1、AUTOMOTIVE SAFETY The increasing importance of safety perform- ance in all aspects of motor vehicle design, development, manufacturing and marketing, makes itnecessary for professionals working in these areas to develop an understanding and awareness of safety considerations to effec- tively handle
2、future developments in this area. Automotive Safety: Anatomy, Injury, Testing and Regulation begins with a clear, concise introduction to the terminology and concepts relating to human anatomy and injury. This comprehensive bookthenfocuses on the types of injuries that occur by body region and the m
3、echanisms thought to cause them. Selected anatomical, physiological and clinical concepts are included to support the injury material presented. Injury scaling is also discussed, reviewing techniques such as the Abbreviated Injury Scale (AIS), GlasgowComa Scale (GCS), and Harm and Impairment. This i
4、nformative publication concludeswith a discussion on the regulatoryframeworkandbiomechanical basis of Federal Motor Vehicle Safety Standard (FMVSS) 208 and the New Car Assessment Program (NCAP). Organized into four information-packed chapters, contents of this valuable publication include: Terminolo
5、gy; Anatomy and Injury; Injury Scaling; Regulation and Testing. Appendices include various safety laws and regulatory-related documents which are referred to in the text. In addition, R-103 includes an extensive reference section and is packed with illustrations and diagrams. Automotive Safety: Anat
6、omy, Injury, Testing andRegulation is an essential reference for all automotive safety professionals-either tech- nical ormanagerial, as well as anyonewanting a better understanding of this fascinating area of study. ,5 f eThe EngineeringSociety _ ForAdvancing Moblilty W-LandSea AirandSpace IN TERNA
7、 T IO NA LLIBRAAutomotive Safety Anatomy, Injury, Testing Gary Davidoff, M.D.; Kennerly Digges, Ph.D.; David Doyle, Ph.D.; Frederic Eckhauser, M.D.; Paul Gikas, M.D.; Robert Green, M.D.; Fred Hankin, M.D.; Donald Huelke, Ph.D.; Ellen MacKenzie, Ph.D.; Jeffrey Marcus, Ph.D.; John McGillicuddy, M.D.;
8、Arthur Pancioli, Jr., M.D., II.B.; Elaine Petrucelli; DonaldTrunkey,M.D.; DavidViano,Ph.D. Also, specialthankstoGeraldTanny, Ph.D., for his long-distance “cheerleading.“ (In many instances, the reviewers did not get to see final versions of the manuscript, so any errors in the final product should n
9、ot be associated with them. Rather, to paraphrase a well-known quotation, “The book stops here (with me).“) The research, writing and re-writing of this volume required a great deal oftime and energy, and I thank those near and dear who accepted my commitment to this project. Whenever possible, I ha
10、ve referenced statements in the book to one or more currently availablepublished sources. Ihopereaders will letmeknowofanyadditional citations which should be included. Last but not least, my thanks to the crew at SAE, who by their helpfulness and professionalism, helpedme todecide that this firstbo
11、ok should be a firstbook. Iknow there were many people helping “behind the scenes“ and I hope they will know this thank you is for them as well. itro uc ion Thisbook is theoutgrowth ofanumberoflectures Ihavepresented during the last five years.Aswas thecase with those lectures, thebookdiscusses “spe
12、cifics“and also seeks to provide background material and concepts which will be most useful over a long period oftime, both in theirown rightand as afoundation foradditional study especially to help grasp future developments. The text of this book is divided into four chapters: Terminology, Anatomy
