Chapter 3

Mechanical injury
目录 Section 1 Overview

Section 2 The basic form of

mechanical injury

Section 3 Types of Mechanical Injury

Section 4 Mechanical damage to

important parts

Section 5 Forensic Appraisal of

Mechanical Injury
 grasp
The concept and basic types of mechanical damage;
content and requirements of mechanical damage
inspection

Familiar with
The inspection principle and forensic identification
task of mechanical injury

To understanding
Mechanism and influence factors of mechanical
injury
 Section One

Overview
1 、 The concept and classification of mechanical injury

1.1 Mechanical injury

The abnormality of the structure, function or metabolism of the tissues and
organs caused by the effect of the injury on the human body is called
injury, and the body injury caused by mechanical violence is called
mechanical injury.
 1.2 Classification of mechanical injuries

1.2.1. According to the characteristics of the injured

（ 2 ） Sharp injury （ 3 ） Firearm wound

（ 1 ） Blunt injury
1.2.2. Classification by injury time
（ 1 ） Life injury（ 2 ） Dying
（ 3 ） Post-mortem injury
1.2.3. Classification by nature of damage
（ 2 ） He killed（ 3 ） Accident or disaster injury
（ 1 ） Suicide injury
1.2.4. Classification by damage pattern
（ 1 ） Exfoliation
（ 2 ） contusion （ 4 fracture
（ 3 ） wound （ 5 ） Rupture of internal organs
（ 6 ） Dismemberment
 2 、 Mechanism of mechanical damage

2.1 Physical factors affecting mechanical force

1. According to the principles of mechanics
F=ma ， a=(v-v0)/(t-t0) 。

2. The effect of speed on kinetic energy

Ek=1/2mv2 ，
3. Potential energy
Ep=mgh v=2gh

4. Other factors affecting mechanical force

（ 1 ） P=F/S 。 （ 2 ） P=m v -m v =Ft 。
2 2 1 1
 2.1 Structural characteristics and reactivity of human
tissues and organs
1. Organizational characteristics
The skin is the main target of trauma, but the skin of different parts of the body has
different thickness, different degree of keratinization, different dermatoglyphic direction
and different subcutaneous tissue structure, so it is the same skin, and the damages formed
in different parts of the body may be different 。

2. Biomechanical characteristics of tissues or organs

The composition and structure of different tissues and organs of the body are different,
and their elasticity, toughness and tension are also different, and the resistance to external
forces is very different.
3. Factors such as the body's health, age and disease
Young people’s tissue elasticity and toughness are stronger than that of the
elderly, and enlarged liver and spleen are prone to rupture,etc. 。
3 、 Inspection and recording of mechanical damage
1. Injury site
Comprehensively inspect and record the injuries of various parts of the body, and number
them one by one 。

2. Inspection principle
Record the number and distribution of damage in the order from primary to
secondary, top to bottom, front to back and surface to inside 。
 Section Two

Basic form of mechanical injury

 1 、 Morphological damage
1.1 abrasion
1. Concept
It refers to the peeling and defect of the epidermal layer or the epidermal layer and part of the dermis
layer caused by the friction of the rough surface of the wounding substance and the body surface. 。
2. classification
（ 1 ） scratches ， finger nail abrasion ： Damage caused by scratching or scratching the surface of the
skin by nails or hard objects with pointed ends 。
（ 2 ） grazes ， brush abrasion ： Damage caused by friction between the body surface and rough
objects or the ground 。
（ 3 ） impact ， crush in abrasion ： An abrasion formed on the edge of the injured object when it hits
he surface perpendicular to the body surface, causing the injured object to sink into the skin.
（ 4 ） friction ， pressure abrasion ： Objects with rough surfaces, which are damage caused by
rubbing against the skin while pressing on the skin 。
 1.2 contusion ， bruise

It is a closed injury whose main changes are intradermal hemorrhage or

subcutaneous hemorrhage caused by rupture of intradermal or subcutaneous blood
vessels caused by blunt injury substances acting on the human body.
Contusion can also occur in internal organs and cause bleeding under the
membrane of the organ, such as the brain, heart, spleen, lung, liver, kidney,
mesenteric or muscle.
 1.3 wound
1. concept
Refers to the rupture of the entire skin and subcutaneous tissues such as muscles, blood
vessels, nerves or rupture of the capsule of internal organs caused by greater violence 。

