How is manual strangulation typically different from strangulation using ligatures?

Manual strangulation is characterized by the use of the hands to constrict the neck, which means that it requires no tools or external objects. This method relies solely on the physical strength of the perpetrator to obstruct the airflow and disrupt blood flow to the brain. The absence of ligatures—such as ropes, cords, or other materials—distinguishes it from ligature strangulation, where an external object is used.

In contrast, strangulation with ligatures involves additional implements, which can vary in complexity and may include various types of materials or devices. This method can also create different injuries and leave different marks compared to manual strangulation. The distinction emphasizes the direct physical interaction in manual strangulation as opposed to the use of external tools in ligature cases. Thus, the correct understanding of manual strangulation highlights its inherent reliance on the perpetrator's own body rather than any tools, leading to the conclusion that it requires no additional implements.