13、and Injury, Injury Scaling,andRegulationsandTesting. Chapter 1,Terminology,provides a non-technical introduction to some of the terminology and concepts relating to the bodys structure and function, which are used in the other chapters. Chapter 2, Anatomy and Injury, provides a discussion, by body r
14、egion, of the types of injuries which occur and the mechanisms thought to cause them. Most of the technical terms are defined as they are introduced into the discussion, and so this chapter should be “readable“ without a clinical or injury biomechanics background. It does, however, discusssomefairly
15、advancedconcepts,andsoshouldbeofinteresttothosewith strong clinicaland/orbiomechanicsbackgrounds as well.Chapter3,Injury Scaling,discusses various techniques for assigning a numerical assessment to various injuries. The numbermay represent a ranking, such as is the case for the Abbreviated Injury Sc
16、ale (AIS) which was developed specifically for application to vehicular trauma, ormay representaquantitative assessment, e.g., the“Harm“conceptwhich isfrequently used in conjunction with Federal regulatory assessments. Chapter 4, Regulation and Testing,discussestheregulatoryframeworkandbiomechanical
17、basisofFederalMotor Vehicle Safety Standard (FMVSS) 208 (“Occupant Crash Protection“) and theNew Car Assessment Program (NCAP). The discussion includes the tests themselves, existing and proposed test criteria, and the test dummies. Finally, the Appendices provide copies of various safety laws and r
18、egulatory-related documents which are referredtointhetextandwhich, itwasthought,wouldnotbereadilyaccessible tomany of the readers. iiiTable ofContents Chapter 1 1.1 1.2 Chapter 2 2.1 2.2 2.3 2.4 2.5 2.6 Chapter 3 3.1 3.2 3.3 3.4 3.5 Chapter 4 4.1 4.2 4.3 4.4 4.5 4.6 v Terminology . Introduction Anat
19、omy and Injury Terminology Anatomy and Injury Introduction . The Head. The Spine The Chest TheAbdomen . The Pelvis and Lower Extremities Injury Scaling Introduction Anatomic Scales (AIS, ISS, POD, OIC) Physiologic Scales (GCS,MISS) . Combinations (TRISS) . Impairment, Disability and Societal Loss (H
20、arm, IPR, Disability Scale) . Regulation and Testing . Introduction Regulatory Background and NCAP Test Devices Test Procedures Test Criteria Interpretation ofRegulatory Testing REFERENCES . APPENDICES A. National Traffic andMotor Vehicle Safety Act B. Administrative Procedure Act . . ; C. President
21、ial Executive Order 12291 (1981) D.Motor Vehicle Information and Cost Savings Act . E. Code ofFederal Regulations Part 571 (FMVSS 208) . F. Code ofFederal Regulations Part 572 (TestDummy) . G. Docket 74-14; Notices 38, 39, 45, 47 . H.U .S. Court ofAppeals (1972) I. Part 501 (NHTSA Organization) and
22、Part553 (Rulemaking Procedures) 1 1 1 9 9 9 20 29 34 41 47 47 47 52 56 57 61 61 61 64 65 66 76 81 93 129 133 139 145 149 153 165 167Chapter 1 Terminology 1.2 Anatomy and Injury Terminology This chapter briefly discusses some terminology and con- cepts relating to the human bodys structure and functi
23、on and some terninology relating to injury, and explains how a few of these terms are, at times, misused. Many of the terms and concepts introduced in this chapter will be discussed in Chapter 2,whichcovers injury toeachbodyregion in detail.Thischapter ends with a brief annotated bibliography for th
24、ose seeking additional reading on the topics discussed. It is anticipated that people with a wide variety of back- grounds will beusing thisbookandthatsomeofthematerial will be much more familiar to some readers than to others. As a general guideline, it is suggested that a reader who is already qui
25、te familiar with such terms as “anterior superior iliac spine,“. “mid-sagittal“ and “eversion,“ might wish to glance at this chapter, but probably need not read it in detail. FOREHEAD (FRONTAL) HEAD CRANIUM EYE (ORBITAL) FACE . MOUTH (ORAL) NECK SHOULDER BREAST (MAMMARY) _ARM PIT ARM (AXILLARY) F AN
