Asphyxial deaths: judicial hanging: 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: judicial hanging

Sample item

In judicial hanging with a long drop, the usual mechanism of death is:

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

The answer and the reasoning

B. Fracture-dislocation of the upper cervical spine with spinal cord injury

In judicial hanging the long drop of the body's weight causes sudden traction, producing the hangman's fracture, a bilateral fracture through the pedicles of C2 with C2-C3 dislocation and cord or brainstem injury. Death is rapid. In suicidal hanging the body weight is smaller and death is usually from asphyxia and cerebral ischaemia.

Option by option

  • A. Slow asphyxia from tracheal compression

    Slow asphyxia describes suicidal hanging with a short drop, not a judicial long drop.

  • B. Fracture-dislocation of the upper cervical spine with spinal cord injury (correct)

    Correct. A hangman's fracture with cord transection causes immediate death.

  • C. Venous congestion of the brain

    Venous congestion of the brain is a mechanism of short-drop hanging.

  • D. Carotid sinus reflex with slow cardiac arrest

    Reflex arrest can occur, but it is not the usual mechanism with a long drop.

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 B, Fracture-dislocation of the upper cervical spine with spinal cord injury. In judicial hanging the long drop of the body's weight causes sudden traction, producing the hangman's fracture, a bilateral fracture through the pedicles of C2 with C2-C3 dislocation and cord or brainstem injury.

Why is "Slow asphyxia from tracheal compression" not the answer?

Slow asphyxia describes suicidal hanging with a short drop, not a judicial long drop.

Why is "Venous congestion of the brain" not the answer?

Venous congestion of the brain is a mechanism of short-drop hanging.

Why is "Carotid sinus reflex with slow cardiac arrest" not the answer?

Reflex arrest can occur, but it is not the usual mechanism with a long drop.

What concept does this question test?

It tests Asphyxial deaths: judicial hanging in Forensic Medicine. Death is rapid. In suicidal hanging the body weight is smaller and death is usually from asphyxia and cerebral ischaemia.

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: judicial hanging?

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.