Mechanical Asphyxia

Lecture Plan
 Hanging
 Causes of death
 Mechanism
 Autopsy – technique & findings
 Medico-legal aspects
 Judicial hanging
 Auto-erotic hanging
 Hanging
 Hanging involves
compression of the
neck structures by a
ligature placed around
the neck which is
constricted with the
help of all or part of
the body weight.
 Hanging
 Mechanism
 2Kg pressure is sufficient to compress Jugular
Veins
 5Kg – carotid arteries
 Air passages can be blocked by tongue being
forced back against posterior pharyngeal wall
Forensic Anatomy
 Hanging
 Types
 Based on degree of
suspension
 Complete Hanging
 Partial Hanging
 Hanging
 Types
 Based on degree of
suspension
 Complete Hanging
 Partial Hanging
 Based on the position
of knot
 Typical
 Atypical
 Knot on the front is
unusual
 Hanging
 Causes of Death
 Immediate
 Vagal inhibition
 Airway occlusion
 Vascular congestion
 Cerebral anaemia
 Delayed
 Infection
 Cerebral hypoxia
sequelae
 Autopsy
 External Examination
 Post mortem staining
is usually in glove and
stocking distribution
 Dependant parts of
viscera may also show
post mortem staining
 Autopsy
 External Examination
 Post mortem staining
is usually in glove and
stocking distribution
 Dependant parts of
viscera may also show
post mortem staining
 Urination, defecation &
ejaculation may
happen during death
 Autopsy
 External Examination
 Petechiae
 Face may be livid
 Tongue may appear
protruded and bitten
 Subconjunctival
hemorrhages are seen
more often in partial
hanging – rare in
complete hanging
 Autopsy
 External Examination
 Hypostatic petechiae
may be present
 Autopsy
 External Examination
 Hypostatic petechiae
may be present
 Vertical streaks of
salivary dribble may
be seen extending
down from angle of
mouth
 Autopsy
 External Examination
 Hypostatic petechiae
may be present
 Vertical streaks of
salivary dribble may
be seen extending
down from angle of
mouth
 One eye may remain
open and the pupil
may be dilated (le
facies sympathique)
 Autopsy
 The ligature material
 Removed by cutting
away from the knot
 Lengths of different
parts of the ligature
(noose, short free end,
long free end)
measured
 Autopsy
 The ligature material
 Removed by cutting
away from the knot
 Lengths of different
parts of the ligature
(noose, short free end,
long free end)
measured
 The pattern of the
material is compared
with the ligature mark
 Sometimes unusual
materials are used
 Autopsy
 The ligature mark
 May be very faint
 Usually brownish black
furrow
 There may be more
than one ligature mark
when the ligature slips
or when there is more
than one turn around
neck
 Autopsy
 The ligature mark
 Oblique and
discontinuous
 Usually placed above
the level of thyroid
cartilage
 Sometimes blisters are
seen below the mark
 Autopsy
 The ligature mark
 Oblique and
discontinuous
 Usually placed above
the level of thyroid
cartilage
 Sometimes blisters are
seen below the mark
 Sometimes other
findings may be
mistaken for ligature
mark
 Autopsy
 Brain and Thoracic viscera removed before
neck is dissected
 Flap dissection of neck done under
bloodless field
 Neck dissection
 Skin is retracted
under bloodless field
 Neck dissection
 Strap muscles
removed in layers
 Neck dissection
 Strap muscles
removed in layers
 Neck dissection
 Strap muscles
removed in layers
 Neck dissection
 Thyroid gland
exposed
 Neck dissection
 Thyroid gland
removed
 Neck dissection
 Trachea reflected.
Prevertebral muscles,
fascia and vertebral
column can be
visualized
 Neck dissection
 Neck structures are
removed
 Infiltration of blood or
injuries looked for.
 Abnormal mobility of
vertebral joints looked
for
 Neck dissection
 Tissue beneath the
pressure abrasion
usually appears pale
and glistening in
hanging
 Neck dissection
 Hyoid bone fractures
looked for
 Abduction fractures
suggest hanging
 Neck dissection
 Intima of carotid may
show tear
 Lower end of
sternomastoid or
platysma may show
contusion
 Medico-legal aspects
 Hanging is almost invariably suicidal.
 Accidental hanging – rare
 Homicidal hanging – rare
 Judicial hanging
 Accidental hanging
 Usually kids who play games
 Sometimes people get caught in
clotheslines or wires
 Homicidal hanging
 The victim is usually a weak individual
 Children
 People incapacitated by alcohol or drugs
 Lynching
 A person is accused of some crime and
hanged by a mob
 Nowadays the word has a broader meaning
 Originally a punishment used by whites
against blacks
 Judicial Hanging
 It is the most common form of legal
execution.
 The “drop” is adjusted based on the
weight of the person
 The intention is to cause quick death
 without causing decapitation
Hangman's fracture
 Post –mortem suspension
 Death is due to some other means and the
body is hanged
 Le facies sympathique & salivary dribble
mark not present
 Cellophane test (for fibers) - negative
 Presence of general asphyxial signs
depends on actual cause of death
 Auto-erotic hanging
 The subjects desire is
to partly asphyxiate
himself – to enhance
sexual pleasure by
masturbation
 The failure of safety
features leads to
death
 Auto-erotic hanging
 Common in western
countries among
white males
 Cross dressing is
often seen
 Pornographic
literature/materials
may be seen in the
vicinity
 Auto-erotic asphyxia
 Methods other than
hanging are also
employed
 Portions covered
 Hanging
 Causes of death
 Mechanism
 Autopsy – technique & findings
 Medico-legal aspects
 Judicial hanging
 Auto-erotic hanging