Medical physics The medical physics overlaps the two very large fields of medicine and physics and study :- The application of physics to the function of the human body , it is called the physics of physiology . - The physics of the instruments are used in medicine . - The medical application of : The laser light UV light IR light Nuclear radiation radiological physics Forces on and in the Body The fundamental origins of forces :1. The gravitational force :- From Newton law :- There is a force of attraction between any two objects . F = mg g = acceleration of gravity m = The mass f = The force - Ex: our weight is due to the attraction between the earth and our bodies . - The medical effects of gravitational force :a- The formation of varicose veins in the legs as the venous blood on its way to the heart . b- The medical effect of gravity on the skeleton ( on the bones ) , in some way contributes to healthy bones , if a person becomes wightless , such as in an orbiting satellite , he may lose some bone minerals . 2- The electrical force : This force is more complicated than gravity since it involves attractive and repulsive forces between static electrical charges as well as magnetic produced by moving electrical charges (electric currents). Ex: The electrical force between an electron (`e ) and a proton (P + ) in hydrogen atom is about 1039 times greater than the gravitational force between them . (e+P) atom ele. force in H atom 1039 > ( e + p ) att. force in H Ex:- our bodies are basically electrical machines : - The forces produced by the muscles are electrical charges attracting or repelling other electrical charges . - The control of the muscles . 3- The nuclear force :It acts as the force to hold the nucleus together against the repulsive forces produced by the protons on each other . The types of problems involving forces on body :- statics , where the body in equilibium . - dynamics , when the body is accelerated . - friction , is involved in both statics and dynamics . Statics Objects are stationary ( static ) they are in a state of equilibrium when:1. The sum of forces in any direction is zero Fi = 0 , f1 + f2 + f3 + f4 = 0 ( First condition of equilibrium ) 2. The sum of the torgues about any axis is zero : = 0 ( Second condition of equilibrium ) =F.l where = The torque f = the force l = The vertical distance from the pivot ( fulcrum point ) to the line action of the force . cw = ccw sum of clock wise torque = sum of counter clock wise torque . F2 Fi=0 F1 F3 F4 ( Fulcrum point ) A L F The kind of levers in the body :Many of the muscle and bone systems of the body acts as levers . 1- First class lever : The fulcrum point ( P ) between the resistance force ( weight ) W and the effort force the muscle force ( M ) . W M P Ex: in the head of human : W = The weight M = Muscle force F = the force at the fulcrum point ( P ) 2- Second Mclass level : W ( Feet ) P f 3- Third class lever ( The hand ) M f W Ex: The lever system in the body is the case of the biceps muscle and the radius bone acting to support a weight ( W ) in the hand . M R W )The Forces and dimensions ) 4Cm 30Cm W Where R = the reaction force of the humerus on the ulna . M = the muscle force supplies by the biceps . W = the weight in the hand . M R W P 4Cm 14Cm H 30Cm )The Forces and dimensions ) W The force and dimensions where the weight of the tissue and bones of the hand and arm ( H ) at their center of gravity . From this example , find the value of M ? Solution :Two torques : 1due to the weight W Torque about point P Frictional Forces : A force which resist the motion between two surfaces ( in contact) depend on the nature of the surface and independent on the area of the surface Ffricitional forces :1- static friction ( Fs ) : The effective force between surfaces that are at rest with respect to one another . Fs = s N Where :s = coefficient of static friction ( used to find the maximum resistance force on an object can exert before it starts to move ). N = normal force . 