机械性损伤英文版

MechanicalInjury

WangDaihongAssociateChiefPhysicianMedicalDoctorHUSTTongjihospitalofxianningHepatopancreatobiliarySurgeryDepartmentofTheeco-circumstancescenterhospitalFirst:conception

1.Injury:injuryorwoundcausedbyeffectfactorsinthebody,whichleadtothedestructionoftheorganizationalstructureanddysfunction.2.Mechanicalinjury：effectfactorsactonhumanbodybymachanicalmovementandleadtothedestructionoftheorganizationalstructureanddysfunction.Second:Mechanicaldamageofforensicmedicineidentification1.TasksandobjectoflivingdamageforensicidentificationTask：①Injuryseverity;②Injuryways；③Tojudgetheinjuringobjects；④Tojudgetheinjuringtime；⑤Injurydegree；⑥Laborcapacity；⑦Oldinjuringandnewinjuring；⑧Compensation;Object：livingbody2.Tasksandobjectofdeadbody'sdamageforensicidentificationTasks：①Todeterminethecauseofdeath；②Todetermineit'santemorteminjuryorpostmorteminjury；③Tojudgetheinjuringobjects；④Injuringtime；⑤personalidentificationandsoon;Object：deadbodyThird:thethreeelementsofdamageformation：1.injuringobjects（murderweapon）:anobjectwhichcausedmechanicaldamage.Features：variousinjuringobjects（solid；liquid；gas）Theextentofthedamagedependsonthequality,shapeandsizeofthings,butinsomecasesthereisanexception.Therelativemotionformsbetweenhunamnbodyandinjuringobjects：Movingobjectandrelativestaticbody.Humanmovementandrelativelystationaryobject.Movingobjectandmovinghuman.Thecommonhardinjuringobjectsincludeblunt,sharpsandfirearms.Blunt:toolswithnotipsandedge,suchasfistsandfeet...Sharps:toolswithtipsandedge,suchascuttingmachineandsting...Firearms:bullet,explosivesandothertools.2.Actingforce：CompressionandStretch:actingforceapplyonthesameaxis,insamedireaction,calledcompression,whileinoppositedireactioncalledstretch.Shear:tomakethecrosssectionsslidingtogether.torsion：apairofequalforceapplyforacertainobject.Bending:actingforceapplyforskullorribsfotsagandrecovery.3.humantissue：Differenttissuesofhumanbodypartsanddifferenttissuesandorgansoftheanatomyoftheorganizationstructure,sothedamagetoleranceandresistanceisdifferent.Differentappearancesatdifferentpositionsofthebodyshapealsoaffectstheshapeofdamage.Injuredareaorgansortissuesforpathologicalchangesimpactonthedegreeofinjury.Theprincipleofmechanicaldamage1、Physicalfactors:externalforcesandinjuringobjects(size,direactionandnumber)2、Biologicalfactors:thebodyflexibilityandthespecialstructureofhumanbody.3、Humanbody'senginerystate(health,diseasestate)4、ThecontactforcepositionFourth:thebasicformofmechanicalinjury（6forms）

1.Abrasion:injuringobjectsapplytohumanbodyandleadtoseparationbetweenskinanddermis,it'salsocalledepidermalpeeling,whichisacommonbluntinjury.①features：Parts:canoccurinanypartofthebody,highlightareasaremostly.Scratchcanexistaloneandoftenaccompaniedwithotherinjuries,suchasbitemarks,scratches,theconjugatemark,whichcanbeassociatedwithbruiseorcontusion.Differentsizes,shapesandstrips,sheetsorstrip,sometimeshavefreeflap.thesearetheevidenttojudgethedirectionoftheviolentaction.Colorcanbelightbrown,darkbrown,lightredordarkred.②Commontype:accordingtotheinjurymovementdirection,speedandhumancontact,itcanbedividedintothefollowingkinds:

●Scratches：Sharpandhardobjects,suchasnailsandpinsskimovertheskinandmakeskindefect,thegeneralstressareaissmall,theforcealongthetangentialdirectionstreakthesurfaceoftheskin,maketheskindisplacedorfoldingalongthedirectionofforces,suchastherapecase,scratchesoftenoccurinvictim'stprivateparts,stockinside,handsandarms.

