DEATH BY ASPHYXIA

Causes of Death in Hanging

 Simple asphyxia by blockage of the air passage;
ASPHYXIA –all forms of violent death which results primarily  Congestion of the venous blood vessels in the brain;
from (1) the interference with the process of respiration or (1) the  Lack of arterial blood in the brain;
condition in which the supply of oxygen to the blood or to the  Syncope due to pressure in the vagus and carotid sinus;
tissue or both has been reduced below normal level.  Injury on the spinal column and spinal cord; and
 Combination of any of the above-mentioned causes.
TYPES OF ASPHYXIAL DEATH: A-ASH
Determinations Whether Hanging is Ante-mortem or Post-
1. ANOXIC DEATH: associated with the failure of the arterial mortem:
blood to become normally saturated with oxygen PRINCIPAL CRITERION: VITAL REACTION – but hanging made
a. Breathing in an atmosphere without or with insufficient immediately after death may also show vital reaction, while
oxygen; hanging of a living subject whose shows bodily resistance has
b. Obstruction of the air passage due to external pressure; been weakened may show slight vital reaction.
c. Paralysis of the respiratory center due to poisoning;
d. Shutting of blood from the right side of the heart to the FINDINGS SHOW THAT HANGING IS ANTE-MORTEM
left without passage through the lings a. Redness or ecchymosis at the site of the ligature;
b. Ecchymosis of the pharynx and epiglottis;
2. ANEMIC ANOXIC DEATH: due to decreased capacity of the c. Line of redness or rupture of intima of the carotid artery;
blood to carry oxygen d. Subpleural, subepicardial punctiform haemorrhages.
a. Severe haemorrhage;
b. Poisoning – carbon monoxide; B. ASPHYXIA BY STRANGULATION
c. Low haemoglobin level in the blood
STRANGULATION BY LIGATURE: produced by the
3. STAGNANT ANOXIC DEATH: brought about by failure of
compression of the neck by means of a ligature, which is
circulation
tightened by a force other than the weight of the body.
a. Heart failure;
b. Shock; Usually, ligature is drawn tight by (1) pulling the ends after
c. Arterial and venous obstruction. crossing at the back or front of the neck, or (2) several folds of
ligature may be around the neck tightly places and the ends are
4. HISTOTOXIC ANOXIC DEATH: due to failure the cellular
knotted, or (3) loop is thrown over the head and a stick is
oxidative process – although oxygen is delivered to the
inserter beneath it and twisted till noose is drawn tight.
tissues, it cannot be utilized properly
a. Cyanide; Hanging Strangulation by Ligature
b. Alcohol Hyoid bone is frequently Hyoid bone is frequently spared.
injured.
PHASES OF ASPHYXIAL DEATH: DCA Direction of the ligature mark is Ligature mark is usually
1. DYSPNEIC PHASE: due to the lack of oxygen and retention of inverted V shape with the aspex horizontal and knot is on the
carbon dioxide in the body tissue as the site of the knot. same plane.
Ligature is usually at the level of Ligature is usually below the
– breathing becomes rapid and deep, the pulse rate the hyoid bone. hyoid bone.
increases; Ligature groove is deepest Ligature groove is uniform in
– rise in blood pressure; opposite the knot. depth in its whole course.
– face, hands and fingernails becomes bluish. Vertebral injury is frequently Vertebral injury is not observed.
observed.
2. CONVULSIVE PHASE: due to the stimulation of the central
nervous system by carbon dioxide
Causes of Death in Strangulation by Ligature
– cyanosis becomes more pronounced;  Asphyxia due to the occlusion of the windpipe.
– eyes become staring and pupils are dilated;  Coma due to arrest of cerebral circulation.
– Tardieu Spots: petechial hermorrhages caused by the  Shock or syncope.
rupture of the capillaries on account of increase of intra-  Inhibition of the respiratory center due to the pressure on the
capillary pressure; vagus and sympathetic nerves.
– victim may become unconscious
3. APNEIC PHASE: due to the paralysis of the respiratory system THROTTLING OR MANUAL STRANGULATION: form of
of the brain asphyxia death where the constricting force applied in the neck
– breathing becomes shallow and gasping; is the hand.
– rate becomes slower till death;
– heart later fails. Special Forms of Strangulations
– recovery at this stage is almost nil due to the permanent 1. PALMAR STRANGULATION: palm of the hand of the offender is
damages inside the brain on account of prolonged cerebral pressed in front of the neck without employing the fingers.
anoxia. 2. GARROTING: a ligature, a metal collar or a bowstring is place