26、TECUBITALTORSO UPPER OREARM (UMBILICAL) EXT EREMT GROIN EXTREMITY PUBIC HAND PPALM THIGH |FEMORAL KNEE KNEECAP (PATELLA) LOWER LEG EXTREMITY ANKLE FOOT Figure 1.1 - Anatomical Position - - Anterior View (Showing Anatomical Regions) Anatomy may be briefly defined as the study of the bodys structure a
27、nd, as such, is frequently concerned with describing the shape and location of various parts of the body. One way of specifying location is to divide the body into regions. For ex- ample, the deltoid or shoulder region, the hip, the scapular or shoulder blade region, the calf, the shin, the sole of
28、the foot (plantar region) and so on (Figures 1.1 and 1.2). Anotherfrequently usedmethod ofdescribing location is to specify relative location, i.e., superior(toward the head), inferior (away from the head), anterior (towards the front), posterior (towards the rear) (Figure 1.3), medial (toward the c
29、enter), and lateral (away from the center). These pairs ofterms may be considered as describing a set ofaxes. For Cartesian coordinates, the vertical axis in the plane ( -PARIETAL BASE OF SKULL (OCCIPITAL) NECK (CERVICAL) SHOULDER (DELTOID) - DELTOID lJ L - SCAPULAR ARM (BRACHIAL) FLANK I-| SMALLOF
30、BACK (LUMBAR) HIP SACRAL BUTTOCK (GLUTEAL) BACK OF KNEE (POPLITEAL) CALF -SOLEOF FOOT (PLANTAR) Figure 1.2 -Anatomical Position - - PosteriorView(Showing Anatomical Regions) 1 1.1 Introduction(CRANIAL) SUPERIOR CARTESIAN UP = +Y, DOWN =-Y - OUTSIDE = +X, INSIDE =-X +X FRONT = +Z, BACK =-Z +z (a) FRO
31、NTAL PLANE - - (VENTRAL) (DORSAL) ANTERIOR POSTERIOR (CAUDAL) INFERIOR Figure 1.3 - Anatomical Directions of the paper is frequently referred to as Y, the horizontal axis in theplane ofthepaper asX, anda third axis, directed perpendicu- larly out of that plane, as Z. It is a very straightforward ste
32、p to extend the Cartesian coordinate system (Figure 1.4a) to the anatomical coordinate system (Figure 1.4b). The positive Y-axis corresponds to the superior direction, and the positive Z-axis corresponds to the anterior direction. The X-axis corresponds to the lateral-medial axis. For the purpose of
33、explanation, the positive X-axis will be assumed to correspond to the lateral direction. (This will be explained more fully later.) This is shown in Figure 1.4b. The X, Y and Z, or lateral-medial, superior-inferior, and anterior-posterior axes, respectively, alsomay be defined as the ANATOMICAL LAT.
34、 SUP. UP-DOWN = SUPERIOR-INFERIOR OUTSIDE-INSIDE = LATERAL-MEDIAL FRONT-BACK = ANTERIOR-POSTERIOR (b) Figure 1.4 - Anatomical Coordinates (Axes) intersection of three planes (Figure 1.5a). In fact, in some instances, the anatomical planes aremore frequently referred to than the anatomical axes. Figu
35、re 1.5b indicates the three planes: the sagittalplanelabeledwithan S,thecoronalplanelabeledwith aC, and the transverse plane labeled with a T. These planes are superimposed over a human figure in Figure 1.5c. It should be noted (Figure 1.5c), that the particular sagittal plane which goes through the
36、 center of the body (dividing it into right and left halves) is referred to as the mid-sagittal plane or median plane. (Anyplaneparallel to this,butnotin thecenterofthebody,would be a sagittal plane.) The plane which goes “through the ears“ so as to divide the body into afrontandrearhalf is referred
37、 to as the coronal plane. The third plane illustrated in Figure 1.5c is the plane bisecting the body into upper and lower halves. This is called the transverse or horizontal plane. It is clear that for the body position shown in Figure 1.5, the calf is below the knee. Therefore, the calf can be said
