Asphyxia: 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.

Try it

Forensic Medicine · Asphyxia: judicial hanging

Sample item

At autopsy of a man executed by long-drop judicial hanging, the neck knot was placed under the chin. Which injury is characteristic?

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

The answer and the reasoning

A. Bilateral fracture through the pars interarticularis of C2 with C2-C3 dislocation

With a submental knot and a drop of several feet, sudden jerking extends the head and produces a hangman's fracture, a bilateral fracture of the pars of the axis with traumatic spondylolisthesis, injuring the cord or brainstem. Death is nearly immediate. In suicidal hangings, which have short drops, such fractures are uncommon.

Option by option

  • A. Bilateral fracture through the pars interarticularis of C2 with C2-C3 dislocation (correct)

    Correct. Hyperextension with a long drop causes a hangman's fracture of C2.

  • B. Fracture of the C7 spinous process

    A C7 spinous process fracture (clay-shoveller's) comes from muscular strain.

  • C. Fracture of the thyroid cartilage with intact spine

    Laryngeal fracture alone would not account for the sudden death with a long drop.

  • D. Fracture of the odontoid peg with transection of the carotid arteries

    Odontoid fracture occurs with flexion injuries and does not typify 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.

More Forensic Medicine questions

Questions about this Forensic Medicine question

What is the answer to this Forensic Medicine question?

The best answer is A, Bilateral fracture through the pars interarticularis of C2 with C2-C3 dislocation. With a submental knot and a drop of several feet, sudden jerking extends the head and produces a hangman's fracture, a bilateral fracture of the pars of the axis with traumatic spondylolisthesis, injuring the cord or brainstem.

Why is "Fracture of the C7 spinous process" not the answer?

A C7 spinous process fracture (clay-shoveller's) comes from muscular strain.

Why is "Fracture of the thyroid cartilage with intact spine" not the answer?

Laryngeal fracture alone would not account for the sudden death with a long drop.

Why is "Fracture of the odontoid peg with transection of the carotid arteries" not the answer?

Odontoid fracture occurs with flexion injuries and does not typify judicial hanging.

What concept does this question test?

It tests Asphyxia: judicial hanging in Forensic Medicine. Death is nearly immediate. In suicidal hangings, which have short drops, such fractures are uncommon.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 Asphyxia: 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.