●Grazes：Objectorroughgroundrubswithskinsurfaceandleadtothebruiseoftheskin.Generallythestressareaislargeandwidelydemaged.Thisoftencanbefoundinthebodypartswhichismoreprominent,anditissheetorstrip,butmaybeaccompaniedbysubcutaneousbleedingandscabskinformation.●Friction：：TheobjectofRoughsurface,suchasropeorotherbraid,oppressesskin,atthesametimerubstheskinsurfacewithaheavyverticalforceandhorizontalforce.Suchas:hangedorstrangled;teethbites.●Impression：：VulnerantofSmallareaimpactsskinsurfacewithhighspeedfromalmostperpendiculardirection,resultingSkinabrasions.Suchabrasionsalwayscausetheinjuryofdeeptissues.Asisthecaseofcarfrontstrikesstraightonthehumanbody,alsothebulletshotintothehumanbody③Identification：withthenormalnaturaldryingwiththedeathofthetableTherightfacialfriction④Forensicsignificance:▲Tipforexternalforce▲Inferthevulnerant▲Inferthedirectionoftheforce▲Specialpartsoffthetable:suchastheneck,innerthighs→inferthedamagereason(casedinferences)▲Inferthewayofinjury2.Contusion,bruise（1）Concept:Non-openskinlesionscausedbytheeffectsofbluntforce,togetherwithVascularruptureofskin,subcutaneoussofttissue,called(intradermalandsubcutaneous).（2）Character:▲Closedtrauma(bothchoppeddownandsubcutaneoushemorrhage)▲Hemorrhagepatterns:Internalbleeding,subcutaneousbleeding,subcutaneoushematoma▲Subcutaneoushemorrhagevariesinforms,withslightembossmentofsurface,canreflecttheareaofvulnerant▲Differentcolorofdifferenttime:(Hbdegradation)Colorvariation(usedtodeterminetheinjurytime：：Skinbleeding(redorpurple)2-3dgreen2-3dyellow2-3dgraduallyvanishSubcutaneoushemorrhage(paleblueorvioletblue)6dblue-green4dyellow1-2wgraduallyvanish▲Largerareaofcontusion(40%),canalsobelife-threatening1ddeathafterinjury---traumaticshock3-4ddeathafterinjury---acuterenalfailure(crushsyndrome)（3)Identificationofsubcutaneousbleedingandlividity（4）ForensicSignificance：：①Subcutaneousbleedingsite,indicatespointofviolence②Subcutaneousbleeding,asignofinjuryduringhislifetime③Accordingtothecolorchangeofsubcutaneousbleeding,injurytimecanbedetermined④Accordingtothedistributionofsubcutaneousbleeding,thecasemaybepreliminarillydetermined⑤Accordingtothepatternsofsubcutaneousbleeding,vulnerantcanbejudged3.wound（1）Concept:Violentactsonthehumanbodyexceedingtheelasticlimitoftheskin,andmaketheskin,subcutaneoustissue,andevenbloodvesselsandnerves,musclesfractured.（2）Character：：▲Openinjury(destructionofskinintegrity)▲Structuresofwound:Woundedge,acorner,acavity,awall,wound,abottom▲Typesofwound:bluntinstrumentinjury,sharpinstrumentinjury,firearmsinjuryDifferencesbetweenbluntinjuryandsharpinjury：bluntsharpwound irregular,smallercybereakneat,regular,largercybereakcornerTearingshapedorY--shapedsharp-edgedWoundedgeirregular(obviousinAbrasionsandcontusions)regularwallwithtissuebridgenonetissuebridgecavityshallow deepbottomcomparativelylargecomparativelysmallbluntwoundTwospecialtypesofbluntwound:TearingandLacerationTearing:causedbyexcessivetractionoftheskin.woundisLinear--shaped,perpendiculartothedirectionoftheforceandinaccordancewithstriae.withcomparativelyregularwoundeage,nocontusionwoundeageandtable,slightlysharpcorner,tissuebridgeofbottomorwall,suchas:Stretchwound.Laceration:causedbybluntpressuresetbackofskin.Commoninpartsofthehardskeletonwithsubcutaneousliner,especiallythescalp.DifferencesbetweenLacerationandIncisedwound,cutwound(astablebelow)laceration

LacerationIncisedwound,cutwoundshapeIrregularlyshapedwounds,ofteninstellate-shaped,wavy--shapedorY--shaped,sometimesinlinear--shaped

