An account of strangulation, its types, mechanism, causes of death, post-mortom signs of death due to strangulation, fracture of thyroid cartilage and hyoid bone, medico-legal aspects of strangulation
We saw the infamous 26/11 at Mumbai, India. We lost some brave-hearts. Hence, we look into the forensics behind firearm injuries. We shall also discuss the JFK assassination case in brief. I would recommend downloading the presentation and view it in power point 2010 or above to see all the effects flawlessly.
An account of strangulation, its types, mechanism, causes of death, post-mortom signs of death due to strangulation, fracture of thyroid cartilage and hyoid bone, medico-legal aspects of strangulation
We saw the infamous 26/11 at Mumbai, India. We lost some brave-hearts. Hence, we look into the forensics behind firearm injuries. We shall also discuss the JFK assassination case in brief. I would recommend downloading the presentation and view it in power point 2010 or above to see all the effects flawlessly.
Asphyxia which means "Pulselessness" and is cause due to absence of oxygen amount in a body. The death cause by asphyxia is known as asphyxial deaths. They are Hanging, Strangulation, Suffocation and Drowning.
Asphyxia which means "Pulselessness" and is cause due to absence of oxygen amount in a body. The death cause by asphyxia is known as asphyxial deaths. They are Hanging, Strangulation, Suffocation and Drowning.
strangulation forensic medicine important.pptxlyuwablue
Our Age Forensic Medicine product is designed to assist medical professionals in accurately determining the age of individuals based on various biological markers. This tool is essential in forensic investigations, helping to provide crucial information for legal proceedings and identification purposes. With advanced technology and precise algorithms, our Age Forensic Medicine product ensures reliable and accurate results, making it a valuable asset in forensic science.
Skull fractures are discussed with their types briefly. The treatments of the fractures are discussed as well depending on the age of the patient if patient is adult or a child. The CT Scans are also given in order to better explain and help you in understanding.
elbow and wrist and hand fracture with managementkajalgoel8
describing anatomy of the wrist and hand ..
what is fracture
mechanism of injury of all the fracture
classification of fracture
clinical features
radiologicals exminations
management of the fracture
Asphyxia
Classification of Asphyxia
Mechanical Asphyxia
Mugging/ throttling
Mechanical Asphyxia
Pathological Asphyxia
Toxic or chemical Asphyxia
Environmental Asphyxia
Traumatic Asphyxia
Positional/postural Asphyxia
Iatrogenic Asphyxia
Tardieu’s or Bayard’s ecchymosis/spots
Hanging
Classification of Hanging
Cause of Death in Hanging
Fatal period in Hanging
Factors which influence the appearance of ligature mark ??
Judicial Hanging
Hangman’s fracture
Strangulation
ligature strangulation
Cause of death
Throttling or Manual Strangulation
Hyoid Bone Fractures
AUTOEROTIC
CHEMICAL Asphyxia
CHOKING
SMOTHERING Asphyxia
POSITIONAL Asphyxia
Drowning
Classification of Drowning
Typical or wet drowning
Mechanism of fresh water drowning
Mechanism of death in fresh water drowning
Mechanism of sea water drowning
Mechanism of death in sea water drowning
Atypical drowning
Dry drowning
Immersion syndrome
Near drowning
Shallow water drowning
Epidemiology of drowning
Cause of Death
Postmortem Examination
Froth
Reference
this ppt is based on clinical anatomy related with upper limb which will help all medical students to understand the upper limb related clinical situations for the diagnostic purposes.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
1. STRANGULATION
by Dr m balaji singh
Professor of Forensic Medicine
ACS Medical College and Hospital, Chennai
Courtesy ; Review of
Forensic Medicine andToxicology by
Dr .Gautam Biswas MD,
Text book of Forensic Medicine
andToxicology by Dr. KrishanVij MD LLB
KNIGHT’S FORENSIC PATHOLOGY
2. Definition
It is a form of violent asphyxial death caused
by constriction of air passage at the neck by
means of a ligature or by any means other
than suspension of the body.