2. component
Wounds, margins, corners, walls, foundations and cavity 。
1.4 fracture

1. Concept
Refers to the destruction of the integrity and continuity of the anatomical structure of bone
tissue under the action of mechanical violence 。

2. classification
（ 1 ） Open fractures and closed fractures
（ 2 ） Direct fracture and indirect fracture
（ 3 ） Linear fractures, depressed fractures, perforated fractures, and
comminuted fractures
1.5 rupture of viscera
External violence damages the anatomical integrity of the internal organs.

1.6 amputation

The huge violent effect caused severe damage and severance of the human body
torso and limbs 。
 2 、 Functional impairment
2.1 neurogenic shock
It means that the nerve endings in certain parts of the body are very sensitive to
the effects of mechanical violence, and can cause severe reflex autonomic
dysfunction, shock and rapid death when hit.
2.2 concussive injury
Refers to concussion, spinal cord concussion, heart concussion, and lung
concussion caused by violent variable-speed external force acting on the head, upper
neck or precordial area.
 Section Three

Types of mechanical damage

 1 、 Blunt injury
concept

blunt force injury ， blunt instrument injury , Refers to the damage caused by blunt tools
without sharp edges and sharp points hitting the human body. Common blunt tools include sticks,
masonry, bamboo poles, axe backs, hoe backs, barrels or gun handles and other daily objects and
tools.
 1.1 bare-hands injury
It is an injury caused by parts such as hands, feet, and body, and the severity of the injury
varies 。
1.2 bite wound
Injury caused by the bite of the upper and lower teeth of a person or animal on the human
body 。
1.3 stick injury
It is an injury caused by hitting the human body with sticks or hard objects such as sticks.
If the stick hits thicker subcutaneous tissues such as the trunk, limbs, etc., it often forms a
strip-shaped contusion band with a pale middle and parallel sides
The trauma caused by inserting a blunt slender stick into the human body is called poking
wound (blunt penetrating injury).
 1.4 brick-stone injury
Refers to damage caused by bricks hitting the human body 。
1.5 crush injury
Refers to extensive damage to the skin and deep tissues caused by the compression or
impact of a huge or heavy object 。
 多见于工伤意外和自杀，他杀较少见

1.6 injury due to fall from height

Refers to the injury caused by the human body falling from a height and colliding with
the ground or an object 。
More common in work accidents and suicides, homicide is less common, but the current
method of death is very difficult to determine 。
 多见于工伤意外和自杀，他杀较少见

1.7 transportation injury

Refers to the general term for various injuries that occur during transportation, that is,
various transportation vehicles and objects involved in transportation activities that cause
the integrity of human tissues and organs to damage or dysfunction or even death during
operation.
 多见于工伤意外和自杀，他杀较少见

Road traffic injury

（ 1 ） Pedestrian injury

1 ） Impact injury: Refers to the damage caused by a part of the car directly hitting the
human body, also known as direct impact injury.
The most typical is the bumper injury of the lower limbs caused by the car bumper. The
typical tibia fracture is wedge-shaped, and its tip indicates the direction of the wheel. 。
 多见于工伤意外和自杀，他杀较少见

2 ） Tumbling injury : Refers to the injury caused by the human body being hit by a wheel or
thrown up and then falling and colliding with the ground. 。
3 ） Running-over injury: Refers to the injury caused by a car tire running over the human body.
When the wheel rolls over the human body, the skin peels off and the subcutaneous hemorrhage
occurs, and the skin peels off at the place opposite to the raised part of the tire. This characteristic mark
is called tire mark.
Crushing injuries often cause separation of the skin and muscles, forming larger circular or bag-like
lacerations, accompanied by massive bleeding or plasma exudation, and a sense of fluctuation when
touched.
 多见于工伤意外和自杀，他杀较少见

4 ） Extension wound: It means that the skin tissue is greatly stretched. When the stretching
force exceeds the tensile limit of the skin, the skin splits along the dermatoglyph and forms a small
tear.
5 ） Dragging injury: As the clothing of the victim is hung by the vehicle, the victim's body is
dragged on the ground to form a dragging injury. The area is generally large, mostly on the side of
the body, and the protruding part of the body surface is the most important.
 多见于工伤意外和自杀，他杀较少见

