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7/27/2019 PPT REFERAT HANGING.ppt
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HANGING
Ihsan Bayu 030.05.110 FK TRISAKTI
Indra Pratama 030.07.117 FK TRISAKTI
Kartika 030.08.134 FK TRISAKTILinta Isna 030.07.144 FK TRISAKTI
Regina Fristasari 030.07.212 FK TRISAKTI
Dosen Penguji: dr.Arista Hardinisa, Sp.F
Residen Pembimbing : dr.RP Uva Utomo
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Introduction
Hanging cases are the common cause of deathas result of asphyxia. Based on facts, hangingis one of suicidal methods which is often foundin many countries.
In England, there is more 2000 cases ofhanging each year.
In US, there was 279 accidental death by
hanging and strangulation. In Bali, there is 39 suicidal cases and hanging
is about 36 cases (in 2009).
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Introduction (2)
Hanging can occur in various ages.
Formerly, death punishment was established by
hanging.
It is important to know all about hanging because
hanging is very common manner of death which is
caused by asphyxia.
in medicolegal aspect, as doctor, we must ensure thatcase is hanging.
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Anatomy of the Neck
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Definition
Hanging is a form of ligature strangulation in
which the force applied to the neck is derivied
from the gravitational drag of the weight of
the body or part of the body
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Classification
A. Mechanism of death:
- Suicidal
- Accidental
- Homicidal
B. Victims position:
- Complete hanging
- Incomplete hanging (partial)
C. Place of knot:- Typical
- Atypical
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Type of Hanging
complete hangingPartial hanging
The victims
feet didnttouch the
ground
Some part
of the
bodytouching
the ground
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Type of Hanging
Typical Hanging Atypical Hanging
The hanging point is over the
occipital area.
The pressure of the carotid artery is
the heaviest
The hanging point located beside
the neck lateral flexion
This caused obstruction of the
carotid artery and vertebral artery
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Cause of Death
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Asphyxia
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Asphyxia
Tracheal obstruction can develop internally
(for example obstruction by foreign bodies), or
externally ( for example by rope ).
Airway obstruction influenced more in
unconsciousness than carotid obstruction
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Brain stem and spinal cord injury
This is associated with dislocation or fracture
of the cervical vertebrae, for example in
judicial hanging, usually occurred in cervical
vertebrae C2-3 or C3-4 because of the knot
position in the neck.
Upper medula spinalis is pulled, stretched, or
twisted and pressing the medulla oblongata
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Brain Ischemia
Occurred because of obstruction airway.
Tracheal obstruction can develop internally
(for example obstruction by foreign bodies), or
externally ( for example by rope ).
Airway obstruction influenced more in
unconsciousness than carotid obstruction
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Vagal Reflex
Pressure to ganglion nerve of carotid artery by
rope that caused vagal reflex, triggered heart
beat deceleration.
Vagal reflex caused slow arrythmia, then the
victim died because of cardiac arrest
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Anoxic Anemic
Stagnant Histotoxic
Anoxia
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Berat
(Lbs)
Berat
(Kilogram)
Ketinggian
(kaki)
Ketinggian
(meter)
14 stone
(196 lbs)
89 kg 8 ft 0 in 2,44m
13,5 stone
(189 lbs)
86 kg 8 ft 2 in 2,49m
13 stone
(182 lbs)
83 kg 8 ft 4 in 2,53m
12,5 stone
(175 lbs)
79 kg 8 ft 6 in 2,58m
12 stone
(168 lbs)
76 kg 8 ft 8 in 2,63m
11,5 stone
(161 lbs)
73 kg 8 ft 10 in 2,68m
11 stone
(154 lbs)
70 kg 9 ft 0 in 2,73m
10,5 stone
(147 lbs)
67 kg 9 ft 2 in 2,78m
10 stone
(140 lbs)
64 kg 9 ft 4 in 2,83m
9,5 stone
(133 lbs)
60 kg 9 ft 6 in 2,88m
9 stone
(126 lbs)
57 kg 9 ft 8 in 2,93m
8,5 stone
(119 lbs)
54 kg 9 ft 10 in 2,98m
8 stone 51 kg 10 ft 0 in 3,03m
N i i l i P i
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No intravital sign Postmortem sign
1.
2.
3.
4.
5.
6.
7.
8.
9.
non continous circular noose mark and located at
upper neck
usually single knot, on the side of the neck
Ecchymosys is clearly visible on one side of the
noose mark
livor mortis is clearly visible above the noose mark
and on lower extremities
Parchmentisation (parchment sensation on the
noose mark when palpated)
Cyanotic face, lips, ear, etc is very clearly visible
especially if the cause of death is asphyxia
Swollen face, congestion and protrusion of the
eyes, accompanied with visible veins on forehead
Tongue could be sticking out
Penis erection with semen discharge is usually seen
on male victim. Faeces discharge may also occured
Dribbling saliva on the side of the mouth, vertically
to the chest. This is an absolute sign of antemortem
hanging
Continous circular noose mark, located not too high on
the neck
Usually multiple knot, wrapped tightly and located in
front of the neck.
Ecchymosis on one side of the noose mark is not present
or visible
Livor mortis is located on hanged body part fitting with
the corpse position after death
Parchimentisation is not present or clearly visible
Cyanotic face, lips, ears, etc depend on the cause of
death
Tongue is not sticking out, unless the cause is
strangulation
Penis erection, semen discharge, and faeces discharge
are not present
Dribbling saliva is not present on cases other than
hanging cases
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External examination finding
Noose mark- Clear and deep
- Diagonal line
- Dark brown colored and parchment paper
sensation when touched
- On the knot area, triangular shape can be seen
- The perimeter of the borderline is clearly visible
Asphyxia signs- Cyanotic
- Vein congestion
- oedema
Livor mortis on lower
part of the body
Secretion of urine and
faeces
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Hangmark
Ropes widht ParchmentisasiNoose
groove
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SIGN OF ASPHIXIA
Cianotic
face
Pale &
Oedema
face
Protusionof eye
Tardieu spot
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Neck
positionProtrusion
of tongue
Dribbled
down of
saliva
Livormortis
Discharge of sperm, urine, feces, and menstrual blood
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Internal examination finding
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HEAD
Brain
congestionand
oedema
hemorrhagic
spots on
meningens
INTERNAL
EXAMINATION
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NECK Tissueundernoose
mark
Platisma
and neck
muscle
Red line
Larynx and
trachea
congestion
Hangman fracture
Hyoid cartilage
fracture
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THORAX ,
ABDOMEN, and
BLOOD
Tardieus
spots on
pleura,
pericard or
peritoneum
Organ
congestion
Blood in the heart is
darker and more
dilute
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Hangman Fracture
Hangmans fracture results from
hyperextension of the upper cervical spine.
The axis breaks symmetrically across its
pedicles or lateral masses, and the fracturemay extend across the posterior part of the
body.
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In the second book of Penal Code at Chapter
XIX :
Matter 338
Matter 339
Matter 340
Matter 344 Matter 345
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