機械性損傷英文版

MechanicalInjury

WangDaihongAssociateChiefPhysicianMedicalDoctorHUSTTongjihospitalofxianningHepatopancreatobiliarySurgeryDepartmentofTheeco-circumstancescenterhospital1First:conception

1.Injury:injuryorwoundcausedbyeffectfactorsinthebody,whichleadtothedestructionoftheorganizationalstructureanddysfunction.2.Mechanicalinjury：effectfactorsactonhumanbodybymachanicalmovementandleadtothedestructionoftheorganizationalstructureanddysfunction.2Second:Mechanicaldamageofforensicmedicineidentification1.TasksandobjectoflivingdamageforensicidentificationTask：①Injuryseverity;②Injuryways；③Tojudgetheinjuringobjects；④Tojudgetheinjuringtime；⑤Injurydegree；⑥Laborcapacity；⑦Oldinjuringandnewinjuring；⑧Compensation;Object：livingbody32.Tasksandobjectofdeadbody'sdamageforensicidentificationTasks：①Todeterminethecauseofdeath；②Todetermineit'santemorteminjuryorpostmorteminjury；③Tojudgetheinjuringobjects；④Injuringtime；⑤personalidentificationandsoon;Object：deadbody4Third:thethreeelementsofdamageformation：1.injuringobjects（murderweapon）:anobjectwhichcausedmechanicaldamage.Features：variousinjuringobjects（solid；liquid；gas）Theextentofthedamagedependsonthequality,shapeandsizeofthings,butinsomecasesthereisanexception.Therelativemotionformsbetweenhunamnbodyandinjuringobjects：Movingobjectandrelativestaticbody.Humanmovementandrelativelystationaryobject.Movingobjectandmovinghuman.5Thecommonhardinjuringobjectsincludeblunt,sharpsandfirearms.Blunt:toolswithnotipsandedge,suchasfistsandfeet...Sharps:toolswithtipsandedge,suchascuttingmachineandsting...Firearms:bullet,explosivesandothertools.2.Actingforce：CompressionandStretch:actingforceapplyonthesameaxis,insamedireaction,calledcompression,whileinoppositedireactioncalledstretch.Shear:tomakethecrosssectionsslidingtogether.torsion：apairofequalforceapplyforacertainobject.Bending:actingforceapplyforskullorribsfotsagandrecovery.63.humantissue：Differenttissuesofhumanbodypartsanddifferenttissuesandorgansoftheanatomyoftheorganizationstructure,sothedamagetoleranceandresistanceisdifferent.Differentappearancesatdifferentpositionsofthebodyshapealsoaffectstheshapeofdamage.Injuredareaorgansortissuesforpathologicalchangesimpactonthedegreeofinjury.7Theprincipleofmechanicaldamage1、Physicalfactors:externalforcesandinjuringobjects(size,direactionandnumber)2、Biologicalfactors:thebodyflexibilityandthespecialstructureofhumanbody.3、Humanbody'senginerystate(health,diseasestate)4、Thecontactforceposition8Fourth: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.9②Commontype:accordingtotheinjurymovementdirection,speedandhumancontact,itcanbedividedintothefollowingkinds:

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

●Grazes：Objectorroughgroundrubswithskinsurfaceandleadtothebruiseoftheskin.Generallythestressareaislargeandwidelydemaged.Thisoftencanbefoundinthebodypartswhichismoreprominent,anditissheetorstrip,butmaybeaccompaniedbysubcutaneousbleedingandscabskinformation.10●Friction：

TheobjectofRoughsurface,suchasropeorotherbraid,oppressesskin,atthesametimerubstheskinsurfacewithaheavyverticalforceandhorizontalforce.Suchas:hangedorstrangled;teethbites.●Impression：VulnerantofSmallareaimpactsskinsurfacewithhighspeedfromalmostperpendiculardirection,resultingSkinabrasions.Suchabrasionsalwayscausetheinjuryofdeeptissues.Asisthecaseofcarfrontstrikesstraightonthehumanbody,alsothebulletshotintothehumanbody③Identification：withthenormalnaturaldrying withthedeathofthetable11Therightfacialfriction12④Forensicsignificance:▲Tipforexternalforce▲Inferthevulnerant▲Inferthedirectionoftheforce▲Specialpartsoffthetable:suchastheneck,innerthighs→inferthedamagereason(casedinferences)▲Inferthewayofinjury132.Contusion,bruise（1）Concept:Non-openskinlesionscausedbytheeffectsofbluntforce,togetherwithVascularruptureofskin,subcutaneoussofttissue,called(intradermalandsubcutaneous).

