Asphyxia: age and hyoid fracture: 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 · Asphyxia: age and hyoid fracture

Sample item

Two victims of manual strangulation are autopsied, one aged 22 and one aged 62. The same degree of neck compression was applied. Which statement is most accurate?

AHyoid fractures are more likely in the 22-year-oldBFractures occur only in hanging, never in strangulationCFractures are equally likely at all agesDHyoid and laryngeal fractures are more likely in the 62-year-old because of ossification

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

The answer and the reasoning

D. Hyoid and laryngeal fractures are more likely in the 62-year-old because of ossification

In young people the hyoid and thyroid cartilages are flexible and unossified, so they may bend without breaking even under heavy compression. Beyond about 40 years ossified cartilage is brittle and fractures more readily. An absence of fracture in a young adult does not exclude manual strangulation.

Option by option

A. Hyoid fractures are more likely in the 22-year-old
The flexible structures in a young person resist fracture.
B. Fractures occur only in hanging, never in strangulation
Fractures occur in strangulation, as in throttling, as well as in hanging.
C. Fractures are equally likely at all ages
Fracture risk depends on ossification, so it is age-dependent.
D. Hyoid and laryngeal fractures are more likely in the 62-year-old because of ossification (correct)
Correct. Ossification makes the older larynx more prone to 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.

Questions about this Forensic Medicine question

What is the answer to this Forensic Medicine question?

The best answer is D, Hyoid and laryngeal fractures are more likely in the 62-year-old because of ossification. In young people the hyoid and thyroid cartilages are flexible and unossified, so they may bend without breaking even under heavy compression.

Why is "Hyoid fractures are more likely in the 22-year-old" not the answer?

The flexible structures in a young person resist fracture.

Why is "Fractures occur only in hanging, never in strangulation" not the answer?

Fractures occur in strangulation, as in throttling, as well as in hanging.

Why is "Fractures are equally likely at all ages" not the answer?

Fracture risk depends on ossification, so it is age-dependent.

What concept does this question test?

It tests Asphyxia: age and hyoid fracture in Forensic Medicine. Beyond about 40 years ossified cartilage is brittle and fractures more readily. An absence of fracture in a young adult does not exclude manual strangulation.

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: age and hyoid fracture?

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.