机械性损伤英文版.ppt

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1、Mechanical Injury Wang Daihong Wang Daihong Associate Chief Physician Medical Doctor Associate Chief Physician Medical DoctorHUST Tongji hospital of xianning Hepatopancreatobiliary Surgery Department of The eco-circumstances center hospital2021/9/232021/9/231 1First:conception1.Injury:1.Injury:1.Inj

2、ury:1.Injury:injury injury or or wound wound caused caused by by effect effect factors factors in in the the body,which body,which lead lead to to the the destruction destruction of of the the organizational organizational structure structure and dysfunction.and dysfunction.2.Mechanical 2.Mechanical

3、 2.Mechanical 2.Mechanical injury injury injury injury：effect effect factors factors act act on on human human body body by by machanical machanical movement movement and and lead lead to to the the destruction destruction of of the the organizational organizational structure and dysfunction.structu

4、re and dysfunction.2021/9/232021/9/232 2Second:Mechanicaldamageofforensicmedicineidentification1.Tasks 1.Tasks and and object object of of living living damage damage forensic forensic identificationidentificationTaskTaskTaskTask：Injury severity;Injury severity;Injury waysInjury ways；To judge the in

5、juring objectsTo judge the injuring objects；To judge the injuring timeTo judge the injuring time；Injury degreeInjury degree；Labor capacityLabor capacity；Old injuring and new injuringOld injuring and new injuring；Compensation;Compensation;ObjectObjectObjectObject：living bodyliving bodyliving bodylivi

6、ng body2021/9/232021/9/233 32.Tasks and object of dead bodys damage forensic identificationTasksTasks：To determine the cause of deathTo determine the cause of death；To To determine determine its its antemortem antemortem injury injury or or postmortem injurypostmortem injury；To judge the injuring ob

7、jectsTo judge the injuring objects；Injuring timeInjuring time；personal identification and so on;personal identification and so on;ObjectObject：dead body dead body 2021/9/232021/9/234 4ThirdThird:the three elements of damage formationthe three elements of damage formation：1.injuring 1.injuring 1.inju

8、ring 1.injuring objectsobjectsobjectsobjects（murder murder murder murder weaponweaponweaponweapon）:an an object object which caused mechanical damage.which caused mechanical damage.FeaturesFeatures：various injuring objectsvarious injuring objects（solidsolid；liquidliquid；gasgas）The The extent extent

9、of of the the damage damage depends depends on on the the quality,quality,shape shape and and size size of of things,things,but but in in some some cases there is an exception.cases there is an exception.The The relative relative motion motion forms forms between between hunamn hunamn body body and

10、injuring objectsand injuring objects：Moving object and relative static body.Moving object and relative static body.Human movement and relatively stationary object.Human movement and relatively stationary object.Moving object and moving human.Moving object and moving human.2021/9/232021/9/235 5n nThe

11、 The common common hard hard injuring injuring objects objects include include blunt,blunt,sharps and firearms.sharps and firearms.Blunt:tools Blunt:tools with with no no tips tips and and edge,such edge,such as as fists fists and feet.and feet.Sharps:tools Sharps:tools with with tips tips and and e

12、dge,such edge,such as as cutting cutting machine and sting.machine and sting.Firearms:bullet,explosives and other tools.Firearms:bullet,explosives and other tools.2.Acting force2.Acting force2.Acting force2.Acting force：Compression Compression and and Stretch:acting Stretch:acting force force apply

13、apply on on the the same same axis,in axis,in same same direaction direaction,called,called compression,compression,while in opposite direaction called stretch.while in opposite direaction called stretch.Shear:to Shear:to make make the the cross cross sections sections sliding sliding together.toget

14、her.torsiontorsion：a a pair pair of of equal equal force force apply apply for for a a certain object.certain object.Bending:Bending:acting acting force force apply apply for for skull skull or or ribs ribs fot fot sag and recovery.sag and recovery.2021/9/232021/9/236 63.human tissue3.human tissue：D

15、ifferent tissues of human body parts and different tissues and organs of the anatomy of the organization structure,so the damage tolerance and resistance is different.Different appearances at different positions of the body shape also affects the shape of damage.Injured area organs or tissues for pa

16、thological changes impact on the degree of injury.2021/9/232021/9/237 7Theprincipleofmechanicaldamage1、Physicalfactors:externalforcesandinjuringobjects(size,direactionandnumber)2、Biologicalfactors:thebodyflexibilityandthespecialstructureofhumanbody.3、Humanbodysenginerystate(health,diseasestate)4、The

17、contactforceposition2021/9/232021/9/238 8Fourth:the basic form of mechanical Fourth:the basic form of mechanical injury injury（6 forms6 forms）1 1 1 1.Abrasion:.Abrasion:.Abrasion:.Abrasion:i i i injuring njuring objects objects apply apply to to human human body body and and lead lead to to separati

