Mechanisms of traumatic rupture of the aorta and associated peri-isthmic motion and deformation.

This study investigated the mechanisms of traumatic rupture of the aorta (TRA). Eight unembalmed human cadavers were tested using various dynamic blunt loading modes. Impacts were conducted using a 32-kg impactor with a 152-mm face, and high-speed seatbelt pretensioners. High-speed biplane x-ray was used to visualize aortic motion within the mediastinum, and to measure deformation of the aorta. An axillary thoracotomy approach was used to access the peri-isthmic region to place radiopaque markers on the aorta. The cadavers were inverted for testing. Clinically relevant TRA was observed in seven of the tests. Peak average longitudinal Lagrange strain was 0.644, with the average peak for all tests being 0.208 +/- 0.216. Peak intraluminal pressure of 165 kPa was recorded. Longitudinal stretch of the aorta was found to be a principal component of injury causation. Stretch of the aorta was generated by thoracic deformation, which is required for injury to occur. The presence of atherosclerosis was demonstrated to promote injury. The isthmus of the aorta moved dorsocranially during frontal impact and submarining loading modes. The aortic isthmus moved medially and anteriorly during impact to the left side. The results of this study provide a better understanding of the mechanisms associated with TRA, and can be used for the validation of finite element models developed for the examination and prediction of TRA.

Study of potential mechanisms of traumatic rupture of the aorta using insitu experiments.

Traumatic rupture of the aorta (TRA) is an important transportation-related injury. This study investigated TRA mechanisms using in situ human cadaver experiments. Four quasi-static tests and one dynamic test were performed. The quasi-static experiments were conducted by perturbing the mediastinal structures of the cadavers. The mechanisms investigated included anterior, superior, and lateral displacement of the heart and aortic arch. The resulting injuries ranged from partial tears to complete transections. All injuries occurred within the peri-isthmic region. Intimal tears were associated with the primary injuries. The average failure load and stretch were 148 N and 30 percent for the quasi-static tests. This study illustrates that TRA can result from appropriate application of nominal levels of longitudinal load and tension. The results demonstrate that intraluminal pressure and whole-body acceleration are not required for TRA to occur. The results suggest that the role of the ligamentum arteriosum is likely limited, and that TRA can occur in the absence of pulmonary artery injury. Tethering of the descending thoracic aorta by the parietal pleura is a principal aspect of this injury.

Dynamic biaxial tissue properties of the human cadaver aorta.

This study focuses on the biaxial mechanical properties of planar aorta tissue at strain rates likely to be experienced during automotive crashes. It also examines the structural response of the whole aorta to longitudinal tension. Twenty-six tissue-level tests were conducted using twelve thoracic aortas harvested from human cadavers. Cruciate samples were excised from the ascending, peri-isthmic, and descending regions. The samples were subjected to equibiaxial stretch at two nominal speed levels using a new biaxial tissue-testing device. Inertia-compensated loads were measured to facilitate calculation of true stress. High-speed videography and regional correlation analysis were used to track ink dots marked on the center of each sample to obtain strain. In a series of component-level tests, the response of the intact thoracic aorta to longitudinal stretch was obtained using seven aorta specimens. The aorta fails within the peri-isthmic region. The aorta fails in the transverse direction, and the intima fails before the media or adventitia. The aorta tissue exhibits nonlinear behavior. The aorta as complete structure can transect completely from 92 N axial load and 0.221 axial strain. Complete transection can be accompanied by intimal tears. These results have application to finite element modeling and the better understanding of traumatic rupture of the aorta.

Mechanical properties and anthropometry of the human infant head.

The adult head has been studied extensively and computationally modeled for impact, however there have been few studies that attempt to quantify the mechanical properties of the pediatric skull. Likewise, little documentation of pediatric anthropometry exists. We hypothesize that the properties of the human pediatric skull differ from the human adult skull and exhibit viscoelastic structural properties. Quasi-static and dynamic compression tests were performed using the whole head of three human neonate specimens (ages 1 to 11 days old). Whole head compression tests were performed in a MTS servo-hydraulic actuator. Testing was conducted using nondestructive quasi-static, and constant velocity protocols in the anterior-posterior and right-left directions. In addition, the pediatric head specimens were dropped from 15cm and 30cm and impact force-time histories were measured for five different locations: vertex, occiput, forehead, right and left parietal region. The compression stiffness values increased with an increase in velocity but were not significantly different between the anterior-posterior and right-left directions. Peak head acceleration during the head impact tests did not significantly vary between the five different impact locations. A three parameter model that included damping represented the pediatric head impact data more accurately than a simple mass-spring system. The compressive and impact stiffness of the pediatric heads were significantly more compliant than published adult values. Also, infant head dimensions, center of gravity and moment of inertia (Iyy) were determined. The CRABI 6-month dummy impact response was similar to the infant cadaver for impacts to the vertex, occiput, and forehead but dramatically stiffer in lateral impacts. These pediatric head anthropomorphic, compression, and impact data will provide a basis to validate whole head models and compare with ATD performance in similar exposures.

Improved estimation of human neck tensile tolerance: reducing the range of reported tolerance using anthropometrically correct muscles and optimized physiologic initial conditions.

