Hanging: Postmortem findings,Strangulation,Medico-legal aspects of hanging
‘La facies sympathique’ is a condition seen in cases of:
NEET 13; COMEDK 13
A |
Hanging |
|
B |
Strangulation |
|
C |
Throttling |
|
D |
Railway accidents |
‘La facies sympathique’ is a condition seen in cases of:
NEET 13; COMEDK 13
A |
Hanging |
|
B |
Strangulation |
|
C |
Throttling |
|
D |
Railway accidents |
Ans. Hanging
Following is most suggestive of antemortem hanging:
DNB 09
A |
Salivary dribbling |
|
B |
Congestion of lungs |
|
C |
Ligature marks |
|
D |
Petechial hemorrhages |
Following is most suggestive of antemortem hanging:
DNB 09
A |
Salivary dribbling |
|
B |
Congestion of lungs |
|
C |
Ligature marks |
|
D |
Petechial hemorrhages |
Ans. Salivary dribbling
Hanging causes injury to:
JIPMER 14
A |
Carotid artery |
|
B |
Esophagus |
|
C |
Trachea |
|
D |
Vertebral artery |
Hanging causes injury to:
JIPMER 14
A |
Carotid artery |
|
B |
Esophagus |
|
C |
Trachea |
|
D |
Vertebral artery |
Ans. Carotid artery
Lynching is a type of:
AFMC 11; FMGE 13
A |
Homicidal hanging |
|
B |
Suicidal hanging |
|
C |
Judicial hanging |
|
D |
Accidental hanging |
Lynching is a type of:
AFMC 11; FMGE 13
A |
Homicidal hanging |
|
B |
Suicidal hanging |
|
C |
Judicial hanging |
|
D |
Accidental hanging |
Ans. Homicidal hanging
Outward displacement of fractured hyoid bone is seen in:
UP 10
A |
Manual strangulation |
|
B |
Ligature strangulation |
|
C |
Hanging |
|
D |
Bansdola |
Outward displacement of fractured hyoid bone is seen in:
UP 10
A |
Manual strangulation |
|
B |
Ligature strangulation |
|
C |
Hanging |
|
D |
Bansdola |
Ans. Hanging
In a case of hanging, ligature mark is an example of:
NEET 13
A |
Contusion |
|
B |
Pressure abrasion |
|
C |
Laceration |
|
D |
Burn |
In a case of hanging, ligature mark is an example of:
NEET 13
A |
Contusion |
|
B |
Pressure abrasion |
|
C |
Laceration |
|
D |
Burn |
Ans. Pressure abrasion
What is the situation of the knot of ligature in cases of typical hanging‑
A |
In front of chin |
|
B |
Angle of mandible |
|
C |
Occiput |
|
D |
Mastoid |
What is the situation of the knot of ligature in cases of typical hanging‑
A |
In front of chin |
|
B |
Angle of mandible |
|
C |
Occiput |
|
D |
Mastoid |
Ans. is ‘c’ i.e., Occiput
Typical hanging : The ligature runs from the midline above the thyroid cartilage, symmetrically upward on both side of neck to the occipital region, the point of suspension (knot of ligature) being on occiput (at nape of neck).
Atypical hanging : Any variation from typical knot site (i.e. other than occiput/nape of neck) is called atypical hanging. Most common site of knot is near one side of mastoid process or angle of mandible.
Judicial Hanging causes
A |
C2-3 fracture dislocation |
|
B |
C4-5 fracture dislocation |
|
C |
C6-7 Fracture dislocation |
|
D |
None of the above |
Judicial Hanging causes
A |
C2-3 fracture dislocation |
|
B |
C4-5 fracture dislocation |
|
C |
C6-7 Fracture dislocation |
|
D |
None of the above |
Ans. is ‘a’ i.e., C2-3 fracture dislocation
Judicial hanging
In india, legal death sentence is carried out by hanging the criminal. Placement of knot beneath the chin (submental position) is thought to be most effective, ensuring a quicker death. However some prefer side of neck (left sub aural i.e. below angle of jaw) knot.
The preson is allowed to drop for 5-7 meters according to the weight, age and build of the person. Sudden stop causes fracture dislocation usually at level of C2-C3 or C3-C4 vertebra, and injury to spinal cord and brainstem (pons and medulla).
When a person has suspended himself by applying ligature around neck so that the point of suspension (knot) is situated in the region shown in the picture below.Such a hanging is called as ?
A |
Typical. |
|
B |
Atypical. |
|
C |
Partial. |
|
D |
Incomplete. |
When a person has suspended himself by applying ligature around neck so that the point of suspension (knot) is situated in the region shown in the picture below.Such a hanging is called as ?
A |
Typical. |
|
B |
Atypical. |
|
C |
Partial. |
|
D |
Incomplete. |
Hanging is best defined as the constriction of neck by a ligature tightened by the weight of the body. When the point of suspension is over the center of occiput, there is a maximum possibility of occlusion of the arteries and this is known as typical hanging as shown in the picture above., while all other points of suspension are called atypical hanging.