18、on separation between between skin skin and and dermis,its dermis,its also also called called epidermal epidermal peeling,peeling,which which is is a a common common blunt blunt injury.injury.featuresfeaturesfeaturesfeatures：Parts:Parts:can can occur occur in in any any part part of of the the body,

19、body,highlight highlight areas areas are are mostly.mostly.Scratch Scratch can can exist exist alone alone and and often often accompanied accompanied with with other other injuries,such injuries,such as as bite bite marks,marks,scratches,scratches,the the conjugate conjugate mark,which can be assoc

20、iated with bruise or contusion.mark,which can be associated with bruise or contusion.Different sizes,shapes and strips,sheets or strip,sometimes Different sizes,shapes and strips,sheets or strip,sometimes have free flap.these are the evident to judge the direction of have free flap.these are the evi

21、dent to judge the direction of the violent action.the violent action.Color can be light brown,dark brown,light red or dark red.Color can be light brown,dark brown,light red or dark red.2021/9/232021/9/239 9Common Common type:type:according according to to the the injury injury movement movement dire

22、ction,direction,speed speed and and human human contact,it contact,it can can be be divided divided into into the the following kinds:following kinds:Scratches Scratches Scratches Scratches：Sharp Sharp and and hard hard objects,objects,such such as as nails nails and and pins pins skim skim over ove

23、r the the skin skin and and make make skin skin defect,defect,the the general general stress stress area area is is small,small,the the force force along along the the tangential tangential direction direction streak streak the the surface surface of of the the skin,skin,make make the the skin skin

24、displaced displaced or or folding folding along along the the direction direction of of forces,forces,such such as as the the rape rape case,case,scratches scratches often often occur occur in in victims victims tprivate tprivate parts,stock inside,hands and arms.parts,stock inside,hands and arms.Gr

25、azesGrazesGrazesGrazes：Object Object or or rough rough ground ground rubs rubs with with skin skin surface surface and and lead lead to to the the bruise bruise of of the the skin.skin.Generally Generally the the stress stress area area is is large large and and widely widely demaged.demaged.This Th

26、is often often can can be be found found in in the the body body parts parts which which is is more more prominent,and prominent,and it it is is sheet sheet or or strip,strip,but but may may be be accompanied accompanied by by subcutaneous subcutaneous bleeding bleeding and scab skin formation.and s

27、cab skin formation.2021/9/232021/9/231010 Friction Friction Friction Friction：The The object object of of Rough Rough surface,surface,such such as as rope rope or or other other braid,braid,oppresses oppresses skin skin,at,at the the same same time time rubs rubs the the skin skin surface surface wi

28、th with a a heavy heavy vertical vertical force force and and horizontal horizontal force.Such as:hanged or strangled;teeth bites.force.Such as:hanged or strangled;teeth bites.Impression Impression Impression Impression：Vulnerant Vulnerant of of Small Small area area impacts impacts skin skin surfac

29、e surface with with high high speed speed from from almost almost perpendicular perpendicular direction,direction,resulting resulting Skin Skin abrasions.abrasions.Such Such abrasions abrasions always always cause cause the the injury injury of of deep deep tissues.tissues.As As is is the the case c

30、ase of of car car front front strikes strikes straight straight on on the the human human body,body,also also the the bullet bullet shot shot into the human bodyinto the human bodyIdentificationIdentificationIdentificationIdentification：with the normal natural dryingwith the normal natural drying wi

31、th the death of the table with the death of the table 2021/9/232021/9/231111The right facial friction2021/9/232021/9/231212Forensic significance:Forensic significance:Tip for external force Infer the vulnerant Infer the direction of the force Special parts off the table:such as the neck,inner thighs

32、 infer the damage reason(cased inferences)Infer the way of injury2021/9/232021/9/2313132.Contusion,bruise2.Contusion,bruise2.Contusion,bruise2.Contusion,bruise（1 1 1 1）Concept:Concept:Concept:Concept:Non-open Non-open skin skin lesions lesions caused caused by by the the effects effects of of blunt

33、blunt force,force,together together with with Vascular Vascular rupture rupture of of skin,skin,subcutaneous subcutaneous soft soft tissue,tissue,called called(intradermal(intradermal and and subcutaneous).subcutaneous).（2 2 2 2）Character:Character:2021/9/232021/9/231414 Closed trauma(both chopped d

34、own and subcutaneous hemorrhage)Closed trauma(both chopped down and subcutaneous hemorrhage)Hemorrhage Hemorrhage patterns:patterns:Internal Internal bleeding,bleeding,subcutaneous subcutaneous bleeding,bleeding,subcutaneous hematomasubcutaneous hematomaSubcutaneous Subcutaneous hemorrhage hemorrhag

