机械性损伤英文版.pptx

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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 hospital第一页，共80页。First:conception1.Injury:injury or wound caused by

2、effect factors in the body,which lead to the destruction of the organizational structure and dysfunction.2.Mechanical injury：effect factors act on human body by machanical movement and lead to the destruction of the organizational structure and dysfunction.第二页，共80页。Second:Mechanicaldamageofforensicm

3、edicineidentification1.Tasks 1.Tasks and and object object of of living living damage damage forensic forensic identification identificationTask Task：Injury severity;Injury severity;Injury waysInjury ways；To judge the injuring objectsTo judge the injuring objects；To judge the injuring time To judge

4、the injuring time；Injury degreeInjury degree；Labor capacityLabor capacity；Old injuring and new injuring Old injuring and new injuring；Compensation;Compensation;ObjectObject：living bodyliving body第三页，共80页。2.Tasks and object of dead bodys damage forensic identificationTasks：To determine the cause of d

5、eath；To determine its antemortem injury or postmortem injury；To judge the injuring objects；Injuring time；personal identification and so on;Object：dead body 第四页，共80页。Third:the three elements of damage formationthe three elements of damage formation：1.injuring 1.injuring objectsobjects（murder murder w

6、eaponweapon）:an an object object which caused mechanical damage.which caused mechanical damage.FeaturesFeatures：various injuring objects various injuring objects（solid solid；liquid liquid；gas gas）The The extent extent of of the the damage damage depends depends on on the the quality,quality,shape sh

7、ape and and size size of of things,things,but but in in some some cases cases there there is is an exception.an exception.The The relative relative motion motion forms forms between between hunamn hunamn body body and and injuring objects injuring objects：Moving object and relative static body.Movin

8、g 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.第五页，共80页。n n The The common common hard hard injuring injuring objects objects include include blunt,blunt,s

9、harps sharps and firearms.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 edge,such edge,such as as cutting cutting machine and sting.machine and sting.Firearms:bullet

10、,explosives and other tools.Firearms:bullet,explosives and other tools.2.Acting force 2.Acting force：Compression Compression and and Stretch:acting Stretch:acting force force apply apply on on the the same same axis,in axis,in same same direaction direaction,called,called compression,compression,whi

11、le while in in opposite direaction called stretch.opposite direaction called stretch.Shear:to make the cross sections sliding together.Shear:to make the cross sections sliding together.torsion torsion：a a pair pair of of equal equal force force apply apply for for a a certain certain object.object.B

12、ending:Bending:acting acting force force apply apply for for skull skull or or ribs ribs fot fot sag sag and recovery.and recovery.第六页，共80页。3.human tissue：Different tissues of human body parts and different tissues and organs of the anatomy of the organization structure,so the damage tolerance and r

13、esistance is different.Different appearances at different positions of the body shape also affects the shape of damage.Injured area organs or tissues for pathological changes impact on the degree of injury.第七页，共80页。Theprincipleofmechanicaldamage1、Physicalfactors:externalforcesandinjuringobjects(size

14、,direactionandnumber)2、Biologicalfactors:thebodyflexibilityandthespecialstructureofhumanbody.3、Humanbodysenginerystate(health,diseasestate)4、Thecontactforceposition第八页，共80页。Fourth:the basic form of mechanical injury（6 forms）1 1.Abrasion:i injuring njuring objects objects apply apply to to human huma

15、n body body and and lead lead to to separation separation between between skin skin and and dermis,its dermis,its also also called called epidermal peeling,which is a common blunt injury.epidermal peeling,which is a common blunt injury.features：Parts:can occur in any part of the body,highlight areas

16、 are mostly.Parts:can occur in any part of the body,highlight areas are 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 mar

17、k,which mark,which can be associated with bruise or contusion.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 the have fre

18、e flap.these are the evident to judge the direction of the violent action.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.第九页，共80页。Common Common type:type:according according to to the the injury injury movement movem

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

20、in 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 displaced di

21、splaced 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.Grazes Grazes：

22、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 This often often can can

23、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 by subcutaneous bleeding and scab skin formation.accompanied by subcutaneous bleeding and scab skin formation.第十页，

24、共80页。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 with with a a heavy heavy vertical vertical force force a

25、nd and horizontal horizontal force.Such force.Such as:as:hanged hanged or or strangled;teeth bites.strangled;teeth bites.Impression Impression：Vulnerant Vulnerant of of Small Small area area impacts impacts skin skin surface surface with with high high speed speed from from almost almost perpendicul

26、ar 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 case of of car car front front strikes strikes straight straight on on the the

27、 human human body,body,also also the the bullet bullet shot shot into the human body into the human bodyIdentification Identification：with the normal natural drying with the normal natural drying with the death of the table with the death of the table 第十一页，共80页。The right facial friction第十二页，共80页。For

28、ensic 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 infer the damage reason(cased inferences)Infer the way of injury第十三页，共80页。2.Contusion,bruise 2.Contusion,bruise（1 1）Concept:Concept:Non-open Non-op

29、en skin skin lesions lesions caused caused by by the the effects effects of of blunt 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).subcutane

30、ous).（2 2）Character:Character:第十四页，共80页。Closed trauma(both chopped down and subcutaneous hemorrhage)Closed trauma(both chopped down and subcutaneous hemorrhage)Hemorrhage Hemorrhage patterns:patterns:Internal Internal bleeding,bleeding,subcutaneous subcutaneous bleeding,bleeding,subcutaneous hematom

31、a subcutaneous hematomaSubcutaneous Subcutaneous hemorrhage hemorrhage varies varies in in forms,forms,with with slight slight embossment embossment of of surface,can reflect the area of vulnerant surface,can reflect the area of vulnerant Different color of different time:(Hb degradation)Different c

32、olor of different time:(Hb degradation)Color variation(used to determine 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 gradually vanish vanish Subcutaneous Su

33、bcutaneous hemorrhage hemorrhage(pale pale blue blue or or violet violet blue blue)6d 6d blue-blue-green 4d yellow 1-2w gradually vanish green 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

34、 after injury-traumatic shock 1d death after injury-traumatic shock3-4d death after injury-acute renal failure(crush syndrome)3-4d death after injury-acute renal failure(crush syndrome)第十五页，共80页。（3)Identification of subcutaneous bleeding and lividity 3)Identification of subcutaneous bleeding and liv

35、idity（4 4）Forensic Significance Forensic Significance：Subcutaneous Subcutaneous bleeding bleeding site site,indicates indicates point point of of violenceviolence Subcutaneous bleeding,a sign of injury during his Subcutaneous bleeding,a sign of injury during his lifetimelifetime According to the col

36、or 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 bleeding,the According to the distribution of subcutaneous bleeding,the case may be preliminarilly deter

37、mined 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 第十六页，共80页。3.wound（1）Concept:Violent acts on the human body exceeding the elastic limit of the skin,and mak

38、e the skin,subcutaneous tissue,and even blood vessels and nerves,muscles fractured.（2）Character：Open in jury(destruction of skin integrity)Structures Structures of of wound:wound:Wound Wound edge edge,a a corner corner,a a cavity,a wall,wound,a bottomcavity,a wall,wound,a bottomTypes of wound:blunt instrument injury,sharp instrument injury,firearms injury第十七页，共80页。