Ofteninlinear,spindle-shapedclosedrelatewithstriaewoundeagerough,serrated--shapedfinewaxy--shaped.Oftenaccompaniedwithabrasionsandcontusions,generallylessbleedingsmooth,justsometimesaccompaniedwithabrasionsorcontusions,morebleedingwalluneven,Oftenhastissuebridgebetweentwowallssmooth,notissuebridgebetweentwowallscornerMostobtuse,oftentearing

mostsharpcavityShallow,mayhaveforeignmattersdeeperbottomuneven,apparentdamageoftissuesmooth(3)medicolegalmeaningofwound①Judgmentoffetalwoundbasedonthesite.②Inferringtheinstrumentcausedwoundbasedoncharacteristicsandinvasion.③Inferringthecasepropertiesbasedonsiteandtrait.4.Fracture(1)concep:bonedestructionoftheintegrityandcontinuitycausedbymechanicalforce.（2)classification①opennessandocclusion②Directfractureandindirectfracture③linearfracture,depressedfractures,perforatingfractureandthrypsis.④sites:skullfractures,ribfractures,fractures,vertebralfracturesandsoon.(3)medicolegalmeaningoffracture▲Evidenceofviolence▲Fracturescansavetheoriginal(becauseofthedifficultyofbonedestruction)▲Beabletoinstrumentandmannerofinjuries5.RuptureofvisceraDestructionoftheanatomicalintegrityoforganswithinthebodycavityiscalledthevisceralrupture,foundinbrawls,highfalls,caraccidentsordisastersandsoon;allbodyorganscanbedamagedorbroken.▲visceralconcussion:dysfunction▲visceralcontusionandvisceralfilmcompletearemainlycharacterizedwithhemorrhageandnecrosis,suchascerebralcontusion,pulmonarycontusion,renalcontusion,etc.▲visceralrupture6.Amputation：：Completelydestructionoftheintegrityofthehumantorsoanatomylimbsiscalleddisintegrationofbody,muchfoundinaccidents,explosions,buildingcollapse,highfall,mutilatedbodies,etc.Medicolegalinvestigationtaskistocarryoutpersonalidentification.钝器伤（BluntInstrumentInjury））First:Concept1.Bluntinstrument:allobjectswhichhavenosharpedgesortips.2.Bluntinstrumentinjury:Theinjuriescausedbybluntinstruments.Thistypeofmechanicalinjuryoftenexistsinforensiccases,whoseshapeisvariedmuch.Second:injuriesofhandandfoot1.Injuriesbypalm:referstothedamagescausedbypalmorsideofthehand(1)foundinfaceasusual,e.g.perforationoftympanicmembrane.(2)thedegreeofinjuriesisvariable:whenitisnotserious,theinjuredpartisjustskinredness,sometimeswithbruisingandbleedingundertheskin,whileitcanbedeadlyserious(racranialhemorrhageorreflectiveshock)2.Boxinginjuries:Theinjuriescausedbyfist,resultinginmoreseveredamagethanthatabove.(1)foundinheadandfaceinthefirst:hurtineyesandears,aswellasteethloss;followedbychest-abdominal,heartandlungcanbeconcussedorbroken,andliverandspleenruptured.(2)sometimestheboxingsitesisnotobviousbecauseofcushionofhairandclothes.3.Footkickedinjuries:Theyaremoreseriousthanboxinginjuryandmuchclosedwithpartsofkicking,foundinthelowerextremities,perineumandlowerabdomenandsoon.Third:bitewound1.concept:monsites:intheface,upperlimbsandprominentpartofthebody,suchasear,nose,lips,tongue,nipples,etc.3.thesharperincisorsandcaninescanleavetworelativedamageonthevictim’’sskinlikeanarc,oftenwithflakyabrasions,bruisingorcontusion.4.biteinjuriesshapeisrelatedwiththeteethsize,forceandbiteposition.5.meaning:▲Comparepersonalidentificationbasedonthesuspect’smodelandtherealbitten.