ASPHYXIA FM (1) in Forensic medicine pathology death.pdf

Asphyxia in Forensic medicine

1. DEFINITION a

+ Asphyxia (Greek, 'pulselessness' or ‘absence of pulse') is a
condition caused by interference with the exchange of oxygen and
carbon dioxide in the body.

Asphyxia literally means 'defective aeration of blood” due to any
cause.

Adelson defined asphyxia, as “a state in living organism in which
there is acute lack of oxygen available for cell metabolism
associated with inability of body to eliminate excess of carbon
dioxide.”

2. TYPES/ CLASSIFICATION OF PER
1. Mechanical asphyxia
2. Traumatic asphyxia
3. Environmental asphyxia
4. Toxic asphyxia 2 P 2 T EMI
5. Pathological asphyxia
6. Postural asphyxia
7. latrogenic asphyxia

3. | E
MECHANICAL ASPHYXIA a Y

In this type of asphyxia, flow of air into the body is interfered by
mechanical means.

Mechanical causes are:

Closure of external respiratory orifice viz. mouth and nose —
smothering

Occlusion of oral cavity and oropharynx — gagging
Occlusion of airway by pressure on neck —hanging, strangulation
Obstruction of air passage internally - choking.

4. >

+ The asphyxia is caused by pressure and fi xation of the chest
and abdomen.

+ Traumatic causes are:

+ Stampede

+ Pneumothorax due to penetrating injury to chest

+ Person crushed under vehicle

e Person crushed by fall of wall/collapse of house/earthquake.

TRAUMATIC ASPHYXIA

5. ENVIRONMENTAL ASPHYXIA

+ Non-availability of oxygen in the air causes asphyxia
+ Environmental causes are:

+ High altitude

+ Person trapped in well or granary

+ Respiration in enclosed space.

6. TOXIC ASPHYXIA edi

* This form of asphyxia results from poisonous substances.

* Cessation of the respiratory movements due to paralysis of the
respiratory center in poisoning with morphine, barbiturates and
strychnine. Inhibition of oxidative processes in the tissue
preventing the use of oxygen in the blood, e.g. cyanide
poisoning.

+ Cyanide poisoning

+ Opium poisoning

© Carbon monoxide poisoning

7. PATHOLOGICAL ASPHYXIA =” Y

+ Presence of disease in respiratory passage or in lung prevents
oxygenation and causes asphyxia.

+ Entry of oxygen to the lungs is prevented by disease of the upper
respiratory tract or lungs, e.g. laryngeal edema, spasm, tumors
and abscess.

8. + POSTURAL ASPHYXIA

* Positional asphyxia is due to peculiar body position that prevents
adequate gas exchange.

+ This is seen where an unconscious or stuporous person, either
from alcohol, drugs or disease, lies with the upper half of the
body lower than the remainder.

+ IATROGENIC is mainly associated with anaesthesia.

“drugs may cause side effects which can lead to iatrogenic disease"

9. E

* Following signs are considered as classical signs of asphyxia:
1) Cyanosis

2) Congestion of organs

3) Petechial hemorrhages

4) Pulmonary edema

5) Fluidity of blood

10. F
Cyanosis =.
+ The word cyanosis is derived from Greek means “dark blue”

+ Indicates bluish colouration of skin or mucous membrane. It is
more pronounced in parts having abundant capillary and venous
circulation like lip, tip of nose, nailbeds, ear lobes, tip of tongue

etc.

— Marked anemia
— When dermis is thick

11. Petechial Hemorrhages

+ These are small-point collections of blood and vary in size from a
tenth of a millimeter to about two millimeter. If Larger than two
millimeter, they are called as ecchymoses.

+ Petechial hemorrhages are also called as “Tardieu’s spot”. But
Tardieu spots specifically refer to Petechial hemorrhages occurring
in the visceral pleura.

12. * These hemorrhages are caused by an acute rise in ı®

pressure. The rise in venous pressure causes over-dist

and rupture of thin-walled venules, especially in lax tissue
such as eyelid, pleura, epicardium.

