■■■ C HAPTER 13 M ECHANICAL A SPHYXIA Apoplexy is the term used for (a) Cerebral congestion (b) Cerebral ischaemia (c) Cerebral anoxia (d) Cerebral concussion Hanging is defined as (a) Suspension of body by a ligature around the neck, body weight acting as constricting force (b) Suspension of body by ligature after death (c) Obliteration of air passages by external factors (d) Mechanical interference to respiration The commonest cause of death in hanging is (a) Asphyxia (b) Cerebral venous congestion (c) Asphyxia and cerebral venous congestion combined (d) Cerebral anaemia Delayed death in hanging can be due to the following conditions, EXCEPT (a) Hypoxic encephalopathy (b) Infraction of brain (c) Oedema of lungs (d) Fracture of the cervical vertebrae Weight for occluding internal jugular vein in hanging is (a) kg (b) kg (c) kg (d) 12 kg In hanging last to be occluded is (a) Chapter-13.indd 104 (a) (c) (d) (a) (b) (d) (a) 10 11 (c) (a) Jugular vein (b) Vertebral artery (c) Trachea (d) Carotid In typical hanging death occurs due to (a) Blocking of jugular veins (b) Blocking of carotid arteries (c) Blocking of vertebral arteries (d) Both and (a) and (b) In typical hanging knot is present at (a) Occipital area (b) Mastoid area (c) In front of ear (d) Any of the above Cyanosis occurs when the concentration of reduced haemoglobin exceeds (a) g% (b) g% (c) g% (d) g% Cyanosis is caused by (a) An increased concentration of reduced haemoglobin (b) A decreased concentration of haemoglobin (c) A decreased concentration of oxyhaemoglobin (d) Hypoxia A ligature mark on the neck directed obliquely upwards on both sides is seen in hanging with a (a) Fixed loop with a single knot in midline at the back of the head (b) Running noose (c) Fixed loop with a knot in the region of one ear (d) Low point of suspension 10 (a) 11 (a) 7/13/2011 5:17:30 PM MECHANICAL ASPHYXIA 12 Which one of the following statements regarding ligature mark in hanging is NOT true? (a) In the case of a fixed loop with a single knot at the back of the head, the mark is seen directed obliquely upwards on both sides (b) In the case of fixed loop with the knot in the region of one ear, the mark differs on each side of the neck (c) In case of running noose the mark is oblique on both sides (d) If the ligature is in the form of loop, the mark is prominent on the part of the neck to which the head has inclined 13 All of the following are characteristic of ligature mark of hanging EXCEPT (a) It is usually oblique (b) It does not completely encircles the neck (c) It is usually seen high up on the neck (d) The base is soft and reddish 14 In hanging, the groove produced by ligature may be less well marked with (a) Loop arranged with a fixed knot (b) Low point of suspension (c) Running noose (d) Loop 15 A horizontal ligature mark is seen in the neck in case of hanging (a) When a fixed loop with a fixed knot in the region of one ear is used (b) When a fixed loop with a single knot at the back of the head is used (c) When a fixed loop with a single knot at the chin is used (d) In partial hanging 16 A ligature mark may not be seen in the neck in case of hanging (a) In partial hanging (b) If a loop is made of soft material (c) If narrow ligature is used (d) When a fixed loop with a single knot at the chin is used 12 (c) Chapter-13.indd 105 13 (d) 14 (b) 15 (d) 16 (b) 17 (b) 18 (a) 19 (d) 105 17 In a case of hanging ligature marks in neck are example of (a) Contusion (b) Pressure abrasion (c) Laceration (d) Bruise 18 A reliable sign of antemortem hanging is (a) A thin line of congestion of haemorrhage along the edges of ligature mark (b) Congested, livid face marked with petechiae (c) Swollen, dark coloured protruded tongue (d) Protrusion of tongue 19 The most important feature of antemortem hanging is (a) Fracture of hyoid bone (b) Ligature mark on neck (c) Fracture of thyroid cartilage (d) Dribbling of saliva 20 The width of ligature mark on skin may not correspond with ligature when the ligature used is a (a) Rope (b) Woven belt (c) Nylon or silk fabric (d) Electric wire 21 Hyoid fracture is common in (a) Hanging (b) Strangulation (c) Throttling (d) Choking 22 Slow asphyxia is likely to occur in hanging when (a) Ligature exerts pressure below the chin and does not encircle the neck (b) Ligature exerts pressure below the chin and encircles the neck (c) Ligature exerts pressure at the level of thyroid cartilage (d) Ligature exerts pressure below the level of thyroid cartilage 23 In hanging coma occurs rapidly if ligature completely obstructs (a) Jugular veins (b) Vertebral arteries (c) Carotid arteries (d) Pharynx 20 (c) 21 (c) 22 (a) 23 (c) 7/13/2011 5:17:31 PM 106 S ECTION I: FORENSIC MEDICINE 24 In hanging, asphyxial signs are slight when (a) Suspension is complete (b) Suspension is incomplete (c) The deceased is in a kneeling position (d) The deceased line prone with only the face and chest off the ground 25 All of the following are characteristic of death due to hanging EXCEPT (a) Ligature mark around (b) Ecchymosis of