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Impact Biomechanics of the Thorax

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The Biomechanics of Impact Injury

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Abstract

The thorax occupies the upper part of the torso and contains the lung and heart that are enclosed by a rib cage. Of course, the lung, heart, and the great vessels are vital organs that need to be protected from external forces but the enclosure also needs to be expandable to assist in the respiratory function. The rib cage is capable of expanding the thorax and can provide some protection to the thoracic organs. However, for high speed impacts, the ribs are vulnerable to fracture. Although multiple rib fractures are serious injuries, the fracture of a rib or two is relatively minor. But, when cadavers are used to assess thoracic injury, rib fracture is the only measure because injuries to the heart and lung are generally not assessable in dead tissue. Because of the variability in human tolerance, the number of rib fractures and the number of fractured ribs cannot be correlated to the severity of injuries to the thoracic organs.

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Authors and Affiliations

  1. Department of Biomedical Engineering, Wayne State University, Detroit, MI, USA

    Albert I. King

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  1. Albert I. King
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Appendices

Questions for Chapter 11

  1. 11.1.

    The three-inch chest deflection limit for frontal impact is based on:

    1. [] (i)

      No rib fractures occurring for 3 in. of chest deflection

    2. [] (ii)

      A 32% chest compression which corresponds to a 3 in. deflection and an AIS of 3

    3. [] (iii)

      Flail chest occurring well over 50% of the time

    4. [] (iv)

      Deflection being a component of the Viscous Criterion (V*C)

    5. [] (v)

      An injury severity of AIS 4 or greater

  2. 11.2.

    Kroell et al. (1971, 1974) tested many cadavers at the University of California, San Diego

    1. [] (i)

      The principal aim of their research was to study spinal response to impact

    2. [] (ii)

      Their results could not be used to design a human-like crash dummy

    3. [] (iii)

      The cadavers used were embalmed

    4. [] (iv)

      A 12-inch diameter metal impactor was used

    5. [] (v)

      None of the above

  3. 11.3.

    Thoracic injury due to side impact can involve many organs. Select the correct answer:

    1. [] (i)

      Rib fractures occur only on the impacted side of the thorax

    2. [] (ii)

      Lung injuries can be caused by fractured ends of ribs

    3. [] (iii)

      Aortic rupture can occur

    4. [] (iv)

      (i) and (ii)

    5. [] (v)

      (ii) and (iii)

  4. 11.4.

    The following statements are related to the anatomy of the thorax. Select the incorrect statement:

    1. [] (i)

      The rib cage consists of 12 pairs of ribs

    2. [] (ii)

      The sternum is made up of three different bones

    3. [] (iii)

      The first seven pairs of ribs are connected directly to the sternum

    4. [] (iv)

      The clavicles are attached to the sternum

    5. [] (v)

      There are two pairs of floating ribs

  5. 11.5.

    The heart has the following anatomical features. Select the incorrect statement:

    1. [] (i)

      The heart is composed of a special type of muscle known as cardiac muscle

    2. [] (ii)

      The heart has four chambers

    3. [] (iii)

      The heart has 2 one-way valves

    4. [] (iv)

      The pulmonary artery carries non-oxygenated blood

    5. [] (v)

      The coronary arteries are branches of the ascending aorta

  6. 11.6.

    Direct non-penetrating impact to the sternum with a small high speed projectile can cause the heart to go into ventricular fibrillation

    1. [] (i)

      The cause has not been firmly established

    2. [] (ii)

      The impact needs to occur at the instant of the P-wave in the EKG cycle

    3. [] (iii)

      Revival of victims has generally not been successful

    4. [] (iv)

      (i) and (ii)

    5. [] (v)

      (i) and (iii)

  7. 11.7.

    The heart has the following anatomical features. Select the incorrect statement

    1. [] (i)

      Venous blood enters the right atrium from the vena cava

    2. [] (ii)

      The pulmonary vein carries oxygenated blood back to the heart from the lungs

    3. [] (iii)

      The right ventricle pumps blood into the aorta

    4. [] (iv)

      Blood pressure is higher in the ventricles than in the atria

    5. [] (v)

      Semilunar valves control blood flow to and from the ventricles

  8. 11.8.

    Flail chest is a serious thoracic injury

    1. [] (i)

      It is diagnosed when the chest plate retracts upon inspiration

    2. [] (ii)

      It is due to multiple rib fractures but the number of ribs fractured necessary to cause a flail chest has not been established

    3. [] (iii)

      Bilateral flail chest is a life-threatening injury

    4. [] (iv)

      (i), (ii), and (iii)

    5. [] (v)

      (i) and (iii)

  9. 11.9.

    Injuries to the lung are seen in automotive crashes

    1. [] (i)

      Laceration of the lung can occur when the lung is injured by ends of fractured ribs

    2. [] (ii)

      Hemorrhage in the lung is called a hemothorax

    3. [] (iii)

      If the lung cannot maintain a vacuum because the chest wall is punctured, the condition is a pneumothorax

    4. [] (iv)

      Recovery from lung injuries is generally complete with no residual effects

    5. [] (v)

      All of the above

  10. 11.10.

    Aortic rupture is a life-threatening injury

    1. [] (i)

      It usually occurs at sites in the isthmus of the aorta

    2. [] (ii)

      One hypothesized site is the attachment of the ligamentum arteriosum to the aorta

    3. [] (iii)

      The tears are always longitudinal because the aorta is stronger in the transverse direction

    4. [] (iv)

      (i) and (ii)

    5. [] (v)

      (i) and (iii)

  11. 11.11.

