DEATH BY ASPHYXIA

A. ASPHYXIA BY HANGING: brought about by the suspension of the body by a ligature which encircles the neck and constricting force is the body weight. Causes of Death in Hanging Simple asphyxia by blockage of the air passage; Congestion of the venous blood vessels in the brain; Lack of arterial blood in the brain; Syncope due to pressure in the vagus and carotid sinus; Injury on the spinal column and spinal cord; and Combination of any of the above-mentioned causes. Determinations Whether Hanging is Ante-mortem or Postmortem: PRINCIPAL CRITERION: VITAL REACTION ² but hanging made immediately after death may also show vital reaction, while hanging of a living subject whose shows bodily resistance has been weakened may show slight vital reaction. FINDINGS SHOW THAT HANGING IS ANTE-MORTEM a. Redness or ecchymosis at the site of the ligature; b. Ecchymosis of the pharynx and epiglottis; c. Line of redness or rupture of intima of the carotid artery; d. Subpleural, subepicardial punctiform haemorrhages. B. ASPHYXIA BY STRANGULATION STRANGULATION BY LIGATURE: produced by the compression of the neck by means of a ligature, which is tightened by a force other than the weight of the body. Usually, ligature is drawn tight by (1) pulling the ends after crossing at the back or front of the neck, or (2) several folds of ligature may be around the neck tightly places and the ends are knotted, or (3) loop is thrown over the head and a stick is inserter beneath it and twisted till noose is drawn tight. Hanging
Hyoid bone is frequently injured. Direction of the ligature mark is inverted V shape with the aspex as the site of the knot. Ligature is usually at the level of the hyoid bone. Ligature groove is deepest opposite the knot. Vertebral injury is frequently observed.

ASPHYXIA ²all forms of violent death which results primarily from (1) the interference with the process of respiration or (1) the condition in which the supply of oxygen to the blood or to the tissue or both has been reduced below normal level. TYPES OF ASPHYXIAL DEATH: A-ASH 1. ANOXIC DEATH: associated with the failure of the arterial blood to become normally saturated with oxygen a. Breathing in an atmosphere without or with insufficient oxygen; b. Obstruction of the air passage due to external pressure; c. Paralysis of the respiratory center due to poisoning; d. Shutting of blood from the right side of the heart to the left without passage through the lings 2. ANEMIC ANOXIC DEATH: due to decreased capacity of the blood to carry oxygen a. Severe haemorrhage; b. Poisoning ² carbon monoxide; c. Low haemoglobin level in the blood 3. STAGNANT ANOXIC DEATH: brought about by failure of circulation a. Heart failure; b. Shock; c. Arterial and venous obstruction. 4. HISTOTOXIC ANOXIC DEATH: due to failure the cellular oxidative process ² although oxygen is delivered to the tissues, it cannot be utilized properly a. Cyanide; b. Alcohol PHASES OF ASPHYXIAL DEATH: DCA 1. DYSPNEIC PHASE: due to the lack of oxygen and retention of carbon dioxide in the body tissue ² breathing becomes rapid and deep, the pulse rate increases; ² rise in blood pressure; ² face, hands and fingernails becomes bluish. 2. CONVULSIVE PHASE: due to the stimulation of the central nervous system by carbon dioxide ² cyanosis becomes more pronounced; ² eyes become staring and pupils are dilated; ² Tardieu Spots: petechial hermorrhages caused by the rupture of the capillaries on account of increase of intracapillary pressure; ² victim may become unconscious 3. APNEIC PHASE: due to the paralysis of the respiratory system of the brain ² breathing becomes shallow and gasping; ² rate becomes slower till death; ² heart later fails. ² recovery at this stage is almost nil due to the permanent damages inside the brain on account of prolonged cerebral anoxia.

Strangulation by Ligature
Hyoid bone is frequently spared. Ligature mark is usually horizontal and knot is on the same plane. Ligature is usually below the hyoid bone. Ligature groove is uniform in depth in its whole course. Vertebral injury is not observed.

Causes of Death in Strangulation by Ligature Asphyxia due to the occlusion of the windpipe. Coma due to arrest of cerebral circulation. Shock or syncope. Inhibition of the respiratory center due to the pressure on the vagus and sympathetic nerves. THROTTLING OR MANUAL STRANGULATION: form of asphyxia death where the constricting force applied in the neck is the hand. Special Forms of Strangulations 1. PALMAR STRANGULATION: palm of the hand of the offender is pressed in front of the neck without employing the fingers.