subcutaneous tissues under the ligature mark (c) Trickling of saliva from the mouth (d) Ecchymosis of the larynx or epiglottis 26 Reflex vagal inhibition may occur in (a) Impaction of food in larynx (b) Drowning (c) Hanging (d) All of the above 27 In case of hanging, a typical ligature mark shows following characteristics EXCEPT (a) Oblique (b) High up in neck (c) Continuous (d) Above the level of thyroid cartilage 28 Which one of the following statements regarding width of ligature mark compared to width of ligature in hanging is NOT true? (a) Equal (b) More (c) Less (d) Variable 29 A ligature mark may not be seen in the neck in case of hanging in the following condition EXCEPT (a) If a portion of clothing intervenes between the ligature and the skin (b) If a loop is made of soft material (c) If a narrow ligature is used (d) If the ligature is cut soon after death 30 Scratches or nail marks on the neck in hanging may be found in case of (a) Suicide (b) Accident 24 (a) Chapter-13.indd 106 25 (b) 26 (d) 27 (c) 28 (b) 29 (c) 30 (d) 31 (b) 31 32 33 34 35 36 37 (c) Homicide (d) Suicide and homicide Unequal pupils in hanging is due to pressure on the (a) Parasympathetic chain (b) Sympathetic chain (c) Optic pathway (d) All of the above “Le facie sympathique” is seen in (a) Hanging (b) Strangulation (c) Smothering (d) Aconite poisoning In a case of typical hanging, postmortem hypostasis is seen in (a) Legs and feet (b) Hands and forearms (c) Both (a) and (b) (d) Genitalia When a person has suspended himself by applying ligature around the neck so that the point of suspension (knot) is situated in the region of the occiput Such hanging is called (a) Typical (b) Atypical (c) Partial (d) Incomplete Postmortem staining of lower parts of hands and feet indicates (a) Prolonged suspension after death (b) Antemortem hanging (c) Death due to asphyxia (d) Drowning In hanging transverse splits of carotid arteries may be seen in (a) Outer coats (b) Middle coats (c) Inner coats (d) None of the above Intima of carotid arteries is usually ruptured in (a) Hanging (b) Ligature strangulation (c) Traumatic asphyxia (d) Burking 32 (a) 33 (c) 34 (a) 35 (a) 36 (c) 37 (a) 7/13/2011 5:17:31 PM MECHANICAL ASPHYXIA 38 Hanging with feet touching the ground is seen in (a) Suicidal hanging (b) Homicidal hanging (c) Accidental hanging (d) Postmortem hanging 39 Dribbling of saliva is characteristic of (a) Antemortem hanging (b) Postmortem hanging (c) Homicidal strangulation (d) Suicidal strangulation 40 Lynching is a form of (a) Sexual asphyxia (b) Homicidal hanging (c) Judicial hanging (d) Strangulation 41 Lynching is (a) Practiced in North America (b) Practiced by white people on Negroes (c) Hanging publicly on a tree (d) All of the above 42 Which one of the statement is NOT correct concerning accidental hanging? (a) It may be associated with abnormal sexual behaviour (b) It may occur in workmen in falling from scaffolding and getting entangled in ropes (c) It may occur from suspension of the chin by the steering wheel of a motor car (d) It may occur in infant with a string attached to a toy tied to the crib 43 Postmortem hanging is characterised by the following EXCEPT (a) Marks of violence on the body (b) No dribbling of saliva (c) Signs of dragging on the body (d) Continuous ligature mark round the neck 44 Death in judicial hanging is due to (a) Shock (b) Fracture-dislocation of upper cervical (c) Rapid asphyxia (d) Inhibition of the heart 38 (a) Chapter-13.indd 107 39 (a) 40 (b) 41 (d) 42 (d) 43 (d) 44 (b) 45 (d) 107 45 In judicial hanging fracture, vertebrae are seen at (a) C1–C2 (b) C2–C3 (c) C4–C5 (d) C6–C7 46 In judicial hanging which position of knot is more effective? (a) Back of neck (b) Side of neck (c) Below chin (d) All are equally effective 47 The ligature mark of strangulation is (a) Transverse and completely encircles the neck (b) Usually seen high up in the neck (c) Usually two or three marks are seen due to multiple tying of the ligature (d) Oblique, incomplete 48 A ligature mark may NOT be seen in the neck in case of strangulation by ligature (a) If the ligature is a thin rope (b) If the ligature is removed soon after death (c) If the body is mummified (d) If the body is embalmed 49 Extensive bruising of muscles and subcutaneous tissues in neck is characteristic of (a) Hanging (b) Strangulation (c) Throttling (d) Burking 50 Horizontal ligature mark in the neck is seen in (a) Throttling (b) Hanging (c) Strangulation by ligature (d) Choking 51 All of the following are characteristic of ligature mark of strangulation EXCEPT (a) The mark completely encircles the neck (b) It is usually seen high up in the neck (c) It is transverse (d) Reddening and congestion is present immediately above and below the groove 46 (c) 47 (a) 48 (b) 49 (c) 50 (c) 51 (b) 7/13/2011 5:17:31 PM 108 S ECTION I: FORENSIC MEDICINE 52 A horizontal complete ligature mark below the level of thyroid cartilage with extensive bruising of subcutaneous tissues and muscles adjacent to it indicate (a) Accidental strangulation (b) Homicidal hanging (c) Homicidal strangulation (d) Suicidal hanging 53 Seminal emission is more common in (a) Strangulation by ligature (b) Hanging (c) Smothering (d) Traumatic asphyxia 54 Maximum congestion is seen in (a) Choking (b) Hanging (c) Strangulation (d) Drowning 55 Bleeding from the nostrils, mouth and ears is common in (a) Hanging (b) Strangulation by ligature (c) Smothering (d) Choking 56 Most important sign of strangulation is (a) Ligature mark around the neck (b) Haemorrhage under ligature mark (c) Fracture of hyoid bone (d) Dislocation of cervical vertebrae 57 Evidence of strangulation includes all EXCEPT (a) Ligature mark on the neck (b) Subconjunctival ecchymoses (c) Dribbling of saliva from mouth (d) Congestion of face 58 Which one of the following statements regarding internal findings in the neck in case of ligature strangulation is NOT true? (a) There is severe engorgement and haemorrhage into the tissues in and above the area compressed (b) The muscles of the neck are usually lacerated (c) Bruising of the deeper tissues in the 52 (c) Chapter-13.indd 108 53 (b) 54 (c) 55 (b) 56 (b) 57 (c) 58 (d) 59 (d) 59 60 61 62 63 64 compressed part may be absent if ligature is tightly applied on the neck until death occurs (d) Dislocation of cervical vertebrae may be fractured In ligature strangulation, the lungs show all of the following changes EXCEPT (a) Congestion is marked (b) Silvery-looking spots are seen under the pleural surface (c) Microscopic areas of collapse are present (d) Ecchymoses and subpleural haemorrhages not occur Emphysematous bullae on the surface of the lungs are commonly seen in (a) Hanging (b) Ligature strangulation (c) Drowning (d) Traumatic asphyxia Hanging differs from strangulation by the following features EXCEPT (a) Always suicidal (b) Ligature mark is oblique (c) Neck is elongated and stretched (d) Subcutaneous tissue under the mark is white, hard and glistening All of the following findings indicate death due to ligature strangulation in putrefied body EXCEPT (a) Fracture of the larynx or hyoid bone (b) Bruising of the muscles of the neck (c) Ligature mark (d) Signs of asphyxia Holding the neck of victim in bend of elbow is known as (a) Throttling (b) Mugging (c) Bansdola (d) Garrotting The following are the type of homicidal strangulation EXCEPT (a) Bansdola (b) Mugging (c) Lynching (d) Garrotting 60 (b) 61 (a) 62 (d) 63 (b) 64 (c) 7/13/2011 5:17:31 PM MECHANICAL ASPHYXIA 65 Bansdola is a form of (a) Homicidal suffocation (b) Homicidal strangulation (c) Homicidal hanging (d) Homicidal choking 66 Garrotting is a method of homicidal strangulation which is accomplished by (a) Placing one bamboo stick across the front of neck and one at the back, and tying both ends with a rope (b) Holding the neck of victim in the bend of the elbow (c) Compression of the neck by the hand (d) Throwing a ligature over the neck from behind and quickly tightening it 67 Which of the following is used as a method of execution in some countries? (a) Bansdola (b) Garrotting (c) Mugging (d) Smothering 68 Last part to be dissected during autopsy in asphyxia death (a) Neck (b) Head (c) Abdomen (d) Thorax 69 In a suspected case of throttling, the procedure advised at autopsy is (a) Block removal of neck structures for subsequent detailed examination (b) Skull and chest are opened and examined before in situ examination of neck structures (c) In situ examination of neck structures before opening the skull and chest (d) It is immaterial if you follow any of the above methods 70 In case of throttling the situation and extent of the bruised areas on the neck depend on the following EXCEPT (a) Relative positions of the assailant and victim (b) The manner of grasping the neck (c) The degree of pressure exerted upon the throat (d) The manner of application of the ligature 65 (b) Chapter-13.indd 109 66 (d) 67 (b) 68 (c) 69 (b) 70 (d) 71 (a) 72 (a) 109 71 In case of throttling bruises on the neck may be seen in a completely haphazard manner (a) In frank struggle of victim (b) In children (c) When the neck is small (d) When the assailant’s hand is large 72 The size of the contused areas on the neck in case of throttling may be more than the size of the digits due to (a) Shifting of the grip (b) Maintaining the pressure on the neck (c) Interposing a soft material between the hand and throat (d) Pressure exerted by the right hand 73 Hyoid bone fracture is seen in all of the following EXCEPT (a) Throttling (b) Hanging (c) Choking (d) Strangulation by ligature 74 Fracture of hyoid bone is more common in (a) Hanging (b) Ligature strangulation (c) Manual strangulation (d) Traumatic asphyxia 75 In throttling fracture of the hyoid bone is commonly seen in (a) greater horn (b) Lesser horn (c) Body (d) Both in the body and greater horn 76 Maximum congestion is seen in (a) Choking (b) Hanging (c) Strangulation (d) Drowning 77 In “commando punch” the injury usually occurs to (a) Eye (b) Neck (c) Face (d) Chest 73 (c) 74 (c) 75 (a) 76 (c) 77 (b) 7/13/2011 5:17:31 PM 110 S ECTION I: FORENSIC MEDICINE 78 The following are the differences of strangulation from hanging EXCEPT (a) Carotid arteries damage is rare (b) Fracture dislocation of cervical vertebrae is common (c) Neck is not elongated (d) External signs of asphyxia are well marked 79 Fracture of hyoid bone, thyroid cartilage and cricoid cartilage along with neck muscle bruising suggests (a) Manual strangulation (b) Ligature strangulation (c) Hanging (d) Choking 80 Fracture of hyoid bone with thyroid cartilage along with neck muscle bruising suggests death due to (a) Strangulation (b) Hanging (c) Choking (d) Gagging 81 Bilateral comminuted fractures of the larynx are usually caused by (a) Pressing the neck with the hands (b) A blow to the neck (c) Ligature strangulation (d) Garrotting 82 Anteroposterior compression fracture of the larynx is usually caused by (a) Ligature strangulation (b) Throttling (c) Garrotting (d) Hanging 83 Adduction type of fracture of hyoid bone is seen in death due to (a) Ligature strangulation (b) Hanging (c) Throttling (d) Motor vehicle accidents 84 A blow on the larynx may cause death from (a) Laryngospasm (b) Fracture of hyoid bone (c) Air embolism (d) Nerve paralysis 78 (b) Chapter-13.indd 110 79 (a) 80 (a) 81 (b) 82 (d) 83 (c) 84 (a) 85 (c) 85 Fracture of the body of thyroid cartilage may be seen in the following conditions EXCEPT (a) Throttling (b) In a cyclist in traffic accident (c) Hanging (d) Karate blow to the front of the neck 86 Bruising of the muscles of neck and larynx with fracture of thyroid cartilage and hyoid bone is seen in death due to (a) Hanging (b) Throttling (c) Ligature strangulation (d) Traumatic asphyxia 87 Palmar strangulation is caused by (a) Forcibly closing throat by right palm (b) Forcibly closing throat by both palms (c) Forcibly closing throat by fingers of both hands (d) Karate blow to the front of the neck 88 Swelling and protrusion of the tongue is more common in (a) Hanging (b) Ligature strangulation (c) Traumatic asphyxia (d) Gagging 89 Cricoid cartilage is usually fractured in(a) Throttling (b) Ligature strangulation (c) Traumatic asphyxia (d) A blow to the front of the neck 90 Which one of the following regarding death due to throttling is NOT true? (a) Fracture of the hyoid bone (b) Fracture of thyroid cartilage (c) Collection of blood behind the pharynx, larynx and on the front of the cervical spine (d) Fracture of cricoid cartilage 91 Fracture of hyoid bone and larynx indicate (a) Accidental throttling (b) Suicidal throttling (c) Homicidal throttling (d) All of the above 86 (b) 87 (b) 88 (b) 89 (a) 90 (c) 91 (c) 7/13/2011 5:17:31 PM MECHANICAL ASPHYXIA 92 The most common cause of suffocation is (a) Inhalation of irrespirable gases (b) Closure of glottis (c) Pressure on chest (d) Deprivation of oxygen 93 Which one of the following statements regarding suicidal smothering is NOT true? (a) It can occur by closing the nose and mouth by the hand (b) It is possible by burying the face in a mattress (c) It is possible by lying against the bed clothing to obstruct the nose and mouth (d) It can be effected by tying a polythene bag over the head 94 In suffocation, petechial haemorrhages may be seen in (a) Pericardium (b) Meninges (c) Peritoneum (d) All of the above 95 Which one of the following is NOT correct, concerning accidental smothering? (a) It is less common than suicidal smothering (b) It can occur in a vitiated atmosphere (c) It is not necessary that the mouth and nostrils should be completely closed at the start (d) An intoxicated person may smother himself by burying his face in a pillow or covering with bed clothes 96 It is true regarding subcutaneous rupture of larynx and trachea that (a) It may produce widespread subcutaneous emphysema (b) It can be produced by the impaction of large food bolus (c) It is only a presumption not a reality (d) None of the above 97 Paleness of the face with few petechial haemorrhages in the eyelids are seen when smothering is caused by (a) Closing the mouth and nose by the hand (b) In air-tight place (c) Inhalation of irrespirable gases (d) Head and face enclosed in a plastic bag 92 (a) Chapter-13.indd 111 93 (a) 94 (a) 95 (a) 96 (a) 97 (d) 98 (a) 99 (d) 111 98 The postmortem finding seen in smothering (a) Abrasion on the inner side of the upper lip (b) Fracture body of hyoid (c) Thyroid fracture (d) Curved marks on the neck 99 The positive findings of burial of a living person is (a) Presence of moulds on the body (b) Congestion of liver and spleen (c) Marked pulmonary oedema (d) Earth or sand in trachea and bronchi 100 From autopsy, it is extremely difficult to detect (a) Homicidal smothering (b) Homicidal gagging (c) Homicidal choking (d) Homicidal ligature strangulation 101 Burking is a name derived from a (a) Place (b) Person (c) Firearm (d) Weapon used for murder 102 A method of homicidal smothering and traumatic asphyxia is known as (a) Choking (b) Gagging (c) Burking (d) Overlaying 103 A method of sitting over chest and closing nostrils and mouth to cause asphyxial death is known