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By Dr. Naveen
Violent asphyxial death
1). Hanging
2). Strangulations
3). Drowning
4). Suffocations
Hanging
1.Definition :
–Hanging is a process in which the
body is suspended with a ligature
around the neck which causes
constriction of the air passage
preventing exchange of air
between the atmosphere and the
alveoli of lungs, leading to
asphyxia and death.
In hanging, the constricting
force is either the weight of
the whole body or the weight
of the head alone.
2.Types of hanging
1). Typical hanging.
In a typical hanging, the knot
of the ligature should be at the
nape of the neck on the back.
Typical hanging is not very
common in occurrence.
2).Atypical hanging. In atypical
hanging, the knot of the ligature
may be at any site other than
the nape of the neck. It may be
near one angle of the mandible,
near the mastoid, or below the
chin.
Hence in case of typical
hanging, maximum pressure
is exerted in the front of the
neck, on the midline, i.e.,
over the wind pipe. The
pressure over the jugular
veins and the carotid
arteries are comparatively
less but equal on both sides.
In atypical hanging, the
commonest site for the
knot is near one side
mastoid process or near
the angle of mandible.
Occasionally, it may be
below the chin.
When a knot is on one
side, the pressure over the
vessels on both side is not
equal and it also takes
more time for total
occlusion of the wind pipe.
When the knot is blow the
chin, there may not be much
evidence of asphyxiation as
the respiratory tract is not
directly compressed.
Types of hanging
1.Complete hanging. In this
variety, the body is fully
suspended and no part of the
body touches the ground.
The constricting force here is
the weight of the whole body.
2.
Incomplete or partial
hanging.
The lower part of the body is in
touch with the ground.
Sometimes only the toes,
sometimes the whole foot or feet,
sometimes the knees,
sometimes the buttock,may be in
touch with the ground.
Partial hanging is
taken to be diagnostic
of being suicidal in
nature.
The ligature materials in
cases of hanging
Theligature material may be
anything which may be tied
around the neck with some
additional length for fixing it to
the point of suspension. It can
be a rope, electric wire, belt,
neck tie, bed sheet, scarf, cycle
chain or any such thing.
The knot
The knot may be a fixed
one(double or more), or it
may be a slipping knot or
a running knot.
Precise causes of death due
to hanging
Though a form of violent
asphyxia, not in all cases
of hanging death occurs
due to asphyxia. Any of
the followings may be the
actual cause of death.
Asphyxia along with
1.
apoplexy due to
simultaneous pressure
over larynx and jugular
veins. The combined
effect of asphyxia and
apoplexy is the cause of
death in most cases.
2. Asphyxia alone.
3. Apoplexy alone.
4. Cerebral anaemia or
ischaemia due to pressure
over carotid and vertebral
arteries.
5. Vagal shock. This
may occur due to
inhibition of the heart
due to irritation of the
carotid sinus.
6. Fracture dislocation of
the second and third
cervical vertebrae, which
causes injury to the
medulla and the upper
part of the spinal cord, as
in case of judicial hanging.
Postmortem
appearance of
hanging
A. External findings
1.The ligature mark.
–In most cases of death due
to hanging, the ligature
mark around the neck is
very much conspicuous.
–The ligature mark in case
of hanging is oblique, non-
continuous, placed high up
around the neck, grooved,
parchmentised and
abraded at places.
The ligature mark is non-
continuous because of a gap at the
nape of neck due to hair
intervening between the ligature
material and the skin underneath.
There may also be some gap near
the site of the knot due to the pull
on the knot from the point of
suspension above.
The upper margin of the ligature
mark has a line of postmortem
staining, all around above the
ligature mark. This is due to
settling of blood, from head and
neck above the level of
constriction, caused by the
ligature material.
When the knot is in contact with
the skin, it is usually inverted “V”
shaped, due to extension of
ligature material downward on
both sides from the knot above.
The point of contact of the skin
with the knot may leave a deep
parchmentised abraded
impression.
Factor which influence the
appearance of the ligature mark
(2)Abrasions
and About the edges of About the edges of
ecchymosis ligature mark not ligature mark are
common. common.
Hanging Strangulation by
ligature
Definition :
– Suffocation means a group of conditions of
violent asphyxiation, where passage of air
between the atmosphere and the lungs is
prevented by mechanical ways other than
constriction of neck or drowning.
Types of suffocations