2- Kinetic friction ( Fk ) : The effective force between surfaces that are in relative motion . Fk = k N Fk N Where : Fk = coefficient of kinetic friction . s > k ( Force to start the motion is a greater than needed to keep it moving ) Friction in the body :The walking : As the heel of the foot touches the ground a force is transmitted from the foot to the ground Fig ( 1 ) , we can resolve this force into horizontal and vertical components . Fh N Fig. (1-a) Friction between the heel and surface prevents the foot from slipping forward . Fn = the horizontal reaction component supplied by frictional forces . N = Normal force , supplied by the surface . The maximum force of friction F is F = N Fh N Fig (1-b) When the foot leaves the ground , Fh prevents the toe from slipping backward . Measurment ( Fh ) :The value of the horizontal force component ( Fh ) of the heel as it strikes the ground when a person is walking . Fh 0.15W , W = mg ( person's weight ) When less than 0.15 , his foot slips . - The oefficient of friction in the bone joints is usually much lower than in engineering type materials . If a disease of the joint exists the friction may become large , the synovial fluid in the joint is involved in the lubrication . - Some of organs of human body are lurbricated by a slippery mucus covering to minimize the friction . - The saliva used when we chew food acts as a lubricant . Ex: The mass of ( 10 Kg ) is pulled along a horizontal surface at constant velocity by aforce 50N and which make an angle of 25o with horizontal what is the coefficient of k between block ( mass ) and the plane ? Solution :N F sin 25 25o Fk F F cos 25 W ( 10 x 9.8 ) Fk = k N k Fk N Fk = F cos 25 = 50 N x 0.92 = 46.2 N N= ( 10 x 9.8 ) N – F sin 25 = 98N – ( 50 x 0.38 ) Normal force N = 79N Newton k 46.2 N 0.58 79 N Dynamics : The forces on the body uder the constant acceleration or deceleration of one dimensional motion . The Newton's second law , forces equal mass times acceleration , can be written without vector notation as :F = ma where : F = The force m = the mass a = acceleration m the unit , F { N , dyne } , m { g , Kg } , a { cm , } s s also F = The change of momentum over a short interval of time . 2 2 m F t m = change of momentum = ( mv ) m = mass , v = velocity of this mass t = interval of time Ex: A 60 Kg person walking at 1 m sec-1 bumps into a wall and stops in a distance of 2.5 cm in about 0.05 sec what is the force developed on impact ? Solution: (mv ) = momentum before impact = momentum after impact 60 Kg x 1 ms-1 = 60 Kg x 0 (mv ) = 60 Kg x 1 m s -1 – 0 = 60 Kg m s-1 (mv) 60kgms1 F 1200 Kgm / s 2 1200 N t 0.05s 2 times of weight , N = Kg m s-2 The application of a dynamic force in the body :- The work done by the heart beats ( systole ) 60 g of blood is given a velocity of 1 m/sec upward in about 0.1 sec . The upward momentum is 0.06 Kg x 1 ms-1 and due to third Newton's law producing downward reaction force on the rest of the body is 0.06 Kgs-1 /0.1 sec or 0.6N. - The deceleration of the body take place through compression of the padding of the feet when the person jumps from a height of 1m , under these condition , the body is traveling at 4.5 ms-1 just prior to hitting , and if the padding collapses by 1cm the body stops in 0.005 sec . F ( foot ) = 100 of body's weight (W), force in the (Leg) = 100 W. - The large velocity of modern cars the riders have a larger momentum than when walking , in accident the car stops in a short time , producing very large forces the results of these forces on the passengers can be broken bones , injuries , …death , …. - Consider the case of "Whiplash" A person sitting in an auto that is struck from behind will often suffer a whiplash injury of the neck ( cervical region of the spine ) when the car is struck , forces act through the seat forcing the trunk of the body ahead while the inertia of the head causes it to stay in place , leading to severe stretching of the neck . The method reduce the injuries from accidents :- seatbelts in automobiles . Airbags and shoulder belts . Safety devices . The energy – absorbing steering column reduces the deceleration forces during a collision by increasing the time the trunk of the body takes to come to stop . - If there is no safety devices , there is many injuries , when the auto traveling at 15 m/sec that stops in 0.5 m due to collision , the passenger's head and body are thrown against the dash and stopped , if the dash is padded , the decelerative effect may be minimized , if the dash is not padded or if the head strikes a metal surface , forces far beyond that of human tolerance occur and severe head injuries or death can be expected . The effects of the acceleration :1increase or decrease in the body's weight . 2changes in internal hydrostatic pressure . 3distortion of the elastic tissues of the body . 4the tendency of soilds with different densities suspended in a liquid to separate . 