▲extractingsalivaleftonthesiteofthebite→→bloodtyping▲inferringcasesbasedonbitesite:Suchas:whenbitesideisface,itisrelatedwithwomendisputes;Andwhenontheface,lips,tongue,vulva,etc,adultery-related,Wheninthemurderer'sarm,shoulder,hands,etc,itisstrugglingtoresist.Fourth:stickinjury1.Cylindricalsticksinjurycharacteristics:Injuriesonrelativelyflatbodycanbeformedintostripcontusion.Thewidthofcontusionissmallerthanthediameterofthestick.Intradermalandsubcutaneousskinwillbebleedingwhileitismostseriousincentralportion,bothsidesofwhichisthegradientwithoutobviousboundaries;Ifhumansofttissuelucrativepartsarehitwithafasterpace,itcancausesubcutaneoushemorrhagelikebamboohit,andhollowareaingeneralisstillsmallerthanthediametersticks;Theblowtotheheadwithcylindricalstickscanbeformedthestriporovalhematoma,becauseofcushionofskullunderthescalp;Iftheforceissostrongthatcanbealacerationalongthelongitudinalaxisofthestripstick.Thehittingwiththeendofcylindricalstickscanformcurvedlaceration.2.Squarecolumnshapedsticksinjury：Hitthesofttissueofthebodywiththeedgevertically,whichcancauseanarrowstripcontusion.Andastrip-shapedlacerationcanbecausedbyhittingthebonepaddedpartwithit’sedge.Hitwiththeplanevertically,whichcancausestrip-shapedsubcutaneoushemorrhageVerticalbash,whichcancausehollowsubcutaneoushemorrhage3.Irregularstickinjury：e.g..Bough,trunkorsomethingelse.5.injuriesduetofall1.Definition:Injuriescausedbythecollisionofthemovingbodyandthestationaryobjectswhenfellfromhighplace(includesuddenfall),belongstoaspecialpatternofmechanicalinjury(compoundbluntinjury).2.Formationmechanismandaffectingfactors：：（1））Actingforce→ground=counter-actingforce（2））Affectingfactors：：●Concernedwiththeweight,height,speedandtheactingforce(impactforce),i.e.theheavierandhigherthebodyis→→V↑↑→F↑→→themoreseriousitinjures.●Theimpactpartofthebodyandthewayofcontact：：※Iftheheadlandsfirst,craniocerebralinjurycanbeveryserious,anddeathcanoccurimmediately.※。Ifthefeetlandsfirst,symmetryfracturemayhappentothebilateralcalcanealandembeddingfracturesmayhappentotheknee.※Ifthebuttocklandsfirst,usuallythepelvismaybefractured,theforceconductedalongthespinewhichleadstothefractureofskullbase※Ifthechestlandsfirst,theribsmaybefracturedsubstantiallyandthethoracicorganmaybeinjuredextensively.※Ifthepalmlandsfirst,multiplefracturesanddislocationsmayhappentotheupperlimb●Thepropertiesoftheground：Theharderthegroundis,themoreseveritinjures.（（Connectedwiththeactiontime)●Obstructiona.Thepotentialenergycandecreasesegmentallybydegrees.b.Theremaybeainjurywhichcannotbeexplainedbyfall3.Characteristicsoffallinjury:（1）Commonfeaturesofinjury：：a.Thesurfaceinjuryislessseverbuttheinternalismoresever.b.Usuallyfocusedonthesideofbearingsurface.c.Indirectinjuryismoreseverthanthedirectinjury.(Concussioninjuries)d.Theinjuryiswidespreadandvariedinshape,includingabrasion,contusion,lacerationinjury,fractures,etc.Visceralinjury’’sfeaturesaremulti-organandmultiple.e.Thedirectionoffractureisarrangedconsistentlyandsymmetricallyf.Allofthemarecausedbyaviolence.g.Mostofthehighfalldiedimmediately.（2）Causeofdeath：：a.Commoncausesofdeath：●Severecraniocerebralinjurycauseddeath.●Hemorrhagicshockcausedbytheruptureofvitalorgan.b.Elves：：▲▲Fatembolismcausedbylongbonefracture.▲Drown.4.medicolegalidentificationIncludingaccident、、suicide、、murder.①crimesceneinvestigation：Startingpointofthefall（（footprint、、handprint、、fingerprintorremnantofthedead）Landingpoint:（（Leavemarks,bloodstains,articleswhenbumpagainsttheground））Determinethefallingpart；；②Measuretheheightofthefallandisthereanyobstacle；③Distancemeasurementbetweenthecorpseandthebuilding（（Thedifferencebetweenpostmortemandsuicide））；④Investigationofthecase，，whetherthevictimisconsciousness,andwhetherheorsheisdrinkingortakingdrugs;⑤Completeandsystematicanatomyisespeciallystrictwithclothing（SharpInstrumentInjury）One、Definition1.Sharpinstrumentinjury：Referstoinjuriescausedbyarticleswithsharpedgeoftip2.Partterns：incisedwound、chopwound、、stabwound、clipwound（1））Incisedwound：：①Sharpedgeofthebladeoppresstheskinandmovealongtheaxisofthebladeedgecreatedincisionwound.Thesharpinstrumentwhichcausedthewoundiscuttinginstrument,forexampleallkindsofknives,likeblade,slide,dagger,etc.