（2）Character:14▲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)15（3)Identificationofsubcutaneousbleedingandlividity（4）ForensicSignificance：①Subcutaneousbleedingsite,indicatespointofviolence②Subcutaneousbleeding,asignofinjuryduringhislifetime③Accordingtothecolorchangeofsubcutaneousbleeding,injurytimecanbedetermined④Accordingtothedistributionofsubcutaneousbleeding,thecasemaybepreliminarillydetermined⑤Accordingtothepatternsofsubcutaneousbleeding,vulnerantcanbejudged163.wound（1）Concept:Violentactsonthehumanbodyexceedingtheelasticlimitoftheskin,andmaketheskin,subcutaneoustissue,andevenbloodvesselsandnerves,musclesfractured.（2）Character：▲Openinjury(destructionofskinintegrity)▲Structuresofwound:Woundedge,acorner,acavity,awall,wound,abottom▲Typesofwound:bluntinstrumentinjury,sharpinstrumentinjury,firearmsinjury17Differencesbetweenbluntinjuryandsharpinjury：

18bluntwound19Twospecialtypesofbluntwound:TearingandLaceration

Tearing:causedbyexcessivetractionoftheskin.woundisLinear--shaped,perpendiculartothedirectionoftheforceandinaccordancewithstriae.withcomparativelyregularwoundeage,nocontusionwoundeageandtable,slightlysharpcorner,tissuebridgeofbottomorwall,suchas:Stretchwound.

Laceration:causedbybluntpressuresetbackofskin.Commoninpartsofthehardskeletonwithsubcutaneousliner,especiallythescalp.

DifferencesbetweenLacerationandIncisedwound,cutwound(astablebelow)20laceration2122(3)medicolegalmeaningofwound①Judgmentoffetalwoundbasedonthesite.②Inferringtheinstrumentcausedwoundbasedoncharacteristicsandinvasion.③Inferringthecasepropertiesbasedonsiteandtrait.4.Fracture(1)concep:bonedestructionoftheintegrityandcontinuitycausedbymechanicalforce.（2)classification①opennessandocclusion②Directfractureandindirectfracture③linearfracture,depressedfractures,perforatingfractureandthrypsis.④sites:skullfractures,ribfractures,fractures,vertebralfracturesandsoon.23(3)medicolegalmeaningoffracture

▲Evidenceofviolence▲Fracturescansavetheoriginal(becauseofthedifficultyofbonedestruction)▲Beabletoinstrumentandmannerofinjuries5.

RuptureofvisceraDestructionoftheanatomicalintegrityoforganswithinthebodycavityiscalledthevisceralrupture,foundinbrawls,highfalls,caraccidentsordisastersandsoon;allbodyorganscanbedamagedorbroken.▲visceralconcussion:dysfunction▲visceralcontusionandvisceralfilmcompletearemainlycharacterizedwithhemorrhageandnecrosis,suchascerebralcontusion,pulmonarycontusion,renalcontusion,etc.▲visceralrupture24256.Amputation：Completelydestructionoftheintegrityofthehumantorsoanatomylimbsiscalleddisintegrationofbody,muchfoundinaccidents,explosions,buildingcollapse,highfall,mutilatedbodies,etc.Medicolegalinvestigationtaskistocarryoutpersonalidentification.2627鈍器傷（BluntInstrumentInjury）28First:Concept

1.Bluntinstrument:allobjectswhichhavenosharpedgesortips.2.Bluntinstrumentinjury:Theinjuriescausedbybluntinstruments.Thistypeofmechanicalinjuryoftenexistsinforensiccases,whoseshapeisvariedmuch.2930Second:injuriesofhandandfoot1.