Tardieu’s spot

13. Pulmonary Edema Lo

* Pulmonary edema is a condition where there is excess of fluid
present in lung alveoli. The fluid accumulates due to raised
pulmonary vessel pressure and associated anoxia.

Lungs with Fluid === 77 4

a
L 2
4, y
Ed x,

14. Congestion of Organs _2

+ Hypoxia causes decrease oxygen tension in blood with increased
reduced hemoglobin with capillary dilatation, engorgement and
stasis of blood. The stasis of blood in capillaries causes
congestion of organs.

15. Fluidity of Blood _®2

+ In past fluidity was considered as a marker of asphyxia.

+ It was thought that anoxia/hypoxia causes release of
fibronolysin enzymes from vessel wall. These enzyme causes
fluidity of blood.

16. STAGES OF ASPHYXIA

Stage of Dyspnea

BR

Stage of Exhaustion and Respiratory fail

Stage of Convulsion —

17. Stage of dyspnea +

— Breathlessness

— Feeling of oppression in the chest
— Heaviness in head

— Ringing in the ears

— Tachycardia

— Raised blood pressure

— Stage last for a minute.

18. — Retention of carbon dioxide
— Increase blood lactate

— Respiration becomes labored and spasmodic

— Sympathetic and parasympathetic effects are prominent with
increased secretion of saliva; increase heart rate, and increase
gastrointestinal motility, incontinence of bowel and bladder with
relaxation of sphincters and voiding of urine, feces and semen.

— Clouding of consciousness and convulsions

— Stage last for 1 to 2 minute.

19. — Anoxic brain damage with paralysis of respiratory centers
— Complete insensibility

— Flaccidity of muscle

— Reflexes are lost

— Pupils are widely dilated

— Heart may continue to beat for few more minutes
— Stage last for 2 to 3 minute.

20. a

— Anoxic brain damage with paralysis of respiratory centers

— Complete insensibility

—Flaccidity of muscle

— Reflexes are lost

— Pupils are widely dilated

— Heart may continue to beat for few more minutes
— Stage last for 2 to 3 minute.

21. Definition EU

+ Hanging is a form of violent death produced by suspending
the body with a ligature round the neck, the constricting force
being the weight of the body or a part of body weight.

22. Types of hanging Nal

1) Typical hanging
2) Atypical hanging

1) Complete hanging
2) Partial or incomplete hanging

1) Suicidal hanging
2) Homicidal hanging
3) Accidental hanging

23. D) In relation to death:
1) Antemortem hanging
2) Postmortem hanging
E) Others:

1) Judicial hanging

2) Lynching

24. * Typical Hanging: When the body is suspended by ligature we =) |
suspension at center of occiput i.e. when the knot is at the na
the type of hanging is called as typical hanging.

Atypical hanging: In this type of hanging, the point of suspension is not

at occiput i.e. the knot is not at nape of neck. Thus when knot in hanging
is at other than nape of neck, it is called as atypical hanging.

u
|

À

|
4 x —

a

Posterior aspect

Lateral aspect Lateral aspect

25. Mechanism of Hanging _Al

+ In hanging the constricting force may be-
1) Weight of entire body as in complete hanging or
2) Part of body weight as in partial hanging.

* A constriction pressure of 2 kg is sufficient to occlude jugular
venous system causing cerebral venous congestion.

¢ A constricting pressure of 5 kg can compress the carotid arteries
causing cessation of blood supply to brain.

® A constricting force of 15 kg can compress the trachea causing
obstruction to respiration.

+ A constricting force of 30 kg can obstruct the vertebral arteries.

26. Cause of Death _EU

1) Asphyxia: Obstruction of air way.

2) Venous congestion: Obstruction of jugular venous system.

3) Cerebral anemia: Compression of carotid arteries causing cerebral
ischemia.

4) Vagal inhibition: Vagus nerve or carotid bodies when compressed
may cause vagal inhibition with cessation of heart.

5) Fracture dislocation of cervical vertebrae.

27. Symptoms in Hanging _El
1) Loss of power

2) Subjective sensation such as flashes of lights
3) Ringing in ears

4) Blurring of vision

5) Mental confusion

6) Loss of consciousness

7) Convulsions.