as (a) Overlaying (b) Choking (c) Burking (d) Gagging 104 Burking is combination of smothering and (a) Strangulation by ligature (b) Throttling (c) Gagging (d) Traumatic asphyxia 105 In burking the cause of death is (a) Smothering (b) Traumatic asphyxia (c) Smothering and traumatic asphyxia (d) Cerebral congestion 100 (a) 101 (b) 102 (c) 103 (c) 104 (d) 105 (c) 7/13/2011 5:17:31 PM 112 S ECTION I: FORENSIC MEDICINE 106 The cause of death from choking include all of the following EXCEPT (a) Asphyxia (b) Cerebral anaemia (c) Cardiac inhibition (d) Laryngeal spasm 107 Choking (a) It is a form of asphyxia caused by mechanical occlusion within air passages by a solid object (b) A twig of madar 20 cm long (c) It is practised in India by dais (d) Occurs due to closure of external respiratory orifices 108 Mode of death from obstruction of the air passages from within is (a) Anaemic anoxia (b) Stagnant anoxia (c) Anoxic anoxia (d) Histotoxic anoxia 109 Choking due to regurgitation of food may occur in (a) Under the influence of drink (b) Head injury (c) Traumatic asphyxia (d) Smothering 110 Death caused due to regurgitation of food and inhalation into the respiratory tract is called (a) Smothering (b) Choking (c) Traumatic asphyxia (d) Mugging 111 Homicidal choking can be produced when a victim is (a) An infant (b) Disabled (c) Under the influence of alcohol (d) All of the above 112 Cafe coronary commonly occurs in persons who (a) Had a previous heart attack (b) Intoxicated (c) Suffering from anginal attacks (d) All of the above 113 “Cafe coronary” is (a) A type of death due to choking (b) Sudden death due to coronary thrombosis (c) Death due to alcoholic cardiomyopathy (d) Food poisoning 114 The cause of death in cafe coronary is (a) Asphyxia (b) Coronary thrombosis (c) Sudden heart attack (d) Laryngeal spasm 115 In overlaying death occurs due to (a) Smothering (b) Compression of the chest (c) Inhalation of gastric contents (d) None of the above 116 The term overlaying implies (a) Asphyxia caused by an obstruction within air passages (b) Homicidal smothering (c) Asphyxia resulting from forcing a cloth into mouth (d) Compression suffocation 117 Presence of mucus, saliva and oedema fluid on the clothing tied over mouth and is suggestive of (a) Antemortem gagging (b) Choking (c) Struggle before death (d) Traumatic asphyxia 118 Detection of buccal epithelium on the gagging material may help (a) To establish the sex of the victim (b) To establish the sex of the accused (c) To ascertain the age of the victim (d) To ascertain the age of the accused 119 Traumatic asphyxia results from (a) Injury to the head (b) Crushing of the chest and abdomen (c) Crushing of the lower limbs (d) Fall from a height on the buttocks 106 (b) 107 (a) 108 (c) 109 (a) 110 (b) 111 (d) 112 (b) 113 (a) 114 (a) 115 (b) 116 (d) 117 (a) 118 (a) 119 (b) Chapter-13.indd 112 7/13/2011 5:17:32 PM MECHANICAL ASPHYXIA 120 All of the following are causes of traumatic asphyxia EXCEPT (a) Gross compression of the chest and abdomen (b) Stampede in a crowd (c) Falls of earth or stone during tunnelling (d) Gross compression of the head 121 All the following can cause traumatic asphyxia EXCEPT (a) Railway accident (b) Road traffic accident (c) Stampede in crowd (d) Accidental strangulation 122 The characteristic feature of traumatic asphyxia is (a) Multiple fractures of bones (b) Deep purple colour of the head, neck and upper chest (c) Collapse of the lungs (d) Abrasions and contusions around the mouth and nose 123 Which of the following is not a cause of death due to suffocation? (a) Choking (b) Gagging (c) Smothering (d) Throtting 124 Death is usually accidental in the following conditions EXCEPT (a) Traumatic asphyxia (b) Choking (c) Gagging (d) Overlaying 125 The term “dry drowning” is used when death occurs (a) Within half hour to several days after resuscitation (b) From immediate sustained laryngeal spasm (c) From vagal inhibition (d) From hyperkalaemia 126 In immersion syndrome death results from vagal inhibition due to (a) Cold water striking the epigastrium (b) Cold water stimulating the sensory nerves in the skin 127 128 129 130 131 132 133 113 (c) Cold water entering ear drums or mucosa of the pharynx and larynx (d) All of the above Atypical arrest due to drowning is (a) Cardiac arrest due to drowning (b) Laryngospasm due to drowning (c) Drowning in unconscious state (d) All of the above Dry drowning is (a) When a person falls in a dry well and dies (b) Death occurs due to fall in water from spasm of larynx (c) Falls in water and die due to vagal inhibition (d) All of the above Which is NOT a contributory cause of death in immersion syndrome? (a) Cold water entering the pharynx and larynx (b) Cold water stimulating the nerve endings of the surface of the body (c) High emotion (d) Hyperkalaemia The salt concentration of seawater is about (a) 0.5% (b) 0.1% (c) 2.0% (d) 3.0% In freshwater drowning there is (a) Hypernatraemia (b) Hyperkalaemia (c) Hypermagnesaemia (d) Hypercalcaemia Hypervolaemia and hyperkalaemia are