Unlike other modes of loading, the tolerance of the human neck in tension depends heavily on the load bearing capabilities of the muscles of the neck. Because of limitations in animal models, human cadaver, and volunteer studies, computational modeling of the cervical spine is the best way to understand the influence of muscle on whole neck tolerance to tension. Muscle forces are a function of the muscle's geometry, constitutive properties, and state of activation. To generate biofidelic responses for muscle, we obtained accurate three-dimensional muscle geometry for 23 pairs of cervical muscles from a combination of human cadaver dissection and 50(th) percentile male human volunteer magnetic resonance imaging and incorporated those muscles into a computational model of the ligamentous spine that has been previously validated against human cadaver studies. To account for multiple origins, insertions, and lines of action, 82 muscle partition pairs, including nonlinear passive and active elastic components, were included in the model. Using optimization, we determined physiologically appropriate levels of muscle activation for each of the 23 muscles simulating relaxed (no pre-impact awareness) and tensed (pre-impact awareness) states. Unlike all prior neck models, both of these states of activation were mechanically stable in an upright neutral anatomic position resisting gravity as an initial condition prior to tensile loading. Tensile forces were then applied to the models at the head center of gravity at 500 N/s. Both states of activation predicted injury above C3, consistent with clinically observed tensile neck injuries. Using these more physiologically reasonable estimates of muscle activation significantly narrowed the range of estimates of 50(th) percentile male tolerance to tensile loading. Specifically, while the ligamentous spine fails in tension at an average of 1.8 kN and the total muscle activation predicts neck failure at 4.8 kN, the optimized muscle forces resulted in a whole neck tolerance of 3.1 kN and 3.7 kN for the relaxed and tensed neck, respectively. Moreover, these techniques provide quantitative estimates of load sharing between the neck musculature and ligamentous spine that will be useful in the creation of next generation ATD necks.

The tolerance of the human hip to dynamic knee loading.

Based on an analysis of the National Automotive Sampling System (NASS) database from calendar years 1995-2000, over 30,000 fractures and dislocations of the knee-thigh-hip (KTH) complex occur in frontal motor-vehicle crashes each year in the United States. This analysis also shows that the risk of hip injury is generally higher than the risks of knee and thigh injuries in frontal crashes, that hip injuries are occurring to adult occupants of all ages, and that most hip injuries occur at crash severities that are equal to, or less than, those used in FMVSS 208 and NCAP testing. Because previous biomechanical research produced mostly knee or distal femur injuries, and because knee and femur injuries were frequently documented in early crash investigation data, the femur has traditionally been viewed as the weakest part of the KTH complex. However, the relative risk of hip injuries to the risks of knee and thigh injuries in frontal crashes of late-model vehicles suggests that this may not be the case. This study investigated the frontal-impact fracture tolerance of the hip in nineteen tests performed on the KTH complexes from sixteen unembalmed human cadavers. In each test, the pelvis was rigidly fixed by gripping the iliac wings with the thigh-to-pelvis angle set to correspond to a standard automotive-seated posture. A dynamic load was applied to the knee along the axis of the femur at loading rates that are representative of knee-to-knee bolster impacts in frontal crashes. Rigidly fixing the pelvis minimizes inertial effects along the KTH complex, which results in similar force levels along the KTH complex. Consequently, in these tests, the weakest part of the KTH complex failed first. All seventeen fixed pelvis tests that produced usable data resulted in acetabular fractures at an average applied force of 5.70 kN (sd = 1.38 kN). The lack of injuries to the femoral shaft and distal femur in these tests indicates that the tolerance of the hip is less than that of the femur under frontal-impact loading. To further explore the tolerance of the femur relative to the hip, thirteen uninjured knee/femur specimens from seven cadavers previously used in hip tolerance tests were dynamically loaded. In these tests, the head of the femur was supported in a fixed "acetabular cup" to minimize inertial effects, and load was applied at the knee along the axis of the femur. All of these tests resulted in femoral neck fractures. Two tests also resulted in fractures to the femoral shaft. The average tolerance of the femoral neck from these tests is 7.59 kN (sd = 1.58 kN), which is significantly higher (p < 0.05) than the tolerance of the acetabulum. These results suggest that the mid and distal portions of the femur have a higher tolerance under these loading conditions than the pelvic and femoral portions of the hip.

Cervical spine geometry in the automotive seated posture: variations with age, stature, and gender.

In the mid 1970s, UMTRI investigated the biomechanical properties of the head and neck using 180 "normal" adult subjects selected to fill eighteen subject groups based on age (young, mid-aged, older), gender, and stature (short, medium, and tall by gender). Lateral-view radiographs of the subjects' cervical spines and heads were taken with the subjects seated in a simulated automotive neutral posture, as well as with their necks in full-voluntary flexion and full-voluntary extension. Although the cervical spine and lower head geometry were previously measured manually and documented, new technologies have enabled computer digitization of the scanned x-ray images and a more comprehensive and detailed analysis of the variation in cervical spine and lower head geometry with subject age, stature, and gender. After scanning the radiographic images, 108 skeletal landmarks on the cervical vertebrae and 10 head landmarks were digitized. The resulting database of cervical spine and head geometry was used to study cervical spine curvature, vertebral dimensions, and head/neck orientation as functions of age, gender, and stature. The data were used to characterize neutral posture cervical spine curvatures using two methods: a curvature index and Bézier spline functions. Lateral-view vertebral dimensions were also calculated for each subject, and a cascading series of equations was developed to estimate vertebral size and shape for a selected age, stature, and gender. The orientation of the cervical spine was defined using a neck chord angle, where the neck chord was varied to use different anatomical landmarks and estimates of joint centers for the top and bottom of the neck chord. Results from the study have been incorporated into a MS-Access based software package that allows researchers and modelers to generate cervical spine geometries for occupants of a specified age, gender, and stature. The program allows selection of individual occupants from the database that meet age, stature, gender, or curvature criteria, or creation of a composite cervical spine geometry representative of the selected age, gender, and stature. This tool will allow researchers to configure and vary cervical spine geometry in computer models and experimental test setups used to study head and neck impact response and injury risk.