**Question:** "La facies sympathique" is an expression used in hanging to describe

A. pallor
B. florid discoloration
C. asphyxia
D. cyanosis

**Core Concept:** The term "La facies sympathique" refers to the characteristic facial appearance seen in cases of asphyxia caused by compression of the neck, such as in hanging. The sympathetic nervous system plays a significant role in this process.

**Why the Correct Answer is Right:** When the neck is compressed in hanging, it leads to the disruption of blood flow to the brain and other vital organs. The sympathetic nervous system is activated, causing various physiological changes that result in the "La facies sympathique."

1. **Option A (pallor):** Pallor is not a characteristic feature of asphyxia due to hanging. In fact, pallor is a sign of reduced blood flow or oxygenation, which is unlikely in hanging.

2. **Option B (florid discoloration):** Florid discoloration, also known as the "angry blue face," is a sign seen in the initial stages of asphyxia due to compression, particularly in infants. However, it is not specific to hanging and can be seen in other causes of asphyxia as well.

3. **Option C (asphyxia):** Although asphyxia is the underlying cause of hanging, the term "La facies sympathique" refers to the specific facial changes associated with this condition.

4. **Option D (cyanosis):** Cyanosis is a general term for a blue discoloration due to decreased oxygenation. Although it may be present in some cases of hanging, it is not a specific feature of hanging ascyanosis can be seen in other conditions with decreased oxygenation.

**Why Each Wrong Option is Incorrect:**

- Option A (pallor) is incorrect because it is not a characteristic feature of asphyxia due to hanging.
- Option B (florid discoloration) is incorrect as it is not specific to hanging and can be seen in other causes of asphyxia as well.
- Option C (asphyxia) is incorrect because the term "La facies sympathique" refers to the specific facial changes associated with asphyxia due to hanging.
- Option D (cyanosis) is incorrect because it is not a specific feature of hanging. Cyanosis can be seen in various conditions with decreased oxygenation.

**Clinical Pearls:**

- The "La facies sympathique" is a key finding in hanging asphyxia that helps differentiate it from other causes of asphyxia, which may have different facial changes.
- Asphyxia due to hanging is a common mode of injury in forensic medicine and understanding the specific facial changes can aid in accurate diagnosis and estimation of the time of death in such cases.