Legal Medicine - Asphyxia

asphyxia
The
Thegeneral
generalterm
termapplied
appliedtotoall
all
forms
formsofofviolent
violentdeath
deathwhich
which
results
resultsfrom
fromthe
theinterference
interferencewith
with
the
theprocess
processofofrespiration.
respiration.
The
Thecondition
conditionininwhich
whichthethesupply
supplyofof
oxygen
oxygentotothe
theblood
bloodorortotothe
thetissues
tissues
has
hasbeen
beenreduced
reducedbelow
belownormal
normal
level ..
level
TYPES OF ASPHYXIAL DEATH:
Anoxic Death: failure of the arterial blood to

become normally saturated with oxygen
Anemic-Anoxic Death: due to decreased

capacity of the heart to carry oxygen
Stagnant Anoxic Death: brought about by

the failure of circulation
Histotoxic Anoxic Death: failure of the

cellular oxidative process
anesthesia Alcohol Drowning
pulmonary edema Cyanide and Choking
Heart Failure, Shock, High altitude Hemorrhage,

A-V mal, embolism Patent foramen ovale Foreign body
impaction
Traumatic crush Varicose veins Smothering and

asphyxia Torniquet use overlaying
Carbon monoxide Pneumonia, Asthma,

poisoning Emphysema hemoglobinemia
Classification of Asphyxia
hanging strangulation
suffocation drowning
traumatic crush inhalation of irrespirable

asphyxia gases
IN G
N G
HA
classification of hanging:
As to
As
to the
the location
location
of the
of the ligature
ligature
and knot:
and knot:
-- typical
typical
-- atypical
atypical
As to the amount of
constricting force:
- complete
- partial
As to symmetry:
symmetrical
assymetrical
post-mortem findings in hanging:
Neck elongated and stretched with the head inclined on

the side opposite the knot
Lividity or pallor of the face with swollen and protruded
tongue
Eyes closed or partly opened with pupils dilated on one
side and small on the other
Blue lips with frothy saliva drooling
State of erection or semi-erection of the penis with
some seminal fluid on the meatus
Lividity or ecchymosis on the legs
mechanism of death in hanging:
Tracheal
Trachealobstruction
obstruction
Carotid
Carotidcompression
compression
Vagal
Vagalstimulation
stimulation
Atlanto-axial
Atlanto-axialdislocation
dislocation
strangulation
by Ligature
RARELY suicidal
Usually homicidal and

accompanied by
evidence of struggle
or marks of violence
other forms of strangulation:
Manual Strangulation or Throttling

Palmar Strangulation
Garroting
Mugging or Strangle-hold
Stick Compression
manual
strangulation
COMPARO:
HANGING vs. STRANGULATION
Frequently above the Usually below the

Adams apple Adams apple
Ligature mark is Ligature mark is

inverted V-shape, usually horizontal,
the apex is on the knot is on the same
site of the knot horizontal plane
Ligature groove is Ligature groove is

deepest at the site uniform in depth in its
opposite the knot whole course
Asphyxia by Suffocation
MECHANISM:
MECHANISM: Closure
Closureofofair
airopening
opening
or
orobstruction
obstructionofofthe
theair
airpassageway
passageway
Types:
Types:
- -Smothering
Smothering
- -Choking
Choking
- -Burking
Burking
types of smothering:
Overlaying Gagging
Plastic bag Accidental

Suffocation Smothering of
Epileptic
Choking
- -impaction
impactionofofforeign
foreignbody
bodyininthe
the
respiratory
respiratorypassage
passagesuch
suchas:
as:
1.1.Vomitus
Vomitus
2.2.Regurgitation
Regurgitationfromfromthe
thestomach
stomach
3.3.Bolus food(caf
Bolusofoffood (cafcoronary)
coronary)
4.4.False
Falseteeth
teeth
5.5.Blood
Bloodininoral
oraloperations
operations
6.6.Tuberculosis
Tuberculosis
asphyxia
by
drowning
Asphyxia by Drowning
SUBMERSION
Nostrils and mouth are submerged in water for
some time to prevent the free entrance of air into
the air passage and the lungs
It is not necessary for the whole body to be

submerged
Children drown in shallow pools or ponds
Drunks may drown in shallow creeks