5at a large acceleration the body loss control because it does not have adequate muscle force to work against the large acceleration forces and the blood may pool in various region of the body . if g 3g the blood do not flow to the brain causes black out and unconsciousness . The centrifuge way :Is away to increase apparent weight , it is especially useful for separating a suspension in a liquid , it speed up the sedimentation that occurs at a slow rate under the force of gravity . Stoke law:Let us consider sedimentation of small spherical obejects of density P in a solution of density Po in a gravitaional field ( g ) . We know that falling objects reach a maximum ( terminal ) velocity due to viscosity effects . Stoke has shown that for a spherical object of radius ( a ) , the retarding force Fd and terminal velocity V are related by :Fd = 6aV …………….stoke law Where : Fd = retarding force V = Terminal force = viscosity of liquid When the particle is moving at a constant speed , the Fd is an equilibrium with the difference between the downward Fg and the upward buoyant force : Fd = Fg - F B Fg = force of gravity = 43 a3g Fb = the bouyant force = 43 o g Fd = 6aV – retarding force the terminal or sedimentation velocity : 2a 2 V g ( o ) 9 The Medical use of terminal velocity :- From some disease such as rheumatic heart disease , the red blood cells clump together and the effective radius increase and also increase sedimentation velocity . - From the disease such as : Hemolytic jaundice and sickle cell . Anemia , the red blood cells change shape or breack, the radius decrease , then the rate of terminal of these cells is slower than normal . - Determination of the hematocrit : V gravitational acceleration ( g ) g increase by means of a centrifuge . geff effective acceleration = 4 2f2r f= the rotation rate in revolutions per second . r= the position on the radius of the centrifuge where the solution is located . hematocrit depends on : - radius of centrifuge - speed and duration of centrifugation . - Ultracetrifuge used for molecular weight or large macromolecules, for protein research use 40.000 – 100.000 rpm. W = W x 30 cm = 30 W acting clockwise ………….( 1 ) 2due to M ( Muscle force ) M= 4M …………..( 2 ) counter clockwise hence the arm in equilibrium : W = M 4M – 30 W = 0 M = 7.5 W If W = 100 N M = 7.5 x 100 = 750 N If neglected the weight of the forearme and hand (H). If we H = 15 N : W = 5 N In equilibrium = 0 5N x 30 x 10-2 M + 15N x 14 x 10-2 M = M x 4 x 10-2 M clockwise = counter clockwise 360 N . M = 4 M . N M = 90 N The effect of the angle arm on the muscle force :1- If the forearm at an angle to the horizontal as shown below Fig ( 1 ) : R M H W If take the torque about the joint , M remains constant as changes . The change of M with , the length of biceps muscle changes of M with , each muscle has a min . length to which it can be contracted and a max length to which it can be streched and still function at these two extremes the M can exerts is essentially zero . At some point in between the muscle can produce it max force as shown fig. ( 2 ) . If the biceps pulls vertically does not affect the M required but it does affect the length of the biceps muscle ( L ) . Fig ( 2 ) The maximum force of muscle at its optimum length ( L ) is 3.1 x 107 N/M2 2- The arm can be raised and held out horizontally . Fig ( 3 ) the arm raised and held horizontally from the shoulder by the deltoid muscle . T * 18 cm R 36 cm W1 W2 72 cm Fig ( 3 ) raising the arm Where : T = is tension in the deltoid muscle fixed at the angle . R = is the reaction force on the shoulder joint . W1= the weight of the arm at center of gravity . W2= weight in the hand . What is the force needed to held up the arm under the state of raising the arm ? T ( tension ) at angle resolved into two componenty . T sin , T cos and taking the sum of the torques about the shoulder joint . T sin T T cos cw =ccw 36 W1 + 72 W2 = 18 T sin the tension T 2W 4W21 sin if = 16o , W1= 68N , W2=45N T = 1145 N the force needed to hold up the arm is large . The tension in the Lumbar ( Lower back ) region : - The force at the fifth Lumber vertebra ( LS ) with the body tipped forward at 60o to the vertical and with a weight of 255 N in the hands . - The lifting heavy objects from in correct position is thought to be a primary cause of low back paint due to large the forces are in the Lumbar region of the back , and yield a large pressure in the discs separating the vertebra back . P F F P , PF 2 A r If F is heigh P is large on the disc and give the pain in the back in fig ( 4 ) the pressure in the third Lumbar disc for an adult in different positions . A= picking up 20 Kg in correctry without bending the Knees . B = picking up 20 Kg correctly by bending the knees . Ex: Lifting a weight of 225 N , calculate the force at the ( L5 ) with the body tipped forward at 60o to the vertical . Where : W1= weight of body trunk , W2= weight of arms , head and 225 N A=rigid fulcrum at LS , AB = body trunk ( boom ). AD 2 1 AB, AE AB , 3 2 T = tension in muscle . R= reaction force at L5 . W1=320N , W2=382N , T=3380N Fx=3225N,Fy=1748N , R Fx2 Fy2 , R = 3803N. , The physics of skeleton The function of the bone : 1. Support 2. locomotion . 