L8: Violent Asphyxia Flashcards

1
Q

Def of Asphyxia

A
  • Any condition that interferes with the air flow in respiratory passage and exchange of gases in lungs, leading to hypoxia, hypercapnia and respiratory acidosis.
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2
Q

Causes of Asphyxia

A
  • Pathological
  • Poisonous
  • Environmental
  • Violent
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2
Q

Pathological causes of Asphyxia

A
  • As diphtheria, edema of epiglottis and tumor in air passage.
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3
Q

Poisonous Causes of Asphyxia

A
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4
Q

Environmental causes of Asphyxia

A
  • Breathing in vitiated atmosphere, As in high altitude, climbing, flying, inhalation of CO or pure helium.
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5
Q

Def of Violent asphyxia

A
  • It means mechanical interference with respiratory function of body resulting in depriving the vital organs from 02 supply necessary for their survival
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6
Q

Examples of violent asphyxia

A
  • Drowning.
  • Strangulation.
  • Suffocation.
  • Hanging.
  • Throttling.
  • Sexual Asphyxia
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6
Q

Def of Sexual Asphyxia

A
  • It means abnormal sexual behavior to feel pleasure through induction of hypoxia which may result in accidental asphyxia.
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7
Q

External post-mortem signs of asphyxia

A
  • Swollen Face
  • Prominent Eye
  • Bluish Discoloration
  • Bloody Froth
  • Protruded Tongue
  • Dark Blue Hypostasis
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7
Q

Swollen Face

External post-mortem signs of asphyxia

A
  • The face is swollen, bluish and marked with peticheal hemorrhages.
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8
Q

Prominent Eye

External post-mortem signs of asphyxia

A
  • The eye balls appear prominent, Due to retro-orbital oedema and congestion.
  • Conjunctivae are injected and show sub conjunctival hemorrhage (Tardieu spots) and pupils are dilated.
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9
Q

Bluish Discoloration

External post-mortem signs of asphyxia

A

The lips, ears, finger nails show deep bluish discoloration.

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10
Q

Bloody Froth

External post-mortem signs of asphyxia

A
  • From nose and mouth, due to increased transudation and rupture of fragile anoxaemic capillaries in the air passage.
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10
Q

Protruded Tongue

External post-mortem signs of asphyxia

A
  • The tongue is protruded, swollen and sometimes bruised and bitten.
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11
Q

Dark Blue Hypostasis

External post-mortem signs of asphyxia

A

Postmortem lividity is well developed and is dark blue in colour.

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11
Q

Def of Drowning asphyxia

A

Asphyxia caused by submersion of mouth and nostrils under water

  • leading to obstruction of the air passages by water.
  • It is the commonest cause of mechanical asphyxia.
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12
Q

Time needed for death in Drowning Asphyxia

A

Death takes 2-5 minutes to occur due to complete obstruction of the air passages

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13
Q

Cause of Death in Drowning

A
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14
Q

External PM Picture of drowning

A

Probable Signs:

  • External signs of asphyxia
  • Postmortem cooling
  • Postmortem rigidity
  • Putrefaction
  • Hypostasis
  • Adipocere formation
  • Appearance “Floatation” of the body
  • Glove & stocking skin
  • Goose skin “Cutis Anserina”
  • Postmortem wound
  • Washer Woman Hand

Sure Signs:
- Froth
- Cadaveric Spasm

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15
Q

PM cooling in drowning

A

Rapid takes ½ the time which taken in air.

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15
Q

PM rigidity in Drowning

A

Early disappear, Due to muscle exhaustion.

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16
Q

Putrefaction in Drowning

A

Delayed but start immediately after extraction of body from water.

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17
Q

Hypostasis in Drowning

A
  • Presents in upper ½ of the body
  • “Most dependent part of body” “Head, neck & shoulder”.
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18
Q

Adipocere formation in Drowning

A

starts to appear if prolonged submersion under water.

