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Tuesday, January 06, 2009

contusion of neck muscles is seen along with fracture of Hyoid Bone. Manual Strangulation

Question 67
On postmortem examination, contusion of neck muscles is seen along with fracture of Hyoid Bone. The most probable cause of death is
a.       Manual Strangulation
b.      Drowning
c.       Burking
d.      Smothering
a. Manual Strangulation
Apurva Nandy 1st Edition Page 329
Strangulation is compression of the neck that leads to unconsciousness or death by causing an increasingly hypoxic state in the brain. Fatal strangling typically occurs in cases of violence, accidents, and as the mechanism of suicide in hangings.
Drowning, Burking, and Smothering do not lead to contusion of neck muscles
Strangling involves one or several mechanisms that interfere with the normal flow of oxygen into the brain:
·        Compression of the carotid arteries and jugular veins — causing cerebral ischemia.
·        Compression of the laryngopharynx, larynx, or trachea — causing asphyxia.
·        Stimulation of the carotid sinus reflex — causing brachycardia, hypotension, or both.
Depending on the particular method of strangling, one or several of these typically occur in combination, but vascular obstruction is usually the main mechanism. Complete obstruction of blood flow to the brain is associated with irreversible neurological damage and death, but during strangulation there is still unimpeded blood flow in the vertebral arteries.
Strangulation does not have to be fatal; limited or interrupted strangling is practiced in erotic asphyxia, in the choking game, and is an important technique and in many combat sports and self-defense systems.

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