（ 2 ） Injuries in the car

Emergency braking can cause the driver to lean forward and cause the chest and abdomen to collide
and squeeze on the steering wheel, causing abrasions, contusions, multiple rib fractures, thoracic
deformation, and serious damage to the internal organs of the thorax and abdomen, that is, steering
wheel injury.
In a car accident, due to the sudden acceleration or deceleration of the car body and the people in
the car, and the inertial effect of the head, the neck is overflexed or extended back and forth, which can
lead to cervical dislocation fractures and cervical spinal cord injury, which is called whiplash injury
(whiplash injury) 。
 2 、 Sharp injury
concept
Refers to different types of injuries caused by the use of tools with sharp edges or
points, such as knives, axes, daggers, swords, bayonets, scissors, glass shards, etc.

Morphological characteristics
(1) The anatomical integrity of skin and subcutaneous tissue is destroyed;
(2) The wound is open and bleeding is frequent;
(3) The wound edge is smooth, the wound wall is neat, the wound bottom is deeper,
and the wound angle is sharp;
(4) There is no bridge between wounds;
(5) Often damages deep tissues and organs.
 2.1 incised wound
It refers to a wound formed by pressing the skin with a sharp tool with a sharp edge
while moving along the long axis of the cutting edge to cut the skin and subcutaneous
tissue 。
Incision wounds are characterized by long wounds, boat-shaped wound cavity, smooth
wound walls, no bridges between tissues, sharp wound corners, and often accompanied by
scratches caused by dragging the knife.

Chetron is more common in suicide, and homicide is rare.

 2.2 chop wound
It refers to a wound formed by slashing the human body with a sharp tool that
has a certain weight and is easy to swing.

Cut wounds are often in the shape of a shuttle, with smooth wound walls, no
interstitial bridges, flat wounds, and sometimes more bleeding 。

Slashing wound is more common in homicide, suicide is rare 。

 2.3 stab wound
Refers to the injury formed by piercing the body with a sharp object along the longitudinal
axis
Features:
。
(1) Small wounds and deep wounds, often injuring internal organs or large blood vessels
and endangering life;
(2) The amount of bleeding in the internal organs of the body cavity is more than that of
the wound;
(3) There are often abrasions and contusions around the puncture entrance;
(4) Sometimes the shape of the thorn entrance can reflect the shape of the thorn, and the
shape of the thorn is left 。
Stabbing wounds are more common in homicide, and suicide is rare.
 2.4 scissoring wound
Refers to the injury caused by the cutter and the tip of the two blades of the scissors
penetrating the human tissue 。
classification ：
(1) Barbed cut wound
(2) Clipping and cutting
(3) Shear wound

Scissoring wound is more common in suicide, homicide is less common 。

 3 、 Firearm wound
concept
Human injuries caused by the detonation of gunpowder caused by a firearm are collectively
referred to as firearm injury.
3.1 gunshot wound
Refers to the damage caused by the fired warhead or other projectile hitting the human body.
A typical bullet wound is a perforating bullet wound:
（ 1 ） entrance of bullet
（ 2 ） Ejection tube
（ 3 ） Ejection outlet
 Atypical bullet wound ：

（1 ） blind tract gunshot wound

（ 2 ） Grooved bullet wound ：
（ 3 ） ricochet gunshot wound ）
（ 4 ） circumferential gunshot wound ）
 3.2 shotgun wound
Refers to bullet wounds caused by shotguns or home-made gun pellets.

Wound characteristics: When shooting close to or at close range, the shotguns are
densely packed to form a large single irregularly shaped shooting port with a jagged edge
and a large number of small shotgun ports around. The longer the shooting distance, the
smaller the shot. The more entrances.
 3.3 explosion injury
Refers to multiple compound injuries to the human body caused by the explosion of
flammable and explosive materials.
classification

(1) Blast wound

(2) Damage caused by projectiles
(3) Blast wave injury;
(4) Burns
(5) Other injuries: crush injuries, mechanical suffocation, which can cause toxic gas poisoning at the
burning site.
 Section 4

Mechanical damage to important parts

 1.Brain Injury
1.1 Scalp injury
1. Scalp abrasions

2. Scalp bruise

3. Scalp split

4. Scalp avulsion
1.2 Skull fracture
1. （ fissured fracture ）

2. （ depressed fracture ）

3. （ penetrated fracture ）

4. （ comminuted fracture ）

5. （ bursting fracture ）
1.3 Skull base injury

1.fracture of base of skull It is more common when the force of the feet on the ground is
transmitted from the spine to the base of the skull when falling.

