Maximum soft tissue bruising in neck is seen in –
Correct Answer: Strangulation
Description: Ans. is 'a' i.e., Strangulation o As manual strangulation (throttling) is among the most violent form of asphyxia, hyoid fracture and other injury to neck structures is more common.HangingStrangulationGeneral characteristics 1. There is suspension of body.1. No suspension.2. Compression on neck is by a ligature.2. Compression on neck is by a ligature, hands, slicks, elbow, knee or foot.3. Force of compression is the weight of body (endogenous force).3. It is outside force applied (exogenous force).Local external P.M. findings 4. Ligature mark is above the thyroid is oblique, symmetrical and incomplete.4. Mark is on or below the thyroid. Is horizontal, complete and continuous (in absence of ligature mark there are other injuries on neck depending upon type of strangulation).5. Knot usually present.5. Usually absent.6. Usually no mark at site of knot:6. Mark is horizontal, complete and continuous.y In fixed knot, mark is inverted ' V' shaped.y In running noose, mark is transverse. 7. Mark usually single.7. Usually multiple marks.8. Surface of mark abraded or contused.8. Usually lacerated.9. Surface may show pattern of ligature used.9. Pattern not seen.10. Surface hard.10. Soft, due to frank bleeding.11. Mark-yellowish brown in colour.11. Black.12. Margins of mark showr petechial haemorrhages.12. Frank bleeding present.13. Surrounding skin shows few petechial haemorrhages.13. Multiple haemorrhages present.14. Depth of mark is less.14. More, like a groove.Local internal P,M, findings 15. Under the mark area is seen as dry, white, glistening pad of fat.15. Area is haemmorrhagic16. Muscles may be lacerated.16. Lacerated.17. Usually no laceration of blood vessels and their walls, (lacerated injudicial hanging).17. Lacerated.18. May be fracture of trachea, thyroid and larynx.18. Usually fractured.19. Cervical vertebrae fractured usually at C2-C3 and rarely C3-C4 or C1-C2, injudicial hanging.19. Fracture cervical vertebrae uncommon.20. Fracture of hyoid bone in uncommon.20. Fracture of hyoid bone, of adduction type (inward compression fracture), very common in throtting.21. Injury to spinal cord, pons and medulla common injudicial hanging.21. No injury to spinal cord, pons and medulla.Signs of struggle and violence 22. Signs of struggle and violence absent.22. Due to struggle, abrasions and contusions present on the body.23. No question of sexual assault on female victim, as this is usually suicidal and it is uncommon in females.23. May be sexual assault on female victim.24. Since hanging is usually suicidal no question of hiding the cause of death.24. Since strangulation is usually homicidal there is attempt at hiding the crime. Dead body may be hanged; thrown in water, jungle, or acid: may be burnt.General external RM. findings 25. Features of asphyxia mild.25. Greatly marked.26. Head tilted to side, opposite to knot.26. No such tilting.27. Neck stretched.27. No stretching.28. Face usually pale.28. Deeply congested and deeply cyan used.29. Mild cyanosis on nose, lips, tongue, ears and nails.29. Severe cyanosis.30. Few petechial haemorrhages in eyes and on face.30. Multiple petechial haemmorrhages and eye protruded out31. Tongue usually inside.31. Tongue-protruded, bitten and black.32. Bloody froth at nose and mouth is sometimes present.32. Usually present.33. Usually there is dribbling of saliva from angle of mouth.33. Usually absent.
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