3. protection of organs . 4. storage of chemicals . 5. nourishment . 6. transmission of sound ( middle ear ) . - The spinal column in human body . - The kind of vertebrae . - The bone kind – the shape – the structure of the bone . - The mechanical properties of bone :- Bone is composed of small hard bone mineral crystal attached t a soft flexible collagen matrix . - Some standard physics measurements on a piece of compact bone. - The density of compact bone is 1.9 g/cm3 and change with the age of the body . Young's modulus of elasticity :How much forces is needed to break the bone by compression , tension and twisting . - When the bone placed under tension or compression there is change in its length from the stress – strain curve in fig ( 1 ) . Stress = FA =N/mm2 Strain = LL Stress = 120 N/m2 L 0.015 at fracture L The strain LL increase linearly at first with the stress FA ( hooks's law ) If F increases the L increase more rapidly and the bone breaks at stress of 120 N mm-2 . The ratio of stress to strain in the initial linear portion is called young's modulus Y Y= LF AL , Ybone = 1.8 x 1010 N/m2 . Ex: Man with mass of 100 Kg standing on the one leg has a 1 M shaft of bone with average crosssectional area of 3 cm2 find :1. The pressure in Pa . 2. The amount of shortening in this bone . P= F A . F = Mg = 100 x 10 = 103 N P = 103N/ 3 x 10-4m2 = 13 x 107 Pa = 3 x 10 6 Pa L = Y= LF AY = LF AL 1x103 3 x10 4 x1.8 x1010 10-4 m tension elongate in L due to F A stress LF AY L = compression Shorting in the length of the bone of its length ( L ) Measurment of bone mineral : 1. X – ray technique : In this technique use x – ray beam with different energyies in fig ( 1 ) and the absorption of radiation by calcium varies rapidly with range of the energy . x – ray beam contains much scattered radiation when it reaches the film , the film is not a reproducible detector , then this technique is not useful for measurment of bone mineral due to beam is in homogenous [ hetergeneous beam ]. 2. Photon absorpotiometry :The problems with x – ray techniques were climinated by using:1. monoenergetic x – ray or gamma ray source, monochromatic light. 2. anarrow beam to reduce the scatter . 3. scintillation detector that detects all photons . The strength of bone depends on the mass of bone mineral present [ decreases , 1 to 2% per year ] in this technique the bone to be measured is immersing in auniform thickness of soft tissue . The absorption : I* o is the inteasity of beam before enters the bone . I is the inteasity of beam after enters the beam [ transmition beam ] the bone mineral mass ( MB ) at any point in the beam is proportional the Log (I*o/I) MB Log MB = K Log I o* I I o* I g/cm2 Where K = constant . The pressure The pressure ( P ) : The force per unit area ( gas , liquid , solid ) P F A F= force , A = area The unit of the pressure :- metric system : dynes / cm2 , N/m2 - SI unit Pa ( pascal ) = Newton/m2 N=newton , m2= square meter - The most common method of indicating pressure in medicine is by the height of a column of mercury (Hg). The pressure in fluid :If we have a column of liquid ( blood ) , ( water ) of cross section A ( U tube manometer for measuring the pressure ( P ) . U tube manometer Po h2 P h1 h2h1=h Weight of the column of liquid of its height ( h ) = force of column on the bottom mass ( m ) of a height ( h ) of the liquid = Ah times its mass per unit volume = Ah Where A = Area , h=height , = density of liquid m v , m = mass , v = volume W = f …………………( 1 ) W =mg ……………..( 2 ) , g = accerleration of gravity m = Ah ……………...( 3 ) W = Ah g This weight ( W ) is the force downward of the column on the area ( A ) at the bottom . W gh A P = gh If this column is open to atomsphere ( Po) the pressure on the bottom of liquid column is : P = Po + gh Po = 1.01 x 105 dyn/cm2 h ?? air column PHg = gh = ( 13.6 x 980 cm/sec2 ) h 1.01 x 105 dyn/cm2 = 13.6 g/cm3 x 980 x h h =76 cm The types of recording pressures :1. total ( absolute ) pressure : P = Po + gh 2. gauge pressure P - Po = gh - if the pressure below Po is called negative pressure . ex: pressure inside the Lung below Po ( inspire ). - If the pressure above Po is called positive pressure . Measurement of pressure : 1. The pressure in the bladder can be measured by passing a catheter with a pressure sensor into the bladder through the urinary passage ( urethra ) . 