Forensic Medicine

Monday, May 18, 2015

Asphyxia

·         Traumatic Asphyxia
• Traumatic asphyxia results from respiratory arrest due to mechanical fixation of the chest*, so that the normal movement of the chest wall are prevented.
• Common cause is crushing by falls of earth in a coal mine or during tunnelling or in a building collapse
• An intense cyanosis of deep purple or purple red colour of the head, neck and upper chest, above the level of compression is the prominent feature

·         Strangulation

• Strangulation is that form of asphyxia which is caused from constriction of the neck by a ligature without suspending the body.
• The mark in strangulation completely encircles the neck transversely, below the thyroid cartilage.
• Doing a post-mortem on a suspected case of strangulation in-situ examination of neck structures is done before opening the skull and the chest
• Most important sign of strangulation is ligature mark.
• Fracture of Thyroid Cartilage is more common in strangulation by ligature.
– Mugging—Homicidal strangulation, by holding the neck in the bend of elbow.
– Bansdola—Strangulation with sticks (Homicidal strangulation)
– Garroting—Strangulation by twisting a lever like a tourniquet, homicidal strangulation.
(
Traditionally was practiced in ‘SPAIN’ as a mode of execution.)

Throttling

1. Manual strangulation (always homicidal).
2. Fracture of the hyoid bone in 30-50% cases
• In Hyoid there is inward compression fracture*.
• The periosteum is torn on the outer side.
3. Fracture of the thyroid cartilage and of hyoid bone are usually found in above 40 years

Signs of Asphyxia
• Intense congestion and deep cyanosis of the head and neck is seen in strangulation
• The eyes wide open and pupils dilated
• The tongue swollen and protruded
• Petechial haemorrhages are common into the skin of the eyelids, face, forehead, behind the ears and scalp
• Blood stained froth may escape from the mouth and nostrils and there may be bleeding from nose and ears
• The intima of the carotid artery are not usually damaged
• Fracture of the thyroid cartilage is more common

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