Injuriesbypalm:referstothedamagescausedbypalmorsideofthehand(1)foundinfaceasusual,e.g.perforationoftympanicmembrane.(2)thedegreeofinjuriesisvariable:whenitisnotserious,theinjuredpartisjustskinredness,sometimeswithbruisingandbleedingundertheskin,whileitcanbedeadlyserious(racranialhemorrhageorreflectiveshock)312.Boxinginjuries:Theinjuriescausedbyfist,resultinginmoreseveredamagethanthatabove.(1)foundinheadandfaceinthefirst:hurtineyesandears,aswellasteethloss;followedbychest-abdominal,heartandlungcanbeconcussedorbroken,andliverandspleenruptured.(2)sometimestheboxingsitesisnotobviousbecauseofcushionofhairandclothes.3.Footkickedinjuries:Theyaremoreseriousthanboxinginjuryandmuchclosedwithpartsofkicking,foundinthelowerextremities,perineumandlowerabdomenandsoon.32Third:bitewound1.concept:monsites:

intheface,upperlimbsandprominentpartofthebody,suchasear,nose,lips,tongue,nipples,etc.3.thesharperincisorsandcaninescanleavetworelativedamageonthevictim’sskinlikeanarc,oftenwithflakyabrasions,bruisingorcontusion.4.biteinjuriesshapeisrelatedwiththeteethsize,forceandbiteposition.5.meaning:33▲Comparepersonalidentificationbasedonthesuspect’smodelandtherealbitten.▲extractingsalivaleftonthesiteofthebite→bloodtyping▲inferringcasesbasedonbitesite:

Suchas:whenbitesideisface,itisrelatedwithwomendisputes;Andwhenontheface,lips,tongue,vulva,etc,adultery-related,Wheninthemurderer'sarm,shoulder,hands,etc,itisstrugglingtoresist.34Fourth:stickinjury1.Cylindricalsticksinjurycharacteristics:Injuriesonrelativelyflatbodycanbeformedintostripcontusion.Thewidthofcontusionissmallerthanthediameterofthestick.Intradermalandsubcutaneousskinwillbebleedingwhileitismostseriousincentralportion,bothsidesofwhichisthegradientwithoutobviousboundaries;Ifhumansofttissuelucrativepartsarehitwithafasterpace,itcancausesubcutaneoushemorrhagelikebamboohit,andhollowareaingeneralisstillsmallerthanthediametersticks;35Theblowtotheheadwithcylindricalstickscanbeformedthestriporovalhematoma,becauseofcushionofskullunderthescalp;Iftheforceissostrongthatcanbealacerationalongthelongitudinalaxisofthestripstick.Thehittingwiththeendofcylindricalstickscanformcurvedlaceration.362.Squarecolumnshapedsticksinjury：Hitthesofttissueofthebodywiththeedgevertically,whichcancauseanarrowstripcontusion.Andastrip-shapedlacerationcanbecausedbyhittingthebonepaddedpartwithit’sedge.

Hitwiththeplanevertically,whichcancausestrip-shapedsubcutaneoushemorrhage

Verticalbash,whichcancausehollowsubcutaneoushemorrhage3.Irregularstickinjury：e.g..Bough,trunkorsomethingelse.375.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.3839●Theimpactpartofthebodyandthewayofcontact：※Iftheheadlandsfirst,craniocerebralinjurycanbeveryserious,anddeathcanoccurimmediately.※。Ifthefeetlandsfirst,symmetryfracturemayhappentothe

bilateralcalcanealandembeddingfracturesmayhappentotheknee.※Ifthebuttock

landsfirst,usuallythepelvismaybefractured,theforceconductedalongthespinewhichleadstothefractureofskullbase40※Ifthechestlandsfirst,theribsmaybefracturedsubstantiallyandthethoracicorganmaybeinjuredextensively.※Ifthepalmlandsfirst,multiplefracturesanddislocationsmayhappentotheupperlimb●Thepropertiesoftheground：Theharderthegroundis,themoreseveritinjures.（Connectedwiththeactiontime)●Obstructiona.Thepotentialenergycandecreasesegmentallybydegrees.

