Interference with oxygenation any

where from environment down to

cellular level

Greek meaning is “ Pulse Less”

 CLASSIFICATION OF ASPHYXIA.

ENVIRONMENTAL ASPHYXIA
 MECHANICAL ASPHYXIA
 TRAUMATIC ASPHYXIA
 PATHOLOGICAL ASPHYXIA
 TOXIC ASPHYXIA
 IATROGENIC ASPHYXIA
 give e. g of each asphyxia
 Oxygen deprivation
 CO2 accumulation
 Reduced blood flow to and from the brain.
 Vagal stimulation resulting in cardiac
inhibition
 Complex.

 Arterial blood oxygen saturation.

◦ Normal 90-100 mm/Hg
◦ Drop to 60 mm/Hg in mild hypoxia
◦ Between 40-20 mm/Hg in severe fatal hypoxia
 GENERAL
◦ Cyanosis, congestion, Engorgement right side of
heart, Fluidity of blood ( Fibrinolysin, Capillary
endothelium under stress secretes Fibrinolycin)
◦ Petechial hemorrhage ( Tardieu spots)

 SPECIFIC
◦ Injuries to the larynx, hyoid bone, thyroid cartilage,
carotid arteries and vagus nerve.
 ASPHYXIA

O2 tension Oxygenation
in the lungs

Pulmonary Flow Capillary

Dilatation

Venous return Engorgement

Stasis of Blood
 Absence of O2
 TYPES, four
 1. Anoxic Anoxia,
 Due to mechanical asphyxia leading to defective
oxygenation in lungs e.g. Hanging, Strangulation,
Suffocation etc.
 2. Anemic Anoxia
 Due to reduced O2 caring capacity of blood e.g. CO
poisoning
 3. Histo-toxic Anoxia
 Due to depression of tissue oxidation e.g. Cyanide
poisoning
 4. Stagnant Anoxia
 Due to in efficient circulation of blood e.g. C.C.F and
traumatic Shock
 Or Petechial hemorrhages
Are usually round, dark, well
defined and about the size of pin
head
(up to 2mm).

 Found in those parts where

capillaries are least supported e.g.
Face, Conjunctiva, Epiglottis, Serous
Surface of heart and lungs etc.
 Are due to pathological changes resulting from anoxia.
 The effect of Anoxia on tissue in mainly two fold.
 1. Non Specific
 2. Specific.

 Non Specific effects:

 Body tissue under go parenchymatous degeneration.
 Specific Effects:
 As a result of specific effects following systemic changes are seen.
 Generalized Cyanosis, Vascular Congestion, Edema of tissue and
viscera, Petechial hemorrhage in skin and viscera, fluidity of blood.
 These Signs develop when mechanical obstruction to breathing is
maintained for about 30 seconds.
 Jugular vein …. 4.4 pounds.

 Carotid Artery by.. 11 pounds.

 Trachea by … 33 pounds.
 V Shaped incision.
 Dissection of neck layer by layer is essential.
 Eviscerate cranial, Thoracic and Abdominal
viscera so that body is drained of blood which
provides a clean field for study of neck organs
and prevents any artifectual seepage of blood
in soft tissues of neck.
 Some times when sufficient asphyxia features
are not found, the cause of death is
expressed as “CONSISTENT WITH
ASPHYXIA”.
1. Mechanical asphyxia ;
obstruction of air passages either from within or by
exerting pressure from the out side.
2. Pathological asphyxia ;
Transfer of oxygen to lungs is prevented due to
blockage caused by a disease of respiratory tree.
3 .Toxic asphyxia ;
[Industrial hazards ] uptake of o2 is prevented in
lungs due to presence of poisonous gases ,co ..
 4. Environmental asphyxia .
 Insufficiency of o2 in inspired
air [deep wells or closed spaces ]

5.Iatrogenic asphyxia;
 Associated with anesthesia
and surgery.
 TYPES OF ASPHYXIA LEVEL
 Nose and Mouth
 Suffocation
(Smothering and
gagging)  Glottis
 Hanging
 Larynx and upper
 Strangulation and Trachea

 Throttling  Trachea and main

bronchus
 Choking
 Muscles of Respiration
 Traumatic Asphyxia
 It is a form of violent asphyxia
 Hanging is the suspension of a person by a
noose or ligature around the neck

Hanging can take place with victim

standing, semi-reclining or sitting position
provided pressure on neck is such that it is
sufficient to occlude blood vessels.
 1 COMPLETE:
 Body is suspended with feet off the ground