28. Knot

* Knots are of following types:
1) Simple slip knot- most commonly used
2) Fixed knot/granny knot.

* Knot may be present at following site:
1) Mastoid or mandibular angle

2) Below chin

3) Occiput.

29. Fatal Period _EU

+ Death occurs immediately if cervical vertebrae are fracture-
dislocated or due to Vagal inhibition

+ Asphyxia and others: usual period is 3 to 5 minute.

30. Autopsy Findings _EU

* Clothes: Clothes may bear saliva stains.
+ External Examination:

+ Ligature mark is most important finding in neck. The ligature
used for hanging causes a mark over neck. It is a pressure
abrasion made by ligature.

31. — Face may be congested, puffed up and shows petechial
hemorrhages over skin or conjunctiva.

— Blood tinged froth may be seen oozing from nostrils due to
pulmonary Edema

— Sign of salivary dribbling from the corners of mouth

r

— Glove and stock pattern of postmortem lividity may be seen if body
remains suspended for long time.

— Cyanosis
— Voiding of urine/stool/semen.

32. + Internal Examination "eu

+ A) Neck

— The tissues underneath the mark are dry, white and glistening
with occasional ecchymoses in the muscles.

* Muscles of neck: Platysma and sternocleidomastoid may show
contusion in some cases if violence is considerable

* Hyoid bone: Occasionally, hyoid bone may be fractured and is
more common in individuals above 40 years of age. The fracture
involves the greater horn of hyoid bone. It is also called as
anteroposterior or compression fracture.

33. + The superior horn of thyroid cartilage may get tac

pressure.

+ If hanging is associated with long drop, there may be injury to
larynx and/or fracture-dislocation of upper cervical vertebrae.

B) Brain
— May be congested if there is compression of jugular venous system

— May be pale if there is compression of carotid and vertebral
arteries.

C) Lungs: Lungs are congested and edematous with Tardieu spots
over pleura

D) Abdominal viscera congested.

34. Medico-legal Importance Nal

1. Hanging may be suicidal, homicidal or accidental. Suicidal manner is
more common than homicidal or accidental.

2. Accidental hanging may occur:

— Accidentally at work place for example in factories.

— Playing and mimicking hanging by children

— Sexual deviation-auto-erotic hanging

— During professional performance, e.g. circus, magic show etc.

— Infants and toddlers may get accidentally hanged in restraining belt of
bed or crib.

3. Hanging may be Antemortem or postmortem.

35. Definition _®

* Strangulation is a form of violent asphyxial death caused by
constricting the neck by means of ligature or by any other
means without suspending the body.

+ In strangulation the constriction force is other than the weight of
victim’s body. There is application of external force such as
compression of neck by hands, by rope, by belt, by stick etc.

36. Types of Strangulation mA

A) Strangulation deaths are classified on the basis of means
used to constrict the neck and are of following types.

1. Ligature strangulation

2. Manual strangulation or throttling
3. Mugging

4. Bansdola

5. Garroting

37. Cont.. my

B) Depending on manner of death, strangulation is classified as:

1. Homicidal strangulation
2. Accidental strangulation

38. Cause of Death | @

+ Asphyxia

+ Cerebral hypoxia

* Cerebral congestion
+ Vagal inhibition

+ Fracture dislocation of cervical vertebrae

39. Ligature strangulation 8

+ Ligature strangulation is a violent form of death caused by
constricting the neck by means of a ligature without suspending
the body.

+ Ligature may be in form of rope, belt, wire, cable, dhoti, dupatta
etc.

40. Autopsy findings 8

+ External Examination

— The ligature mark is usually well defined and grooved.

— The mark may be multiple, if ligature is twisted many times
round the neck.

B) Other signs :

— Signs of asphyxia are more prominent

— The face is puffy, edematous and congested

41. Internal examination 8

A) Findings in neck:

The neck will be relatively bloodless, as blood will be drained out
from neck vessels.

Superficial hemorrhages may be present underneath the ligature
mark

The neck muscles may show hematoma or even lacerations

Fracture of hyoid bone and thyroid cartilage may be seen in some
cases.