b.Theremaybeainjurywhichcannotbeexplainedbyfall413.Characteristicsoffallinjury:（1）Commonfeaturesofinjury：a.Thesurfaceinjuryislessseverbuttheinternalismoresever.b.Usuallyfocusedonthesideofbearingsurface.c.Indirectinjuryismoreseverthanthedirectinjury.(Concussioninjuries)d.Theinjuryiswidespreadandvariedinshape,includingabrasion,contusion,lacerationinjury,fractures,etc.Visceralinjury’sfeaturesaremulti-organandmultiple.e.Thedirectionoffractureisarrangedconsistentlyandsymmetrically

42f.Allofthemarecausedbyaviolence.g.Mostofthehighfalldiedimmediately.（2）Causeofdeath：a.Commoncausesofdeath：●Severecraniocerebralinjurycauseddeath.●Hemorrhagicshockcausedbytheruptureofvitalorgan.b.Elves：▲Fatembolismcausedbylongbonefracture.▲Drown.434.medicolegalidentification

Includingaccident、suicide、murder.①crimesceneinvestigation

：Startingpointofthefall（footprint、handprint、fingerprintor

remnantofthedead）Landingpoint:（Leavemarks,bloodstains,articleswhenbumpagainsttheground）Determinethefallingpart；②Measuretheheightofthefallandisthereanyobstacle；③Distancemeasurementbetweenthecorpseandthebuilding（Thedifferencebetweenpostmortemandsuicide）；④Investigationofthecase，whetherthevictimisconsciousness,andwhetherheorsheisdrinkingortakingdrugs;⑤Completeandsystematicanatomyisespeciallystrictwithclothing44（SharpInstrumentInjury）45One、Definition

1.Sharpinstrumentinjury：Referstoinjuriescausedbyarticleswithsharpedgeoftip

2.Partterns：incisedwound、chopwound、stabwound、clipwound（1）Incisedwound：①Sharpedgeofthebladeoppresstheskinandmovealongtheaxisofthebladeedgecreatedincisionwound.Thesharpinstrumentwhichcausedthewoundiscuttinginstrument,forexampleallkindsofknives,likeblade,slide,dagger,etc.②Features：▲Havingthecharacteristicsofsharpinstrumentwound（Nopeelingaroundthewoundandsubcutaneoushemorrhage

）▲woundlengthismuchgreaterthanthedepthofthewoundcavity，spindleshapedandslit-like.▲Ifthereisboneunderthewound,itcanmakescratchesonit.46③Significanceofforensicmedicine：incisedwoundismostoftenfoundedinsuicide.Featuresofcutthroat：（righthand）Handsaregenerallyontheleftneck,crossthethyroidcartilagelevel,rightobliquetowardthe

neck,usuallyhandsheavyandclosehandlight,thetentativelycutisvisibleatthestartingpoint.(alsocalled,testcuts,

hesitationwoundsetc.)tentativecut：isalmostparallel,severalsmallsuperficialincisedwound,fishtailscratches,whicharecharacteristicsofsuicide.Defensewound：Withcaseoffighting,wecanseeinjuriesduetosnatchtheweaponorresistancetocombatinthebackofthevictim’shand,fingerand/orpalmThedifferenceofcutthroatbetweensuicideandhomicide.(Asfollows)4748（2）Chopwound①Definition：Refersto

Injuries

causedbywavingsharpinstrumentwhichhascertainweighttoslashagainstthebody.Thesharpinstrumentwhichcausechopwoundisknownaschoppinginstrument②Features：▲Havingthecommoncharacteristicsofsharpinstrumentinjury.▲Thewoundcavityisdeep,mostlyopenswideandthelengthwon’texceedthelengthofthechoppinginstrument’ssharpedgeingeneral▲Thetissuesareinjuredseverely,usuallyalongwithboneinjury.