seen in (a) Freshwater drowning (b) Saltwater drowning (c) Dry drowning (d) Immersion syndrome Haemodilution occurs in (a) Seawater drowning (b) Freshwater drowning (c) Both seawater and freshwater drowning (d) None of the above 120 (d) 121 (d) 122 (b) 123 (d) 124 (c) 125 (b) 126 (d) 127 (d) 128 (b) 129 (d) 130 (d) 131 (b) 132 (a) 133 (b) Chapter-13.indd 113 7/13/2011 5:17:32 PM 114 S ECTION I: FORENSIC MEDICINE 134 Exchange of water in drowning at alveolar level depends upon (a) Quantity of the water inhaled (b) Osmotic gradient between blood and water (c) Thickness of the alveolar septa (d) All of the above 135 The common cause of death in freshwater drowning is (a) Asphyxia (b) Ventricular fibrillation (c) Laryngeal spasm (d) Vagal inhibition 136 The common cause of death in seawater drowning is (a) Laryngeal spasm (b) Vagal inhibition (c) Exhaustion (d) Asphyxia 137 In dry drowning death is due to (a) Laryngeal spasm (b) Exhaustion (c) Ventricular fibrillation (d) Vagal inhibition 138 The cause of death in immersion syndrome is (a) Laryngeal spasm (b) Ventricular fibrillation (c) Vagal inhibition (d) Asphyxia 139 The complication of drowning in freshwater is (a) Haemodilution (b) Severe pulmonary oedema (c) Hypokalaemia (d) Hypernatraemia 140 Reflex cardiac arrest is due to (a) Sudden flow of water into the nasopharynx (b) Sudden thrust of water over the abdominal region (c) In both (a) and (b) (d) Does not occur in drowning 141 In case of freshwater drowning death occurs within to of submersion due to ventricular fibrillation Which of the following reasons is responsible for this? 142 143 144 145 146 147 148 (a) Total asphyxia is produced due to freshwater drowning (b) Laryngospasm causes vagal inhibition (c) Haemoconcentration of blood caused by osmotic pressure effect (d) Haemodilution, overloading of heart and haemolysis resulting in release of potassium Fatal period in freshwater drowning is about (a) to minutes (b) to minutes (c) to minutes (d) to 10 minutes Hypernatraemia is seen in (a) Freshwater drowning (b) Saltwater drowning (c) Immersion syndrome (d) All of the above Signs of asphyxia are absent in (a) Wet drowning (b) Dry drowning (c) Secondary drowning (d) Seawater drowning Slow death occurs from asphyxia in (a) Freshwater drowning (b) Saltwater drowning (c) Secondary drowning (d) Immersion syndrome In drowning in unconscious state the lungs are (a) Ballooned (b) Not ballooned (c) Collapsed (d) Show congestion and petechial haemorrhages Which of the following is not seen in sea water drowning? (a) Hypernatraemia (b) Hyperkalaemia (c) Fluid retention (d) Intravascular dehydration Victim of drowning in a state of suspended animation can be revived within (a) 10 to 20 minutes (b) 30 to 60 minutes (c) to hours (d) to hours 134 (b) 135 (b) 136 (d) 137 (a) 138 (c) 139 (a) 140 (c) 141 (d) 142 (c) 143 (b) 144 (c) 145 (b) 146 (b) 147 (b) 148 (a) Chapter-13.indd 114 7/13/2011 5:17:32 PM MECHANICAL ASPHYXIA 149 At autopsy, a body was found to have fine froth from the nose and mouth which increased on compression of the chest Which of the following is the most likely cause of death? (a) Opioid poisoning (b) Hanging (c) Drowning (d) Cyanide poisoning 150 Reaction phenomenon is seen in (a) Burns (b) Drowning (c) Poisoning (d) Gunshot injury 151 It is true regarding seawater and freshwater drowning that (a) The mechanism of death is the same (b) The mechanism of death is different (c) The mechanism of death is the same but the time taken is different (d) All of the above 152 Rigor mortis in case of drowning (a) Appears late (b) Appears early (c) Has no effect on appearance (d) Appears early in postmortem drowning 153 Which of the following is NOT true about freshwater drowning? (a) Hypovolaemia (b) Ventricular fibrillation (c) Hyperkalaemia (d) Haemolysis 154 Cutis anserina is seen in (a) Drowning (b) Hanging (c) Electrocution (d) Mummification 155 Washerwoman’s hands and feet are usually seen in a case of drowning in (a) to 12 hours (b) 18 to 24 hours (c) 24 to 36 hours (d) 36 to 48 hours 156 All of the following are features of washerwoman’s hands, EXCEPT (a) Soddening of the skin (b) Thinning of the skin (c) Wrinkling of the skin (d) Bleaching of the skin 115 157 Most important sign of death due to drowning is (a) Washerwoman’s hands and feet (b) Weeds and grass grasped in the hands (c) Cutis anserina (d) Cyanosis 158 Important sign of antemortem drowning is indicated by (a) Cutis anserina (b) Frothy fluid in mouth and nostril (c) Grass and weeds in hands (d) Washerwomen’s hands 159 Postmortem staining is usually found on the face, upper part of the chest and hands and feet in death due to (a) Choking (b) Strangulation (c) Drowning (d) Traumatic asphyxia 160 The most characteristic external sign of drowning is (a) Cutis anserina (b) Washerwoman’s hands and feet (c) Fine, white, lathery froth at the mouth and nostrils (d) Distended abdomen 161 Specific gravity of human body is (a) 1.08 (b) 2.01 (c) 1.05 (d) 2.35 162 Large quantity of froth is found at the mouth