42. B) Other findings:

— Lungs may be congested and edematous and may shi
hemorrhages in parenchyma

— Pleura show hemorrhages. There may be emphysematous bullas
on lung surface due to over distension and rupture of
interalveolar septa.

— Abdominal viscera- congested.

43. THROTTLING (MANUAL STRANGULATION) mu

* It is violent asphyxial death produced by compression of neck
manually i.e. by using human hands. The neck is compressed
by using hands. Either one hand or both hands may be used to

throttle a person.

44. * Autopsy Findings
* In addition to signs of asphyxia, injuries may be seen in neck.
The injuries are in form of contusion and/or abrasion.

À

* Contusions are produced as a result of grasping the neck of
victim by assailant’s fingers.

* Scratch abrasions may be present over neck and are caused by
fingernails of hands

45. + On internal examination bruising of neck muscles m @

present as a direct result of force applied.
+ Hemorrhages are common in strap muscles and platysma.

* Hyoid bone fracture: Fracture of hyoid bone is common in
manual strangulation

46. Mugging @

+ Also known as arm lock

e This is a type of strangulation. It is caused by holding the neck of
person in the bend of the elbow (or bend of knee). Here
pressure is exerted over larynx or side of neck by the forearm
and arm.

47. Bansdola | =

* It is form of strangulation. In bansdola, a wooden poles or sticks or rods or
bamboos are used. One bamboo or stick is placed over front of neck and
another is placed behind the neck. One end of these sticks or bamboos are
tied together by a rope and other ends are brought forcefully together so as
to squeeze or compress the neck in between two sticks to cause death.

J Compressive force

48. Garroting = |

+ Garroting is a type of strangulation. Thugs used this method around
1867 in India. The robbers used this method in lonely places to kill
travelers and rob them.

+ There are various methods such as Indian method, Spanish method
etc.

¢ In Indian method, the victim is attacked from behind without
warning. The neck is grasped by a ligature thrown from behind and
is quickly fastened or tightened by twisting it with lever or two
sticks tied at the end of ligature. Asphyxiation of the unaware
victim causes rapid loss of consciousness and death.

49. * Spanish method: In Spain it is method of judicial executi a
a twisting device known as Spanish windlass is used. It c :
iron color that is placed around the neck and tightened by screw
for strangulating the victim.

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50. Medico-legal aspects @

+ Strangulation is usually homicidal.

+ Suicidal strangulation is rare, because once anoxia sets in, the
nraccura aver tha neck gets relaxed.

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51. Medico-legal aspects @

* Strangulation is usually homicidal.

+ Suicidal strangulation is rare, because once anoxia sets in, the
pressure over the neck gets relaxed.

+ Accidental strangulation is rare, but it may occur when clothing
such as dupatta, neck band, or cord gets tightly drawn around
the neck, in an abrupt manner.

52. Definition XL

* Suffocation is a type of mechanical asphyxia Caused by —
1. Either due to lack of oxygen in the environment or

2. By mechanical obstruction to the air passage by means other
than constriction of neck and drowning.

53. Types of Suffocation

1) Smothering

2) Choking

3) Gagging

4) Overlying

5) Burking

6) Traumatic asphyxia

LR

54. Causes of suffocation

Presence of toxic gases in air such as CO, CO2, etc
Decompression (Reduction in air pressure)

High altitude

Smothering

Overlying

Traumatic asphyxia

ui

55. SMOTHERING ©

=

* Definition: It is form of asphyxia caused by mechanical

occlusion of the external respiratory orifices i.e. the nose and
mouth.

* Death is caused by obstructing the air passage i.e. mouth and
nostril by means of hand, cloth, pillow, towel etc.

56. Autopsy Findings @

+ There may be pale area around the mouth and nose due to

pressure of the object.

Face may also show congestion.

If soft material is used to close mouth and nostrils, no obvious

injuries may present externally. However, the object used may be

stained with saliva and blood.

+ There may be contusions at lips, gums and tongue.