2.combined fracture of calvarium and base of skull

Commonly seen in high falls or traffic accident injuries.

3.contrecoup fracture of base of skull When an external force acts on the skull, the force is
transmitted to a part far away from the force point, causing a fracture in the weaker part of the
skull base.
 1.4 Intracranial hemorrhage
1.traumatic extradural hemorrhage, TEH
Hematoma is more common in the temporal region, followed by the top of the frontal,
temporal or occipital region.
2.traumatic subdural hemorrhage, TSH
acute （ Within 3 days ) 、 Subacute （ 4~14days ）、 Chronic （ 14 days or more ）。
It is common at the top of the temporal, mostly unilateral, and occasionally bilateral.

3.traumatic subarachnoid hemorrhage, TSAH

（ 1 ） Bleeding is mostly in the brain contusion area （ 2 ） Spot-shaped or diffuse, well-
defined bleeding area （ 3 ） Mostly distributed asymmetrically
 1.4 Brain parenchymal injury

1.diffuse axonal injury, DAI

（ 1 ） The disease is characterized by extensive degeneration of white matter, which can
occur in any part of the brain tissue;
（ 2 ） There is no obvious change in the early stage of routine pathological examination.
Through immunohistochemical staining, the lesion can be shown 3 hours after injury, and
silverophilic staining can be seen 15 to 18 hours after injury;
（ 3 ） The contraction ball formed after the axonal rupture can continue to exist for a
long time, and the contraction ball can still be seen in the death after 6 weeks of survival.
 2.cerebral contusion
When the brain contusion formed, the brain tissue was not broken, and the brain shape
and the pia mater were intact.
（ 1 ） coup injury ： Contusion caused by force impact on the lateral brain tissue.
（ 2 ） contrecoup injury ： Contusion caused by the impact of force on the contralateral
brain tissue.
（ 3 ） intermediate coup injury ， inner brain injury ： Contusion of the brain tissue
between the force site and the counter site.
 3.laceration of brain
（ 1 ） Often accompanied by scalp, skull and dura mater injuries.
（ 2 ） The diagnosis of brain contusion is based on cracks on the brain surface, broken brain
tissue, hemorrhage, and destruction of nerve cells and glial cells.

4.cerebral concussion
Diagnose based on ：① History of head trauma ；② Transient consciousness disorder ；③
Nervous system examination to rule out organic disease ；④ There is retrograde or anterograde
forgetting.
 2. Chest injury
2.1 Heart injury
1. Penetrating heart injury

Injuries by sharp objects or firearms are common. Sharp objects, bullets or shrapnel
penetrate the chest wall and enter the heart. The integrity of the heart is destroyed.
It is also common for foreign bodies to remain in the heart.
 2.Non-penetrating heart injury
（ 1 ） Cause of injury ： Blunt violence directly affects the precordial area
（ 2 ） Damage performance:
①Heart contusion
②Ruptured heart
③Ventricular septal rupture
④Injury to the valve, chordae, or papillary muscle
2.2 Large vessel injury

Aorta, innominate artery, pulmonary artery injury.