15. Strangulation
death by compression of the neck from the exterior.
Compression by: Application of ligature (ligature
strangulation).
Application of human hand(s)- (manual strangulation/
throttling).
Any other means, with stranglehold, foot or by some
solid substance, etc.
the weight of the victim’s body has no role
16. LIGATURE STRANGULATION
The pressure upon the neck may be affected by
compressing whole or a part of the circumference of the
neck
Causes of Death
death is not merely due to asphyxiation but a varying
combinations of all the mechanisms involved.
cardiac inhibition is more common than in hanging, as is
obvious from the anatomy of the neck structures and the
location of the carotid sinus .
18. Causes of death - level of
occlusion in strangulation and in hanging
Airway occlusion
Brouardel- calculated that the force needed to close
the trachea - 15 kg.
direct compression of the larynx or trachea- in
strangulation
root of the tongue is lifted upwards and backwards
against the soft palate and roof of the mouth – in
hanging
19. Causes of death……
Occlusion of the neck veins- classic’ signs of
congestion, cyanosis, oedema and petechiae
above the line of constriction.
external jugular veins are most vulnerable
Brouardel’s experiments suggest that a ligature
with a tension of 2 kg blocks the jugular return;
20. Causes of death………
Compression of the carotid arteries
(carotid arteries resists occlusion as they are situated much
more deeply and obscured by the sternomastoid muscles )
unconsciousness will ensue ( if bilateral compression)
tension of 5 kg is necessary to occlude
the carotid arteries and 30 kg for the vertebral
arteries (Brouardel) .
21. Differences between
Hanging strangulation
-----------------------------------
Age-More common in
adolescents and young or
elderly adults
-------------------------------------
Nature of death- Mostly
suicidal
Face- signs of congestion
less marked and petechiae
rare
Tongue -Swelling and
protrusion is less marked
--------------------------------------------
No age limit as it can be effected
any age for enmity, rivalry, etc
--------------------------------------------
Mostly homicidal
Congested, livid and marked
with petechiae
Swelling and protrusion is more
marked
--------------------------------------------
22. Hanging strangulation
------------------------------
Bleeding -Bleeding from nose,
mouth and ears not common
Saliva -Often dribbles out of the
mouth
Neck- Stretched and elongated
in fresh bodies
External signs of asphyxia-
usually notwell-marked
Bleeding from nose, mouth and
ears may present
Such dribbling is very rare
Not so
External signs of asphyxia
well-marked (minimal, if
death is due to vasovagal and
carotid sinus effect )
23. Hanging strangulation
------------------------------
Ligature mark –
Oblique,
non-continuous,
placed high up in the neck
between the chin and the larynx.
Base of the groove or furrow
being hard, yellow and
parchment-like.
Underneath subcutaneous tissue
the mark is usually hard, white
and glistening
Ligature mark –
Horizontal or transverse,
continuous round the neck,
low down in the neck below or
across the thyroid.
Base of the groove or furrow
being soft and reddish.
Subcutaneous tissue
underneath may be ecchymosed
24. Hanging strangulation
------------------------------
Abrasions and ecchymoses
(a)Abrasions and ecchymoses
round about the edges of the
ligature mark are rare.
(b) Scratches, abrasions and
bruises on the face,
neck and other parts of the body
are usually
not present
(a) Abrasions and
ecchymoses
round about the edges of the
ligature mark are common
(b) Scratches, abrasions,
fingernail marks and bruises
on the face, neck and other parts
of the body are usually present.
25. Hanging strangulation
------------------------------
Injury to muscles of
neck -Rare
Carotid arteries - Internal
coats usually ruptured in
violent cases of a long drop
Larynx and trachea -
Fracture of larynx and
trachea—rare (applicable
to judicial hanging also).