③Significanceofforensicmedicine：49NatureoftheCase:Mostcasesarehomicide,followedbythedamage;suicideandaccidentsarerare.Characteristicsofhomiccide:theinjuriesaremostseeninthehead,neck,chest,andforthefatalwound,thevictimhastofightwiththeleftresistance.Accordingtothesizeofcharacterstoinferinjuries.3）刺創(chuàng)（stabwound）①Concept:Sharp'scutting-edgealongthelongitudinalaxisdirectionstabbedintothehumanbodyformedthetube.Ingeneral,isablindtubepuncture,thesametothenopunctureexports,andafewcanseethepenetratingstabwound(entrances,income-generatingroad,export).50②Characteristics▲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。51ForensicSignificance:▲Stabwoundaremorehomicidesorhurtedbyothers,suicideandaccidentsarerare.▲Punctureincome-generatingpatternsinferredfrominjuries.52火器傷（firearminjury）531.Concept:humaninjuriescausedbygunpowderdetonationoravarietyofgunpowderdetonatedweaponscalledfirearmswounds,includingbulletwoundandexplosivewound.2.槍彈創(chuàng)（bulletwound）Bulletwoundisthemostcommontypeoffirearmswound,referstowoundcausedbylaunchwarheads.Typicalbulletwoundisperforatinggun-shotwound,includingentranceofbullet,canalofbulletandexitofbullet.543.ntypicalbulletwound：①blindtractgunshotwound②Gullybullet③ricochetgunshotwound④circumferentialgunshotwound4.Features①Entranceofbullet:theshapeisrelatedwithdistanceofshot,includingcloseshot,short-distanceshotandlong-distanceshot.②Contusioncollar：Contusioncollarisalsocalledstrikecollar.Thebulletstrikeandfrictiontheskinwhenitrotateingthroughtheskin,whichimpacttheskinaroundtheedgesoftheinjuredplacewithtwotofourmillimeter.Itisbrightredatthebeginningandturntobedarkbrownlaterbecauseofparchment-liketransformation.55Greasecollar：Greasecollarisalsocalledwipecollar:oil,rust,metalpowderanddustattachingtothebulletcoveronorinthecontusioncollar,generalonemillimeterwide.Contusioncollarandgreasecollaralwaysoverlapeachother.X-ray:metalshadowaroundtheentrance.PatternedImpression（槍口印痕）：Short-distanceandclose(onemillimeter)shotcouldformpatternedimpression,thatistosay,themuzzlewillpressskinwhencloseshootingsothatleftlocalpatternedimpression.56Significanceofbulletentrance’sfeatures▲Provesitisentranceandshort-distanceshoot▲Determinethetypeofgunaccordingtopatternedimpression▲Gunpowderparticlesandash:▲Provesitisshort-distanceshoot.Whentheshootingdistanceisin15to30centimeterwithhandgunandinonemeterwithrifle,incompletecombustionofgunpowderparticlescanshootoutwithbulletintheskinandwound(theclosertheshootingdistance,thesmallerthetattooingscopeanddarkerthecolor;▲Onthecontrary,ifthescopeislargeandshootingdistanceover50centimeter,youcannotfindtattooing,burningandgunpowderparticles,etc.).57Significanceofexitofbullet’sfeatures(distinguishfromentranceofbullet）Itisoftencranny-shapedorstar-shaped.Generallynotissuecoloboma,skinaroundthewoundcanbecompletelyclosedNogunpowdertracesonthesurroundingskin,thatistosay,therearenocontusioncollar,greasecollar,gunpowdertattooing,gunpowderparticlesorsymptomsofskinrednessring.DistinctionofentranceofbulletandexitofbulletonskullCanalofbullet:connectionbetweenentranceandexitofbulletiscanalofbullet,whichcandeterminethedirectionofshooting.58Dependontheentryshapeandsizetodeterminethedirection:*Verticalinjection:1cm(diameter)size(includingcontusionsanddirtround),entrancecentertissuehasbeendefected.*Obliqueinjection:ellipse,oneofthesidesoftheslopetipsoftheshootingdirection.*Contactintothegunpowdergeneratedwhenpowerfulairflow,warheadsarewornoutskin,gaspouredintosubcutaneoustissue,skinteartakestheformofstarmountain-shaped.59ForensicidentificationofMechanicaldamage60ForensicSignificance(1)whetherthebullethit:theentrenceofthebulletandtheexitofthebulletthedamageofthericochetisatypical.Thehookdamageiscausedbytangenttrauma.Theheadercanbeblownupwhenitisshootbyarifleatacloserange.(2)shootingdistance:Accordingtothecharacteristicsoftheentrancecloseshoot:Muzzleprints,skinburning,smokeandgunpowderparticleshalonearlyshoot:theentranceissurroundedbysmokeandgunpowderparticleshalo.farshoot:onlythecontactrings(bruisedirtwheel+wheel)canbeseen,nootheringredients