and nose in the following, EXCEPT (a) Strangulation (b) Electrical shock (c) Traumatic asphyxia (d) Opium poisoning 163 A child got drowned in a pond The most characteristic finding at autopsy is (a) Petechial haemorrhages (b) Washerwoman’s feet (c) Cutis anserina (d) Froth at mouth and in respiratory passage 149 (c) 150 (b) 151 (b) 152 (b) 153 (a) 154 (a) 155 (b) 156 (b) 157 (b) 158 (c) 159 (c) 160 (c) 161 (a) 162 (c) 163 (d) Chapter-13.indd 115 7/13/2011 5:17:32 PM 116 S ECTION I: FORENSIC MEDICINE 164 Froth of drowning can be differentiated from that due to other causes by (a) Microscopic detection of mucus (b) Detecting excess of sodium chloride (c) Detecting excess of potassium (d) Detecting excess of magnesium 165 Absence of foam in drowning can be found in (a) Dry drowning (b) Immersion syndrome (c) Both (a) and (b) (d) Wet drowning 166 The colour of the postmortem staining may be pink or cyanotic in death due to (a) Hanging (b) Drowning (c) Traumatic asphyxia (d) Throttling 167 The important finding of antemortem drowning is (a) Froth in mouth and nostrils (b) Washerwoman’s hands and feet (c) Fluid and air in the bronchi (d) Haemoconcentration 168 All of the following are the findings in sea-water drowning EXCEPT (a) Pulmonary oedema (b) Hypernatraemia (c) Hyperkalaemia (d) Haemoconcentration 169 Regurgitation of gastric contents into the larynx and trachea in cases of drowning is due to (a) Ingestion of large quantities of water (b) Medullary hypoxia (c) Stimulation of gastric mucosa by substances in ingested water (d) All of the above 170 The most characteristic internal finding in drowning is (a) Emphysema aquosum (b) Froth in the trachea (c) Mud and sand particles in the terminal bronchioles (d) Diatoms in the lungs 171 In freshwater drowning the lungs are (a) Ballooned but light in weight (b) Ballooned and heavy (c) The shape of sectioned portion is not retained (d) Copious amounts of fluid pours out of the cut section 172 In saltwater drowning the lungs are (a) Ballooned and heavy (b) Ballooned but light in weight (c) Pale pink in colour (d) On section water does not pour out 173 In death due to drowning in sea difference of at least % in chloride content in left and right side of heart is significant (a) (b) 10 (c) 25 (d) 60 174 A person brought to casualty showing froth at the mouth and nose, which increases on compression of chest, is seen in (a) Secondary drowning (b) Strangulation (c) Dry drowning (d) Hanging 175 Petechial haemorrhages in drowning may be seen in (a) Subpleural tissues of lung (b) Submucosa of trachea (c) Bronchioles (d) Alveoli 176 Drowning can be diagnosed if there is (a) Cyanosis (b) Fracture of hyoid bone (c) Water and diatoms in lungs and stomach (d) All of the above 164 (a) 165 (c) 166 (b) 167 (c) 168 (c) 169 (b) 170 (c) 171 (a) 172 (a) 173 (c) 174 (a) 175 (a) 176 (c) Chapter-13.indd 116 7/13/2011 5:17:32 PM MECHANICAL ASPHYXIA 177 Drowning is characterised by the following signs EXCEPT (a) Lungs are ballooned (b) Trachea and bronchi contain froth and sand (c) Diatoms are present (d) Stomach is empty while lungs are full of water 178 Bulky oedematous lungs with fine froth and diatoms are suggestive of (a) Antemortem drowning (b) Postmortem drowning (c) Antemortem hanging (d) Suicidal hanging 179 In drowning, emphysema aquosum is seen in (a) 30% (b) 50% (c) 80% (d) 95% 180 Emphysema aquosum is seen in (a) Wet drowning (b) Dry drowning (c) Secondary drowning (d) Immersion syndrome 181 Paltauf ’s haemorrhages are seen in (a) Electrocution (b) Hanging (c) Throttling (d) Drowning 182 Presence of aquatic vegetation in lower respiratory tract in a case of drowning (a) Is positive proof of drowning (b) Not a definite sign (c) Not significant at all (d) Can be seen in both antemortem and postmortem drowning 183 Water is found in the stomach in cases of drowning in (a) 20 to 30% cases (b) 30 to 40% cases (c) 50 to 60% cases (d) 60 to 70% cases 184 Water can be absent in the stomach in cases of drowning due to (a) Immersion syndrome (b) Putrefaction (c) Both (a) and (b) (d) Absorption of water after death 117 185 In cases of death due to drowning, water in small intestine is (a) An important finding (b) Not an important finding (c) Helps in estimating time since death (d) None of the above 186 Temporal bone haemorrhages are found in (a) Throttling (b) Drowning (c) Cyanide poisoning (d) Arsenic poisoning 187 In a putrefied body, the most important finding indicating death due to drowning is (a) Specific gravity of plasma from right side of heart is more than left (b) Difference in chloride in right and left side of heart (c) Presence of water in the pleural cavities (d) Presence of diatoms in internal organs 188 If the postmortem is delayed in a case of drowning (a) The typical findings in the lungs may disappear (b) The typical findings in the lungs are not affected (c) The diatom test becomes negative (d) None of the above 189 Acid digestion technique is used for (a) Detection of algae in stomach contents in drowning (b) Detection of diatoms