2. direct cystometry a needle is passed through the wall of the abdomen directly into the bladder . In this method ( cystometric method ) give information about the bladder and the pressure more than the catheter technique . Example : What height of water will produce the same pressure as 120 mm Hg ? P ( 120 mm Hg ) = gh = 13.6 g/cm3 x 980 cm/sec2 x 12 cm = 1.6 x 105 dynes/cm2 for water 1.6 x 105 dynes / cm2 = 1.0 g/cm3 x 980 cm/sec2 x h cm H2O h 163 cm H2O The h of H2O can be obtained by multiplying the h of Hg by 13.6 - Eye pressure - Pressure in the digestive system - Pressure in the skeleton - Pressure in the urinary bladder Ex: Positive pressure is used in blood transfusions , contaner is placed 1 m above a vein with a venous pressure of 2 mm Hg , what is the net pressure acting to transfer the blood into the vein . P of d blood = blood x103 mm Hg = 76.5 mm Hg of blood = 1.04 g/cm3 of Hg = 13.6 g/cm3 of H2O= 1.0 g/cm3 Net pressure = 76.5 – 2 = 74.5 mm Hg H. W: P of air ?? of air = 1.3 x 10 -3 g /cm3 Negative pressure ( suction ) is to drain body cavities . In the drainage arrangement . the negative pressure supplied to the collection bottle is 100 mm Hg and the top end of the tube is 37 cm above the end negative pressure at the lower end of the tube . Pressure of 37 cm of water = H O x370mm Hg 2 Net pressure = 100 mm Hg – 370 1.0 13.6 = 73 mm Hg 1 mm Hg = 1.3 x 103 dyn g / cm2 1 mm Hg = N/m2 1 Pa = 9.869 x 10-6 atm 1 atm = 1 atmosphere = 1.013 x 105 N/M2 = 1.013 x 105 Pa 1 cm Hg = 1.333 x 103 N/M2 = 1.316 x 10-2 atm 1 Pa = 7.501 x 10-4 cm Hg 1 atm = 76 cm Hg = 760 mm Hg Physics of the cardiovascular system CVS :The blood , blood vessels and the heart . The blood : 7% of the body mass or 4.5 Kg ( ~ 4.5 Liters ) in a 64 Kg person . The component of the blood :1red blood cell ( erythrocytes ) - Flat disk ( 7 m in diameter ( dia. ) - 45% of the volume of the blood - 5 x 106 cells/mm3 of the blood 2The blood plasma Clear fluid 55% of the blood 3White blood cell ( Leukocytes ) - ( 9 – 15 m dia. ) - 8000 cell's/mm3 - in some infection in the body , the number of this cell's increases like , cancer , Leukemia . 4Platelets - 1~ 4 m in dia. - 3 x 105 platelets /mm3 of blood. The blood vessels : 1- arteries 2-veins 3-capillary bed The heart : - double pump pulmonary 20% of ( blood ) - circulatory systems systemic (general ) 80% of blood - The heavier and stronger muscular walls on the left side of the heart and the circular shape of the left ventricle produces the high pressure to circulate the blood . The valves of the heart : - natural valves flow of blood only in the correct direction . - artificial ( mechanical ) valves Work done by the heart : - The work of the heart from the contraction of the heart muscles forces . - 80 ML of blood through the Lungs from the right ventricle and a similar volume to the systemic circulation from the left ventricle . - The work done by the heart ( W ) W = PV Where P = constant pressure V = volume pumped - The pressures in two pumps of the heart are not the same , in the pulmonary system the pressure is very low due to the low resistance of the blood vessels in the Lungs . - Physical ( W ) is ( average ( P ) x volume of blood is pumped ) The pressures of blood throughout the circulatory system : Let us start with the blood in the left side of the heart and follow Toi di lang thang lan trong bong toi buot gia, ve dau khi da mat em roi? Ve dau khi bao nhieu mo mong gio da vo tan... Ve dau toi biet di ve dau? http://nhatquanglan.xlphp.net/ LV ( 120 – 125 ) mm Hg arteries 120 mm Hg ( systolic pressure ) 80 arterioles ( 80 25 ) mmHg cappillaries ( 25 – 7) mmHg veins ( 7 – 5 ) mmHg RV (25 mmHg) Lung (25) LA ( 7 – 8 mmHg) LV(120 mmHg) W = Pdv The P of blood at systolic is 120 mmHg The pressure at the resting phase diastole is 80 mmHg. Example : If the average pressure is 100 mmHg (100 mmHg=1.4x 105 dynes /cm2) and 80 mL of blood is pumped each second ( pulse rate of 60/min ) what is the ( W ) of the heart . W per second = P V = 80 x 1.4 x 105 = 1.1 x 107 ergs = 1.1 J/sec = 1.1 W . Blood pressures and its measurment :The measurment of blood pressure by two method:1. direct method 2. indirect method 1. Direct method : hollow needle blood vessel pressure of blood transmits through cather ( hollow plastic tube ) to the pressure transducer . 