Kinds of Smothering 1. Causes of Death in Drowning 1. readily pulls on pressure and exudes water and froth from the section 3. Regurgitation of food from the stomach. SMOTHERING: caused by closing of the external respiratory orifices. corrugated and sodden in appearance 5. Laryngeal spasm due to submersion. the chloride content in the right side of the heart will be more as compared with the left Findings Conclusive that a Person Died of Drowning Presence of materials or foreign bodies in the hands of the victim Increase in the volume (emphysema aquosum) and edema in the lungs (edema aquosum) Presence of water and fluid in the stomach contents corresponding to the medium where the body was recovered Presence of froth. Average time required for death in drowning is 2 to 5 minutes. 6. Blood-stained fluid may be found inside the chest GETTLER·S TEST: a quantitative determination of the chloride content of the blood in the right and left ventricle of the heart ² normally. 3. 5. Clothes are wet. the body floats. o ´Tete de Negriµ ² the bronze color of the head and the neck of a person who died in water during decomposition. either by the use of hand or by some other means. Post-mortem lividity is usually marked in the head. Sumbersion when unconscious External Post-Mortem Findings 1. Mouth may be closed or half-opened with the tongue protruding 7. 2. a metal collar or a bowstring is place around the neck and tightened at the back. 2. the chloride content in the right side of the heart will be less as compared with the left ² if drowning took place in fresh water. ACCIDENTAL SMOTHERING OF EPILEPTIC 3. ´Champignon d·ocumeµ ² the whitish foam which accumulates in the mouth and nostrils 4. Blood in tonsillectomy operation. neck and chest. ATYPICAL DROWNING a. Suicidal smothering by means of his own hands is not possible. ² if drowning took place in salty water. Tracheo-bronchial lumina 5. GAGGING: the application of materials to prevent air to have access through the mouth or nostrils 4. D. the chloride contents of the blood is the same in both sides of the heart. overlapping the heart. ´goose-skinµ or ´goosefleshµ 3. foam or foreign bodies in the air passage found in the medium where the victim was found Presence of water in the middle ear . 3. TYPICAL DROWNING: primary cause of death in ordinary submersion is asphyxia ² water interferes with the free exchange of air in the air sacs. face is pale and with foreign bodies clinging on the skin surface. Most Common Forms of Foreign Bodies Impacted are: 1. ASPHYXIA BY SUFFOCATION: the exclusion of air from the lungs by closure of air openings or obstruction of the air passageway from the external openings to the air sacs. 7. False set of teeth. with eyelids livid. Cadaver spasm ² presence of firmly clenched hands with objects as weeds Post-Mortem Internal Findings 1. with rib markings on the surface and protruded out of the chest upon removal of the sternum 2. GARROTING: a ligature. Skin is puckered. o The body when recovered. c. pale and contracted in the form of ´cutis anserinaµ. OVERLAYING ² most common accidental smothering in children 2. PLASTIC BAG SUFFOCATION CHOKING: suffocation brought about by the impaction of foreign body in the respiratory passage. b. 2. COMPRESSION OF THE NECK WITH A STICK C. floats usually with flexed extremities ² rigor mortis. Vomitus. 4. conjuctaivae injected and pupils dilated 6.2. ASPHYXIA BY SUBMERSION OR DROWNING: nostrils and mouth are submerged in any watery. ´Edema Aquosumµ ² due to the entrance of water in the air sacs which makes the lungs doughy. The length of survival in drowning is proportional to the amount of froth in the respiratory tract. Penis and scrotum may be contracted and retracted. viscid or pultaceous fluid for a time to prevent free entrance of air into the passage and lungs. MUGGING (STRANGLE-HOLD): a form strangulation with the assailant standing at the back and the forearm is applied in front of the neck. Detached membrane in diphtheria. Cardiac inhibition following the submersion due to the stimulation of the vagus nerve. Washerwoman·s hand and feet ² skin in bleached. 4. 4. Bolus of food. The pressure on the neck is brought about by the pressure of the flexed elbow. ´Emphysema Aquosumµ ² lungs are distended like balloons. Within 24 hours from drowning. Eyes are half-open or closed. 8. Respiratory haemorrhage.

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