Drowning
Drowning
DROWNING
Drowning
Drowning is a form of asphyxial death
due to aspiration of fluid into the air
passages by submersion of the body in
water or fluid medium.
fibrillation
Heart failure
Death
Sea Water Drowning (3.5%
Nacl)
Hemoconcent Pulmonary
ration edema
Heart failure/
asystole
DEATH
Difference between
fresh & sea water drowning
Petechial
hemorrhages
17
PM
Lividity
Froth
Strangulation
Putrefaction
epileptic fit
Electric shock
Acute pulmonary edema
Poisoning-Cocaine, OP, Morphine,
Barbiturate
Cutis Anserina - or Goose skin It is
puckered and granular appearance with hair
standing on end due to contraction of
erector pilorum muscle.
Occasionally grass & leaves may be found
firmly grasped in hands due to cadaveric
spasm . It is diagnostic of death from drowning
because it shows struggle of victim for life .
Washermans hands
LUNGS
voluminous, bulky,
water logged,
overinflated,
filling the chest
cavity &
overlapping the
heart.
On c/s blood
stained froth oozes
out.
(LUNGS) Fresh Vs Sea
Fresh Sea
Lungs- light
Colour-Pinkish
Consistency- Heavy
Purplish/ Bluish
Emphysematous
Soft,jelly like
Shape-Retained,do
not collapse Not retained,tend to flatten out
No crepitus,copious fluid & froth
On cut section-
Crepitus is heard,little
froth & no fluid
Emphysema aquosum On section,an
edematous condition due to the presence of a
large amount of watery , frothy blood
stained fluid is seen. Drowning fluid
penetrates alveolar walls to enter the
tissues and blood vessels . This is known as
emphysema aquosum . It is presumptive
evidence of death from drowning
Edema aquosum:- this condition develops
when person is passively immersed with no
violent effort of respiration in water / person
is unconcious.
It is a mere flooding of lungs with water with
no formation of column of froth
The stomach contains water of same
characteristics as that in which body was found
immersed and contain mud , sands and algae.
Water is not found in stomach if person died from shock,
syncope & was already dead .
Brain, Liver, Spleen & Kidney Congested
Middle ear- Water & haemorrhage
The heart presents appearance usually in death
from asphyxia, left sides is empty and right is full
of blood.
Antemortem Vs
Postmortem
Antemortem Post mortem
Gettlers Test
Normally chloride content of left and right
side of heart is same
In fresh water drowning chloride content
of left side of heart is lower by 25% than
the right side
In sea water drowning, the reverse occurs
Strontium test: Difference of 75 g/L of
strontium concentration between right and
left side of heart is considered as significant
in seawater drowning.
Diatoms
Diatoms are unicellular algae found
whenever there is water and sufcient
sunlight for photosynthesis
Principle of Diatom Test
The diatom test is based on principle that
Importance of Diatoms
Demonstration of significant quantities
of diatoms indicate:
Death was due to drowning
Person was alive when he was
submerged in water
Site of drowning can be known by
comparing diatom species in body and
the source/site where body was found.
Diatoms
Advantage
Diatoms resist decomposition and can be
demonstrated even in highly decomposed body.
Drawback
Caution should be exercised while interpreting
nondrowning deaths
Medico- legal importance
1.Accidental drowning Most
commonly seen in children
,fisherman ,drunkenness and
epileptics.
2.Suicidal drowning It is commonly
seen in female.
3. Homicidal drowning It is not very
common, though may be seen in
cases of infanticide.
DROWNING
90. Diatom test may be useful as an
investigational aid in deaths due to:
A.Hanging
B.Strangulation
C. Drowning
D. All asphyxial deaths
ANSWER: C, Drowning.
91. The average specific gravity of
human body is about:
A.0.89
B.1.08
C. 1.23
D. 1.65
ANSWER: B, 1.08.
92. All are seen in drowning
except:
A.Miosis
B.Wet heavy lungs
C. Water and weeds in
stomach and lungs
D. Froth from nose and mouth
ANSWER: A, Miosis.
93. Most common consistent feature
in a child who has died from drowning
in a pond is:
A.Suicidal
B.Accidental
C. Homicidal
D. Immersion syndrome
ANSWER: B, Accidental.
