Asphyxia Deaths
• Deaths caused by the decrease in blood oxygen in the arterial flow and the deterioration of tissue oxygenation due to increased CO/.
• Major changes in asphyxia measurements:
1- Cyanosis
2- Petechiae
3- Edema
4- Congestion
• Congestion and edema occur as a result of capillary hypoxia.
• It is particularly evident in the lung and brain.
Some findings in anoxia-related deaths:
Dead spots are usually dark in color.
Petechiae may be found on the skin and conjunctiva.
Edema is seen in organs such as lungs and brain.
Hyperemia can be seen in all internal organs.
Di Maio classification in deaths due to asphyxia:
1- Deaths as a result of occlusion:
Death due to closure of the mouth and nose.
Death due to compression on thorax and abdomen.
Death from environmental hypoxia or anoxia.
Foreign body aspiration or airway edema, tumor, etc. death as a result of pressure.
2- Deaths as a result of strangulation:
A) Ace
B) Choking:
- Hand strangulation
- Tie strangle
C) drowning in water
- Dry drowning
- Wet drowning
Ace
Mechanisms of death in hanging:
Closure of the airways.
Compression of neck veins.
Reflex cardiac arrest caused by stimulation of the glomus caroticum and baroreceptors in the neck (vagal inhibition, neurogenic mechanism).
Medulla spinalis lesions.
Clinical stages of hanging:
1- Loss of consciousness: It is the shortest period. It takes 6-12 seconds on average.
2- Convulsion period: Tonic and clonic convulsions are seen.
3- Decerebration period: It is the period when sphincter control is removed. During this period, stool and urinary incontinence and sperm ejection can be seen.
4- Circulation and respiratory arrest.
All these phases are completed in 5-10 minutes on average.
External signs in death due to hanging:
- Dead spots are more prominent on the lower extremities, in the form of glove-socks.
- Facial congestion and petechial hemorrhages in the sclera are seen.
- The scar (telem) on the neck varies according to the time the person hangs and the hanging tool used.
Drowning in Water
• There are two types:
1- Dry suffocation: It is the death that develops as a result of laryngospasm or reflex cardiac arrest where the liquid does not fill the lower respiratory tract, hits and creates the upper respiratory tract.
2- Wet suffocation: It occurs as a result of aspiration of the liquid up to the lower respiratory tract.
Changes due to immersion in corpses removed from water:
Mushroom foam: It is called the appearance of white foam around the mouth and nose, sometimes with slight blood. A typical sign of actively aspirating water on the mouth and nose of the corpse is the appearance of a white foam with some blood on it.
Presence of diatoms in organs: Diatoms in the inhaled water during drowning pass into the circulation and are shown in these organs as a result of their embolization to the internal organs through the circulation. For diatom studies, samples should be taken especially from brain and bone marrow.
Other findings; it is an indication that the corpse has remained in the water environment for a certain period of time, and they do not make the diagnosis of drowning in water:
Appearance of washer's hand and foot due to maceration of the skin: It occurs as a result of swelling and maceration of the epidermis by absorbing water in areas where the epidermis is thicker than other body parts (fingertips, palms, back of the hand and soles of the feet).
Goose skin appearance (hair stand up): It is formed by the contraction of the erector pili muscles, which are attached to the hair follicles, by the cold effect.
Retraction can be seen on the penis, scrotum and nipples.
Abrasions and lacerations can be seen on the body due to the drifting of the corpse, especially in streams.
Aquatic organisms such as water, mud, algae, plankton, and diatoms can be found in the respiratory and digestive tract.
