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Prediction of multidirectional thoracic impact injuries
Published September 07, 1977 by International Research Council on Biokinetics of Impact in Switzerland
The human chest (or thorax) is a ribbed shell which contains the following important organs: the heart, lungs, trachea, esophagus, great blood vessels and nerves. The size and shape of the thorax depend on the age and sex of the individual, but it may be approximated as a truncated cone with depth less than breadth. The chest cage is a semi-rigid structure which not only provides protection to the internal organs but also facilitates the mechanics of respiration.
Thoracic injuries may be divided into two types: (a) injuries to the endothoracic organs; and, (b) injuries to the thoracic cage. Injuries to the endothroacic organs include arterial and ventricular ruptures, aortic ruptures, damage to the electrical conducting system and the cardiac muscle, pneumothorax, hemothorax, pulmonary contusions and rupture of the bronchi. Of these, the most frequent and most serious is the rupture of the thoracic aorta. The cardiac injuries are probably caused by the impingement of the heart between the spinal column and the sternum. Also, there is an increased possibility of cardiac rupture if the heart is full of blood. Aortic tears usually occur immediately above the heart or in the descending aorta at the isthmus. The tears are usually transverse to the vessel axis and the exact mechanism of failure is not yet understood. Injuries to the thoracic cage include fractures of the ribs and sternum, and dislocations and fractures of the thoracic vertebrae. Fractures of the rib cage can produce soft tissue damage through the interaction of the ends of broken ribs with internal organs.