ThrottlingBy : Hafsa Hassan Peoples university of medical and health science3rd year MBBS

ThrottlingA.K.A "Manual Strangulation“

Introduction:

It is one of the type of homicidal strangulation.

Definition:

Throttling is defined as constriction of the neck of the person by other person with one or both hands.

Suicide is not possible and cases of homicide following sexual assault is a common occurrence.

Related term: " Mugging" Mugging is compression of the neck of the victim in the bend of the elbow or by applying a foot or knee to the neck

There are three mechanism .•Cerebral anoxia •Reflex cardiac a systole •Asphyxia Cerebral anoxia : It occurs due to occlusion of blood vessels supplying brain, resulting in stagnation of circulation leading to anoxia, coma death. Reflex cardiac asystole: Occurs due to the variation of tension within the carotid sinuses.

Sudden sympathoadrenal and parasympathetic stimulation leads to circulatory failure and ultimately to death

Occurs due to external pressure on the wind-pipe from the front and the side.

Non Specific :It includes Facial congestion, cyanosis, Petechial

hemorrhages.

Specific:These are specific for methods used for

throttlingA. Skin bruises on sides and front of neck with adjacent nail mark.B. There is internal bruising of laryngeal soft tissue due to pressure against spine.

• Neck of a rape victim with roundish bruises and scabbed abrasions from attempted manual strangulation.

•Petechial hemorrhages on the skin of the eyelids and subconjunctival (sclera) hemorrhage in the medial angle of the left eye (one day after having been throttled).

Petechial hemorrhage of eye lid

Definition:Blockage of air passage from any

part of trachea down the carina by foreign body.Mostly occur accidentally ,however homicidal attempt can be observed in infants .

Example:bollus/ Buttons or coin kept in mouth of childs

slip into upper air passage.

A) Anoxic Anoxia B) Reflex Cardiac inhibition; in an attempt for dislodge.Autopsy Findings: A)Non specific: are the general findings of asphyxia.B) Specific:1)Finding of foreign body in trachea.2) Bruised mucosa at the sight of lodgment.

Type of asphyxia that leads to death as a result of accidental happening and occurs in relation to closed spaces, deep sea diving or very high altitude.

Examples:A. child trapped inside the trunk or an

unused refrigerator. B. An adult fell into a deep well.

• Atmosphere is deficient in oxygen, which gets replaced by other gases such as Carbon dioxide, carbon monoxide, nitrogen, methane etc . These gases prevent hemoglobin from taking up oxygen because of their strong reducing action or greater affinity for Hb as in case of carbon monoxide. And the end result is tissue Anoxia.

•There are general pathologic asphyxial changes occur A) Cyanosis B)Congestion C) Petechial hemorrhages on face and internal organ like lungs D) tissue edema Spectroscopic examination of blood is useful to demonstrate condition of hemoglobin.