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7- Drowning (Immersion):. It is a form of violent asphyxia in which death results from submersion of mouth and nostrils of a living person under water. Classification (types) of drowning : 1- Typical (wet) drowning: 2- Dry drowning. 3- Secondary drowning (Near-drowning).

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7- Drowning (Immersion):

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    1. 7- Drowning (Immersion):

    2. It is a form of violent asphyxia in which death results from submersion of mouth and nostrils of a living person under water • Classification (types) of drowning: 1- Typical (wet) drowning: 2- Dry drowning. 3- Secondary drowning (Near-drowning).

    3. Physiopathological changes: • In fresh water  hypervolemia  hypoxia and potassium excess. • In salt water pulmonary edema  hypovolemia and circulatory shock.

    4. Dry drowning: Water in the larynx  laryngeal spasm  asphyxia Near-drowning (2nd drowning syndrome):

    5. glistening pleural surface of a lung

    6. PM picture of drowning: • These are signs of asphyxia unless death occurred from 1- shock, 2- syncope, 3- concussion.

    7. External appearances • Signs of immersion: These are found in any body found dead in water (whatever the cause of death). • Coolness of the body. • Goose-skin the skin is wrinkled. • Washerwoman-skin: the skin is sodden. • Peeling of the epidermis in the form of gloves and stockings. • Hypostasis

    8. 2- Sure external signs: A-Froth: (Fine – White – Odorless _ increase) B-Cadaveric spasm of the hands on weeds, mud, sand, etc.

    9. Internal appearances • Voluminous lungs with indentation marks of ribs on their lateral surfaces. • Respiratory passages contain froth (having the same characters of that found externally at the mouth and nostrils), • foreign material ( weeds, mud, sand,.).

    10. A normal pink aerated appearance with minimal anthracotic pigmentation,

    11. Diffuse alveolar damage in which the lung is diffusely firm and rubbery

    12. Diatoms: • These are microscopic, unicellular algae, found in fresh as well as salt water. • When a live person is drowned in water, they penetrate his alveolar membrane and pass with the circulation to distant organs. • But when a dead body is thrown into water, the absence of beating heart prevents circulation of diatoms to distant organs.

    13. some of the plant material in the water was aspirated into a bronchus.

    14. The medico-legal (ML) importance of diatoms: • 1- Sure signs of drowning, • 2- Could still be identified in putrefied bodies, • 3- Could give an evidence of the site of drowning (fresh or salt water species).

    15. How to know that death was due to drowning: 1-Froth at mouth and nostrils: fine, white, abundant. 2.Cadaveric spasm on weeds, mud or sand. 3.Lungs: voluminous, edematous with indentation marks of the ribs. 4.Froth in the air passages. 5. Diatoms in the tissues.

    16. In putrefied bodies: • Only diatoms could be identified