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19
Q

Appearence “Flotation” of the body in Drowning

A

Occurs after 5-8 days in summer, double this period in winter.

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20
Q

what does Flotation of the body depend on?

A
  • Rate of putrefaction.
  • Specific gravity of body: fatty bodies float earlier.
  • Nature of the water: it occurs earlier in salty water than in fresh water.
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21
Q

Characters of Glove & Stocking skin in Drowning

A

Occurs after 2 weeks

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22
Q

Etiology of Glove & Stocking skin in Drowning

A

Due to separation of epidermis from dermis in hands & feet.

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23
Q

Characters of Goose skin:
“Cutis Anserina”
in Drowning

A

Granular & puckered skin with erection of hair

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24
Q

Etiology of Goose skin:
“Cutis Anserina”
in Drowning

A

Due to spasm in erector pillae muscle

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25
Q

PM wounds in Drowning

A

It may be found, due to fishes or propellers of ships.

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26
Q

Characters of Washer woman hands in Drowning

A

Wrinkled, bleached & sodden skin of the hand

“Like washer woman’s hand”

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27
Q

what are sure signs of Drowning?

A
  • Froth
  • Cadaveric spasm
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27
Q

Etiology of wahser woman hand in Drowning

A

Due to loss of skin tone “after submersion under water for 12-18 hrs”.

28
Q

Def of Hanging

A

It is suspension of body from neck by a ligature, in which the force is applied to the ligature through body weight.

28
Q

Classification of Hanging

A
29
Q

Signs of Homicidial Hanging

A

Very rare, except when

  • murderer suspends victim after narcotizing him, or in P.M. suspension is done to simulate suicide.
29
Q

Causes of death in Hanging

A
29
Q

Signs of suicidal hanging

A

The commonest form in this case there are:

  • Circumstantial evidence, (locked door from inside, suicide note, efc.)
  • Absence of signs of resistance and struggle.
  • Presence of other means of suicide (i.e. previous attempts).
29
Q

Signs of Accidental Hanging

A

Rare and may occur in case of:

  • Children playing with ropes.
  • Falling men from scaffold and entangled in ropes.
29
Q

External Postmortem picture of Death From Hanging

A
29
Q

Def of Ligature Mark

A
  • Pressure mark on neck at the site of ligature.
  • Appears as a depression “Groove” which has same characteristic pattern of ropo.
29
Q

Color of Ligature Mark

A
  • Early; it appears pale.
  • Late: it turns yellowish brown, dry, hard & parchment.
30
Q

Site of Ligature Mark

A
  • High up in neck above thyroid cartilage
30
Q

Shape of Ligature Mark

A
  • Area of hyperaemia, bruises & abrasions occasionally present”
  • May be complete & horizontal or incomplete and oblique.
31
Q

Def of Strangulation

A
  • Constriction the neck by a ligature, which presses on the air passages from outside preventing the air from passing to lungs.
32
Q

Classification of Strangulation

A
  • Ligature strangulation
  • Manual strangulation or Throttling
  • Mugging
33
Q

Ligature strangulation

A

When ligature material is used to compress neck.

34
Q

Manual strangulation or Throttling

A
  • When human fingers, palms or hands are used to compress the neck.
35
Q

Causes of death in case of strangulation

A
36
Q

Mugging

A

Strangulation caused by holding the neck of the victim in bend of elbow or knee of the assailant.

37
Q

Homicidal Strangulation

A

almost the commonest.

38
Q

Accidental Strangulation

A

It may occur in the following cases:

  • During delivery, when umbilical cord turns around infant’s neck.
  • Children playing with ropes.
39
Q

Suicidal (self) strangulation

A

rare

40
Q

Difference between hanging and strangulation

A
41
Q

External Postmortem picture of Death From Strangulation

A
42
Q

Def of Throttling (Manual Strangulation)

A

Constriction of neck by hands for two minutes or more.