②Features：：▲Havingthecharacteristicsofsharpinstrumentwound（（Nopeelingaroundthewoundandsubcutaneoushemorrhage）▲woundlengthismuchgreaterthanthedepthofthewoundcavity，，spindleshapedandslit-like.▲Ifthereisboneunderthewound,itcanmakescratchesonit.③Significanceofforensicmedicine：：incisedwoundismostoftenfoundedinsuicide.Featuresofcutthroat：：（righthand）Handsaregenerallyontheleftneck,crossthethyroidcartilagelevel,rightobliquetowardtheneck,usuallyhandsheavyandclosehandlight,thetentativelycutisvisibleatthestartingpoint.(alsocalled,testcuts,hesitationwoundsetc.)tentativecut：isalmostparallel,severalsmallsuperficialincisedwound,fishtailscratches,whicharecharacteristicsofsuicide.Defensewound：：Withcaseoffighting,wecanseeinjuriesduetosnatchtheweaponorresistancetocombatinthebackofthevictim’’shand,fingerand/orpalmThedifferenceofcutthroatbetweensuicideandhomicide.(Asfollows)suicidehomicide

positionAreaswithinthesuicide'sreachliketheneck,wristandgroinAnyparts,usuallyonneck,faceandthewoundisdeepandusuallyalongwithdisfiguretentativecutVerycommonnoneDefensewoundnoneverycommon

ThedirectionofincisedwoundonneckTherighthander’swoundspreadfromtheabovetheleftsidetotherightthelowerright,andthestartingpointisdeep;thelowerrightisshallow.WhichisjustoppositefromthelefthanderWithoutacertaindirection（2））Chopwound①Definition：：ReferstoInjuriescausedbywavingsharpinstrumentwhichhascertainweighttoslashagainstthebody.Thesharpinstrumentwhichcausechopwoundisknownaschoppinginstrument②Features：：▲Havingthecommoncharacteristicsofsharpinstrumentinjury.▲Thewoundcavityisdeep,mostlyopenswideandthelengthwon’’texceedthelengthofthechoppinginstrument’’ssharpedgeingeneral▲Thetissuesareinjuredseverely,usuallyalongwithboneinjury.③Significanceofforensicmedicine：：NatureoftheCase:Mostcasesarehomicide,followedbythedamage;suicideandaccidentsarerare.Characteristicsofhomiccide:theinjuriesaremostseeninthehead,neck,chest,andforthefatalwound,thevictimhastofightwiththeleftresistance.Accordingtothesizeofcharacterstoinferinjuries.3））刺刺创创（（stabwound））①Concept:Sharp'scutting-edgealongthelongitudinalaxisdirectionstabbedintothehumanbodyformedthetube.Ingeneral,isablindtubepuncture,thesametothenopunctureexports,andafewcanseethepenetratingstabwound(entrances,income-generatingroad,export).②Characteristics▲Sometimesspinyentrancecanreflectthecharacteristicsofthemurderweapons(includingpunctureentrance,income-generatingtube,punctureexport)Suchas:triangularscraperisa"delta";circularbayonetfusiformshape.Singlebladeknifeisasharp,double-edgedpuncture（（twoheadsharp））▲Thorntubescansuggestthedirection:thorntubelengthsaregenerallyshorterthanthethorn,butifthestingerhandleimprintontheskin,orintheabdomen,maybelongerthanthethorn▲Lightsuperficialinjury,internaldamage,characterizedbysmallwounds,creatingacavity(road),thevisceralinjuryisseriouslyandvisceralbleedingmorethanthesuperficialwound.▲Puncturescanbeseeninanypartofyourbody,butmostcanbeseeninthechestabdomen。。ForensicSignificance:▲Stabwoundaremorehomicidesorhurtedbyothers,suicideandaccidentsarerare.▲Punctureincome-generatingpatternsinferredfrominjuries.