Injuries: 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 · Injuries: judicial hanging

Sample item

A prisoner is executed by long-drop judicial hanging. Which neck finding is expected at autopsy compared with usual suicidal hanging?

AFracture of the hyoid with bruises from fingertipsBFracture-dislocation of the upper cervical vertebrae with damage to the spinal cordCIntact vertebrae with petechiae in the conjunctivaeDIntact neck with only a faint ligature mark

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

The answer and the reasoning

B. Fracture-dislocation of the upper cervical vertebrae with damage to the spinal cord

Judicial hanging uses a long drop so that the sudden arrest produces fracture-dislocation of the upper cervical vertebrae (classically C2 to C3, the hangman's fracture) with damage to the cord and brainstem, giving rapid death. In most suicidal hangings the drop is short and death is due to asphyxia or vascular occlusion, with intact vertebrae.

Option by option

A. Fracture of the hyoid with bruises from fingertips
Hyoid fracture with fingertip bruises indicates manual strangulation.
B. Fracture-dislocation of the upper cervical vertebrae with damage to the spinal cord (correct)
Correct. The long drop produces cervical fracture-dislocation with cord injury.
C. Intact vertebrae with petechiae in the conjunctivae
Intact vertebrae with petechiae are typical of short-drop asphyxial hangings.
D. Intact neck with only a faint ligature mark
A faint mark with an intact neck does not explain death by judicial hanging.

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.

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 vertebrae with damage to the spinal cord. Judicial hanging uses a long drop so that the sudden arrest produces fracture-dislocation of the upper cervical vertebrae (classically C2 to C3, the hangman's fracture) with damage to the cord and brainstem, giving rapid death.

Why is "Fracture of the hyoid with bruises from fingertips" not the answer?

Hyoid fracture with fingertip bruises indicates manual strangulation.

Why is "Intact vertebrae with petechiae in the conjunctivae" not the answer?

Intact vertebrae with petechiae are typical of short-drop asphyxial hangings.

Why is "Intact neck with only a faint ligature mark" not the answer?

A faint mark with an intact neck does not explain death by judicial hanging.

What concept does this question test?

It tests Injuries: judicial hanging in Forensic Medicine. In most suicidal hangings the drop is short and death is due to asphyxia or vascular occlusion, with intact vertebrae.

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 Injuries: 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.