38、 to be “inferior to the knee,“ or the calfregion can be said tobe inferior to the knee region. Similarly, it can be said that “the knee is superior to the calf.“ Within the coronal plane, a location can be specified which is either toward the center line of the body (referred to as “medial“) orawayf
39、rom the center line ofthebody (referred to as “lateral“). For example, the clavicle is a bone which is oriented approximately in the medial-lateral direction, and, therefore, reference can bemade to the “lateral“ part ofthe bone, which is the partcloser to the shoulder, and the “medial“ partofthe bo
40、ne, which is the part closer to the sternum (Figure 1.6). Otherfrequently used terms are internal (deep) and external (superficial) andproximal (near)and distal (far). Internal ordeep refers to locations relatively deep within the body whereas 2 TERMINOLOGYCHAPTER 1 1. CARTESIAN V FXZ (a) 111. ANATO
41、MICAL (WITH SUBJECT) DORSAL (POSTERIOR) VENTRAL- (ANTERIOR) (b) - CORONAL PLANE - MEDIAN PLANE (MID-SAGITTAL) TRANSVERSE PLANE (HORIZONTAL) PROXIMAL DISTAL (C) Figure 1.5 - Anatomical Coordinates (Planes) external or superficial refers to locations relatively nearer to the surface ofthe body. Thus,w
42、emay referto the superficial layerof skin, theepidermis,andthedeeperlayerofskin (thelayerbeneath the epidermis), the dermis. Proximal describes thatwhich is closer, eitherto themidline of the body or to some other reference, and distal, the opposite, refers to a location which is further away from t
43、he median or some other reference. Proximal and distal are most frequently usedwhendescribing locationonalimb, inwhichcasetheyrefer, respectively, to near or far with regard to the point ofattachment ofthe limb to the torso. Thus, the knee is proximal to the ankle, but the knee is distal to the thig
44、h. Frequently, fractures along the shaft ofa long bone such as the femur, tibia and fibula (Figure 1.6) are described, in part, by theirlocation alongthe length ofthebone.Thedesignation refers to the standard anatomical position and is basedon conceptually dividing the bones length into thirds. The
45、third closest to the torso isdescribed asthe“proximal“third(abbreviated “P/3“),the middle third isdescribed asjustthat (abbreviated“M/3“),andthe third furthest from the torso is described as the “distal“ third (abbreviated “D/3“). Thus, a fracture oftheproximal third ofthe femur would indicate that
46、the fracture is located in the superior (cephalic)regionofthethigh(nearthehip),ratherthanbeingnear the knee, or in the middle ofthe thigh. (This is discussed inmore detail in the section on the pelvis in Chapter 2.) It isimportant tonote thatanatomical terminology isalways used with respect to a ref
47、erence position for the body, the “anatomical position“ (Figures 1.1 and 1.6). Basically, it is a standing erect position facing forward, palms forward. It is X X SJ-ELVI FEMUR PATELLA LEG J?AXLA Figure 1.6 - The Skeleton - - Front View important to note, in particular, with regard to the descriptio
48、n of injury location, thatregardlessofthepositionandarrangementof the particular injured person being described, the anatomical terminology is with regard to the anatomical position. Thus, the wrist isalways distal to theelbow, regardless ofhow a particular upper limbmay be positioned, e.g., even if
49、the elbow is bent, so that inaparticularinstance, thewrist isclosertothetorsothanthe elbow. Itisfrequentlyconvenienttodiscussthebodywithreference to rather obvious subdivisions, namely the head, neck, upper extremities, lower extremities and torso (Figure 1. 1). The trunk or torso may be further subdivided into an upper region, the thorax, and a lower region, the abdomen. (Note: the term stomach, which is sometimes informally used to denote the abdomen, shouldnotbeused inthatcontext. Rather, thestomach refers to a particular organ within
