 Types
 Signs of asphyxia
 Ligature strangulation
 Manual strangulation
 Hyoid bone fracture
 others
 Medico-legal importance

3. Terms and concepts
1. Mechanical Asphyxia- external pressure
applied to neck, chest or other parts of the
body positioned in such a way that respiration
becomes difficult or impossible.
2. Anoxia- The term anoxia means a total
depletion in the level of oxygen, an extreme
form of hypoxia or low oxygen.
3. Bloodless dissection of neck- abdomen and
thorax opened, then brain removed, head
moved to drain out blood………… then neck
opened

4. Form of asphyxia
caused by
constriction of
neck by a ligature
or by any means,
without
suspending the
body.
1. Ligature
strangulation
2. Throttling
3. Garroting
4. Mugging
5. Bansdola
Definition Types

5. Signs of asphyxia

7. Signs of asphyxia (cont……)
 Cyanosis
 Face- swollen and blotchy.
 Eyes- wide open, pupils dilated suffused and
bulging.
 Tongue is swollen, protruding and caught between
teeth.
 Blood stained froth from the mouth or the nose.
 Hands clenched.
 Ligature mark which commonly depends upon the
size, type, form, etc. of the ligature with edema

8. Ligature strangulation
 Form of asphyxia caused by constriction of neck
by a ligature without suspending the body.
 Materials used for ligature strangulation can be
anything from flexible rubber tubing to cloth, or
stick, wooden planks, belts, wire, rope etc.
 Causes of death-
 Asphyxia
 Combined asphyxia and venous congestion
 Cerebral anoxia or congestion
 Vagal inhibition
 Vertebral fractures (rare)

14. Ligature strangulation (cont.)
 PM findings
 External
 Signs of asphyxia
 Ligature well-defined and depressed; usually in the middle of
or below thyroid cartilage; prominent at front (due to thickness
of skin); interrupted in front by clothing fingers of victim.
 Knot mark seen of present
 Peticheal hemorrhages- ligature anti/postmortem ?
 Turns on pulling the victim with the rope- complex ligature
 Patter of ligature indicative of weapon used
 Cord, wire, thin rope- The thinner the ligature more deep will
be the mark (cheese cutter method).
 Marks of struggle

15.  Pseudo-strangulation
1. Children and infants- bending of neckfolds
2. Short-necked victims- similar
3. Decomposing bodies with tight collars, shirt
buttoned at neck or other cloth round the neck
 Internal
 Hemorrhage and under ligature into deep tissue
 Base of tongue and larynx- bruising and
hemorrhage
 Lungs- congested; silver looking spots on pleural
surface
 Brain- congested and hemorrhagic
 Thyroid cartilage- one or both horns fractured

16. Manual strangulation/Throttling
 Compression of neck by human hands
 Death- vagal stimulation  sudden cardiac
death

18. Manual strangulation/Throttling
(cont...)
 PM findings
External
Signs of asphyxia
Bruises produced by tips of fingers; absent- soft
material between neck and hand, pressure
maintained until death and amount of pressure
minimal
Marks of thumb on one side and fingers on other
side.
Nail marks-crescentic (persistent pressure) and

19. Internal
Bruise- deep layers of
skin, fascia (s and d),
sheaths of muscle and
subcutaneous tissue of
thyroid
Sternoclidomastoid- torn.
Subarachnoid
hemorrhages
Fractures- superior cornu
of thyroid cartilage and
hyoid bone

20. Hyoid bone fractures
 Inward fracture-
 Seen in throttling-
main force is an
inward
compression on
the hyoid bone.
 Fingers squeeze
the greater horns
towards each
other, due to
which the bone
may be fractured
and post
fragments
displaced
inwards.
 Anterio-posterior
compression
fracture
 Hanging, ligature
strangulation, run
over accidents.
 the hyoid bone
forced backwards
divergence of
greater horns
increased fracture
with outward
displacement of
the posterior small
fragments.
 Avulsion fracture
 Hanging and
throttling
 Very rare and is
due to over
activity of neck
muscles without
direct action or
injury to hyoid
bone.

21. Others
 Garroting- victim attacked from behind
without warning.
 Spanish windlass

22. Others (cont……)
 Mugging- strangulation by holding neck of victim
in the bend of elbow (generally from behind)
 Bansdola- neck compressed between two
bamboo sticks.

23. Medico-legal aspects
 Suicidal- rare
 Homicidal- common;
signs of struggle;
position of offender.
 Accidental- in kids,
infants, alcoholics/
epileptic/imbeciles,
fetus, slipping of
suspended strings
 Suicidal- rare
 Homicidal- common;
finger nail abrasion.
 Accidental-
demonstration of
affection, joke,
physiological
experiment
Ligature strangulation
Manual
strangulation/throttling

24. FEATURES HANGING STRANGULATION
LIGATURE MARK OBLIQUE,ABOVE THE
LEVEL OF THYROID
CARTILAGE.
TRANSVERSE, AT OR
BELOW THE THYROID
CARTLAGE,COMPLETELY
ENCIRCLING THE NECK.
INJURIES UNDER THE LIGATURE,
ONREFLECTION OF
SKIN,TISSUE LOOK
PALE,BRUISING OF
MUSCLES IS LESS
COMMON
BRUISING OFNECK
MUSCLES IS MORE
COMMON
HYOID BONE FRACTURE MAY OCCUR FRACTURE IS UNCOMMON
THYROID
CARTILAGE
FRACTURE IS LESS
COMMON
FRACTURE IS MORE
COMMON
LARYNX &TRACHEA RUPTURE RARE RUPTURE MAY OCCUR
SIGNS OF ASPHYXIA LESS PROMINENT MORE PROMINENT
BLEEDING FROM EAR
,NOSE,&MOUTH IS LESS
COMMON
FROM EXTERNAL ORIFICE
IS MORE COMMON