American Board of Medicolegal Death Investigators (ABMDI) Practice Exam

What is the primary cause of strangulation?

1. Compression of the neck

2. Direct pressure on the chest

3. Insufficient blood flow to the brain

4. Inhalation of foreign objects

The correct answer is: Compression of the neck

The primary cause of strangulation is the compression of the neck. This physical action can obstruct the trachea (windpipe) and blood vessels, leading to a lack of oxygen and blood flow to the brain. When the neck structures are compressed, it affects both the airway and the carotid arteries and jugular veins, severely restricting oxygen delivery to the brain and potentially causing loss of consciousness or death if maintained for a sufficient duration. Strangulation often occurs as a result of manual force or ligatures, making neck compression the fundamental mechanism at play in these scenarios. While insufficient blood flow to the brain is a consequence of neck compression, it does not denote the primary act causing strangulation itself. Direct pressure on the chest can lead to asphyxia but is not the defining feature of strangulation. Inhalation of foreign objects is also unrelated, as it pertains to airway obstruction rather than neck compression. Thus, understanding the distinct mechanism of neck compression is crucial in identifying the primary cause of strangulation.