外科急诊创伤(英文)-贯通伤.ppt

Penetrating Trauma Sections Introduction to Penetrating Trauma Physics of Penetrating Trauma Specific Tissue/Organ Injuries Special Concerns with Penetrating Trauma Introduction to Penetrating Trauma 38,000 Deaths in US annually due to shootings. Mechanisms of penetrating trauma Knives, Arrows, Nails, etc Understanding principles of energy exchange increase the Index of Suspicion associated with the MOI Physics of Penetrating Trauma Recall Kinetic Energy Equation Greater the mass the greater the energy Double mass = double KE Greater the speed the greater the energy Double speed = 4x increase KE Physics of Penetrating Trauma Small Fast bullet can cause greater damage than large and slow. Different bullets of different weights traveling at different speeds cause Low Energy/Low Velocity Knives and arrows Medium Energy/Medium Velocity Weapons Handguns, shotguns, low-powered rifles 250-400 mps High Energy/High Velocity Assault Rifles 600-1,000 mps Physics of Penetrating Trauma Bullet spins as it travels down barrel Rifling in barrel Allows bullet to travel straight with slight yaw Bullet departs barrel, spinning with a slight wobble or yaw Weapon forced backward and absorbs energy Recoil Physics of Penetrating Trauma Remainder of energy propels bullet forward at a high rate of speed. Trajectory is curved due to gravity As bullet strikes object, it slows and energy is transferred to object. Law of Conservation of Energy Ballistics Study of the characteristics of projectiles in motion and effects upon objects impacted Factors affecting energy exchange between a projectile and body tissue Velocity Profile Stability Expansion Fragmentation Secondary Impacts Shape Energy Dissipation Drag: wind resistance Cavitation: formation of a partial vacuum and cavity within a semi-fluid medium Profile: Size and shape of a projectile as it contacts a target Larger the profile=greater energy exchange Expansion and fragmentation results in damage Stability Allows for