+ Foreign bodies in form of fibers or piece of cloth etc. may be found
in oral cavity

57. Medico-legal Importance E

1) Homicidal smothering is common.
2) Accidental smothering is rare.

3) A newborn baby may die due to suffocation if the baby is born
with amniotic sac covered with

58. GAGGING El

* Definition: Gagging is a type of asphyxia caused by preventing
the air entry into the respiratory tract by stuffing gag material
into the mouth.

+ The gag material may be rolled cloth, cotton, rug, paper etc.

59. Autopsy Findings M Y

* Autopsy findings consist of congestion and abrasion of hard
and soft palate.

* Gag may be present in the oral cavity.

60. Medico-legal Importance 2

1) Homicidal death: Gags are inserted into mouth of infants or
incapacitated person with an intention to kill them.

2) Some times accidental death may occur when a gag is inserted
into the mouth of a victim to prevent from shouting.

61. Overlying ©

+ Overlying is also called as compression suffocation

e It results when mother or other person sharing a bed with
infant.

+ These deaths are accidental in nature.

62. Burking © |

+ Burking is a form of mechanical asphyxia where death is caused by
a combination of smothering and traumatic asphyxia.

+ William Burke and William Hare killed 16 persons during 1927-28 in
Scotland and sold their bodies to Dr. Robert Knox for use as
specimens in his anatomy classes in Edinburgh Medical School, in
what became known as the case of the Body Snatchers (West Port
murders).

63. + Method: A victim was invited to their house and given a ©
When drunk, he was thrown on the ground and Burke woul

or sit on the chest and close the nose and mouth with his hands,
and Hare used to pull him around the room by the feet.

Medico-legal importance: This
method combines smothering and
traumatic asphyxia.

64. CHOKING Ba

* Definition: Choking is a form of asphyxial death caused by
mechanical obstruction of the air passage from within.

+ Thus in choking, there is blockage of airway internally.

© Choking may be caused by objects like-coins, dentures, fish or
animal bone,

65. Cause of Death sn

1) Asphyxia
2) Vagal inhibition

3) Laryngeal spasm

66. + Autopsy findings: 8

+ Foreign body that causes obstruction will be found in the
respiratory passage.

+ Respiratory passage is congested and at the site of foreign body
may show inflammation.

67. Medico-legal Importance _& '
+ Choking is usually accidental. In children, choking may occur

while playing with small objects or while eating may inhale solid
particle or food bolus.

* Suicidal or homicidal choking is rare phenomenon.

* Café coronary: A person under the influence of alcohol may
some time inhale food bolus or piece of bone or meat

68. Traumatic asphyxia ©

= -
: Traumatic asphyxia is form of violent asphyxia caused
due to mechanical fixation of the chest preventing respiratory
movements.

V Causes of Traumatic asphyxia

1. The chest and usually abdomen are compressed by an
unyielding object
2. Crushing in crowds as occurs in mob of people.

69. Medico-legal Importance _®

1. Deaths are usually accidental.

2. Death may be homicidal as in burking.

70. Definition _&

+ Drowning is a form of asphyxial death, where: air entry into
lungs À is prevented que :

+ Complete submersion is not necessary because the
process will be complete even if the nose and mouth are
submerged.

71. &
me

+ This is a classical form of drowning either in fresh water or
salt water. Here water is inhaled and swallowed and lungs

get water lodged.

+ In some cases, no or little water is inhaled in respiratory
tract. In such cases, death is more or less instantaneous with
lungs are left dry. This is best type of case for resuscitation.

72. A)
Shallow Water Drowning u

¢ In this condition, drowning occurs in small puddle of water
when depth of water is only few inches but sufficient to
submerge the mouth and nostrils.

+ It occurs mostly accidental in those persons who are disabled
or incapacitated such as small children, epileptics, drunkards,
comatosed persons following head injury etc.

73. Immersion Syndrome €

« Also called as hydrocution.

ein this condition death is 2 r ing sults
cardiac arre e ragal inhibitio . Sudden contact of cold
water with ‘body surface especially epigastrium, ears, nostrils,

larynx or pharynx stimulates nerve endings and causes vagal
inhibition.