around the neck and tightened at the back.
A. ASPHYXIA BY HANGING: brought about by the 3. MUGGING (STRANGLE-HOLD): a form strangulation with the
suspension of the body by a ligature which encircles the neck assailant standing at the back and the forearm is applied in
and constricting force is the body weight.
 front of the neck. The pressure on the neck is brought about by 4. Washerwoman’s hand and feet – skin in bleached, corrugated
the pressure of the flexed elbow. and sodden in appearance
4. COMPRESSION OF THE NECK WITH A STICK 5. Eyes are half-open or closed, with eyelids livid, conjuctaivae
injected and pupils dilated
6. Mouth may be closed or half-opened with the tongue
C. ASPHYXIA BY SUFFOCATION: the exclusion of air from protruding
the lungs by closure of air openings or obstruction of the air 7. Post-mortem lividity is usually marked in the head, neck and
passageway from the external openings to the air sacs. chest.
8. Cadaver spasm – presence of firmly clenched hands with
SMOTHERING: caused by closing of the external respiratory objects as weeds
orifices, either by the use of hand or by some other means.
Post-Mortem Internal Findings
 Suicidal smothering by means of his own hands is not
1. “Emphysema Aquosum” – lungs are distended like balloons,
possible.
overlapping the heart, with rib markings on the surface and
protruded out of the chest upon removal of the sternum
Kinds of Smothering
2. “Edema Aquosum” – due to the entrance of water in the air
1. OVERLAYING – most common accidental smothering in
sacs which makes the lungs doughy, readily pulls on pressure
children
and exudes water and froth from the section
2. ACCIDENTAL SMOTHERING OF EPILEPTIC
3. “Champignon d’ocume” – the whitish foam which accumulates
3. GAGGING: the application of materials to prevent air to have
in the mouth and nostrils
access through the mouth or nostrils
4. Tracheo-bronchial lumina
4. PLASTIC BAG SUFFOCATION
5. Blood-stained fluid may be found inside the chest
CHOKING: suffocation brought about by the impaction of
GETTLER’S TEST: a quantitative determination of the chloride
foreign body in the respiratory passage.
content of the blood in the right and left ventricle of the heart –
normally, the chloride contents of the blood is the same in both
Most Common Forms of Foreign Bodies Impacted are:
sides of the heart.
1. Vomitus;
2. Regurgitation of food from the stomach;
– if drowning took place in salty water, the chloride content in
3. Bolus of food;
the right side of the heart will be less as compared with the left
4. Detached membrane in diphtheria;
– if drowning took place in fresh water, the chloride content in
5. False set of teeth;
the right side of the heart will be more as compared with the left
6. Blood in tonsillectomy operation;
7. Respiratory haemorrhage.
Findings Conclusive that a Person Died of Drowning
 Presence of materials or foreign bodies in the hands of the
D. ASPHYXIA BY SUBMERSION OR DROWNING: nostrils
victim
and mouth are submerged in any watery, viscid or pultaceous
 Increase in the volume (emphysema aquosum) and edema in
fluid for a time to prevent free entrance of air into the passage
the lungs (edema aquosum)
and lungs.
 Presence of water and fluid in the stomach contents
 Average time required for death in drowning is 2 to 5 corresponding to the medium where the body was recovered
minutes.  Presence of froth, foam or foreign bodies in the air passage
 The length of survival in drowning is proportional to the found in the medium where the victim was found
amount of froth in the respiratory tract.  Presence of water in the middle ear
 Within 24 hours from drowning, the body floats.
o The body when recovered, floats usually with
flexed extremities – rigor mortis.
o “Tete de Negri” – the bronze color of the head and
the neck of a person who died in water during
decomposition.

Causes of Death in Drowning

1. TYPICAL DROWNING: primary cause of death in ordinary
submersion is asphyxia – water interferes with the free exchange
of air in the air sacs.
2. ATYPICAL DROWNING
a. Cardiac inhibition following the submersion due to the
stimulation of the vagus nerve;
b. Laryngeal spasm due to submersion;
c. Sumbersion when unconscious

External Post-Mortem Findings

1. Clothes are wet, face is pale and with foreign bodies clinging
on the skin surface.
2. Skin is puckered, pale and contracted in the form of “cutis
anserina”, “goose-skin” or “gooseflesh”
3. Penis and scrotum may be contracted and retracted.