Asphyxial deaths: hyoid fracture and age: practice question

A Forensic Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Forensic Medicine · Asphyxial deaths: hyoid fracture and age

Sample item

A 19-year-old woman is strangled manually, yet the hyoid bone is intact at autopsy. What best explains this?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. The greater horns are still cartilaginous and flexible in young persons

The greater horns of the hyoid usually unite with the body by about 40 years. In the young the joints are flexible, so the bone bends without fracturing, and an intact hyoid does not exclude strangulation. Fractures are commoner in older persons whose hyoid has ossified.

Option by option

  • A. The hyoid is always fractured in strangulation

    The hyoid is not invariably fractured in strangulation, particularly in the young.

  • B. Hyoid fracture occurs only in ligature strangulation

    Hyoid fractures are commoner in manual strangulation than ligature strangulation.

  • C. The hyoid fuses early and resists any force

    Fusion occurs late, around the fourth decade, not early.

  • D. The greater horns are still cartilaginous and flexible in young persons (correct)

    Correct. Unfused flexible horns in young persons seldom fracture.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Forensic Medicine question

What is the answer to this Forensic Medicine question?

The best answer is D, The greater horns are still cartilaginous and flexible in young persons. The greater horns of the hyoid usually unite with the body by about 40 years.

Why is "The hyoid is always fractured in strangulation" not the answer?

The hyoid is not invariably fractured in strangulation, particularly in the young.

Why is "Hyoid fracture occurs only in ligature strangulation" not the answer?

Hyoid fractures are commoner in manual strangulation than ligature strangulation.

Why is "The hyoid fuses early and resists any force" not the answer?

Fusion occurs late, around the fourth decade, not early.

What concept does this question test?

It tests Asphyxial deaths: hyoid fracture and age in Forensic Medicine. In the young the joints are flexible, so the bone bends without fracturing, and an intact hyoid does not exclude strangulation. Fractures are commoner in older persons whose hyoid has ossified.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Asphyxial deaths: hyoid fracture and age?

Learn postmortem changes with their timelines, and toxicology as poison, sign, test and antidote. Then use the flashcards and the other Forensic Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.