95. Which of the following signs
would indicate that the death was
ante mortem?
A.Cutis anserine
B.Washer womans hands
C. Weed and grass in the hands
D. Cyanosis
ANSWER: C, Weed and grass in the hands .
96. Which one of the following is a
definite sign of death due drowning?
A.Hanging
B.Strangulation
C. Drowning
D. Throttling
ANSWER: C, Drowning.
98. The term near drowning refers to:
A.1-2 %
B.10-15 %
C. 25 %
D. 30-30 %
ANSWER: B, 10-15 %.
101. Paltaufs hemorrhages are seen in:
A.Drowning
B.Firearm injury
C. Hanging
D. Strangulation
ANSWER: A, Drowning.
102. Bleaching of the cuticle becomes
quite evident after ... hours of
immersion:
A.2
B.12
C. 24
D. 48
ANSWER: B, 12.
103. Floatation of the body in our
country in summers occurs in:
A.12 hours
B.24 hours
C. 3 days
D. 6 days
ANSWER: B, 24 hours.
104. Besides drowning froth at the
mouth may be seen in a few other
conditions. Identify that condition
below:
A.Opium poisoning
B.Sulphuric acid poisoning
C. Head injury
D. Tetanus
ANSWER: A, Opium poisoning.
105. How many species of diatoms
are there?
A.About 100
B.Between 500-1000
C. Between 2000-5000
D. About 15,000
ANSWER: D, About 15,000.
107. Diatom test may be negative in
a case of:
A.Freshwater drowning
B.Seawater drowning
C. Drowned body but
decomposed
D. Dry drowning
ANSWER: D, Dry drowning.
108. For diatom test, the best site
for taking samples is:
A.Lungs
B.Bone marrow in ulna
C. Bone marrow in femur
D. A large and fleshy muscle
ANSWER: C, Bone marrow in femur.
109. Emphysema aquosum is seen
in:
A.Wet drowning
B.Dry drowning
C. Secondary drowning
D. Immersion syndrome
ANSWER: A, Wet drowning.
110.Hyperventilation before
underwater swimming:
A.Electrocution in water
B. Drowning in cold water
C. Immersion in boiling water
D. Postmortem submersion
ANSWER: B, Drowning in cold water .
113. Froth at the mouth and nostrils in a
dead body is seen in all of the
following cases, EXCEPT
A.Snake bite
B. Organophosphate poisoning
C. Drowning
D. Burns
ANSWER: D, Burns .
114. Post mortem lividity may not
develop at all in a case of
A.Hanging
B. Strangulation
C. Smothering
D. Drowning
ANSWER: D, Drowning.
115. The colour of post mortem lividity in
a case of drowning is
A.Bright pink
B. Purple
C. Scarlet
D. Cherry red
ANSWER: A, Bright pink.
116. Floater is the term applied to
A.Bacteria
B. Plant
C. Sea weed
D. Algae
ANSWER: D, Algae.
119. One of the following is NOT an
antemortem sign of drowning
A.Vagal inhibition
B. Asphyxia
C. Ventricular fibrillation
D. Pulmonary oedema
ANSWER: A, Vagal inhibition.
121. Post mortem staining is usually
found on the face, upper part of the
chest and hands and feet in death
due to
A.Choking
B. Strangulation
C. Drowning
D. Traumatic asphyxia
ANSWER: C, Drowning.
122. In most characteristic internal
finding in drowning is
A.Emphysema aquosum
B. Froth in the trachea
C. Right chambers of heart
full
D. Diatoms in the lungs
ANSWER: A, Emphysema aquosum.
123. In fresh water drowning the lungs are
A.Throttling
B. Drowning
C. Cyanide poisoning
D. Arsenic poisoning
ANSWER: B, Drowning.
128. Increase in magnesium content of left
ventricle even by 1 mg/100 ml
suggests
A.Pulmonary oedema
B. Air embolism
C. Vagal inhibition
D. Suffocation
ANSWER: B, Air embolism.
131.Exchange of water in drowning at
alveolar level will depend upon
A.Cyanosis
B. Water in stomach and lungs
C. Froth at nose and mouth
D. Washer womans feet and
hands
ANSWER: B, Water in stomach and lungs.