35、e varies varies in in forms,forms,with with slight slight embossment embossment of surface,can reflect the area of vulnerant of surface,can reflect the area of vulnerant Different color of different time:(Hb degradation)Different color of different time:(Hb degradation)Color variation(used to determ

36、ine the injury time Color variation(used to determine the injury time：Skin Skin bleeding bleeding(red red or or purple purple)2-3d 2-3d green green 2-3d 2-3d yellow yellow 2-3d 2-3d gradually vanishgradually vanish Subcutaneous Subcutaneous hemorrhage hemorrhage(pale pale blue blue or or violet viol

37、et blue blue)6d 6d blue-blue-green 4d yellow 1-2w gradually vanishgreen 4d yellow 1-2w gradually vanish Larger area of contusion(40%),can also be life-threatening Larger area of contusion(40%),can also be life-threatening1d death after injury-traumatic shock1d death after injury-traumatic shock3-4d

38、3-4d death death after after injury-injury-acute acute renal renal failure failure(crush crush syndrome syndrome)2021/9/232021/9/231515（3)Identification of subcutaneous bleeding and lividity3)Identification of subcutaneous bleeding and lividity3)Identification of subcutaneous bleeding and lividity3)

39、Identification of subcutaneous bleeding and lividity（4 4 4 4）Forensic SignificanceForensic SignificanceForensic SignificanceForensic Significance：Subcutaneous Subcutaneous bleeding bleeding site site,indicates indicates point point of of violenceviolence Subcutaneous bleeding,a sign of injury during

40、 his Subcutaneous bleeding,a sign of injury during his lifetimelifetime According to the color change of subcutaneous According to the color change of subcutaneous bleeding,injury time can be determined bleeding,injury time can be determined According to the distribution of subcutaneous According to

41、 the distribution of subcutaneous bleeding,the case may be preliminarilly determinedbleeding,the case may be preliminarilly determined According According to to the the patterns patterns of of subcutaneous subcutaneous bleeding bleeding,vulnerant can be judged,vulnerant can be judged 2021/9/232021/9

42、/2316163.wound3.wound3.wound3.wound（1 1 1 1）Concept Concept Concept Concept:Violent:Violent:Violent:Violent acts acts acts acts on on on on the the the the human human human human body body body body exceeding exceeding exceeding exceeding the the the the elastic elastic elastic elastic limit limit

43、limit limit of of of of the the the the skin,and skin,and skin,and skin,and make make make make the the the the skin,skin,skin,skin,subcutaneous subcutaneous subcutaneous subcutaneous tissue,tissue,tissue,tissue,and and and and even even even even blood blood blood blood vessels vessels vessels vess

44、els and and and and nerves,nerves,nerves,nerves,muscles muscles muscles muscles fractured.fractured.fractured.fractured.（2 2 2 2）CharacterCharacterCharacterCharacter：Open in jury(destruction of skin integrity)Open in jury(destruction of skin integrity)Structures Structures of of wound:wound:Wound Wo

45、und edge edge,a a corner corner,a cavity,a wall,wound,a bottom,a cavity,a wall,wound,a bottomTypes Types of of wound:wound:blunt blunt instrument instrument injury injury,sharp instrument injury,firearms injurysharp instrument injury,firearms injury2021/9/232021/9/231717Differences between blunt inj

46、ury and Differences between blunt injury and Differences between blunt injury and Differences between blunt injury and sharp injurysharp injurysharp injurysharp injury：blunt blunt blunt blunt sharp sharp sharp sharp woundwoundirregular,smaller irregular,smaller cybereakcybereakneat,regular neat,regu

47、lar,larger cybereak larger cybereak cornercornercornercornerTearing shaped or Y-Tearing shaped or Y-shapedshaped sharp-edged sharp-edgedWound Wound Wound Wound edgeedgeedgeedgeirregular(obvious irregular(obvious in in Abrasions Abrasions and and contusions)contusions)regularregularwallwallwallwallwi

48、th tissue bridgewith tissue bridgenone tissue bridge none tissue bridge cavitycavitycavitycavityshallowshallowdeepdeepbottombottombottombottomcomparatively largecomparatively largecomparatively smallcomparatively small2021/9/232021/9/231818blunt woundblunt wound2021/9/232021/9/231919Two Two Two Two

49、special special special special types types types types of of of of blunt blunt blunt blunt wound wound wound wound:Tearing:Tearing:Tearing:Tearing and and and and LacerationLacerationLacerationLaceration TearingTearingTearingTearing:caused caused caused caused by by by by excessive excessive excess

50、ive excessive traction traction traction traction of of of of the the the the skin.skin.skin.skin.wound wound wound wound is is is is Linear-shaped,Linear-shaped,Linear-shaped,Linear-shaped,perpendicular perpendicular perpendicular perpendicular to to to to the the the the direction direction direct