《法医学》教学课件：5 机械性损伤

1、机 械 性 损 伤mechanical injury,分 类,按致伤物 the inflictng weapon 钝器伤 blunt instrument injury 锐器伤 sharp instrument injury 火器伤 firearm injury,概 述,形态改变为主的损伤,擦伤 abrasion 挫伤 contusion 创 wound 骨折、关节脱位 fracture 内脏破裂 viscera rupture 肢体断离 fragmentation of whole body,概 述,擦 伤 abrasion,钝器 rough object 摩擦 rub or scratch

2、 表皮剥脱 superficial layer peeled off,擦 伤,abrasion类型及形态特点,抓痕 scratch or finger nail abrasion 擦痕 grazes or brush abrasion 撞痕 impact or crushing abrasion 压擦痕 friction or pressure abrasion,擦 伤,擦伤 scratch,抓伤 finger nail abrasion,基本形态,挫 伤 contusion or bruise,钝器 皮内、皮下出血,概 述,皮内出血衣物的纺织花纹印在尸体上,基本形态,皮下出血与尸斑,基本形态

3、,皮下出血切开-凝血块,基本形态,创 wound,开放性损伤 open injury,概 述,创的分类,钝器创撕裂创、挫裂创 Blunt instrument wound- laceration 锐器创-切创、砍创、刺创 剪创 Sharp- cut, slash, stab 火器创-枪弹创、爆炸伤 Firearms wound- bullet wound,创,锐器创Sharp,基本形态,钝器创 Blunt instrument wound,骨和关节损伤,骨折 fracture 关节脱位 dislocation,概 述,骨 折,a:局部肿胀、血肿 b:畸形 c:反常活动 d:骨擦音 e:常伴关节

4、脱位,骨关节损伤,骨折（闭合性）,基本形态,胫腓骨下段骨折,基本形态,内部器官破裂rupture of visceral,致命伤 临床易漏诊（钝器伤、刺创）,概 述,内脏破裂（肝）,基本形态,内脏破裂（脾）,基本形态,肢体断离amputation,碎尸案 交通事故 群死群伤案（如爆炸、火灾等灾害）,概 述,空难尸体肢体离断,基本形态,功能改变为主要表现的损伤,神经源性休克(neurogenic shock) 震荡(concussive injury),概 述,徒手伤 bare hand injury,钝器伤,钝器伤 blunt instrument injury,棍棒伤 stick injur

5、y,竹打中空（铁轨样挫伤） tramline or railway line bruise,钝器伤,竹打中空,钝器伤,橡皮管-挫伤,钝器伤,酒瓶-额部挫裂创,钝器伤,砖-挫裂创,钝器伤,挤压伤 crush injury 挤压综合征 Crush syndrome,钝器伤,坠落伤 injury due to fall from height,钝器伤,尸体背侧,高坠伤,面部散在擦伤,高坠伤,胸壁大片出血,高坠伤,心前侧裂口,高坠伤,心背侧撕裂,高坠伤,内部器官多发破裂,高坠伤,sharp instrument injury面部创（已缝合）,锐器伤,犹豫伤试切痕 hesitation marks or

6、 hesitation wound or tentative cut,锐器伤,刎颈-剃须刀 incised wound,砍断创chop wound,锐器伤,菜刀-砍创,锐器伤,斧头-颅骨凹陷性骨折,锐器伤,三角刮刀刺创stab wound,锐器伤,三棱刮刀创,锐器伤,蒙古刀-心贯通创,剪创 scissoring wound,锐器伤,复习题 review,1. Classification of mechanical injury 2. Classification of head injury by clinicopathological correlation 3. DAI、Diffuse traumatic axonal injury (TAI),擦伤 abrasion 挫伤 contusion 创 wound 骨折、关节脱位 fracture 内脏破裂 viscera rupture 肢体断离 fragmentati