depression of nervous activity sometimes to the point of abolition of certain reflexes.
Psychological changes such as memory disturbances and abnormal emotional states
are found sometimes. In extreme cases, there may be paralysis or muscular dysfunc-
tion. Unconsciousness and subsequent amnesia for events immediately preceding
the injury result more commonly from blows to the head than from air blast. Recov-
ery from minor concussion apparently may be complete, but repeated concussion
may produce lasting damage.
Impacts, Blows, Rapid Deceleration. This type of force is experienced in falls, in
motor vehicle or aircraft crashes, in parachute openings, in seat ejections for escape
from high-speed military aircraft, and in many other situations. Interest in the body’s
responses to these forces centers on mechanical stress limits.Accident statistics from
the United States (from 1979 to 1986) indicate that serious injuries to occupants of
automobiles involved in frontal impacts, and who were wearing seat belts, were most
commonly to the head (approximately 35 percent), followed by the thorax (includ-
ing abdomen), and lower extremities (approximately 25 percent each). The distribu-
tion of injuries in fatal accidents involving military helicopters and pilot ejections
from fixed-wing aircraft is similar to that of the automobile statistics cited with, in
addition, injuries to the spine in approximately 13 percent of cases.
5
For crewmen
who survived seat ejection from military aircraft, the most common injury was to the
spine, while for passengers surviving civil air transport accidents the most common
injury remained to the head.
4
Serious injuries to the head usually involve brain injury, either with or, commonly,
without skull fracture.The brain may suffer either diffuse or focal injuries.The former
consists of brain swelling, concussion, and diffuse axonal injury, that is, mechanical
disruption of the nerve fibers; the latter consists of localized internal bleeding and
contusions (coup and contrecoup). Concussion is the most common brain injury.
Skull motion and fracture have been extensively investigated (see later in this sec-
tion), and have led to criteria for head injury (see Human Tolerance Criteria).
The most common neck and spinal injury is caused by rearward flexion and for-
ward extension of the neck, such as commonly occurs in rear-end motor vehicle col-
lisions (“whiplash”), and results in localized pain in the neck and shoulders, and even
cord injuries.The motion can also result in dislocation or fracture of the first and sec-
ond vertebral joints, and may lead to the spinal cord being crushed or severed. Both
neck and spine may be injured by vertical accelerations directed from the head or
buttocks, leading to dislocation and fracture with, again, the potential for spinal cord
injury. The nature and degree of injury is critically dependent on the body position
at impact.
The chest encloses important organs—the heart, lungs, trachea, esophagus, and
major blood vessels—and so injuries may be divided into those affecting the organs,
and those affecting the rib cage. Injuries to the internal organs include ruptures of the
heart, the lung, and of the arteries connected to the heart, while injuries to the rib
cage involve fractures of the ribs and sternum, and sometimes dislocations and frac-
tures of the thoracic vertebrae. Compound rib fractures may, if sufficiently displaced,
also result in puncturing of internal organs. Organs within the abdomen (especially
liver, kidneys, and spleen) are also subject to injury by external trauma involving
transverse (e.g., front-to-back or side-to-side) accelerations.
Common injuries to the lower extremities involve fractures of the long bones and
injuries to the joints.
Force Duration. The correlation between the response of the body system to
continuous vibration and to spike and step-force functions may be used to guide and
interpret exposures. The tissue areas stressed to maximum relative displacement at
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