STRANGULATION

From Big Medical Encyclopedia

STRANGULATION — a kind of strangulyatsionny mechanical asphyxia, at a cut a prelum of bodies of a neck is carried out by a loop or hands.

At. as a rule, points by a loop to murder, however it is possible also as a result of accident (e.g., hits of the free ends of a scarf, a scarf or a tie in moving parts of the car) or as a way of suicide. In the latter case the loop usually not only is tied and tightened, but also in addition twisted any subject inserted into a loop — turning. A loop at At. is located, as a rule, horizontally, at the level of a thyroid cartilage or slightly below it, evenly squeezing a neck from all directions. When the loop was tightened by the victim, the node is located in front or sideways more often, during the tightening of a loop by other person the node is located behind more often. Print of a loop on skin of a neck (a strangulyatsionny furrow) at At. also is located with a loop horizontally in relation to a longitudinal axis of a body, usually happens evenly deep and closed that distinguishes it from a strangulyatsionny furrow during the hanging (see). Only in rare instances, e.g., if under a loop there was any subject or parts of clothes, a strangulyatsionny furrow at At. can be a loop discontinuous. The loop from rigid material (a wire, a twine) leaves deeper strangulyatsionny furrow, from soft material (a towel, a scarf) — less deep, but a wide strangulyatsionny furrow. For the purpose of the concealment previous At. a loop the performance of self-hanging is possible. In these cases on a neck of a corpse find two strangulyatsionny furrows, however one of them has the kosovoskhodyashchy direction and is located in an upper part of a neck that is characteristic of hanging. Is important as well establishment of the fact of posthumous formation of this furrow with the help gistol., gisto-chemical and biochemical methods of a research (see Hanging).

At At. dense squeezing of bodies of a neck and, first of all, large veins owing to what venous stagnation in the fabrics and bodies located above a loop quickly develops happens a loop. In this regard at an outside research of a corpse note sharp cyanosis and puffiness of the person, existence multiple small - and krupnotochechny hemorrhages in an upper part of a neck, a century and under scleras, especially in corners of eyes. From a mouth the tip of language quite often acts, to-ry it is bitten. Livors mortis are diffuse, saturated sinebagrovy color. Often At. is followed a loop by involuntary defecation, an urination and ejaculation. At necropsy find sharp venous stagnation in soft tissues of the head (even large hemorrhages are possible, to-rye it is necessary to differentiate with traumatic), venous stagnation in tissue of a brain and its covers, hemorrhages in a mucous membrane of a mouth, in the field of a root of language, back and side walls of a throat, an epiglottis, in cellulose of a mediastinum on the course of a gullet, and at a strong prelum of a neck a loop also in muscles on the course of a strangulya-tsionny furrow; changes of horns of a hypoglossal bone, thyroid cartilage and other cartilages of a throat. Besides, at macro - and microscopic examination find the changes characteristic of acute (asphyxial) death (see Asphyxia). When at At. a loop death comes from primary cardiac standstill owing to a per? the irritations of a vagus nerve, a verkhnegortanny nerve and a sinocarotid zone described above signs are expressed more weakly.

14 EXODONTIA


One of major factors in ge ~ to a neza of death at At. hands is the prelum of carotid arteries, the verkhnegortanny and wandering nerves and a sinocarotid zone, reduction of a gleam of a trachea and a smykaniye of a glottis. Specific characters At. hands are the grazes of a longitudinal or semi-lunar form on the perednebokovy surfaces of a neck arising from action of nails, and oval or rounded shape bruises from a prelum of a neck fingers. At newborns of damage at strangulation are located with hands on a back surface of a neck more often. They need to be differentiated with the damages put with the woman in labor at a self-care if childbirth happens without foreign assistance.

Bruises and grazes at At. hands it is also necessary to differentiate with damages and changes of other genesis, napr, grazes on a neck from shaving by the stupid razor, displays of skin diseases, prints of buttons of a shirt, etc. At. hands is always murder therefore on a body of the victim often find the additional injuries received in the course of fight and self-defense. The damages to occipital area arising from pressing of a nape to firm objects and injuries of edges are typical at a prelum of a thorax by a knee of the forward during pressing of a body of the victim to the earth or a floor. At necropsy in addition to the general symptoms of asphyxia find hemorrhages in hypodermic and intermuscular connecting fabric, in the thickness of a root of language, in a circle of a throat, gullet, thyroid gland, in an outside cover (adventitia) of carotid arteries, muscles of a neck. Often changes of horns of a hypoglossal bone, cartilages of a throat and trachea come to light.

If strangulation of any origin does not come to an end with death, then at victims the same postasfikti-chesky phenomena can develop, as at cancelled hanging (see). Severity of injuries is defined at the same time according to the existing rules (see Damages to the medicolegal relation).

Bibliography: Avdeev M. I. Judicial

medical examination of a corpse, page 300, M., 1976; To about N of c e in and the p I. A. Medicolegal diagnosis of strangulations, Kiev, 1968; Forensic medicine, under the editorship of

V. M. Smolyaninov, page 88, M., 1982.

BB. J1. Melnikov.

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