2. Indirect method : The instrument is used to measure the pressure is called sphygmomanometer . - Sphygmomanometer : ( manometer ) pressurecuff – gauge on the upper arm – stethoscope . - The measurement : - stethoscope placed over the brachal artery at the elbow . - The pressure cuff is inflated rapidly to a pressure used to stop the How of blood ~ 130 MMHg - The air in the cuff is gradually released . - The pressure in the cuff drops below the systolic pressure The turbulent flow of boold through the artery causes sound vibrations Sound heard by stethoscope K – sound ( Korotk off sound ) K sound systolic pressure level . - If the pressure in the cuff reduce , K sounds become Louder and then begin to fade K sound die out diastolic pressure . Blood pressure Systolic (contraction) Diastolic (relaxation) 120 80 12 8 Normal blood pressure = mm Hg Arterial blood pressure cm Hg Venous blood pressure ( 8 – 16 ) mm H2O ( blood ) Mean of blood pressure = dias. P + 13 [syst – dias ] Pulse of blood pressure =[ syst. – dia. ] The effect of accerleration :- The pressure in the arteries in the body varies from one point to another due to he gravitational forces . - Shows direct measurments of blood pressure made on a standing person open glass tube manometers are shown connected to arteries in : 1. foot { P1 = 200 mm Hg , h = 2.6 m } 2. upper arm { P2 = 100 mm Hg , h = 1.3 m } 3. hed { P3 = 60 mm Hg , h = 0.8 m } The blood rises to the same level , P1 at ( 1 ) > P2 > P3 due to g gravitational force . P1 = gh [ by column of blood ( of height h ) between heart and foot ] + pressure of the heart . density of the blood ( 1.04 g/cm3 ) h of blood = 13 times of hHg - If P of blood 120 80 1560 1040 mm Hg mm of blood - If g on earth = 3g blood rise only 43 cm above the heart . - P is the same on all point in the body when the body is horizontal ( not standing ). Laplace Law : How the tension in the wall of a tube related to the radius of the tube and the pressure inside the tube . Consider a long tube of radius ( r ) carrying blood at pressure P Fig ( 1 ) uniform section of a tube of length ( l ) wall thickness ( t ) and radius ( r ). L t r P1 Pe The pressure across the blood vessel ( tube ) wall is called transmural pressure (Ptm) Ptm = Pi – Pe (mean ) = Patiral Pi = internal blood pressure = P = Pvenous = P If Pe is very small Ptm = Pi = P Pe = external tissue pressure The tension in the wall : The pressure inside the tube is uniform on the wall and can mathematically divide the tube in half as shown in Fig ( 2 ) . The force trying to seprate the upper X lower halves is the Ptm times an area ( A ) . F = PtmA A by integration , that area against the pressure acts is the diameter ( R ) of the tube times ( l ) . F = Ptm ( Rl ) R=2r F =2rl Ptm = 2rl P Ptm = P = P In oreder , the tube in equilibrium pushing force = tension force ( T ) ( holding two halves ) 2rl P = 2Tl T = tension force per unit length T = rP Laplace law If r is small T is small and there is no break in this wall . Table ( 1 ) Aorta ( r = 1.2 cm ) Typical artery ( r = 0.5 cm ) Small capillary ( r = 6 x 10-4 cm ) Small vein ( r = 2 x 10-2 ) Vena cava ( r = 1.5 cm ) Typical pressures and T P = 100 mm Hg T=156,000 dynes/cm = 1.3 x 105 dynes/cm2 P = 90 mm Hg T = 60,000 dynes/cm P = 30 mm Hg T = 24 dynes/cm P = 15 mm Hg T = 400 dynes/cm P = 10 mm Hg T = 20,000 dynes/cm Bernoullis Principle :Based on the low of conservation of energy : The velocity of blood ( fluid ) increase at the narrow section of the part at r2 PMin VMax The work done on the any system W W = KE + PE W = P V = P M KE = Kinetic energy = 12 MV2 PE = Potential energy = Mgh P M = 1 2 MV2 + Mgh P = 12 V2 + gh ( P 1 – P2 ) = P1 + gh1 + 1 2 1 2 ( V - V ) + g ( h2 – h1 ) 2 2 2 1 V = P2 +gh2 + 2 1 1 2 V 2 2 If there is no friction with the walls of a tube then the pressure decrease where the velocity of fluid flow increase : P V1 If the system is heart the work ( W ) Used for – raise the pressure in the arteries - impart KE to the blood - work against friction - increase the velocity of blood Example :From the left dise of normal human heart , the difference in height from the ventricle to the aorta is ( 15 cm ) , the velocity of the blood at this point as 40 cm/sec . Find the work done for each 1 cm3 of 1 g of blood ? Where is :blood = 1.04 g/cm3 1.0 g/cm3 P l artery = 80 mm Hg ( dias ) ( aorta ) = 120 mm Hg ( syst ) initial velocity before systole = 0 venous drain pressure = 0 left arterial pressure prior to contraction = 0 V1, P1 , h1 velocity , pressure and height of the blood entering the heart . V2, P2 , h2 velocity , pressure and height of the blood leaving the heart . The work done by heart is W : W = P V According to Bernouollis principle W = KE + PE + P KE = velocity change ( work of velocity change ) = 12 x 1g ( 40 cm/sec)2 = 8 x 102 dyne cm 1 2 2 m V V 2 1 = 2 PE = height change = mg ( h2 – h1 ) ( work of height change ) = 1g x 980 cm/sec2 x 15 cm = 0.15 x 105 dyne cm P = pressure change = m ( P2 – P1 ) ( work of pressure change ) = 1g 1g / cm3 x 120 mm Hg = 1 cm3 x 12 cm Hg = 12 x 1.3 x 104 dyne/cm2 = 1.6 x 105 dyne cm P >> KE P. E 10% of P The work per 1 cm3 of blood pumped = 1.7 x 105 dyne cm The work per 60 cm3 of blood pumped = 107 dyne cm ( the work of LV ) The work by RV = 16 work by LV Total work by the leavt = ( 1 + 16 ) 107 = 1.16 x 107 dyne cm Note : the pressure in pulmonary artery is 120 mm Hg The medical important of venturi effect : If any artery is narrowed by internal plagues or by external pressure resulting from a tumor then the blood pressure in the constricted region of the artery will fall very dramatically Vmax Pmin A1 > A2 V1 < V2 P1 > P2 V1A1 = V2 A2 equation of continuity the venturi tube method has been adapted to measure the flow velocity of blood in arteries . Example : A liquid of density 950 Kg m-3 flows in a horizontal pipe of radius 4.5 cm in a section of the tube of restricted radius 3.2 cm , the liquid pressure is 1.5 x 103 Nm-2 less than in the main pipe calculate the velocity of the liquid in the pipe . Solution : Let the pressure in the main tube is P1 Let the pressure in the restricted tube is P2 P1 > P2 V1 < V2 r1 > r2 P1 = P2 + 1.5 x 103 N m-2 From Bernoulis principle P + 12 V2 + gh = constant the pipe is horizontal there is No P. E P1 + 12 V = P2 + 12 V 2 1 2 2 P1 – P2 = 12 ( V - V ) 2 2 2 1 P2 + 1.5 x 10+3 – P2 = 12 ( V - V ) 2 2 2 1 1.5 x 10+3 = 12 ( V - V ) -2 ( V - V ) = 3x10 = 3950 = 31.6 x 10 ………….( 1 ) x10 2 2 2 2 2 1 3 2 1 3 from equation of continuity : A1V1 = A2V2 r V1 = r V2 r V1 = r V2 2 1 2 2 2 1 2 2 V1 = r2 r1 2 V2 …………….( 2 ) from eq. ( 1 ) and eq. ( 2 ) we get : -2 V - r V = 31.6 x 10 r 2 2 1- 4 2 2 2 1 r2 r1 4 = 31.6Vx 10 2 2 -2 1- 3 .2 4 .5 4 = 31.6Vx 10 -2 2 2 31.6 x 10-2 V22 1- 0.3 = 0.7 V = 31.6 x 10-2 2 2 V2 = 31.6 x 10-2 0.7 m The flow of blood : The volume rate of flow through the tube of a liquid of viscosity is given by : Q= r 4 P 8L [ Poiseuille's equation ] Where : Q is volume rate of flow cm cm ML , Q = V = Volume S time min sec 3 3 Q = Vt = ALt = A A = cross – section area of tube = velocity of liquid ( blood ) The physical factors effect the [ Q ] :1 Q = A Q the blood velocity ( ) is related in an inverse way to the total cross – sectional area of the vessels carries the blood ( average velocity ) = Q A ( flow rate ) Q = x A in aorte 30 cm/sec in capillary = 1 mm/sec The relation between the velocity of blood ( l ) and the cross – sectional area ( A ) in the circulatory system . 2- The pressure difference ( P ) from one end to the other end of the blood vessel : P1 P P2 l Q ~ ( P1 – P2 ) = P 3- the length of the vessel Q ~ L1 4- The pressure gradiant Q ~ LP , mmHg cm 5- The radius of the blood vessel Q r4 Q = a 4 P 8 l [ applied to rigid tubes ] but not applied exatly to blood vessel due to change of radius through the heart rate . The viscosity of blood :Q 1 if is high Q is low In the real fluid ( blood , water ) is characterized by beingcompressible and by there being internal forces acting in it , there is frictional forces when the fluid is moving and such forces lead to a loss of mechanical energy . The property of a blood that determines the magnitude of these disspitive forces is known as the viscosity ( ) . The unit of :Cgs unit is poise ( P ) SI unit is pascal second ( PaS ) PaS = 10 P 1 Kgm-1S-1 = 10 P 1 P = 0.1 PaS 1P = dyne . cm-1 . sec-1 The dependence of : 1. percentage of red blood cell in the blood ( hematocrit ) hematocrit increase is increase If increase when hematocrit polycrthemia ) deacrease in Q. > 75% depend on the temperature ( T ) If T is large , is small and Q is high If T is small , is high and Q is small T of human from normal 37oC to 0oC Increase the of blood by a factor of 2.5 . The flow rate through a tube depends on the : 1. pressure difference : P = pressure , f = Q = flow F2 = 2F1 2. The length of the tube : F2= 2F1 at the same pressure 3. The viscosity of the ( fluid ) ( blood ) , water F2= 2F1 4. The radius of the tube ( F2 = 16 F1 Q = f = r4 The radius has the largest effect on flow rate of the liquid . The kind of blood flow : 1. Laminar flow :It is a slow , smooth and quietly flow of blood in most blood vessels . The properties of Laminar flow : - the layers of blood in contact with the walls of the blood vessels is essentially stationary . - the next to the outside layer is moving slowly and the layer in center of the vessel is moving more rapidly . - the effect of Laminar flow on the distribution of red blood cells in the circulatory system is not uniform . ( parobla shape ) There are more in the center than at the edges And this produces two effects : 1. red blood cells in small vessel from the side of a main vessel will be slightly due to the skimming effect . 2. hematocrit in the extremities is high . 