 2 INCOMPLETE:
 With the feet touching the ground

 a. Typical Hanging,
 Knot is at occipital region
 b. Atypical Hanging,
 Knot is mostly at the side of the face.
 1. Vagal Inhibition by pressure over carotid sinus or in
Vagus nerve
 2. Cerebral Anoxia by compression of jugular veins or
carotid arteries.
 3. Asphyxia by lifting of glottis and tongue into
pharynx and obstructing airway.
 4. Fracture Dislocation and separation of upper cervical
segment of spinal cord (Judicial Hanging)
 5. Combination of any of the above.
 In Judicial hanging
 death may be instantaneous from a
fracture of cervical vertebrae and
associated injury to spinal cord.
 If no injury to spinal cord and
blockage of air passage is not
complete then 5-8 minutes is
common fatal period.
 Depends on mode of death.
 In Asphyxial death appearance will be:
 External Appearance:
 Head is stretched and is always inclined to the side
opposite the Knot due to gravitational force.
 Face is pale
 Eye ball is prominent (Congestion)
 Tongue may protrude (due to pressure by ligature at its
base and dark brown) (Drying)
 Saliva: Dribbling from the corner of the mouth opposite
to the side of Knot (Pressure on Salivary glands)
 P.M Lividity: on the skin of dependent arms and legs on
skin and face above ligature.
 It is a pressure mark which is not continuous
and absent at the place of Knot. Appears as
groove. Direction of mark is oblique towards the
Knot, situated at the upper part of the neck
above thyroid Cartilage.
 CHARACTERISTICS depends upon type of
material used. It is well defined groove with
hard material like rope, wire or belt and
definition is diffused with soft ligature material
like cloth.
 Depth:
 Is deepest at a point opposite to Knot and
gradually becoming shallower towards it.
 Abrasion and bruises of skin at the site of Knot
and bed of groove- along the edges areas of
hyperemia and a few ecchymosis.

 Ligature and Knot may be a fixed noose (Rope

Knotted) or running noose (Loop)
 It should be photographed and Knot is
preserved by cutting body noose.
 NOTE:
 Ligature mark due to hanging resist
putrefaction ( due to avascularity which retards
access of bacteria and may be seen in bodies
exhumed 6 days after death)
 Dissection of neck layer by layer.
 In Judicial hanging much local injury: muscle
fibers may torn and posterior horn of thyroid
cartilage fractured.

 Hyoid bone may be fractured but over 40 years

(increase calcification and brittleness).
broken fragments displaced outwards
 Periostial tear only on inner side of the bone.
 Whether it is A/M or otherwise

 1. Presence of vital reaction in skin and deeper tissues

in relation to ligature mark will point to A/M hanging.
 2. Area of hyperemia and ecchymosis along the
edges of groove is a definite A/M sign and is confirmed
histologically.
 3. Autopsy should be complete to exclude other causes
of death specially poisoning.
 4. May be suicidal, homicidal or accidental.
 IN ANTEMORTEM HANGING
 1.Hyperemia of trachea and epiglottis.
 2.Lymph nodes above and below ligature
mark shows congestion and hemorrhage.
 3.Intimal tears of carotid arteries with
subintimal hemorrhage.
 4.Under ligature mark: compressed and dry
white bands of subcutaneous tissues with
petechial hemorrhage and ecchymosis.
 These findings are never seen in P-M
hanging. These findings may be slight or
absent if death is sudden due to vagal
inhibition.
 Allow a drop of 5-7 feet or more to cause
fracture dislocation of cervical column. C2
and C3 or C3 and C4.
 Spinal Cord is torn.
 Pons and medulla injured.
 Instantaneous death due to damage of
spinal cord and brain stem. Though heart
may continue to beat for 15 to 20 minutes.
 May occur in sexually deviant individuals during
masochistic examination condition known as
Sexual Asphyxia or

Autoerotic hanging
 Totally confined to men usually between puberty
and middle age. Sexual pleasure can be enhanced
by partial production of blood supply to brain
achieved by some form of hypoxia or pressure on
neck.
 Once sexual gratification is achieved person come
back to normality by release of restricting
apparatus but occasionally the device
malfunctions and death ensues.
 Hypoxia may be induced by masks pads on
the face or envelopment in plastic but self
suspension or semi strangulation is most
common mode. May take a form of noose
around the neck ( padded to avoid mark)
which is attached to the neck.
 Associated with the signs of sexual
activity, transvestism, Pornography- semi
nakedness etc.
 Toxicological analysis may reveal
recreational drugs like Alcohol, Cocaine
etc.
 Also known as lynch law
 CHARLES LYNCH [JURIST ]


 DEFINITION;
 To put to death [as by hanging ] by mob action
with out legal sanction.
 To murder [an accused person ]by mob action n
without lawful trial , as by hanging.