Phases of Drowning:
1. Respiracion de Surprise
2. Phase of resistance
(first apnea)
3. Dyspneic phase
4. Another apnea
5. Terminal respiration
Causes of Death in Drowning:
TYPICAL
- cause of death is
asphyxia
ATYPICAL
- cardiac inhibition due to vagal stimulation
- laryngeal spasm
- submersion when
unconscious
Time factor in drowning:
1 min. , considered fatal

4 min. , possibility of
revival
23 min., average time
for death
N.B. the length of time for

survival in drowning is
proportional to the amount of
froth in the respiratory tract
Post-mortem findings:
Wet clothes, pale face with foreign
bodies clinging on skin surface
Cutis anserina or goose skin or
goose flesh
Firmly clenched hands with objects,
weeds or stones
Mouth closed or half- Penis and scrotum are

open with tongue retracted
protruding Washerwomans hands and
Physical injuries due feet
to struggle Livid eyes, conjuctival
injection and dilated pupils
Internal findings in Drowning
Emphysema aquosum
Edema aquosum
Champignon d ocume
Tracheo-bronchial congestion
Fluid with bloody froth
Right side of the heart is
usually distended
conclusive findings in drowning:
Foreign bodies in hands; cadaveric spasm

Emphysema Aquosum
Edema Aquosum
Stomach contents: water or fluid,
corresponding to the medium where body
was submerged
Froth, foam or foreign body in the air
passage consistent with the medium
Water in the middle ear
floating
Naked body
Naked floats after 24 24
hrs.hrs.
body floats after
Those with
Those clothes or apparels
with clothes or apparels
take more
take time
more time
TETE DE DE
TETE NEGRI
NEGRI
Compression Asphyxia
Traumatic
or
Crush
Asphyxia
Causes:
Landslide
And Highway
Masonry accidents accidents
Rubble of collapsed Mine Collapse and

buildings Stampede
Burking
BURKE and HARE
Murderer sits or kneels

on the chest with one
hand covering the
mouth and nostrils of
the victim.
Inhalation of
Irrespirable
Gases
carbon monoxide
CARBONIC OXIDE
SILENT KILLER
From incomplete combustion of

carbon fuel as in burning of wood, oil,
coal, kerosene, gasoline and charcoal
Limits oxygen carrying capacity of the

blood due to its 250 X more affinity to
hemoglobin.
carbon dioxide
Product of respiration,
complete combustion
and fermentation or
decomposition of
organic matters
Found also in drainage

pipes, deep wells,
sewage tanks
hydrogen sulfide
hydrogen cyanide
the war gases:
LACRIMATOR or Tear Gas
Chloracetophenone
Bromobenzyl
Cyanide
Ethyl Iodoacetate VESICANT or
Blistering Gas
Mustard Gas
Lewisite
STERNUTATOR or ASPHYXIANT or Choking
Vomiting Gas Gas
Diphenyl Chlorine
Chlorarsine Phosgene
Diphenyl Chloropicrine
Cyanarsine Diphosgene
Dipenylamine
Chlorarsine
BLOOD POISONS
Hydrocyanic Acid
Hydrogen Sulfide
PARALYSANTS or Nerve
Carbon Monoxide
Gas
Anti-cholinesterase
From the lost sea He rises,
Creating armies in every shore,
Turning men against their
brothers,
Till Man exists no more.
- NOSTRADAMUS

Legal Medicine - Asphyxia

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asphyxia

Anoxic Death: failure of the arterial blood to

Anemic-Anoxic Death: due to decreased

Stagnant Anoxic Death: brought about by

Histotoxic Anoxic Death: failure of the

Heart Failure, Shock, High altitude Hemorrhage,

Traumatic crush Varicose veins Smothering and

Carbon monoxide Pneumonia, Asthma,

traumatic crush inhalation of irrespirable

Neck elongated and stretched with the head inclined on

Usually homicidal and

Manual Strangulation or Throttling

Frequently above the Usually below the

Ligature mark is Ligature mark is

Ligature groove is Ligature groove is

Plastic bag Accidental

It is not necessary for the whole body to be

Children drown in shallow pools or ponds

Drunks may drown in shallow creeks

1 min. , considered fatal

N.B. the length of time for

Mouth closed or half- Penis and scrotum are

Foreign bodies in hands; cadaveric spasm

Rubble of collapsed Mine Collapse and

BURKE and HARE

Murderer sits or kneels

From incomplete combustion of

Limits oxygen carrying capacity of the

Found also in drainage

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