    The cadaver has been frequently used to assess the effect of blunt impact to the thorax. The possible deficiencies in using the cadaver as a surrogate are:

    1. [] (i)

      Ventricular fibrillation cannot be determined

    2. [] (ii)

      Flail chest cannot be firmly established

    3. [] (iii)

      Lung injury from blast waves cannot be established

    4. [] (iv)

      (i), (ii), and (iii)

    5. [] (v)

      (i) and (iii)

  12. 11.12.

    Criteria for chest injury for frontal impact can take several forms. Select the correct answer:

    1. [] (i)

      V*C = 2.0 for a 25% probability of an AIS 4+ injury

    2. [] (ii)

      Thoracic trauma index (TTI) = 75 g

    3. [] (iii)

      T12 acceleration in excess of 60 g for less than 3 ms

    4. [] (iv)

      Chest compression of 4 in.

    5. [] (v)

      Chest compression of 40%

  13. 11.13.

    Thoracic response to frontal impact by a 152-mm diameter impactor was obtained by Kroell et al. in the 1970s. Response corridors were obtained from these test data

    1. [] (i)

      The corridors form the basis for the design of the Hybrid III dummy chest

    2. [] (ii)

      The stiffness of the Hybrid III chest was increased slightly because the cadaveric data did not simulate human muscular response

    3. [] (iii)

      Volunteer test data provided by Patrick show that the increase in stiffness in the living human was negligible

    4. [] (iv)

      The increased stiffness of the Hybrid III chest represents an inability to design a human-like dummy chest

    5. [] (v)

      All of the above

  14. 11.14.

    Response of the thorax to static and dynamic shoulder belt loading was studied by several investigators

    1. [] (i)

      None of them used human cadaver

    2. [] (ii)

      Static volunteer data were inconsistent among investigators

    3. [] (iii)

      Post-mortem dynamic pig stiffness values were higher than the dynamic volunteer data

    4. [] (iv)

      (i), (ii), and (iii)

    5. [] (v)

      (i) and (ii)

  15. 11.15.

    The following injuries to the thorax are rated as AIS 3

    1. [] (i)

      Two to three rib fractures

    2. [] (ii)

      Intima tear of the aorta

    3. [] (iii)

      Four or more rib fractures with a stable chest

    4. [] (iv)

      Lung contusion

    5. [] (v)

      (iii) and (iv)

  16. 11.16.

    For frontal chest impact , a chest deflection of 32.6% corresponds to

    1. [] (i)

      Three to four rib fractures

    2. [] (ii)

      A V*C of 2.0 for a 25% probability of an AIS 4+ injury

    3. [] (iii)

      A chest deflection of 3 in. in a 50th percentile male

    4. [] (iv)

      (i) and (iii)

    5. [] (v)

      (ii) and (iii)

  17. 11.17.

    Laboratory research in impact biomechanics

    1. [] (i)

      m2y2 = k12 (y1 − y2) − k23 (y1 − y3) − kve23 (y2 − y4) − c23 (y2 − y4)

    2. [] (ii)

      m2y2 = k12 (y1 − y2) − k23 (y2 − y3) − kve23 (y3 − y4) − c23 (y2 − y4)

    3. [] (iii)

      m2y2 = k12 (y1 − y2) − k23 (y2 − y3) − kve23 (y2 − y4) − c23 (y2 − y3)

    4. [] (iv)

      m2y2 = k12 (y1 − y2) − k23 (y2 − y3) − kve23 (y3 − y4) − c23 (y2 − y4)

    5. [] (v)

      m2y2 = k12 (y2 − y1) − k23 (y2 − y3) − kve23 (y2 − y4) − c23 (y2 – y4)

      figure a
  18. 11.18.

    Modeling of the thorax can have several goals. Among them are:

    1. [] (i)

      Study of injury to the viscera of the thorax

    2. [] (ii)

      Simulate non-automotive impact events

    3. [] (iii)

      Use it to replace the Hybrid III dummy entirely

    4. [] (iv)

      All of the above

    5. [] (v)

      (i) and (ii)

  19. 11.19.

    The thoracic model developed by Wang et al. (1995) has the following features:

    1. [] (i)

      It is a finite element model capable of simulating static loading only

    2. [] (ii)

      It does not simulate any abdominal organ

    3. [] (iii)

      It assumes non-linear tensile and compressive response for the heart and lungs

    4. [] (iv)

      It does not simulate the thoracic spine as a column of vertebrae and discs

    5. [] (v)

      None of the above

  20. 11.20.

    Frontal response of the Hybrid III dummy in the plateau region of the force-deflection curve was increased to account for muscle effect in the living human

    1. [] (i)

      This increase is justifiable because the data to design the dummy were obtained from cadavers

    2. [] (ii)

      This is not justifiable because there is evidence that living human response yields the same plateau

    3. [] (iii)

      There are no volunteer impact test data to support the increase

    4. [] (iv)

      There are data from several volunteers to support the increase

    5. [] (v)

      None of the above

Answers to Problems by Chapter

Prob

Ans

1

(ii)

2

(v)

3

(v)

4

(iii)

5

(iii)

6

(v)

7

(iii)

8

(iv)

9

(v)

10

(iv)

11

(iv)

12

(iii)

13

(v)

14

(v)

15

(v)

16

(iv)

17

(iii)

18

(v)

19

(v)

20

(ii)

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King, A.I. (2018). Impact Biomechanics of the Thorax. In: The Biomechanics of Impact Injury. Springer, Cham. https://doi.org/10.1007/978-3-319-49792-1_11

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  • DOI: https://doi.org/10.1007/978-3-319-49792-1_11

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-49790-7

  • Online ISBN: 978-3-319-49792-1

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