Ligature Strangulation

Ligature Marks Strangulation

In ligature strangulation, the pressure on the neck is applied by a constricting band that is tightened by a force other than the body weight. Virtually all cases of ligature strangulation are homicides. In the authors' experience, ligature strangulation is the most common method of homicidal asphyxia, though the incidence of manual strangulation follows fairly closely. In a study of 133 homicides caused by asphyxia, ligature strangulation accounted for 48 of the deaths manual strangulation for...

Stab Wounds by Anatomical Location

Lethal Knife Wounds

Most fatal stab wounds are located in the left chest region. Among a number of explanations is that most people are right handed and, when facing a victim, will tend to stab the left chest. In addition, if the intention is to kill someone, one would stab in the left chest where the heart is thought to be. Most fatal stab wounds of the chest involve injury to the heart or aorta. Deaths due solely to a stab wound of the lung are less common. Fatal stab wounds of the right chest usually involve...

The Living Rape Victim

Vagina Rape Victim

Rape presents a unique problem to physician clinicians in that they often inherit the burden of not only treatment, but proper collection of evidence. For the correct handling of rape cases, both medically and legally, there must be coordination between the physicians examining the victims and the police agency with jurisdiction. It is preferable that victims of rape be examined at one central hospital by experienced physicians trained in the handling and treatment of such patients and in the...

Fractures of the Skull

Basilar Skull Fracture

The second type of injury that can be incurred is to the skull. In general, whenever a head is either struck with or strikes an object having a broad flat surface area, the skull at the point of impact flattens out to conform to the shape of the surface against which it impacts. As the skull is flattened and bent inward, adjacent, but more distant areas, are bent outward by a wave of deformation consisting of the central area of inbending and the peripheral outbending Figure 6.1 2,3 This...

Methamphetamine and Amphetamine

Methamphetamine is a potent CNS stimulant that is readily produced illicitly.14,18 In the brain, it acts by both increasing release of dopamine and blocking its re-absorption, causing hyperstimulation of receptor neurons. Methamphetamine is also a cardiovascular stimulant. It blocks re-uptake of norepinephrine and causes an increase in catecholamine release. The euphoric effect is similar to cocaine but may last as long as ten times that of cocaine. Methamphetamine is metabolized to...

Traumatic Asphyxia Combined with Smothering

Positional Asphyxia

Traumatic asphyxia combined with smothering is a combination of both these entities. It can be accidental or homicidal. An accidental form is overlay, where an infant is placed in bed for the night with either an adult or a larger child. Subsequently, the infant is found dead. During the night, the other individual rolled onto the infant, killing it by a combination of Figure 8.11 A 5-month-old infant killed by python. No petechiae, hemorrhage, or bruising of body. Puncture marks on face have a...

Battered Baby Syndrome

Battered Baby Syndrome

The battered baby syndrome refers to a condition characterized by repeated intentional acts of trauma to a young child inflicted at the slightest or most trivial provocation. Deprivation of food and water is a variant of this trauma. Classically, the child presents to a physician or an emergency room with an acute injury accompanied by evidence of both old and recent bruises, fractures, and other injuries. There might be skull or extremity fractures, ruptured viscera, subdural hematomas, or...