613)determinethenatureofthecasemaybeinitially:Suicidesaregenerallyclosetoorincontactwithfire,andthedirectionofmulti-groundsbeforefiringbackorsideshot,butnotethathomicidecanbecopied.Long-rangeshooting,andshootingdirectionisshotfrombehind,usuallyfoundinhomicideoranaccident,butnotethatsuchasituationcannotbecopiedsuicide.(4)determinethedirectionofshooting:shoottheentranceandexitportconnectionTiltangle:horizontalangleshootingdirection(upordowntilt)Deflectionangle:theanglebetweenthefiringlineandthesagittalplane(leftandrightdeflection)(5)determinethetypeoffirearm:Pleaseidentifyrelevantexpertsinballisticstechnology62(6)Themannerofdeath:homicidecommonFeatures:●shootingsitedoesnotnecessarilyunique,commontothechestandabdomenandhead●Number:70percentofhomicideonlyonegunshotwound,foundinsuicideSuicideFeatures:●site:moreinthetemporal,followedbytheforehead,leftchestandmouth,nostrilsorexternalauditorycanal●shootingincontactwithorclosetothecommonshooting●Theuseofgunsinpistolcommon,ofteninthevicinityorinthehandsofthedeceased●havegotdizzygunpowdersmoke,gunpowderparticles,splash-likebleeding63※shotentranceandexitportdifference:64Theascertainofthecauseofdeath

fatalinjury1.fatalinjury:Directlyleadingtodeathorhavingadirectcausalrelationshipbetweendamageanddeath2.absolutelyfatalinjury:Atthecurrentmedicallevel,leadingtodirectfatalinjurytoanyoneunderanyconditions653.conditionalfatalinjury:Leadingtothedamageofdeathonlyincertainadverseconditions,andaccordingtodifferentconditionstheinjurycanbedividedintoindividualfatalinjuryandoccasionallyfatalinjury.4.nonfatalinjury:Donotcausethedamageofdeathundertheusualcondition.Nonfatalinjuryisdividedintoseriousinjuries,minorinjuriesandlightinjuries66Directmechanicaldamagecauseofdeath1、bleeding2、shock3、concussion4、embolism5、asphyxia6、infection7、dysfunctionofimportantorgans

67Secondtheidentificationofantemorteminjuryandpostmorteminjury1.vitalreaction(1)Definition:Livingonthevariouspathogenicfactorsorinjuryreactioniscalledvitalreaction.(2)type:bleeding,tissuecontraction,soressurroundedbyswelling,woundinfection,theformationofscabskin,inhalationandswallowing,inflammatoryreaction,hemostaticresponse,embolism,absorption68（二）antemorteminjuryandpostmorteminjuryThird

thejudgementoftheinjurytimeTheinjurytimeismainlybasedonthespecificreactionoflivinginferred,justlikethevitalreactioncanbebasedonthepresenceorabsenceoflifeafterdeathtospeculatelifetimeinjury.Theinjurytimereferstothetimefromtheforensicexaminationoftheinjury(live);tothetimeofinjuryfromdeath(corpse).70Inavarietyofvitalreaction,theappearanceofcells﹑inflammatorymediators﹑enzymes﹑cytokinesandsoon,andthepeakanddeclineoftheappearancehaveacertaintimesequence.Unfortunatelyduetoindividualdifferences,thedifferencesofinjuryandotherdifferencesofalltheindexdetectionsleadtosomeresearchresultswhichcanonlystaysontheresearchstage,difficultlyorrarelyappliedtotheactualtestcase.四.Thedeductionofinjury-causinginstrumentsaccordingtotheformofinjuryaccordingtotheresidueinthetissueaccordingtotheattachedtraceofthedeductionofinjury-causinginstrumentsaccordingtothetraceoftheclothessimulatinginjuryexperiment

五.Deductthemanner