From Big Medical Encyclopedia

HANGING — a type of the strangulyatsionny mechanical asphyxia developing as a result of a prelum of a neck a loop under the influence of weight of own body.

Approach of death prp P. is caused by a complex of factors: emergence of an obstacle to normal passing of air to lungs (development in this regard the general acute hypoxia), a prelum of carotid arteries and jugular veins, defiant sharp disturbance of a hemodynamics of a brain and its acute hypoxia, the excessive irritation (owing to a prelum) the wandering and verkhnegortanpy nerves leading to weakening of cordial activity up to a sudden cardiac standstill.

At P. the body, as a rule, is in freely visyashchskhm situation. when legs have no support; however P. of willows a sitting position is possible, reclining and lying since the weight of the head is sufficient for tightening of a loop and a prelum of a neck. By the form p to character of a loop subdivide on opened and closed, sliding and motionless, and depending on quantity of rounds — on single, double and multiple. The type of a loop, and also a way of setting of nodes have a certain criminalistic value in this connection on site detection of a corpse or in a morgue remove a loop, without damaging a node (cut it from the party, opposite to it), and carefully describe court in the act or the conclusion. - medical examinations.

Fig. 1. Macrodrug of a lung at mechanical asphyxia: dot subpleural hemorrhages (Tardye's spot) are visible. Fig. 2. Macrodrug of a carotid artery: cross anguishes of an intima (Amyuss's sign) during the hanging in vertical position are visible. Fig. 3. Corpse of hung: a strangulyatsionny furrow on a neck, a bite of a tip of language, sanious allocations from a nose and a mouth.

One of the major signs of P. is the strangulyatsionny furrow on a neck — a trace on skin from a prelum its loop (tsvetn. fig. 1 — 3). In a typical case it is located on a front surface of a neck according to a thyroid cartilage or over it, on side surfaces of a neck rises to mastoids, on back is interrupted in the field of an occipital hillock due to the lack of dense contact of the node of a loop delayed up with skin of a neck. Thus, the furrow is not closed and slantwise ascends in front back. At an atypical arrangement of a loop nodes are located in front or on a side surface of a neck, and the strangulyatsionny furrow also is kosovoskhodyashchy and not closed according to the location of a node. At P. in situation reclining or lying the strangulyatsionny furrow can have horizontal pl even the kosoniskhodyashchy direction. Expressiveness of a strangulyatsionny furrow depends on material of a loop (the rigid loop, napr, from a wire, leads to formation of a narrow and deep furrow; soft, napr, from a towel, a scarf or a tie — to unsharply expressed strangulyatsionny furrow with indistinct borders) and extents of posthumous drying of skin of a furrow (over time it becomes more dense and gains yellowish or reddish-brown color). The relief of a bottom of a strangulyatsionny furrow quite often reflects qualitative features of a loop (rounds of a rope, prints pryazhr!, etc.). Prp P. in vertical position of a body the upper regional roller of a furrow hangs, npzhniya is as if smoothed; at double p multiple loops between their rounds additional rollers with traces of infringement of skin are formed.

Except a strangulyatsionny furrow the sharp cyanosis of face skin acting from a mouth and, as a rule, the language clamped between teeth (at its survey bites are defined), subkonjyunkti-valny ecchymomas, traces of involuntary release of urine and a calla are characteristic of P. Morfol, changes of internals have the general character typical for death from mechanical asphyxia (see). Occasionally there are fractures of a thyroid cartilage and hypoglossal bone, and at corpulent people at P. in vertical position — cross parallel anguishes of an intima of carotid arteries are lower than the level of a strangulyatsionny furrow (Amyuss's sign) and hemorrhages in nodding muscles in places of their attachment to a breast.

At court. - medical examination in P.'s cases should investigate and differentiate attentively bruises which can result from blows about blizraspolozhenny objects during convulsive movements or be a consequence of fight and self-defense or the accidental reasons which are not connected with

P. P. — one of the most frequent ways suicides (see) therefore for the purpose of concealment of a crime perhaps instsenirovany P. V other cases natural folds of skin or traces from hard collars can imitate a strangulyatsionny furrow on a corpse. In this regard at P. the issue of a prizhiznennost of its education shall be resolved. In an intravital strangulyatsionny furrow if to consider it in a transmitted light between two slide plates (Bokarius's test), small hemorrhages, especially in rollers are well visible. At microscopic examination of such strangulyatsionny furrow flattening of epidermis and a papillary layer of a derma, a plethora and hemorrhages in regional and transfer rolls, rapprochement, homogenization, a basophilia and a metachromasia of collagenic fibers are found. Kernels of epithelial cells have the extended form, in muscle fibers disappearance of cross striation and granular disintegration is observed. The argentofiliya, swelling, vacuolation, fragmentation and glybchaty disintegration of axial cylinders of nerve fibrils are noted. At posthumous emergence of a furrow it is possible to find only flattening of layers of skin, and all described signs are absent. At a biochemical research high concentration of a histamine in skin of a furrow, dominance of maintenance of a glycogen in blood from peripheral vessels in comparison with the blood taken from vessels of a brain testifies to an intravital origin of a strangulyatsionny furrow.

Considering similarity morfol, manifestations, it is necessary to differentiate P. from strangulation by a loop (see. Strangulation ).

The item, as a rule, comes to an end with death since without assistance of people it cannot be released from a loop. At break of a loop, bystry extraction and holding resuscitation actions of the person sometimes it is possible to save from it. At the minimum signs of life it is necessary to release as soon as possible the victim from a loop, to put it on a back, having given to the head and an upper part of a trunk sublime situation, to fix language and to begin artificial respiration (see) and indirect cardiac massage (see). After removal from a hypoxemic state various residual states are possible: excitement, spasms, amnesia. Also deeper damages, napr, symmetric necroses in subcrustal nodes of a brain are possible.

Bibliography: Avdeev M. I. Forensic medical examination of a corpse, page 300, M., 1976; Thunders of JI. And. and Mityaeva of N. A. Posobiye on medicolegal histology, page 106, M., 1958; Forensic medicine, under the editorship of V. M. Smolyani-nov, page 173, M., 1975; F e d about r about in M. I. Medicolegal and clinical value of post-asphyxial states, Kazan, 1967.

Yu. L. Melnikov, I. V. Buromsky (tsvetn. fig. 1 — 3).