2. Turbulent flow :It is rapid and noisy flow of blood , for example , where the blood is flowing rapidly past the heart valves . The heart sounds heard with a stethoscope are caused by turbulent flow , measurement of blood pressure , the constriction produced by the pressure cuff on the arm produces turbulent flow and the resulting vibrations can be detected by stethoscope on the brachial artery . 3. Critical flow : The velocity of blood increase by reducing the radius of the tube , it wiill reach a critical velocity ( Vc ) when Laminar flow changes into turbulent flow : L . f T . f at V = Vc Vc is critical velocity of blood Vc r , = viscosity of blood , = density of blood , r = radius of vessel Vc = K r , K = constant of proportional K = Reynold number K = 1000 (fluid, blood , ….) flowing (in long tube of constant diameter) But if there is bend or obstruction , K < 103 Vc is lower Example : Find the Vc of blood in the aorta of radius 1 cm ( adult ) Vc = K r at normal state blood 37 o C = 4 x 10-3 pas , of = 1.04 g cm-3 103 Kg/m3 , r=1cm , K=103 Vc = 103 x4 x103 pas 103 Kgm3 x10 2 m Vc = 0.4 m/sec , the range of velocity of blood in Aorta ( 0 – 0.5 m s-1 ) and thus the flow is turbulent during part of the systole . The efficiency of flowing : From poiseuilles equation : r 4P Q 8L Q P R = 8L r 4 the volume flow depends upon the pressure drop (P ) per unit length of the tube : L . f T . f at V = Vc P = Pc Q = Qc At critical point at P = Pc , the flow becomes turbulent and a great deal of energy is converted to the KE of eddies . From the curve ( slope )Lf >> ( slope )Tf Q Q P Lf P Tf increase in pressure increase in Laminar flow rate than in the turbulent flow rate . the laminar flow is more efficilent than turbulent flow . flow through an artery with an obstruction :at normal artery ( 1 ) VA = QA at P1 VA = QA at P2 for artery ( 2 ) P2 > P give the same Q If Q = VB at P1 for ( 1 ) at P2 for ( 2 ) need much pressure to give the same Q Heart sound :-The opening and closing of the heart valves contribute to the heart sounds and the turbulent flow occurs at these times and the vibrations produced are in the audible rang . - fig below show the sound heard with a stethoscope from normal heart . Cardiovascular diseases : 1- hypertension ( high blood pressure ) W = P dv work done by the heart tension of heart muscle times how long it acts . High blood causes the muscle tension increase the work load of heart . 2- Fast heart rate ( tachy cardia ) increase the work load since the time of the heart muscle spend contracting increasing . 3- heart attack 4- congestive heart failure : causes by an enlargement of the heart from laplace law : T = rp , if r of the heart is large , the tension ( T ) of the heart muscle must be large . If r is double T is double at the same pressure how the muscle of the heart is stretched , it may be not be able to produce sufficient force to maintain normal circulation . 5. heart valve defect : 1. stenosis ( not open wide ) not close enough ( using artificial valve ) 2. in sufficiency 6.blood vessels disease : – aneurysm is a weakening in the wall of an artery resulting in an increase in it diameter ( R ) . if R is increase increase the tension in the wall of the vessel . - formation of sclerotic plagues can causes turbulent flow and produce a murmur . artery bagues narrow region r is reduce velocity of blood increase and decrease in wall pressure due to Bernolli effect if this blaque may dislodge and travel with the blood until it lodges in smaller artery and will shut off the blood supply to the ( brain ) , it will produce a stroke another type of cerebrovascular accident . Question for CVS 1. A liquid of density 950 Kg m-3 flows in a horizontal pipe of radius 4.5 cm in a section of the tube of restricted radius 3.2 cm the liquid pressure is 1.5 x 103 Nm-2 less than in the main tube find the velocity of the liquid in the pipe ? 2. The level of blood in the bottle using for blood transfusion is 1.3 meter above the needle which has an internal diameter of 0.36 mm and 3 cm in length . In one nunute 4.5 cm3 of liquid pass through the needle . Find the viscosity of blood at 37o C . 3. The radius of the aorta in human is 1 cm and the cardiac output is 5 x 10-3 m2 /minute . what is the average velocity of flow in the aorta ? 4. An artery with a 3 mm radius is partially blocled with to plaque ; in the constricted region the effective radius is 2mm and the average blood velocity is 50 cm sec-1 find : a. What is the average velocity of the blood in the unconstricted region . b. For the blood in the constricted region , find the equivelent pressure due to the KE of the lood .