Common
Damage to internal coat is
rare
Fracture of larynx and
trachea comparatively
more common
26. Hanging strangulation
------------------------------
Hyoid bone- Fracture of the
hyoid bone less common
Thyroid cartilage- Fracture
is less common
Cervical vertebrae- Fracture
and/or dislocation common
in judicial hanging
Sexual assault- Evidence of
sexual assault is rarely seen
in homicidal hanging
Fracture of the hyoid bone is
uncommon (may possible in
throttling)
Fracture is more common
Fracture or dislocation is
rare
evidence of sexual assault is
not uncommon in young
female victim of homicidal
strangulation.
28. Autopsy Findings
In majority of cases, general features associated
with the asphyxial type of death are evident with
some demonstration of their local accentuation.
the findings are described as:
1.General appearances—external and internal
2.Local appearances—external and internal
29. General External Findings
The asphyxial findings will be prominent when sufficient
pressure has been exerted.
strangulation is a slow process,
But hanging is a rapid one.
In deaths due to vagal inhibition, the asphyxial findings will be
least or none at all.
30. General External Findings………
Frothy blood tinged fluid may exude from the mouth
and nostrils.There may be evidence of passage of
urine/feces and/or seminal emission
Face: It may be swollen and blotchy with scattered petechial
haemorrhages over the eyelids, face, forehead and scalp.
Eyes: Usually suffused and bulging with dilated pupils.
Tongue: Swollen, protruding (the protruded portion may
be dark colored) and sometimes caught between the teeth.
31. Local(neck)External Findings
The ligature material – ligature mark (pressure furrow ) is
basically a abrasion
depth varies inversely with the width of the constricting
material.
narrower material, the deeper ligature mark
Examples; cords, wires, narrow ropes, chains, twines from the
trees, etc.- cause deeper marks.
softer materials like sarees , scarves, ties, towels, stockings,
strips of bed linen, mufflers, etc.- cause broader and faint marks.
32. At autopsy – how to preserve material
observe the ligature material around the neck,
removed by cutting it away from the knot,
preserved for future correlation of the findings.
The knot secured by tying the component parts with a
string
handed over to the police
in a sealed packet after proper labeling
33. Features of ligature
the mark usually is horizontal, across or below the
thyroid cartilage, completely encircling the neck.
Sometimes indistinct at the back of the neck due to thick
musculature .
When fresh, the furrow (groove) may be less conspicuous
than after drying.
The mark is generally yellowish-brown shortly after death
will become dark brown color, dried and parchment like
after some time.
34. factors influencing the appearance of the
ligature mark
composition and pattern of the ligature material –
patterned abrasion
the pattern better appreciated by examining under
oblique lighting + magnifying lens.
Even flexible stick or cane can act as a ligature if the
ends are pulled back from behind the victim.
35. Ligature mark may be quite
indistinct or absent.
. If the ligature material was soft and broad like
saree or yielding type and removed soon
after death
In homicides, the assailant attacks from
behind, and a U-shaped ligature material
pulling against the front and sides of the neck
of victim- mark is absent on nape of the neck.
36. Knots and their impressions
The knot may be fixed after each turn or may be
fastened at the end of the turns, imparting
corresponding complexity to the ligature mark on the
skin.
In case of multiple turns around the neck, skin folds
between the adjacent loops may be pinched and
hemorrhagic particularly when the ligature material is
tough and of sinking nature like cords, wires, etc.
37. Knots and their impressions……
localized irregular indentations or
abrasions or abraded contusions observed
in ligature mark in case of strangulation.
But in hanging a gap in ligature mark
is always present underneath the
knot.
38. Course of ligature around the neck
The ligature may be -indistinct or absent on the nape
of the neck -due to thick musculature at this area.
The mark may be oblique resembling hanging, when
the victim is dragged after being strangled in
recumbent posture .
Period and degree of constriction will
proportionately influence the appearance of the mark
upon the neck.