74. Immersion Syndrome E

« Also called as hydrocution.

. u this condition death isn rownii resul
diac arre e sagal inhi . Sudden contact of cold
water with body surface especially epigastrium, ears, nostrils,

larynx or pharynx stimulates nerve endings and causes vagal
inhibition.

75. Fall in water
{

Contact with cold water

|
Vagal inhibition
}

Cardiac arrest

y

Death

XK

76. Secondary Drowning E

e Also called as near drowning

e It refers to a condition where there is survival of a person
following an immersion episode. The victim may die
subsequently as a result of pathophysiological
consequences.

* This is not drowning in truest sense but a complication of
drowning.

77. [=)
Autopsy Findings 2 q

1. Clothes are wet.

2. Skin is cold, wet and pale. Skin may show Cutis anserina i.e.
appearance of gooseflesh or goose skin. It is a state of puckered
and granular appearance of skin with hairs standing on end due to
contraction of arrector pili muscle.

3 Washerwoman’s hand: Prolonged immersion in water leads to
maceration of skin due to imbibitions of water.

+ There is whitening and wrinkling of skin particularly on palmar
surface of hands and feet

78. Cont.. 54

+ Froth: Fine, whitish, leathery froth is seen oozing from mouth

and nostrils.
+ Cadaveric spasm: Grass, mud, sand etc. may be clinched in hands.
Presence of cadaveric spasm indicates person was alive when he

was drowned.

79. Internal Examination E ?
An

> Changes in lungs

— Appearance: The lungs are voluminous, oedematous, ballooned,
water lodged, bulged.

— Paltauff’s hemorrhages: These are subpleural hemorrhages
mostly noted over anterior surface and margins of lungs. They
are caused due rupture of interalveolar partitions beneath the
pleura

> Other findings

— Respiratory passage shows whitish, fine froth and may show
sand, mud etc.

80. Cont .. LR

* Stomach and proximal intestine may contain swallowed water or
in addition may show sand, mud etc.

+ Water may be found in middle ear and claimed to be proof of
drowning.

81. Medico-legal Importance 54

1. Most drowning deaths are suicidal or accidental in nature.

2. Accidental drowning can occur in toddlers and children by fall in
bath tub, swimming pool etc.

3. Accidental deaths can also occur in recreational activities such as
boating, diving, River rafting etc.

4. Accidental deaths can be related with fishing or occupational
activity. Mass fatality may occur in boat sinking, floods etc.

5. Homicidal drowning are rare.

82. Definition _

+ It is a form of asphyxial death where air entry into lungs is
prevented due to submersion of mouth and nostrils into
water or any fluid medium.

83. Submersion in
water

Water in air
passage

Asphyxia

Churning of

air + water =
froth formation-
block air passage

Attempt for
inspiration

More water
inhaled

Need for air

Try to drive
out water

84. Dr. Krup Vasavda

MD (Ayu). PGDAA. PGDCRCDM. CYS. CIN

Associate professor
Department of FMT
E mail:- [email protected]

9033785940 Csusscise |

85. Definition = &

+ Fresh water or freshwater is any naturally occurring liquid
containing low concentrations of dissolved salts and other total

dissolved solids.

+ Although the term specifically excludes seawater and brackish
water etc.

* 90% of drowning cases occur in freshwaters such as rivers and
pools.

87. Dr. Krup Vasavda

MD (Ayu). PGDAA. PGDCRCDM. CYS, CIN

Associate professor
Department of FMT

E mail:- [email protected]

9033785946

88. Dr. Krup Vasavda

MD (Ayu). PGDAA. PGDCRCDM. CYS. CIN

Associate professor
Department of FMT
E mail:- [email protected]

Nel 9033785940 | SUBSCRIBE |

89. Features Antemortem Hanging Postmortem Hanging

Ligature mark Produces imprint mark, may be No such features
grooved, brownish, parchment like

Salivary dribbling Present Absent

Le facie Present Absent

sympathique

Blisters Present Absent

Asphyxial signs Present Absent

Drag marks Absent May be Present

over body

90. Dr. Krup Vasavda

MD (Ayu). PGDAA. PGDCRCDM. CYS. CIN

Associate professor
Department of FMT
E mail:- [email protected]