火器伤伤（firearminjury）1.Concept:humaninjuriescausedbygunpowderdetonationoravarietyofgunpowderdetonatedweaponscalledfirearmswounds,includingbulletwoundandexplosivewound.2.枪弹创（（bulletwound）Bulletwoundisthemostcommontypeoffirearmswound,referstowoundcausedbylaunchwarheads.Typicalbulletwoundisperforatinggun-shotwound,includingentranceofbullet,canalofbulletandexitofbullet.3.ntypicalbulletwound：：①blindtractgunshotwound②Gullybullet③ricochetgunshotwound④circumferentialgunshotwound4.Features①Entranceofbullet:theshapeisrelatedwithdistanceofshot,includingcloseshot,short-distanceshotandlong-distanceshot.②Contusioncollar：Contusioncollarisalsocalledstrikecollar.Thebulletstrikeandfrictiontheskinwhenitrotateingthroughtheskin,whichimpacttheskinaroundtheedgesoftheinjuredplacewithtwotofourmillimeter.Itisbrightredatthebeginningandturntobedarkbrownlaterbecauseofparchment-liketransformation.Greasecollar：Greasecollarisalsocalledwipecollar:oil,rust,metalpowderanddustattachingtothebulletcoveronorinthecontusioncollar,generalonemillimeterwide.Contusioncollarandgreasecollaralwaysoverlapeachother.X-ray:metalshadowaroundtheentrance.PatternedImpression（（枪口印痕痕）：Short-distanceandclose(onemillimeter)shotcouldformpatternedimpression,thatistosay,themuzzlewillpressskinwhencloseshootingsothatleftlocalpatternedimpression.Significanceofbulletentrance’’sfeatures▲Provesitisentranceandshort-distanceshoot▲Determinethetypeofgunaccordingtopatternedimpression▲Gunpowderparticlesandash:▲Provesitisshort-distanceshoot.Whentheshootingdistanceisin15to30centimeterwithhandgunandinonemeterwithrifle,incompletecombustionofgunpowderparticlescanshootoutwithbulletintheskinandwound(theclosertheshootingdistance,thesmallerthetattooingscopeanddarkerthecolor;▲Onthecontrary,ifthescopeislargeandshootingdistanceover50centimeter,youcannotfindtattooing,burningandgunpowderparticles,etc.).Significanceofexitofbullet’sfeatures(distinguishfromentranceofbullet）Itisoftencranny-shapedorstar-shaped.Generallynotissuecoloboma,skinaroundthewoundcanbecompletelyclosedNogunpowdertracesonthesurroundingskin,thatistosay,therearenocontusioncollar,greasecollar,gunpowdertattooing,gunpowderparticlesorsymptomsofskinrednessring.DistinctionofentranceofbulletandexitofbulletonskullCanalofbullet:connectionbetweenentranceandexitofbulletiscanalofbullet,whichcandeterminethedirectionofshooting.Dependontheentryshapeandsizetodeterminethedirection:*Verticalinjection:1cm(diameter)size(includingcontusionsanddirtround),entrancecentertissuehasbeendefected.*Obliqueinjection:ellipse,oneofthesidesoftheslopetipsoftheshootingdirection.*Contactintothegunpowdergeneratedwhenpowerfulairflow,warheadsarewornoutskin,gaspouredintosubcutaneoustissue,skinteartakestheformofstarmountain-shaped.ForensicidentificationofMechanicaldamageForensicSignificance(1)whetherthebullethit:theentrenceofthebulletandtheexitofthebulletthedamageofthericochetisatypical.Thehookdamageiscausedbytangenttrauma.Theheadercanbeblownupwhenitisshootbyarifleatacloserange.(2)shootingdistance:Accordingtothecharacteristicsoftheentrancecloseshoot:Muzzleprints,skinburning,smokeandgunpowderparticleshalonearlyshoot:theentranceissurroundedbysmokeandgunpowderparticleshalo.farshoot:onlythecontactrings(bruisedirtwheel+wheel)canbeseen,nootheringredients3)determinethenatureofthecasemaybeinitially:Suicidesaregenerallyclosetoorincontactwithfire,andthedirectionofmulti-groundsbeforefiringbackorsideshot,butnotethathomicidecanbecopied.Long-rangeshooting,andshootingdirectionisshotfrombehind,usuallyfoundinhomicideoranaccident,butnotethatsuchasituationcannotbecopiedsuicide.