39. Gaps in ligature marks due to
long hair ( plait) or clothing, collars or ornaments at the
front may interpose between the ligature and the skin
of the neck.
At times, ligature mark may be interrupted at the front
by the interposition of the victim’s fingers or hand in an
attempt to pull the ligature and frustrate the attempts
of the assailant.
40. Effect of edema, and decomposition
The ligature may appear to be deeply embedded into
the tissues of the neck due to oedema of the tissues,
which initially might not have been applied so tightly.
The swelling can continue to increase after death
due to decomposition and thus adding to the depth
of the groove.
41. Other external local findings-
signs of struggle
evidence of abrasions, scratches or abraded
contusions over the face, arms and other parts of
the body of the victim,
If the assailant happens to kneel over the chest of
the victim, bruising of these areas may be present –
Burking.
43. General Internal Findings
signs of asphyxia—congestion of the respiratory
tract .
- subpleural petechial haemorrhages
(Tardieu spots),
emphysematous bullae at occasional places.
Other organs may also show congestion.
In case of vagal inhibition, these changes are
absent.
45. Local Internal Findings- contusions
Bruising of the soft tissues of the neck and the muscles –
more common than hanging.
contusions are prominent - rough ligature material +
struggle and resistance.
Bruising of the subcutaneous tissue may present , when even no
ligature mark on the surface of the skin.
Bruising may be minimal when the ligature has
been tightly secured and not removed until circulation
ceases or in case of vagal inhibition.
46. Injuries to the blood vessels
- this is rare in strangulation.
However, a deeply sunken narrow ligature applied
forcibly may damage the carotids.
47. Injuries to the hyoid bone,
Rare - because the level of ligature is below the
bone and the traction on the thyrohyoid
ligament is not much.
However, if some broad ligature is tightly and forcibly
applied, the hyoid bone may get involved.
Fracture may possible in throttling.
49. Internal Findings -
Subcapsular and interstitial thyroid
hemorrhages are common.
Fracture of cricoid cartilage is less common.
Rings of trachea may sustain fracture when
considerable force is applied.
50. Other internal findings
Lungs are congested, edematous with
numerous subpleural petechial hemorrhages.
Brain is congested with petechiae in white
matter.
All other organs are congested.
51. Medico legal importance of
strangulation
Strangulation should be assumed to be
homicidal, until the contrary is proved
56. Homicidal strangulation
women- strangulation associated with sexual
intercourse.
„There are two or more firm knots, each on separate
turns of the ligature.
„Abrasions and fingernail marks and torn / disarranged
clothing of the victim indicating that a struggle.
„By spot inspection -The ligature is loosely present
around the neck.
57. Accidental strangulation
Cord around neck accidental strangling may
occur in uterus, -umbilical cord around neck.
„Children may get entangled in ropes during play or
strangled in their cots.
Persons under the influence of alcohol, epileptics
and imbeciles may be strangled either by a tight
scarf or collar or necktie
Woman in bike journey may be strangled by a tight
scarf
sexual asphyxia by attempted
partial strangulation
59. Suicidal strangulation
„Suicide by strangulation is rare,
but not impossible
The victims employ a specific mechanism for
tightening the ligature, but the person can apply a
single or double knot before consciousness is lost.
„In suicidal strangulation, signs of venous congestion
are very well marked ( it is a slow process)
„.
61. Suicidal strangulation……
The ligature should be found in situ; body should
not show any signs of violence or marks of struggle.
Laryngeal fractures are rare, and injuries are mild
and often confined to the single ligature mark.
„Detailed examination of the scene and of the
deceased person, along with circumstances leading
to the death should be investigated
Suicide note may present
65. cause of death- in throttling
i. Asphyxia .
ii. Cerebral anoxia - cerebral circulation.
iii. Vagal inhibition- pressure on carotid sinus and
vagus, sympathetic nerves.
About half of the deaths are due to vagal
inhibition.