9033785940 [ susscrıse |

91. DIFFERENCE BETWEEN HANGING AND STRANGULATION

Features

Manner
Saliva Dribbling

Ligature mark

Tissue
underneath
mark

Hanging
Usually suicidal

From mouth over chin

or chest

Oblique, noncontinuous,
usually above the level of
thyroid cartilage

Dry, pale, hard
and glistening

Strangulation
Usually homicidal

No such dribbling

Horizontal, continuous,
usually at or below the
level of thyroid cartilage

Bruised

92. Features
Neck

Neck muscle
Larynx and

trachea
Bleeding

Signs of asphyxia

Hanging
Stretched and
elongated
Injury to neck
muscle rare
Injury/fracture
rare
From nose,
mouth or ear is
less common

Less prominent

Strangulation
Not so

Injury to neck
muscle common

Injury/fracture
more common

From nose, mouth
or ear is common

More prominent

93. vs

Dr. Krup Vasavda

MD (Ayu). PGDAA. PGDCRCDM. CYS. CIN

Associate professor
Department of FMT
E mail:- [email protected]

94. Features Antemortem Postmortem

Drowning Drowning
Froth over Fine, lathery froth, appears Absent, even if present,
mouth and spontaneously it is coarse, not
nostrils spontaneous
Cadaveric spasm May be seen Absent
in hands
Trachea and Presence of algae, mud along with Absent
bronchioles frothy mucus
Lungs Ballooned up, bulky, edematous, Collapsed, decomposed

bear indentations of ribs

95. Features Antemortem Drowning | Postmortem Drowning

Mud and algae in Maybe present Absent

stomach and small

intestine

Diatom and Gettler Positive Negative

tests

Injuries If present, need to be Injuries inconsistent with

consistent with drowning drowning
Other suggestive Water in the middle ear, Water is never present in
signs retracted genitals, cutis middle ear; others are
anserina, washer- not valuable and
woman's hands, Corroborative Signs

96. Features Antemortem Drowning | Postmortem Drowning

Mud and algae in Maybe present Absent

stomach and small

intestine

Diatom and Gettler Positive Negative

tests

Injuries If present, need to be Injuries inconsistent with

consistent with drowning drowning
Other suggestive Water in the middle ear, Water is never present in
signs retracted genitals, cutis middle ear; others are
anserina, washer- not valuable and
woman's hands, Corroborative Signs

97. Dr. Krup Vasavda

MD (Ayu). PGDAA. PGDCRCDM. CYS, CIN

Associate professor
Department of FMT
E mail:- [email protected]

9033785940 Csusscise |

98. + Autoerotic asphyxiation (AEA) involves self-induced hypoxia
or intentionally denying air supply through means such as
self-strangulation or chemical substances that cause
asphyxiation, specifically to heighten sexual arousal and
pleasure.

+ Autoerotic asphyxiation fatalities (AEAF) are events during
which hypoxia becomes anoxia or severe oxygen
deprivation, resulting in death.

99. Partial asphyxia caused by pressure on carotid vessels or
obstruction of air passages causes cerebral ischemia and may lead
to hallucinations of an erotic nature in some men.

The degree of asphyxia produced by mechanical means is
controlled, i.e. the victim is in a position that allows self-release.
But in some cases, death occurs accidentally.

These cases are associated with some form of abnormal sexual
behaviour, usually masochism and transvestism.

Victims are usually young males; the scene is typically the victim's
own house, bedroom, bathroom, and basement and the door is
locked from the inside.

100. 1. Hanging: Most frequent method. The presence of padding under
the noose, nakedness of the victim, feminine attire and exposed
genitalia are the hallmarks of these deaths. Frequently, the person
ties his arms, legs and sometimes waist and genitalia (bondage)
with a rope, string or chain.

2. Sexual gratification may be obtained by electrical stimulation. For
this, electrodes are applied to the genitals or the abdomen;
usually, a low-voltage supply from a battery is used.