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Throttling
By : Hafsa Hassan
Peoples university of medical and health science
3rd year MBBS
Throttling
A.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
throttling
A. 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.

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Throttling, Choking and environmental asphyxia

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  • 2. Throttling By : Hafsa Hassan Peoples university of medical and health science 3rd year MBBS
  • 3. Throttling A.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
  • 4. 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.
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  • 6.  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.
  • 7. Non Specific : It includes Facial congestion, cyanosis, Petechial hemorrhages. Specific: These are specific for methods used for throttling A. 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.
  • 8. • Neck of a rape victim with roundish bruises and scabbed abrasions from attempted manual strangulation.
  • 9. •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).
  • 11. 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.
  • 12. 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.
  • 13. 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.
  • 14. • 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.
  • 15. •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.