Hanging: Postmortem findings,Strangulation,Medico-legal aspects of hanging.
Introduction
Postmortem findings
- Ligature mark is above thyroid cartilage, inconplete, bitaterally symmetrial and directed obliquely upward extending to the angles of mandible, then to mastoid and finally to occipital protuberance. Ligature mark is an example of imprinted/pressure/patterned abrasion.
- There is dribbling of saliva from the angle of the mouth which is confirmatory sign of antemortem
- Hanging. This is due to irritation of submandibular and parotid glands by ligature.
- There may be intimal tear of carotid arteries.
- In case of pressure of ligature on cervical sympathetic ganglia, the eye on that side is found open (La facie sympathique) .
- Fracture of hyoid is usually not seen (may be seen only in l0%). Fracture of thyroid cartilage
- (20-30 % cases) and fracture of tracheal rings (5-l0 %) may be seen.
- There may be congestion and ecchymosis (hemorrhage) in trachea’ larynx, epiglottis and esophagus.
- All these injuries are more common in strangulation because strangulation is more violent than hanging causing more severe injury to neck structures.
- Tardieu spots (petechial hemorrhage) are not as Pronounced as in strangulation.
STRANGULATION
- Strangulation is the form of asphlxia caused by constriction of neck by ligature or some other method, but without suspension of the body. So the force constricting the neck is external force (not the weight of the body as occurs in hanging).
Depending upon the method used to constrict the neck, strangulation can be divided into:
- Ligature strangulation : Neck is compressed by a ligature of which usually multiple rounds are given and no knot is tied.
- Throttling (manual strangulation) : Neck is compressed by one or both hands. When neck is compressed by two palms, it is known as palmar strangulation.
- Bansdola: Compression of neck with one or two wooden sticlcs or bamboo.
- Garrotting: It is compression of neck by a rope thrown from behind. Spanish windlass is a type of garrotting, which used to be the official mode of execution in spain. In this, an iron collor around the neck was tightened by a screw for strangulation.
- Mugging (choke hold) : It is compression of neck by forearm or in the bend of elbow.
- Strangulation by knee/foot : In this, neck is compressed by knee or foot.
Medico-legal aspects of hanging:
- Hanging is invariably suicidal, until unless otherwise proved. In a suicidal hanging, any material available at that moment of time can be used for the act. A foot stool may be found at the scene of the death which is used for reaching the point of suspension.
- Tragic cases of accidental hanging are also reported where children play dangerous games including simulation of hanging.
- Lynching is a form of homicidal hanging where an accused of murder or rape is hanged in a public square by a mob as a part of carrying out justice.
- Judicial hanging: In some countries, including India, hanging is the mode of carrying out capital punishment or legal execution of death sentence. The rope is allowed to drop 5 to 7 metres according to the height and weight of the person. Bilateral fracture of the pedicle of the second-third or third-fourth cervical vertebrae occurs which is called hangman’s fracture.
- Sudden stop causes fracture dislocation usually at level of C2-C3 or C3-C4 vertebra, and injury to spinal cord and brainstem (pons and medulla).
- the dislocation of the atlanto occipital joint or the odontoid process of the axis vertebra causes pulping of the spinal cord and transaction of the cervical cord. There even can be rupture of the brain stem with proper judicial hanging.
- Postmortem hanging: Sometimes the victim may be murdered by some other means and then hanged postmortem in order to mislead the police. thorough and meticulous postmortem examination, the original cause of death can also be established.
Exam Important
- Hanging. This is due to irritation of submandibular and parotid glands by ligature.
- There may be intimal tear of carotid arteries.
- In case of pressure of ligature on cervical sympathetic ganglia, the eye on that side is found open (La facie sympathique) .
- Fracture of hyoid is usually not seen (may be seen only in l0%). Fracture of thyroid cartilage
- (20-30 % cases) and fracture of tracheal rings (5-l0 %) may be seen
- Lynching is a form of homicidal hanging where an accused of murder or rape is hanged in a public square by a mob as a part of carrying out justice.
- Judicial hanging: In some countries, including India, hanging is the mode of carrying out capital punishment or legal execution of death sentence. The rope is allowed to drop 5 to 7 metres according to the height and weight of the person. Bilateral fracture of the pedicle of the second-third or third-fourth cervical vertebrae occurs which is called hangman’s fracture.
- Sudden stop causes fracture dislocation usually at level of C2-C3 or C3-C4 vertebra, and injury to spinal cord and brainstem (pons and medulla).
- the dislocation of the atlanto occipital joint or the odontoid process of the axis vertebra causes pulping of the spinal cord and transaction of the cervical cord. There even can be rupture of the brain stem with proper judicial hanging.
- Postmortem hanging: Sometimes the victim may be murdered by some other means and then hanged postmortem in order to mislead the police. thorough and meticulous postmortem examination, the original cause of death can also be established.