in tissues in drowning (c) Detection of metallic pieces in the muscles (d) All of the above 190 One of the following is a sure sign of death due to drowning (a) Cutis anserina (b) Water in the stomach (c) Pulmonary oedema (d) Diatoms detected in bone marrow 191 The confirmatory laboratory test for death due to drowning in seawater is (a) Diatom test (b) Chloride test (c) Specific gravity test (d) None of the above 177 (d) 178 (a) 179 (c) 180 (a) 181 (d) 182 (a) 183 (d) 184 (c) 185 (a) 186 (b) 187 (d) 188 (a) 189 (b) 190 (d) 191 (d) Chapter-13.indd 117 7/13/2011 5:17:32 PM 118 S ECTION I: FORENSIC MEDICINE 192 Commonest type of drowning is (a) Suicidal (b) Accidental (c) Homicidal (d) Undetermined 193 Accidental drowning can be ruled out if (a) Hands and feet are tied by a ligature (b) The body is tied up inside a gunny bag (c) Heavy weights are attached to the body (d) All of the above 194 Which of the following sign will indicate that the death due to drowning was antemortem? (a) Cutis anserina (b) Washerwoman’s hands (c) Weeds and grass in the hands (d) Cyanosis 195 Hydrostatic lung can be seen (a) If the body is removed from water within hours of drowning (b) If the body remains in water at a depth of metres for 20 hours (c) In secondary drowning (d) Drowning in shallow water 196 False negative hydrostatic test in a live born foetus is seen in (a) Atelectasis (b) Artificial respiration (c) Emphysema (d) Putrefaction 197 In a suspected case of drowning diatoms can be looked for in (a) Brain (b) Bone marrow (c) Liver (d) All of the above 198 Differenciate between freshwater drowning and seawater drowning (a) Frothing is seen in freshwater drowning only (b) Diatoms are found in the sternum in freshwater drowning (c) Increase in the chloride levels in the left side of heart (d) Pulmonary oedema 199 The following is the absolute and confirmatory laboratory test for deaths due to drowning in seawater 200 201 202 203 204 205 206 (a) Diatom test (b) Chloride test (c) Magnesium estimation (d) None of the above In faked drowning, the following signs may be present EXCEPT (a) Lungs will be normal (b) Heart shows normal chloride contents in both chambers (c) Trachea will not be congested (d) Cutis anserina will be prominent In a person who died of drowning in seawater (a) Lungs are pale pink (b) Signs of asphyxia are not seen (c) Stomach does not contain water (d) The chloride content of left side of heart is higher Diatoms are (a) Parasites (b) Algae (c) Bacteria (d) Fungi The conclusive postmortem finding of death by drowning is (a) Cutis anserina (b) Presence of water in the middle ear (c) Oedematous lung (d) Demonstration of diatoms in the organs of the body Gettler’s test is used in (a) Hanging (b) Strangulation (c) Drowning (d) Poisoning Bleaching of cuticle begins after (a) to hours of immersion (b) 12 hours of immersion (c) 24 hours of immersion (d) 48 hours of immersion Floatation of a body in water is due to (a) Flesh being eaten by fishes (b) Presence of gases (c) Water logging of body (d) All of the above 192 (b) 193 (d) 194 (c) 195 (b) 196 (a) 197 (d) 198 (c) 199 (d) 200 (d) 201 (d) 202 (b) 203 (d) 204 (c) 205 (a) 206 (b) Chapter-13.indd 118 7/13/2011 5:17:32 PM MECHANICAL ASPHYXIA 207 A dead body will float in summer after drowning in (a) to 12 hours (b) 12 to 24 hours (c) 24 to 36 hours (d) 36 to 48 hours 208 Air pockets in clothing may cause (a) Early floatation of the body (b) Late floatation of the body (c) No effect on floatation (d) No floatation at all 209 Deep inspiration above the water level may cause (a) No effect on floatation of body (b) Early floatation of body (c) Late floatation of body (d) Late floatation of body only in seawater 210 Hyperventilation before drowning (a) Can cause immediate death (b) Does not alter the process of drowning 119 (c) Can cause delayed death (d) Can cause secondary drowning 211 The most fatal complication that can occur to divers (under high atmospheric pressure) is (a) Pulmonary oedema (b) Air embolism (c) Vagal inhibition (d) Suffocation 212 Sexual asphyxias are commonly associated with (a) Sadism (b) Fetichism (c) Masochism (d) Voyeurism 213 The most frequent method of sexual asphyxias is (a) Hanging (b) Electrical stimulation of genitals (c) Enveloping the head in a plastic bag (d) Inhalation of stupefying substances 207 (b) 208 (a) 209 (b) 210 (c) 211 (b) 212 (c) 213 (a) Chapter-13.indd 119 7/13/2011 5:17:32 PM ... (c) 125 (b) 126 (d) 127 (d) 128 (b) 129 (d) 130 (d) 131 (b) 132 (a) 133 (b) Chapter- 13. indd 113 7 /13/ 2011 5:17:32 PM 114 S ECTION I: FORENSIC MEDICINE 134 Exchange of water in drowning at alveolar... (c) to hours (d) to hours 134 (b) 135 (b) 136 (d) 137 (a) 138 (c) 139 (a) 140 (c) 141 (d) 142 (c) 143 (b) 144 (c) 145 (b) 146 (b) 147 (b) 148 (a) Chapter- 13. indd 114 7 /13/ 2011 5:17:32 PM MECHANICAL... striking the epigastrium (b) Cold water stimulating the sensory nerves in the skin 127 128 129 130 131 132 133 113 (c) Cold water entering ear drums or mucosa of the pharynx and larynx (d) All of the