2.3 Lung injury

1.contusion of the pulmonary
Blunt external violence causes edema and hemorrhage of the lung parenchyma without
laceration on the surface of the lung. It is the most common lung parenchymal injury in closed
chest trauma, and it is more common in high falls and traffic injuries.
 2.pulmonary laceration
The structural integrity of lung tissue is destroyed.
（ 1 ） Lung fissure caused by fracture ： The broken end of a rib fracture can pierce the
lung. ( 2 ） Squeezing lung fissure ： The rib cage is squeezed by huge violence, the rib
cage sinks, the deformed rib cage rebounds after the pressure is removed, and the
intrathoracic pressure increases sharply, which can cause the lung to rupture.
（ 3 ） Penetrating or penetrating lung injury ： Sharp objects and firearms can injure the
skin from the skin into the lungs and even penetrate the entire chest, causing pneumothorax
and blood pneumothorax.
 3. Abdominal injury
3.1 injuries of the gastrointestinal tract
1.Gastrointestinal contusion

2. Stomach rupture

There are two prerequisites for stomach rupture caused by blunt violence ：
（ 1 ） Stomach is saturated
（ 2 ） External force causes pressure difference between stomach cavity and abdominal cavity

3. Intestinal rupture
 3. Abdominal injury
3.2injuries of the liver
Classification of liver damage ： ① subcapsular hematoma of liver; ②true rupture;
③central rupture

3.3 injuries of the spleen

Classification of spleen injury: ①central rupture; ②subcapsular rupture; ③true rupture
(85%)
 Section Five

Forensic identification of mechanical injury

 1 、 Determination of the cause of death
1.1 Cause of death from primary trauma
1. Severe damage to vital organs of life: the brain, heart, lung, liver, spleen, kidney and
other vital organs are ruptured or crushed.

2. Bleeding: Acute bleeding can be fatal if it reaches more than 30% of the total blood
volume of the whole body at a time, or if a normal adult bleeds 2000-3000ml. Acute
intracranial hemorrhage of 100 ～ 150ml at a time and pericardial hemorrhage of 200 ～
250ml can also cause immediate death 。
3. Primary neurogenic shock: The peripheral afferent nerves of the body surface or
internal organs are strongly mechanically stimulated, causing abnormal sympathetic or
parasympathetic reflex function, leading to microcirculation disorders of vital organs,
and even death.
1.2 Secondary cause of death after trauma
1.infection

2.Secondary shock

3. embolism
（ 1 ） Fat embolism
（ 2 ） Fat embolism
（ 3 ） Thromboembolism
4. Asphyxiation Blood is drawn into the respiratory tract, lung rupture causes pneumothorax, etc.

5. Complications in the healing process Traumatic aneurysm, traumatic epilepsy, etc. 。

 2 、 Distinguishing injuries before and after death

2.1 Diagnosis of injury before death

1. Visible life reaction

(1) Bleeding; (2) tissue shrinkage and wound dehiscence; (3) swelling; (4) foreign body
movement; (5) crust formation; (6) infection 。

2. Histological changes of injuries during his lifetime

(1) Dilation of the marginal lymphatic sinuses of local lymph nodes; (2) Thrombosis; (3) Embolism; (4)
Inflammation; (5) Wound healing 。
 2.2 Diagnosis of dying injury
Due to the extremely short survival time after injury, the life response may be
extremely insignificant, and it is difficult to find morphological changes with
diagnostic value.
 3 、 Inference of injury time
3.1 Visual observation
Intradermal and subcutaneous bleeding skin:
Usually, the oxyhemoglobin in the hemorrhage foci gradually changes into
reduced hemoglobin and methaemoglobin within 1 to 3 days, and is swallowed by
phagocytes;

3 ～ 6d transform into hemosiderin and bilirubin or orange blood crystals;

6 ～ 9d bilirubin is oxidized into biliverdin and gradually absorbed 。

 3.2 Histological method

3.3 Enzymatic histochemical changes

3.4 Immunohistochemical method

3.5 Biochemical detection of inflammatory mediators
 4 、 Inference and identification of injury

4.1 Infer from the shape of the damage

4.2 Infer the injury from the residue in the tissue

4.3 Identify the injured object based on the attachments

and marks on the injured object
4.4 Infer from the marks on the clothes
 5 、 Judgment of the way of death
5.1 Self-killing
Generally speaking, there are no traces of fighting at the scene of suicide death. Most of the
wounded objects remain at the scene, and fingerprints of the deceased are left, and suicide notes can
sometimes be found.

5.2 He killed
There are often traces of fighting at the murder scene, and the scene is messy.
Sometimes, although no obvious signs of fighting were found at the scene, the location,
posture, injury location, number, and distribution of bloodstains of the corpse could not be
explained by suicide.

5.3 Accidental death