(4)determinethedirectionofshooting:shoottheentranceandexitportconnectionTiltangle:horizontalangleshootingdirection(upordowntilt)Deflectionangle:theanglebetweenthefiringlineandthesagittalplane(leftandrightdeflection)(5)determinethetypeoffirearm:Pleaseidentifyrelevantexpertsinballisticstechnology(6)Themannerofdeath:homicidecommonFeatures:●shootingsitedoesnotnecessarilyunique,commontothechestandabdomenandhead●Number:70percentofhomicideonlyonegunshotwound,foundinsuicideSuicideFeatures:●site:moreinthetemporal,followedbytheforehead,leftchestandmouth,nostrilsorexternalauditorycanal●shootingincontactwithorclosetothecommonshooting●Theuseofgunsinpistolcommon,ofteninthevicinityorinthehandsofthedeceased●havegotdizzygunpowdersmoke,gunpowderparticles,splash-likebleeding※shotentranceandexitportdifference:theentrencestheexitsshapemostlyroundoroval-shaped,stellatewhentheyaretouchedMostlyshapedorstellate-shapedfissuresizeGenerallylessthanthediameterofthewarheadTheentranceisgreaterthantheexitportTissuedefectsyes,aturninginneredgeno,woundedgeeversionContusionroundyesnoDirtWheelsyesnoTheascertainofthecauseofdeathfatalinjury1.fatalinjury:Directlyleadingtodeathorhavingadirectcausalrelationshipbetweendamageanddeath2.absolutelyfatalinjury:Atthecurrentmedicallevel,leadingtodirectfatalinjurytoanyoneunderanyconditions3.conditionalfatalinjury:Leadingtothedamageofdeathonlyincertainadverseconditions,andaccordingtodifferentconditionstheinjurycanbedividedintoindividualfatalinjuryandoccasionallyfatalinjury.4.nonfatalinjury:Donotcausethedamageofdeathundertheusualcondition.Nonfatalinjuryisdividedintoseriousinjuries,minorinjuriesandlightinjuriesDirectmechanicaldamagecauseofdeath1、bleeding2、shock3、concussion4、embolism5、asphyxia6、infection7、dysfunctionofimportantorgansSecondtheidentificationofantemorteminjuryandpostmorteminjury1.vitalreaction(1)Definition:Livingonthevariouspathogenicfactorsorinjuryreactioniscalledvitalreaction.(2)type:bleeding,tissuecontraction,soressurroundedbyswelling,woundinfection,theformationofscabskin,inhalationandswallowing,inflammatoryreaction,hemostaticresponse,embolism,absorption（二）antemorteminjuryandpostmorteminjury2014-2-26ThirdthejudgementoftheinjurytimeTheinjurytimeismainlybasedonthespecificreactionoflivinginferred,justlikethevitalreactioncanbebasedonthepresenceorabsenceoflifeafterdeathtospeculatelifetimeinjury.Theinjurytimereferstothetimefromtheforensicexaminationoftheinjury(live);tothetimeofinjuryfromdeath(corpse).Inavarietyofvitalreaction,theappearanceofcells﹑inflammatorymediators﹑enzymes﹑cytokinesandsoon,andthepeakanddeclineoftheappearancehaveacertaintimesequence.Unfortunatelyduetoindividualdifferences,thedifferencesofinjuryandotherdifferencesofalltheindexdetectionsleadtosomeresearchresultswhichcanonlystaysontheresearchstage,difficultlyorrarelyappliedtotheactualtestcase.2014-2-262014-2-26四.Thedeductionofinjury-causinginstrumentsaccordingtotheformofinjuryaccordingtotheresidueinthetissueaccordingtotheattachedtraceofthedeductionofinjury-causinginstrumentsaccordingtothetraceoftheclothessimulatinginjuryexperiment2014-2-26五.DeductthemannersofdeathInForensicMedicine,mannersofdeathincludesuicide,homicide,accidentandtheunknownmanner.Andmanycasescan’tbeclearlyidentifiedaccordingtothejudgmentofthelegalexaminersonly.(一)suicide2014-2-26Generallyspeaking,onthesceneofs