43
Q

Suicidal (self) Throttling

A
  • Impossible because as soon as person loses consciousness, relaxation of his hands occurs with released neck grip.
43
Q

Causes of Death in Throttling (Manual Strangulation)

A
44
Q

Homicidal Throttling

A
  • The commonest.
  • It is accompanied with signs of resistance and struggle.
45
Q

Accidental Throttling

A

Rare

46
Q

External Postmortem picture of Death From throttling

A
47
Q

What Medicolegal cases cause fracture of hyoid bone?

A
  • Throttling
  • Strangulation
  • Hanging
  • Trauma of the neck
48
Q

Fracture of hyoid bone in Throttling

A
  • Fracture of hyoid bone is (Commonest).
  • It leads to inward fracture.
49
Q

Difference between fracture of hyoid bone in throttling & Traumatic fracture

A
  • Sometimes couses subluxation of joint botwoon cornu and body the bone, which is symmetrical with smooth surface and lined with a synovial membrane
  • Traumatic fracture is asymmetric with irregular odgos and bruising around, occurs in subjects above 40 years old.
50
Q

Fracture of hyoid bone in Strangulation

A
  • Fracture of the hyoid bone is (Less common).
  • leads to outward fracture.
51
Q

Fracture of hyoid bone in hanging

A
  • Fracture of the hyoid bone is outward fracture, due to stretch of the supra-hyoid muscles.
52
Q

Def of Suffocation

A
  • Form of asphyxia caused by mechanical obstruction to passage of air into the respiratory tract by means other than constriction of neck or drowning.
53
Q

Types of Suffocation

A
  • Smothering
  • Overlying
  • Burking.
  • Choking and gagging
  • Traumatic asphyxia
54
Q

Def of Smothering

A

It is a manual obstruction of external respiratory orifices, i.e. mouth and nostrils.

55
Q

Homicidal Smothering

A

almost the Commonest.

56
Q

Suicidal (self) Smothering

A

Not recorded

57
Q

Accidental Smothering

A
  • It occurs in cases of fallen houses, when heaps of dust or sand occlude respiratory orifices.
  • Among epileptics and drunkers,
  • Children may die by smothering during playing with plastic bags.
  • When an infant turns into a prone position and buries its face in a pillow.
58
Q

External Postmortem picture of Death From Smothering

A
59
Q

Def of Choking

A
  • It is an inside occlusion of the air passages by foreign bodies.
59
Q

Types of Choking

A
  • Pathological
  • Accidental
  • Homicidal choking (Gagging)
60
Q

Pathological Choking

A
  • Diphtheria
  • Angio-neurotic oedema of glottis.
61
Q

Accidental Choking

A

Irritant fumes inhalation:

  • leading to oedema of glottis and choking

Foreign body impaction:

  • Vomitus or tooth, as in coma or anesthesia
  • Or aspirated blood or gauze after operations as
    tonsillectomy
  • Or coins; or solid particles of some food materials.
62
Q

Homicidial Choking (Gagging)

A

It is rare and often occurs in infanticide by
packing infant’s pharynx with a piece of cotton.

63
Q

Def of Overlying

A
  • Occurs when sleeping mother overlays her suckling infant by rolling on it or by accidental resting her arm or her heavy lactating breast on its respiratory orifices
64
Q

Def of Traumatic asphyxia

A
  • Asphyxia resulting from respiratory arrest due to mechanical fixation of chest, So that normal movements of chest wall are prevented.
65
Q

Causes of Traumatic asphyxia

A
  • Due to house collapse, accidentally or in wars/earthquake.
  • Stampede by crowd, running in panic,
    e.g. outbreak of fire /public gathering.
  • Run over by a vehicle or overturned vehicle (especially tractors).
66
Q

Causes of death in falling houses

A
  • Vagal inhibition
  • Concussion
  • Vital organ injury
  • Choking
  • Traumatic asphyxia.
67
Q

Def of Burking

A

It is a combination of

  • Homicidal smothering
  • Traumatic asphyxia.